Throughout our lives there is no better test of character, and sometimes courage, than being able to weather new or difficult challenges alone—the first day of school, summer camp, college, or time away from spouse and children.
Coping with an illness or a hospital stay, though, isn’t one of life’s milestones that anyone needs to—or should—face on his or her own. Having someone with you can bring you comfort and in many cases improve your care. That person (or persons) can act as your advocate when you are not able to advocate for yourself, and there’s evidence that family/friend involvement can reduce the risk of medical errors, help patients follow medical advice, and simply lead to better patient outcomes.
That’s why it’s puzzling that so many hospitals still have restrictive visitor policies, even when the patient is critically ill or dying. A survey of 606 hospitals across the country published in the journal Critical Care in 2013 found that 76 percent put limits on the time friends and family could spend with patients, the number of visitors a patient could have, or the age of visitors. That number increased to nearly 90 percent for patients in intensive care units.
In general, hospitals cite several reasons for limiting visitor access. Examples include concern that too much activity might put physiological stress on someone who is ill, that visitors might expose the patient to germs, or that visitors could interfere with patient care in some cases.
But those risks can be managed, and the benefit to the patient far outweighs them. In the 1980s I learned how important family and friends could be to someone who is ill. I took care of many AIDS patients at a time when medicine had little to offer, and I saw how tough it was when patients had to go it alone.
The best situation for a patient was for doctors to be in partnership with friends and family, to work as a team that had no barriers of any kind. I was fortunate to practice at a hospital that understood that the medical personnel were the “visitors” in patient’s lives and what we could provide was a safe space for everyone involved in a patient’s life to gather and work together when it really counted.
A campaign started by our friends at the Institute for Patient- and Family-Centered Care (IPFCC) calls on hospitals to meet this standard. Called Better Together, its goal is to change the concept of families as “visitors.” It highlights 12 hospitals in the U.S. and Canada that have family-centered policies. IPFCC has developed a tool kit to help hospitals and doctors move toward more welcoming approaches.
The initiative recognizes the need for patient privacy. If a patient prefers to navigate an illness alone, so be it. But if his or her preference is to be accompanied by family or friends, those people should have reasonable access around the clock that does not interfere with the care process.
This is tricky business. But the IPFCC approach is a good one to help sort out all the details. When it comes to health, it is hard to predict when times will get tough. No one should be forced to ever be alone in the hospital.
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