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

Time Point 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?