When families seek mental health treatment, it’s often because of a “problem child.” Family therapists consider this person to be the “identified patient” and recognize that the troubled individual is part of a family unit whose members all benefit from assistance.
By contrast, when a resident enters long-term care, we tend to focus solely on the needs of the resident, even though they’re almost always part of a family system that is being affected by their placement.
Oddly, we do this in spite of the fact that it’s frequently a family member who chooses the facility or community where the loved one will live.
If we consider that we’re admitting families rather than just the residents themselves, we’d recognize the need to provide family-centered care in addition to resident-centered care.
Instead, we repeatedly attend to the needs of families in a haphazard, reactive fashion. Those tense family meetings with the director of nursing and the administrator after the staff “mishandled” an interaction with a family member are more likely a lack of organizational attention to the needs of families and an absence of proper training than they are a reflection of staff error or of a “difficult” family.
Here are some ways to implement family-centered care:
1. Convey essential information to families about your facility or campus in a way that’s easy to access. If your website offers only platitudes about how you really care and then lists insurance options, you’re telling potential customers what you really care about and it isn’t them. Instead, turn your site into a 24/7 support kiosk, answering questions families commonly have about your community and helping them to be better caregivers and community members. Include, for example, information about their role in care plan meetings or how to help their loved one adjust to their new home. Add a list of resources they might want to consult. (My book, “The Savvy Resident’s Guide,” for example, is one way to offer information and soothe the frayed nerves of family members.)
2. Hold regular family meetings on topics that frequently affect them, such as caregiver stress, understanding dementia, and making the most of an off-campus pass (a great session to hold before the holiday season, hint, hint). Even though this may seem like yet another task to add to an already burdened staff, it will save time in the long run: Rather than answer the same questions individually, your staff can direct families to the meetings where questions can be discussed simultaneously and in depth.
3. Reach out to families during transitions in care, such as moving from an independent apartment to the care center in a continuing care retirement community.
4. Set aside parking spaces for family members, who may be ill or elderly themselves and have difficulty walking from a distant parking spot.
5. Promote an active family council that can establish a family welcoming committee and take the lead on running some of the family info meetings.
6. Facilitate communication between residents and family members in a variety of ways, including setting up video calls so that distant relatives can stay connected and explaining to visitors how to relate successfully to residents with impaired hearing or dementia. Have a computer accessible and provide assistance for residents who might want to stay in touch with others via Facebook and other social media platforms.
7. Offer more support around the end of life, including frank discussions about the efficacy of various medical treatments and information on palliative or hospice care. Help them make the most of the time they have left with their loved one and sensitively suggest resources for support when they are bereaved. Be sure to phone and/or send handwritten notes after the loss of the resident, emphasizing your appreciation for them, their loved one and their choice of your facility.
Addressing the needs of the family as a whole is likely to result in better care, happier residents, more satisfied family members, and fewer emergency family meetings.
Faced with the need for placement and a decision between an organization that offers insurance information versus one that offers family-centered care, the clear choice for family members is to select the one that conveys an understanding of what they’re going through — and shows that they really do care.
Eleanor Feldman Barbera, PhD, author of “The Savvy Resident’s Guide,” is a 2014 Award of Excellence winner in the Blog Content category of the APEX Awards for Publication Excellence program. She also is the Gold Medalist in the Blog-How To/Tips/Service category of the 2014 American Society of Business Publication Editors Midwest Regional competition. A speaker and consultant with nearly 20 years of experience as a psychologist in long-term care, she maintains her own award-winning website at MyBetterNursingHome.com.
