Assisted Living, News

Keys to successful transitions: putting your best foot forward

Editorial note: This post is an excerpt from HCPro’s title, Customer Services in Assisted Living: Strategies for Building Successful Partnerships by Kelly Smith Papa, MSN, RN.

It is important to start the relationship off right with new residents and their families. That is why the admission process is so crucial for the transition into the assisted living community. It is absolutely necessary to be clear about the process, goals, and costs associated with the care and services provided by the community. The community knows how it plans to accomplish goals for the resident; however, the family members have a different approach to how the goals will be met by the community.

While both the family and the community want goals to benefit the resident, the fact is that many times the family does not communicate with the community because the family believes the community is on the “same page.” When this is allowed to progress through the admission process, and then on into the day-to-day care, the family may respond disproportionately to the situation. For example, the family may become irate if the resident falls during the first few days, but the resident had been falling at home. The family believed the resident would not fall once he or she moved into the community. Because the family believed the community was on the same page, and no discussion about falls had taken place, the family felt the community did not do their job.

As part of the admission process, it is essential to explain that the community will do and what the community cannot do. Interview the family and identify their expectations; do not allow the family to assume they know what the community will be able to do.

But keep in mind that families may be emotional, dealing with fear, failure, and loss. Here are some tips to help residents and families ease into the admission:

  • Appoint an admission, sales or marketing coordinator to act as more than a “greeter”; this person is the first contact and confidante to whom the family will reach out. While this person may be the staff member who acquires the signatures on the sales agreement, she is also the “face of the community.” This person must have the people skills to understand the anxiety the families and residents bring with them on moving day. This person is the one who creates the “first impression.”
  • Make new residents and families comfortable and welcome right away. Create welcome baskets or a bouquet of their favorite flowers to decorate their apartment. Prior to move in day, inquire about favorite treats or comfort foods and have a small snack out for them to enjoy while completing paperwork. Or if the elder loves a certain type of cookies, have a tray of them ready in their room as they are moving in. These special touches will help the new resident and family know that the community’s intention is to get to know the person and help them feel at home.
  • Acknowledge the “sinking feeling” families must feel when they accompany their loved one to a new home. The act of walking through the front doors is the first step to the realization that they have just begun a new journey.   At some point, the family may have to come to terms with the fact that their loved one will never return to the family home.
  • Use a method to “assign” a care contact person for the family. Using this method, the community appoints one person to be the contact person for the family. It isn’t enough to say, “If you have any questions, just give us a call.” You must give the family member a name, an introduction and a business card. The care contact person will form a working relationship with the family member and be the “go to person” during the first weeks after moving in.
  • Inform the family that they should expect their loved one to react to the placement with emotions that are rarely seen. Let the family know the community is prepared to help the resident if the resident cries, attempts to leave, refuses to eat, becomes agitated, etc. These reactions to a transition are common among many residents, but the family may not be prepared to observe them in their loved one.
  • Separate the forms into manageable sections. If at all possible, divide the sales agreement and other needed forms into manageable pieces. Not every document must be completed on the day of admission. Organize the admission packet into portions according to prioritization for signatures with the most important first. For those forms that require witnesses, explanation, or assistance. Some forms can even be given to the family member and they can be seated in a quiet room to complete them in privacy.
  • Allow for consultation time. Families will feel apprehensive and will linger because they are not sure what to do or what is expected of them. Give them time to consult with staff and adjust to the concept of being a part of the community. Move-in day may escalate their fears and anxiety, offering the family time to ask questions and review the plan for their loved one may provide comfort to the family; even if that opportunity was offered early on in the tour and interview process.
  • Make need accommodations to help family members who might be elders themselves as they are making the decision to bring their loved one to your assisted living. For example, if a husband is bringing his wife to a memory care assisted living, yet he himself doesn’t suffer from cognitive impairment, yet has a hard time ambulating long distances. If the family wants to be in the community to greet the arriving resident, find a comfortable location for them to wait without being interrupted by staff.
  • Encourage visiting the first few days and inform the family that the resident may be unusually tired. For the first few days, it is wise for the family to expect to visit with their loved one for short visits—about 30 minutes per visit. Once the resident becomes familiar with the community and has time to meet new people, find their way around encourage family members to visit often for longer visits.
  • Introduce staff. Introduce the resident to his or her care partners and instruct staff that every time they see the resident in their room, the halls or dining room, they reintroduce themselves for the first few days. Residents and families have a “sea of faces” to try to put names to. By introducing yourself several times, it saves the resident and family members from asking staff their name. As a policy be sure that name tags are worn and prominently display their names and roles.
  • Families won’t know what to ask. Since families are unfamiliar with the community’s routines and processes, explain what is happening and what will happen next, for example, “I will take you to the dining room” or “After you have lunch, I will take you to the art room.” Letting residents know what is happening, and what happens next will assure the residents that they are secure and someone is taking care. By keeping residents informed, it may lessen anxiety, confusion, and insecurity.
  • Provide emergency numbers for key staff. Point out the emergency numbers in the resident and family handbook. Because the community is a 24-hour business, the family expects someone to answer the phone no matter when they call.
  • The admission process must include enough time for staff to make “small talk” with families and new residents. Encourage each staff member to tell the resident how they will assist the resident. Families and residents are not able to tell the difference between roles by the uniform, appearance of the staff, or the name badge. Staff must inform customers what they do and how the residents will interact with them during their stay.