Family Members Fretting? Prevention is the Best Cure


It’s one of the trickiest tasks in long-term care: managing relationships with a resident’s family.

No one can dispute that family members have a right to participate in the care process. However, because most of them aren’t clinicians, they can’t always see the rationale behind choices from you and your staff. This leaves room for misunderstanding, and regrettably, the occasional conflict.

But that doesn’t mean that clashes are inevitable. Every organization has to strike the delicate balance of encouraging family involvement, without stoking disagreements. And, as with many clinical problems, the best way to manage potential conflict between staff and family is to prevent it from arising in the first place.

Here are some strategies for long-term care facilities to do just that.

First, Exercise Empathy

Before anything else, it’s important to understand where this friction comes from.

Admission to long-term care is never easy on family. It’s a decision fraught with emotion. Turning a relative over to the hands of strangers can make a family member feel guilty or ashamed.

Further, many residents come to long-term care after a serious medical episode, or some new evidence of the resident’s deterioration.  Nobody takes an event like that in stride. Family members might even be vicariously traumatized by the experience, which induces fearfulness, anxiety, hopelessness, and distrust.

With all this affecting them, is it any wonder that family members bring high expectations to the care experience? That they worry about their family member when they can’t be around? That they sometimes over-step to make sure their loved-one is okay?

If you understand their behaviors as expressions of these powerful emotions, some solutions to the problem become clear.

Solutions like…

1) Take the Mystery Out of Long-Term Care

Most people in America have no direct experience with long-term care. To them, the workings of a skilled-nursing facility or an assisted living residence  are largely a mystery, and what little they know has been molded by ugly stereotypes.

That’s why it’s urgent that your facility does everything possible to dispel the unknowns. Don’t leave family members guessing about what goes on in your facility. Give them a window into what you do. Share the events that arise in the resident’s day. That will reveal how hard your staff works to keep residents safe and comfortable.

If they can see what’s going on, family members will feel a lot less anxious.

2) Give Them Back Some Control

Another source of anxiety stems from the lack of control family members have over the entire care process. For most of them, it’s clear enough that they can’t control the physical frailty of their loved ones. But before admission to a long-term care facility, they could at least supervise some aspects of their family member’s daily life.

Once they’re admitted in to a facility, however, much of that control disappears. Family members are no longer in charge of ensuring their loved one is fed, clean, and secure. While that can be liberating, it’s also frightening. They can end up missing the certainty that comes from hands-on involvement.

Any measure of influence you can return to family members will go a long way. Even the simplest things, like providing a feedback mechanism, or enabling off-site maintenance requests, can give the family member a sense of agency. They’ll be grateful for it.

3) Recruit Them as Allies

Even better is to take that agency one step further, by turning family members into active participants in the resident’s care.

Researchers Annika Hertzberg and Sirkka-Liisa Ekman called this cultivating a “‘We,’ as opposed to a ‘Them and Us,’” mentality between family members and staff. The idea is to strengthen collaborative relationships by opening up channels of communication, improving documentation about the residents’ activities, and working together on minor practical problems.

These steps foster a feeling of fellowship. They engender a sense that staff and family are in this together. And of course, that’s the truth.

Care with a United Front

Caring for a dependent person, after all, is a complex proposition. It demands tremendous effort from caregivers, whether they’re in the family or not.

The techniques described above can show family members that you and your staff are just as committed as they are. They’re also a way of extending an invitation for family to be a part of this new phase of their loved one’s life.

That may not clear up every misunderstanding between family and staff — but it’s an excellent place to start.