Assisted Living, News, Skilled Nursing Facility

Tip: Fostering family learning and engagement

The following is an excerpt from Serving Residents With Dementia: Transformative Care Strategies for Assisted Living Providers by Kerry C. Mills, MPA.

When staff are asked what their organization can do to make them more successful in their roles, one of the most common answers is, “Educate the families.” During the hundreds of trainings for direct care teams (DCT) that I’ve lead, I’ve nearly always encountered at least one staff member who exclaims, “You have to share this information with the families—they do this stuff wrong all the time.”

Share guiding principles
Although you cannot force family members to learn or physically alter their behaviors with their loved ones, you can effect change—and show staff you listen to their recommendations—by educating families on the philosophies, policies, and processes that shape your organization’s care delivery, such as the following:

  • Our staff have been trained in best dementia care practices, and we have asked them to share these with you as appropriate. Please tell us if you are uncomfortable with this.
  • Our staff will be checking on your loved one when you come to visit in case either of you need anything.
  • Our staff will offer you the same meal/snack/drink that we are serving our residents.
  • Please accept some of this because it will make your loved one feel like they are treating you. If you would prefer not to do so, this is a good time to excuse yourself.
  • We recognize that families are an important part of our community and care team. In addition to fostering an enriching environment for your loved one, we seek to respect and support you. We understand that it can be hard for you to watch these changes happen in your loved one. Please feel free to speak with any of us about your feelings.
  • Our staff see your loved one in all aspects of the day and want to share with you what he or she has been up to since your last visit.

Imparting such practices can empower the people who can actually help families the most—the DCT members who spend every day with their loved ones. There is often a great chasm between the success that the DCT witnesses each day and the stories the families end up hearing. Staff may have a tendency to say too much, share their personal feelings about a situation (e.g., “I can get your mom to shower, and I don’t know why others can’t”), or put down a colleague (even unknowingly). Such intimations, which may overemphasize the less pleasant parts of the day, can alarm or upset families.
To avoid painting an unrepresentative picture of your program, give staff parameters on what information to share with families and how to share it. Suggest that they emphasize positive engagements
and happenings that illustrate a person with dementia acting like his or her old self. For instance, “Molly, your dad was dancing up a storm with all the ladies. It is amazing how happy
he is when he is grooving to music,” or “George, your mom has the best sense of humor.

Every morning, we read a joke to start the day, and her comments are always funnier than the actual joke. She keeps the rest of the residents laughing. We just love her!” Note, however, that emphasizing the good does not mean that assisted living facilities for persons with dementia staff should keep important information of a less positive nature from families. News about declines, adverse events, and any other developments that could affect a resident’s overall well-being should be shared with loved ones right away.