On my placement at the moment, I was treating a patient with my supervisor in the gym. We invited his wife to come along to watch so that she became familiar with the activities that she will be doing with him once he is discharged. Throughout the whole session she would speak for her husband and say things like the poor baby can't stand up it will hurt him. She would also interfere during the session by helping her husband with the activities/exercises even though he was perfectly capable of doing them independantly. We decided that the next time we brought the patient to the gym for treatment we would tell the wife that it was now protocol that no family members are allowed in the gym during treatment session. She was compliant with this but still hovered at the door watching. Luckily for us, this patient was very motivated and willing to do anything we asked him so minimal education/motivation was needed for him. Most of the education was directed at the wife to ensure the patient becomes fully independant at home.
This situation made me realise how important family members are to the patient. Sometimes however you have to be strict on visitors because they can impact on treatment sessions and the progression of the patient's function.
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Fanily members as you've explained can be very tricky- so far, I have been encouraged to involve them as much as possible and not to ignore them. However, sometimes their stress or anxiety about our treatments can very much interfere with our activities and the response we get from the actual patient. I think it is always worth allowing them to be active/passive participants in our treatments, but if they appear to be detrimental to achieving goals and good rapport with the patient then they should definately be left out of the equation.
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