Managing family relationships in senior living communities

As a health care provider, how many times have you seen a certain family member walk into the facility and you have witnessed the entire staff disappear? Maybe you have even occasionally sought out refuge behind a closed office door. 

Poor communication creates scenarios in which crucial information is not exchanged between the staff and family. When this happens, many family members feel that the staff is withholding information - setting up tension and distrust between the staff and family members. Improving family relationships and grievances start with improving the interaction and communication between staff and family members.

Staff training

Good communication and customer service training skills should be taught to the staff during orientation as an expectation of their daily interactions within the senior living community. Staff training should also include active listening skills. Skills education can include, but is not limited to:

• Stop what you are doing and make eye contact when someone addresses you.
• Be at the same eye level of the person talking to you.
• Limit distractions.
• Use positive voice tone, body language and facial expressions.
• Acknowledge what was said and agree or say “yes” whenever possible.
• Say what you can do and do it.
• Project confidence and competence.

Resident and family communication

It is important for staff to encourage the resident and families to share their concerns and grievances. It is far better for the issues to be addressed early on than it is to have the concerns balloon into a situation which now involves an attorney or survey team. It doesn’t matter to the resident and family if the concern is a lost pair of socks or the reporting of a significant injury, the situation needs to have the staff members complete attention, empathy, and timeliness of follow-up until completion. Whatever complaint process is used, make sure it includes these steps:

• Encourage the residents and family members to share their concerns and grievances, and provide a form or an e-mail address, should they not feel comfortable confronting staff.
• Document the concern/grievance and state it back to the resident and /or family to ensure proper conveyance of the message.
• Apologize for any resident or family inconveniences.
• Designate a staff member to investigate and follow-up with the resident and/or family.
• Investigate and gather the facts of the concern/grievance.
• Try to find a solution to the concern/grievance.
• If there is a solution, do what you say you were going to do.
• If the Community is unable to resolve or meet the concern/grievance; that also needs to be documented and communicated to the resident and/or family.
• Communicate the follow-up resolution or outcome of the investigation to the resident and/or family.

Satisfaction surveys

In addition, the community can build better relationships with residents and family members by conveying to them that their concerns are taken seriously. The community can do this by developing satisfaction surveys. When the satisfaction survey is put together, keep some of these things in mind:

• Keep it simple – use checkboxes or rating scales so the survey is easy to fill out and compile later.
• If the survey is going to be mailed, include a postage-paid or tear-off postcard for easy return.
• An e-mail also is an option, for those that prefer electronic communications.
• Develop questions that will help you gauge your customer service. (e.g., Do you feel staff listens to you: Are their responses timely? etc.)
• Be careful about conducting multiple surveys at the same time, as it takes time to address any problems that are voiced.
• Summarize, prioritize, and act upon results; then address them.
• Distribute the result to staff, and even to the residents (if appropriate).
• List both types of comments: things which are done well and things that need improvement.

In conclusion, managing family relationships takes time; however, it is very beneficial and assists with managing risk in the community once there is a good foundation.

More resources

Below are other resources which may assist your senior living community with managing family relationships and communication:

• AgingCare.com, “Seniors Behaving Badly in Long-Term Care Facilities
• McKnights Long-Term Care News, “Effective Communication with Seniors”
• Agency for Healthcare Research and Quality, “Module 4: Teamwork and Communication: Facilitator Notes”
• National Library of Medicine, “The Nature of Staff-Family Interactions in Nursing Homes: Staff Perceptions”
• Rn.com, "The Difficult Patient Tool Kit, Part 2: Dealing with Family"
• Seniors Matter, “Requiring positive approach and skills in dealing with tough family members”