Family dynamics and caregiver burden in home health care.

Planning an intervention involves the assessment of medical needs followed by an analysis of the family composition, dynamics, role allocations, coping mechanisms, mode of emotional expression, and the point in the family's developmental sequence. Therapeutic targets should be identified and prioritized. At that point, a behavioral probe or some specific recommendation that the family can easily follow should be made. A careful analysis of the response will indicate the ease with which more difficult change prescriptions can be introduced. Failure of the family to follow even the most simple suggestion may indicate that family therapy is needed. If the family is successful at carrying out the probe suggestion, however, the home health care team can proceed with greater confidence that their efforts will lead to improved patient care and healthy family functioning.