11. Module 10 · Supporting relatives

11.2. Application: talking with relatives in five steps

Application

Talking with relatives: a five-step conversation

This page shows one way to prepare a conversation with a relative who is worried, critical or full of guilt. The steps are a frame to adapt, not a script. Your organisation’s rules on confidentiality and communication apply in every case.

Worked example: Mr Brandt and the water glasses

Five steps for a conversation with a relativeFive steps: from complaint to partnership1ListenTime, quiet place,do not interrupt2AcknowledgeName the feeling,thank for caring3InformFacts, what you do,what you do not know4InvolveAsk for history,offer a role5AgreeOne next step,who, when, recordThe example is fictitious. Adapt the steps to the person and the situation.
Figure 10.3: A five-step conversation with a relative, using a fictitious example. Source: own illustration.

Return to Mr Brandt from the beginning of the module. A carer, Ms Aydin (fictitious), asks a colleague to cover for her and invites him for a coffee in the quiet lounge. She follows the steps in Figure 10.3.

  1. Listen. She asks, “What worries you most when you leave in the evening?” He talks for several minutes about how little his wife drinks. She does not defend or explain yet.
  2. Acknowledge. “You have looked after her for six years and you are afraid that something is missed. That is understandable. Thank you for watching so closely.”
  3. Inform. She explains how the team offers drinks through the day, that intake is noted, and that she will check the record with the nurse in charge. She says openly that two days last week were not recorded fully.
  4. Involve. “You know her habits better than anyone. Which cup does she like? Would you like to bring her afternoon tea yourself?” He tells her that his wife only drinks from a blue cup with a thin rim.
  5. Agree. They agree that the blue cup goes on the care plan, that he brings tea at 3 p.m., and that Ms Aydin will speak to him again on Friday. She notes this in the record and tells the team at handover.

Notice what changed. The facts did not change much, but the relationship did. Mr Brandt moved from controlling to contributing, and the team gained useful life history. Ms Aydin also admitted a gap in the recording. This honesty builds trust, and it is an example of how appreciation and transparency work together.

Phrases to adapt
SituationYou might say
Opening“I have ten minutes now. What would you like me to know?”
Acknowledging“It sounds as if you are carrying a lot.”
Relieving guilt“You looked after her for a long time. Moving here is not a failure. You are still a very important part of her life.”
Not knowing“I do not know that yet. I will find out and tell you by tomorrow.”
Offering a role“Would you like to help her with her lunch, or bring photographs?”
Setting a limit“I want to find a solution with you. I cannot do that when we shout. Shall we talk again with my team leader?”
Exercise (voluntary self-check). Mrs Schneider (fictitious), 80, moved into the care home two weeks ago after her husband, who cared for her at home, fell ill himself. He phones the ward every day, shouts that “nobody here cares”, and last time said that he “should never have let this happen”. What may be behind his behaviour? Name two feelings. Then plan the five steps of a conversation with him, with one sentence for each step.
Hint 1
Look at the last sentence he said. What does “should never have let this happen” tell you about guilt? Use Figure 10.2, stage 3 and 4.
Hint 2
He is also ill himself. Think of what he can still contribute, even if he cannot visit daily, such as information about her habits or a phone call at a fixed time.
Suggested answer
Feelings: guilt, worry, helplessness, and perhaps exhaustion and grief. Conversation: (1) Listen: “Please tell me what you are most afraid of.” (2) Acknowledge: “You looked after your wife for years while you were unwell yourself. That is a lot.” (3) Inform: say what the team does each day and offer a fixed time for a phone call with news. (4) Involve: ask for her routines, favourite music and the way she likes to be addressed, and invite him to a visit when he is well enough. (5) Agree: a call every day at a set time with one named carer, a record of what you agreed, and a pointer to care counselling for himself (section 7a SGB XI) or the Alzheimer Gesellschaft. Do not argue about whether “nobody cares”. Answer the worry.
In German practice you will hear …
  • Angehörige – relatives; in care, the people close to the person with dementia
  • Angehörigengespräch – conversation with relatives, often at admission or after a change
  • Pflegeberatung – individual care counselling under section 7a SGB XI
  • Pflegekurs – care course for relatives, offered under section 45 SGB XI
  • Selbsthilfegruppe – self-help group, often for relatives of people with dementia
  • Alzheimer Gesellschaft – German Alzheimer’s Society with local branches and counselling
  • Pflegeunterstützungsgeld – wage replacement for short-term time off work to organise care
  • Biografiebogen – life-history form that relatives often help to fill in