Although we tend to treat illness as an individual problem, it almost always affects and involves the whole family.  Likewise, self-management is often best approached as a family matter. 

• Studies by Dr. Catherine Chesla at UCSF show that family coherence and support is a major factor in type 2 diabetes self-management and outcomes. 
• As Dr. Barry Jacobs, Director of Behavioral Sciences for the Crozer-Keystone Family Medicine Residency in Springfield, PA, puts it, “When you’re dealing with chronic illness, you have to worry about the family as a whole, how are people eating, what problems they’re having. All the behaviors people need to adopt to take care of their diabetes are embedded in the family.”

How Families Can Improve Patient/Provider Relationships

Clinicians can learn much about their patients’ behavior and lives from family members. A depressed patient may say they’ve been “doing pretty well.” Their spouse may contribute that, “Actually, he hasn’t been out of bed in two days.”

Family members can also help patients remember your instructions and information. They can ask questions that the patient is afraid to ask. They can write down your information and advice.

Between appointments, family members can help patients self-manage. They can cook healthier food, go on walks with the patient, help them remember to take medicines. 

Family Downsides

Of course, not all families are good self-management supporters. If they act like “self-care police,” always challenging patients on what they’re eating or whether they’ve checked their blood sugars, they can alienate the patient and impede self-management.

• Poor family dynamics have been found to impede self-management behaviors and outcomes in some studies, such as this one conducted by Maine Health.

So family inclusion should be determined largely by the patient. Families may need to learn constructive ways to help their ill family member. Otherwise, their good intentions can make things harder.