# Value-Concordant Decision Making in Patients on Prolonged Mechanical Ventilation: A Family-Centered Care Approach Using the Calgary Family Assessment and Intervention Models

## TL;DR

This paper describes how family-centered care, using specific models, helped a patient and family make a value-aligned decision about prolonged mechanical ventilation.

## Contribution

The paper introduces a practical integration of FCC with the CFAM and CFIM for complex medical decision-making.

## Key findings

- Structured family conferences improved shared understanding and decision-making.
- The integrated approach clarified core family values and reframed assumptions about care goals.
- The method supported a nonhierarchical partnership and fostered trust.

## Abstract

Family-centered care (FCC) emphasizes collaboration with family members to build shared understanding and support decision-making. The Calgary Family Assessment Model (CFAM) and the Calgary Family Intervention Model (CFIM) provide a practical structure for translating this approach into family assessment, communication, and tailored family support. A man in his 60s with high cervical (C3/4) spinal cord injury required prolonged mechanical ventilation. Nurses integrated FCC with the CFAM and CFIM through structured family conferences using teach back and circular questioning, CFAM-guided assessment, CFIM interventions across cognitive, affective, and behavioral domains, and an option grid comparing home and facility care. This bedside implementation clarified the core value-time to talk freely with family-and reframed a binary “wean-then-home” assumption into parallel planning. The patient and family chose to discontinue weaning and transfer to a facility with flexible visitation, as this was the best goal, being value-concordant and safe. This integrated approach supported a nonhierarchical partnership and fostered trust, shared understanding, and effective decision making.