Long-Term Care Survey Alert

Are you using your family council in this helpful way?

Step 1: Set the stage up front. "One of the best things facilities can do to reduce risk of lawsuits and complaints to the state is to help families develop realistic expectations for their resident's care and outcomes," advises former Ohio survey agency chief Kurt Haas, RN. You can let the family know that even though you have 24/47 nursing care, you can't promise to prevent their resident from falling, adds Haas, currently CEO of Nursing Home Perspectives in Canal Winchester, Ohio.

You do, of course, identify the resident's risks and how you plan to manage those, advises Joy Cornelius, a risk management consultant with Robinson Adams Insurance in Birmingham, Ala. "Get the family involved in the care plan process and keep them informed."

Step 2: Identify and help distressed families. Be on the lookout for family members who appear to be angry, guilty, and/or sad, advises Cornelius. Frame the situation by saying to staff: "This is a family who is angry and they may have some problems. We have to help them through this," she adds.

Stay in touch with the family with follow-up phone calls and/or when they come to visit the resident. "You don't want to let an upset family member get more upset or angry," says Cornelius. "The person may be angry because they promised their mother they'd never put her in a nursing home and they weren't able to keep that promise. So the person directs that anger at the nursing home."

Step 3: Use the family council proactively. "Get families involved with the family council and don't let the meeting turn into a forum for complaints only," advises Francis Battisti, PhD, LCSW, a nursing home consultant and principal of Battisti Network in Binghamton, N.Y. "Focus on positive things, as well. Families who are members of the council can welcome other new residents and families or serve as volunteers at the facility." Battisti knows of one man who continued on the family council and as a volunteer at the facility where his deceased wife had been a resident.

Step 4: Appoint the right go-to person for families. You want someone who is good at sitting and listening to people, Cornelius stresses. When you ask a family member(s) what you can do to make the experience easier for them, "sometimes they will say, 'just listen,'" she notes. "You may not be able to fix it, but you can offer the person something to drink, and an opportunity to vent their feelings and frustrations."

Key: The person hearing families out should never say they know what the person is going through if they don't, Cornelius cautions. "I've heard nursing home employees who say they didn't have a clue what families were going through until it was their mother or grandmother admitted to a facility. And suddenly nothing the facility did was good enough, even if the relative was admitted to the facility where they worked."

Tip: Develop a resource list of community agencies, including church support groups, and mental health professionals for family members who need more support than the facility can provide. Tap the local Alzheimer's Association for names of practitioners trained in helping family caregivers cope with a loved one who has the disease.