Does this scenario sound familiar? You are in the office with an elderly woman--your patient--and her daughter. You have just finished outlining the optimal treatment plan for a condition the mother has. You have thoroughly explained the scope of the treatment and why this is the best option. The mother seems on board and ready to proceed but the daughter is resistant and the mother depends on the daughter to make these decisions and get her to the office for care. How do you resolve this conflict so that the patient gets the necessary treatment?
At the Institute of Podiatric Excellence and Development (IPED) podiatrists have the opportunity to discuss such types of situations with peers at all stages of their careers from brand new practitioners to veteran foot doctors. Sharing information is part of IPED’s mission and something we have prided ourselves on from the outset. Professionals in the field offer the following advice on helping patients and their caregivers move from indecision to confidence with treatment plans.
Understanding the Paralysis
When you encounter resistance in a patient or caregiver your instinct may be to use persuasion to bring about the resolution you know is best. However, this often backfires. First you need to understand the cause of the resistance. Usually the reasons have to do with 3 fears:
- Fear of what others might think. Can the person justify the decision? That means they need to understand it completely and believe in it or the care provider.
- Fear of making a decision that might be regretted later. Am I missing something? How do I know this is the very best treatment plan out there? What if something goes wrong—do I understand the risks? Am I making the right choice?
- Fear of loss. This can be loss of the health of a loved one or loss of a position a person currently holds in a relationship or family.
Achieving Positive Resolution
The key to moving to resolution is exploration. In the end a solution must create comfortable decisions by meeting the person’s needs and addressing the fear of loss. Ask the resistant person what they want and why. Then ask about the impact it will have if they do not get this solution. This line of discussion will help draw out the real concerns and hopefully lead to a resolution that is best for the patient and his or her caregiver.