Communicating with Families and Carers

Relatives or carers often play a key role. They may add collateral history, support decision-making, or assist with practical matters such as transport and treatment adherence. The aim is to welcome their input while keeping the patient's voice central and confidentiality intact.^[1][3][7]

When to involve families and carers

Involvement can be especially valuable when patients have dementia, learning difficulties, or other cognitive challenges that limit recall or expression; are children, where parental input provides essential context for symptoms and behaviours; or rely on others for support in following care plans, such as instilling eye drops or attending follow-up. In these cases, carers complement-but do not replace-the patient's account.^[4][5]

Prioritising the patient's voice

Even with family present, communication should be directed to the patient first.^[2][3]

Practical steps to prioritise the patient's voice include:

• facing the patient when asking questions
• giving extra time for the patient to respond before seeking clarification from the carer
• checking consent before discussing sensitive issues in front of relatives

These steps keep patients active participants rather than passive observers.^[1][2]

Managing family dynamics

Relatives may sometimes dominate the conversation. Constructive management can involve thanking the relative for support while explaining you would like to hear from the patient first, redirecting eye contact and body language to the patient to reinforce their central role, and involving the relative at appropriate points-for example, clarifying history or discussing practical arrangements.^[3][1]

Documentation and accountability

Records should reflect the patient's words and relevant contributions from carers. Note consent where sensitive information is shared, and record any adjustments made to support communication. This demonstrates respect for autonomy and confidentiality while acknowledging carers' roles in continuity of care.^[6][2][5]

References (numbered in text) Why we include references

1. 2. Communicate effectively with your patients — General Optical Council Find (opens in a new tab)
2. Decision making and consent — General Medical Council Find (opens in a new tab)
3. Confidentiality: Using and disclosing patient information for direct care — General Medical Council Find (opens in a new tab)
4. Dementia: assessment, management and support for people living with dementia and their carers (NICE guideline NG97) — National Institute for Health and Care Excellence Find (opens in a new tab)
5. Mental Capacity Act 2005: Code of Practice — Office of the Public Guardian (GOV.UK) Find (opens in a new tab)
6. Records Management Code of Practice for Health and Social Care — NHS Transformation Directorate / NHS England Find (opens in a new tab)
7. Family Functioning and Medical Adherence Across Children and Adolescents With Chronic Health Conditions: A Meta-Analysis — Alexandra M Psihogios; Heather Fellmeth; Lisa A Schwartz; Lamia P Barakat; Journal of Pediatric Psychology Find (opens in a new tab)