What is The K.I.N.D. Method?
The K.I.N.D. Method
K – Knowledge
I – Inquire and listen
N – Need to brainstorm
D – Decide and Do it
The Kind Method is a problem solving approach to making ethical medical decisions. The four step process is based on four core concepts: Knowledge, Inquire and Listen, Need to Brainstorm, and Decide and Do it.
The first step is Knowledge. If you don’t know enough information, you won’t be able to make a good decision. Patients make this mistake all the time when they don’t find out more about their disease and their medical options. Doctors also make this mistake when they don’t find out about the patient’s preferences and quality of life goals.
The second step is to Inquire and Listen. This is where most of us get stuck. We don’t ask enough questions. We don’t ask the right questions. And when people tell us the answers, we don’t listen well enough. Or we don’t like the answers and we refuse to listen. We need to ask better and to listen better.
Once you have collected enough information, then you can begin to figure out what you should do. Don’t just jump to the first thought that enters your mind. Instead do step three. You Need to Brainstorm to figure out your options. What is brainstorming? It is coming up with at least three different choices that you can consider. The choices may be as simple as: 1. Do what the doctor said, 2. Don’t do what the doctor said, or 3. Do only part of what the doctor said. Now that you have these three options, you can begin to seriously think about your choices and how each choice would affect your life. Think carefully because it is your life we are talking about.
Once you have done this, now it is time for step four. The fourth step is to Decide and Do it. At this point, the deciding may be easy but the doing may be more difficult. But if you have gone through the first three steps, you can feel more confident that you are making the right decision and it is time to take action.
Got a question? Ask Viki.
Family as Stakeholder
January 30, 2009 by Viki Kind
Filed under For Healthcare Professionals
I had an interesting discussion the other day about what to call the family when they are involved in the patient’s care. Do we call them simply family? Or caregiver? Or stakeholder?
Each of these terms comes with assumptions about the family’s role in the healthcare setting.
If you are a caregiver, you are changing someone’s diapers and helping push their wheelchair. If you are the family, then I would ask, “Are you there to help or are you going to make things worse because of the conflicts already within your family?”
I like the term, family as stakeholder because as a stakeholder you get a voice.
You have a stake in what is happening to your loved one. You have to take off work to go with the patient to their doctor’s appointments. When the patient is discharged from the hospital, you are responsible for their care. When the patient can’t pay their bills, you may feel responsible, even though you aren’t really responsible. While the doctors and nurses may grieve when the patient dies, it is your own deeper pain and loss you will have to deal with. Even though you aren’t the patient, you experience the effects of the situation.
Now, if you are from a culture where the family is more important than the individual, then your family may make it difficult for the healthcare team because the “family as decision maker” isn’t how healthcare works. Healthcare is based on autonomy which means the patient is in charge of making the decisions about their body. Now I am a big fan of autonomy because it is the patient’s body which will feel the effects of the medications, the pain of the surgery and the long term suffering associated with their disease. As the family, we only witness what they are going through. But as much as I love autonomy, I understand how hard it is to be the family and see your loved one in pain, afraid or maybe dying.
The pediatric physicians get this. Pediatricians practice “Family Centered Medicine.” What does this mean? It means they take into account how the patient’s situation is affecting the entire family. The patient is still the primary person that they focus on but they don’t ignore that the family has a role in whether or not the child will get better. But this isn’t how it works in adult medicine. It is only about the patient.
So what can you do if you want a voice? Be cooperative and respectful when you are dealing with the doctors and nurses. Say please and thank you when people help your loved one. Pay attention to what the doctor is saying because the patient may be too sick to listen. And when you see something that is going wrong, don’t threaten to sue but instead bring it to everyone’s attention and ask, “How can we solve this problem together.” You don’t want to become the enemy. You want to be a part of the team.
I had an interesting discussion the other day about what to call the family when they are involved in the patient’s care. Do we call them simply family? Or caregiver? Or stakeholder? Each of these terms comes with assumptions about the family’s role in the healthcare setting. If you are a caregiver, you are changing someone’s diapers and helping push their wheelchair. If you are the family, then I would ask, “Are you there to help or are you going to make things worse because of the conflicts already within your family?”
I like the term, family as stakeholder because as a stakeholder you get a voice. You have a stake in what is happening to your loved one. You have to take off work to go with the patient to their doctor’s appointments. When the patient is discharged from the hospital, you are responsible for their care. When the patient can’t pay their bills, you may feel responsible, even though you aren’t really responsible. While the doctors and nurses may grieve when the patient dies, it is your own deeper pain and loss you will have to deal with. Even though you aren’t the patient, you experience the effects of the situation.
Now, if you are from a culture where the family is more important than the individual, then your family may make it difficult for the healthcare team because the “family as decision maker” isn’t how healthcare works. Healthcare is based on autonomy which means the patient is in charge of making the decisions about their body. Now I am a big fan of autonomy because it is the patient’s body which will feel the effects of the medications, the pain of the surgery and the long term suffering associated with their disease. As the family, we only witness what they are going through. But as much as I love autonomy, I understand how hard it is to be the family and see your loved one in pain, afraid or maybe dying.
The pediatric physicians get this. Pediatricians practice “Family Centered Medicine.” What does this mean? It means they take into account how the patient’s situation is affecting the entire family. The patient is still the primary person that they focus on but they don’t ignore that the family has a role in whether or not the child will get better. But this isn’t how it works in adult medicine. It is only about the patient.
So what can you do if you want a voice? Be cooperative and respectful when you are dealing with the doctors and nurses. Say please and thank you when people help your loved one. Pay attention to what the doctor is saying because the patient may be too sick to listen. And when you see something that is going wrong, don’t threaten to sue but instead bring it to everyone’s attention and ask, “How can we solve this problem together.” You don’t want to become the enemy. You want to be a part of the team.
