Assessing Family Preferences for Participation in Care in Hospitalized Older Adults

By: Marie Boltz, PhD, GNP-BC, FGSA, FAAN, Pennsylvania State University

WHY: Hospitalization is a critical event in the older person’s life, with profound implications for health and function. Nurses are in a unique position to work with families as partners to provide quality care to hospitalized older adult patients. Family members provide essential information, encouragement and motivation to the patient, companionship and comfort, while serving as advocates for the patient’s preferences and needs. The first step in establishing this partnership is assessing the family’s preferences for participation in the care of the patient.  

BEST PRACTICES: The Family Preference Index (FPRI) is a brief, easy to administer instrument to measure family preferences, or family caregiver’s personal choice about providing care to their hospitalized relatives.  Assessment of family preference should be supplemented with an evaluation of other factors that impact caregiving ability, including the family’s legal authority (including power of attorney status), as well as the family’s understanding of the patient’s needs, and stress level. (See Try This:® Caregiver Strain Index).  This information can be included in the initial psychosocial assessment and updated as needed.

TARGET POPULATION: The families of hospitalized older adults.

STRENGTHS AND LIMITATIONS: Little is known about family participation in hospital care for older adults. There is limited research and instrument development in this area. Initial qualitative study results indicate that the FPRI effectively identified caregiver preferences about providing care. However, the tool’s validity and reliability has not yet been measured. 

MORE ON THE TOPIC:

Best practice information on care of older adults: www.ConsultGeri.org.

Boltz, M., Chippendale, T., Resnick, B., & Galvin, J. (2015). Testing family centered, function-focused care in hospitalized persons with dementia. Neurodegenerative Disease Management, 5(3) 203-215.

Boltz, M., Resnick, B., Chippendale, T., & Galvin, J. (2014). Testing a family-centered intervention to promote functional and cognitive recovery in hospitalized older adults. JAGS, 62(12), 2398-2407.

Levine, C. (2011). Supporting family caregivers: The hospital nurse's assessment of family caregiver needs. AJN, 11(10), 47-51.

Li, H. (2002). Family caregivers’ preferences in caring for their hospitalized elderly relatives. Geriatric Nursing, 23(4), 204-207.

Li, H. (2005). Identifying family care process themes in caring for their hospitalized elders. Applied Nursing Research, 18(2), 97-101.

Nigolian, C.J., & Miller, K.L. (2011). Teaching essential skills to family caregivers. AJN, 111(11), 52-57.