As we continue to explore relationships throughout February, we spoke with James Holloway, Elysium Head of Safeguarding, about the complexities of communication when a person is being treated in hospital.
“When we look at the relationships around a person who is being treated in hospital, there are three which are undoubtedly key; the person, their loved ones and the staff who support them. 
“This is sometimes known as the Triangle of Care, which is an accreditation from the Carers Trust that represents a therapeutic alliance between carers, service users and health professionals. It’s an accreditation our services across Elysium aspire to and are actively working towards. The principles of this approach are certainly what we aspire to in our day-to-day support of people and in our interactions with their loved ones.
“We start from a position of the person we support is at the centre of all we do. However, it is complex, because we also recognise that families and carers and the role they can play is incredibly important.
“We also recognise that for a relative or loved one, they are focused on their relative. The ward may be busy, with different competing priorities for staff, but we try to recognise that for that relative, that family, their loved one’s well-being is their overwhelming concern. They understandably want information, they want to know detail and they want reassurance.
“We absolutely understand that, however there can be a real challenge when a person perhaps, for whatever reason, does not want family or any other ‘outside’ input. There are times when people have specifically made it clear they do not want information about their condition, their care or other details being shared, with anyone.
“So how do we balance the needs and wants of the loved one with the wishes of the person being treated? we can’t share further details if a person does not want us to and we always have to act within the confines of the law, including GDPR. But we can certainly do that in a kind and empathetic way.
“What else can we do? We can think carefully about our vocabulary and our approach. A person’s relatives or loved ones and the background information they have can be incredibly helpful and pertinent for teams supporting them, so while in some cases we may not initially be able to share information, we can always accept it. We can tell people what they are sharing with us is really useful, and we should be willing to hear from them.
“Honesty is important. If a person has specifically said they don’t want information shared, then we have to respect that and we should, in an empathetic way, share that with their loved ones; it’s not us who have made that decision, it is their choice. However, there are reassurances we can give. We can confirm the person is safe and that they are with us. That may be enough in the first instance to reassure their loved ones. And we should reassure them that often, people change their preferences while they are being treated, so we may be able to share more going forward. It’s a flexible and fluid situation.
“Another important aspect of supporting the person’s family or loved ones is making sure they understand what’s being discussed, checking in during a call that we’ve not used too much jargon or legal terminology and that we’ve used clear English. We should be alert to the fact that many people can’t call us during the day and so the professionals they need an update from may have left. Not have access to the right people is challenging for everyone in the ‘triangle’.
“And the understanding is two-way. It’s important for families and carers to know that colleagues work really hard, doing their best always to support people. They do the job they do because they want to help people. They are focused on the well-being of the people they support in the immediacy and they are always their first priority. They might not have the capacity to respond immediately to a loved one, or may have to prioritise a patient while engaging with a loved one. That can be difficult and frustrating for everyone concerned, but it is the reality sometimes of a busy hospital ward environment.
“Our aspiration would always be to enable as open communication between the person, their loved one and professionals as much as possible, and within the law. Ultimately we want families to be involved wherever possible, we welcome that involvement and we do try hard to enable it.
“For those families based far away from their loved one’s hospital, we have virtual tours which help everyone picture the place their loved one is being treated. We have family forums which we know have been very helpful for relatives, and for us.
“Ultimately we know that a relative being admitted to hospital can be a distressing time. Our aim always is to give people the chance to communicate, to be reassured and when and where we can share details, we always aspire to do so in a way that’s positive and empathetic and builds positive relationships.”