Skip to main content

Table 4 Outcome of the Family Meeting

From: Family meetings in palliative care: Multidisciplinary clinical practice guidelines

Below are key points to be recorded at the completion of the family meeting by the Family Meeting's Facilitator.

A copy should be provided to the patient and family carer and one copy kept in the medical record.

Date of meeting: __________________________

Name of family meeting facilitator: _________________________________

Proposed purpose of the meeting: __________________________________

FAMILY MEMBERS PRESENT

Name:

Relationship:

Name:

Relationship:

Name:

Relationship:

STAFF MEMBERS PRESENT

Name:

Role/Discipline:

Name:

Role/Discipline:

Name:

Role/Discipline:

KEY ISSUES RAISED AT THE MEETING

_________________________________________________________________________________

_________________________________________________________________________________

KEY ACTIONS FROM THE MEETING

Current Situation

Goal

Action

Key Person to follow up

Review Date

Adapted (with permission) from Single Session Therapy Resource Guide (The Bouverie Centre 2006)