DISABLED FAMILY COPING
Behavior of signiﬁcant person (family members or other primary per-
son) that disables his or her capabilities and the patient’s capabilities
to effectively address tasks essential to either person’s adaptation to
the health challenge
• Distortion of reality regarding
• Agitation, depression, aggres-
• Impaired restructuring of a
• Taking on illness of patient
• Arbitrary handling of family’s
• Signiﬁcant person with chroni-
resistance to treatment
cally unexpressed feelings (e.g.,
• Dissonant coping styles among
guilt, anxiety, hostility,
• Basic breast-feeding knowledge
ASSESSMENT FOCUS (Refer to comprehensive assessment parameters.)
• Values and beliefs
To the extent possible, family members will participate in aspects of
patient’s care without evidence of increased conﬂict.
The patient will
• Express conﬁdence in his or ability to make decisions despite pres-
sure from family members.
• Contact appropriate sources of support outside the family.
• Take steps to ensure that care needs are met despite family’s short-
• Express greater understanding of emotional limitations of family
SUGGESTED NOC OUTCOMES
Caregiver Emotional Health; Caregiver–Patient Relationship; Care-
giving Endurance Potential; Family Coping
INTERVENTIONS AND RATIONALES
Determine: Assess effects of patient’s disease on ability of family to
cope to identify strengths and weaknesses in patient’s patterns of
Describe role relationships in the family. Evaluate changes that
occur in family relationships during the course of the patient’s hos-
pitalization. This information will be helpful in making a plan.
Have patient identify support systems outside the family to encour-
age responsibility for knowing what support systems are helpful.
Perform: Engage family in assisting with physical aspects of patient
care. Family members should have an opportunity to overcome dys-
Develop short- and long-term goals with both patient and family.
Problems associated with coping may will require long-term plan-
ning to resolve.
Inform: Teach patient strategies to discuss, to confront in a positive
way that will help cope with the present situation. Role-play coping
strategies with the patient to reinforce new adaptive behaviors.
Educate family members about resources in the community that
can assist them with the patient after hospitalization.
Teach patient decision-making skills and assist him or her to prac-
tice with simple decisions. Beginning with simple decisions will
begin helping the patient lay out options before deciding.
Attend: Maintain objectivity when dealing with family conﬂicts. Do
not become embroiled in the dynamics of a dysfunctional family in
order to maintain objectivity and effectiveness.
Focus on being a patient advocate. Reafﬁrm patient’s right to
make decisions without interference from family members. Encour-
age patient to seek help family cannot provide by participating in
Help patient select a support group that best meets personal
needs. Participation in a support group may improve the patient’s
ability to cope as well as provide meaningful relationships.
Listen attentively to patient’s expression of pain over unresolved
conﬂicts with family members. The patient may have to grieve over
the fact that he or she does not have an “ideal” family, capable of
meeting his emotional needs. Therapeutic listening helps patient to
understand himself and his family better and to understand how
conﬂicts from the past affect his behavior.
Manage: Refer patient to a home health agency, homemaker service,
meals-on-wheels, or other appropriate community services for assis-
tance and follow-up. Use of various community services may help
make up the family’s shortcomings in coping.
SUGGESTED NIC INTERVENTIONS
Anger Control Assistance; Caregiver Support; Family Involvement
Promotion; Family Mobilization; Family Support
Andershed, B. (2006, September). Relatives in end-of-life care, Part 1: A sys-
tematic review of the literature the last ﬁve years, January, 1999–February,
2004. Journal of Clinical Nursing, 15(9), 1158–1169.