Communicating with Families in LTC

Part 1: Making the Transition

Proactively Communicate with Families to Ease Transition  Family members may feels guilty about leaving their loved one there, the more you ask about the resident, the more you learn, the more the family will come to trust you. Be curious! Find out as much as possible about the loved one staying at the facility.  Many family members most often did not get the whole picture of the status of the patient. Be clear! Provide the family with realistic expectations  Misunderstanding family dynamics may give rise to difficult situations with nursing home residents and their families Be observant! Notice the interactions between family members and the resident

Follow up with a System for Regular Communication  Decreases Conflict Between Family and Staff  Resolves Family Concerns Before Visits  Informs Family of Resident’s Health Changes TimePoint of Contact Sample Questions During first 24 hours Admissions“Is there anything we can do differently?” At 48 Hours Nursing“Are there any concerns that you have today?” After 72 Hours Social Work “Is there anything I can pass on that will make things better?”

Dealing With Different Family Dynamics  Overinvolved Solution – Give frequent updates and find ways for the family to participate  Disengaged Solution – Gently explore issues like caregiver depression, burnout, or prior abuse by a parent. Allows for referral to address caregiver needs  Know-it All's Solution – Form a partnership with the family member. During a disagreement, use objective data to support recommendations  Factions Solution – Recognize the pattern to reduce frustration. Do not take sides. Try to set healthy boundaries and encourage all stakeholders to talk out their differences The stress of LTC placement can activate pre-existing family conflicts

How to Communicate with an Angry Family Member  Speak Slowly and Calmly  Maintain an open Posture  Apologize when Appropriate  Reflect on Feelings  Validate  Empathize  Respect  Support  Use Problem-Solving Approach

Part 2: Communicating the Diagnosis

Inform Families of all aspects of resident care  Exact Diagnosis Clarify Definitions Discuss Treatment Options  Communication Strategy  Future Planning Explain and Discuss the Progression of Symptoms Adapt Conversation Maintain Sensitivity to the Family

Managing Treatment Expectations It is important to talk about what to expect from treatment  Pharmacologic considerations Side-effects Compliance Outcome  Non-pharmacologic Symptom decline Behavioral Management

Utilize a Team Approach  Enhance Staff Communication  Define Chain of Command for Family Concerns  Provide Family with Enough Information  Maintain Adequate and Consistent Staffing  Inform all Staff and Family about Changes in Care

Discussion  As a team, how are you consistently meeting family expectations for providing adequate information?  What are you currently doing that is working well?  How do you currently share treatment goals with family members?  Managing Symptoms  Controlling Behaviors  Preserving Functions  Maximizing Quality of Life  Managing Treatment Expectations  What could you do differently to facilitate better communication with family members?