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In the overwhelming majority of situations, providers enjoy
excellent relationships with family members. Providers
collaborate routinely with resident representatives to develop
individual service plans, discuss problems that may arise, and
adjust service plans (including level of care changes or moves
to memory care) as resident needs change. In the course of
my many years of working with providers, I have discovered
that the following three simple steps can significantly improve
relationships with family members and significantly reduce the
likelihood of encountering serious problems.
1)
Stay out of your office.
While I have never undertaken
a scientific study, I have no doubt that there is a direct
correlation between the amount of time that an executive
director spends in his or her office and the likelihood that
a community will have problems. Executive directors who
routinely walk their building foster relationships with staff,
residents and family members. Executive directors who
know their family members well are less likely to encounter
difficulties. And executive directors who take the time to be
with their staff are more likely to have happy staff who in
turn are more likely to please residents and visitors.
2)
Communicate with families.
Many of your residents have
children who live out of town, out of state or even out of
the country. Thanks to the miracles of modern technology,
we can now communicate with these people at no cost.
Email can be a great way to bring distant family members
into the daily lives of residents.
3)
Anticipate changes.
Most of your residents will experience
a deterioration in their condition over time. If your first
communication about a resident’s decline is a phone call
advising a family member that their mother needs to move
to memory care, you are likely to be met with resistance.
If, however, you can anticipate a resident’s needs and start
discussions early on, you are much more likely to have the
family buy in when the time comes for a higher level of
services or a move to Memory Care. Contrast the following
two notifications:
a. “Your mother has dementia and needs to move to
Memory Care NOW.”
b. “Mrs. Smith, your mother has started to show signs of
mental decline. She has been misplacing things of
late. And then yesterday, she was unable to find her
way back to her apartment from dinner and had to
be directed by staff. We think that she is still able to
remain in Assisted Living for the time being, especially
if we provide some extra supervision. But realistically,
sometime over the next few months, we are going to
need to transition her to Memory Care.”
It’s pretty obvious which of the two conversations is more likely
to be well received.
Sometimes, even if you have done all of the above and much
more, you may encounter a frustrated family member. There are
steps that you can take to diffuse difficult situations. First, try to
understand what is motivating the family member. In many, if
not most instances, they are dealing with profoundly difficult
emotional issues in watching a loved one deteriorate. This can
be especially true when the loved one has dementia. Some
family members feel guilt for not being able to care for their
loved one themselves. If you can understand what it is that is
motivating a family member to act inappropriately, you will be
better able to diffuse the situation.
On occasion, we have encountered a family member who was
repeatedly confronting caregivers and thus interfering with
the caregivers’ ability to do their jobs. And in some cases, the
confrontation has involved harassment and inappropriate
language (including racial slurs). In those situations, you have a
legal obligation to protect your employees from such behavior.
It may be necessary to impose restrictions on the staff members
with whom family members may communicate, limiting
communication to management.
In many situations involving a family member, getting your
Ombudsman involved can be extremely helpful. I have often
emphasized the benefits of having a good working relationship
with your Ombudsman, and this is one of the circumstances
where having that relationship inures to your benefit. The
Ombudsman is a resident advocate—not an advocate for the
family member. Particularly in situations in which the family
member is acting contrary to the best interests of the resident
or where there is dysfunction within a family (e.g., siblings
insisting on different courses of care for your resident), the
Ombudsman may be able to act as an intermediary and help
resolve difficult situations.
g
Joel Goldman is a partner at Hanson Bridgett, founding board member
of CALA, and nationally known expert on Assisted Living.
C L I F O N I A A S S I S T E D L I V I N G A S S O C I A T I O N
