Family Councils: Suggested Agendas

Many patients remain in the nursing home setting for the balance of their lives. Their final years can either be comfortable or tragic depending on the quality of care they receive.

It is difficult for an individual family to influence the nursing home’s management to improve patient care.

The best opportunity for success in improving patient care is through the nursing home’s Family Council.

Members of the council are the families of the residents. They can set their own agendas and present the facility with their concerns which must be addressed by management.

There are care issues that are common in nursing homes. The following is an outline of several of them and how they can affect nursing home patients’ quality of life.

1. Nutrition. When there is a shortage of staff in the facility, patients who are unable to feed themselves independently, suffer.

2. Hydration. A lack of adequate fluid intake is a cause of significant problems for residents including confusion, falls, and urinary tract infections.

Residents must have water conveniently located in their room. The water container must be regularly filled. Patients must be encouraged to drink water throughout the day.

Once again, inadequate staffing is usually the underlying problem when patients are dehydrated.

3. Assistance with Activities of Daily Living. Another area of concern is the insufficient number of nursing assistants to provide patients with assistance in their activities of daily living.

These activities include: bathing, dressing, grooming, transfers to bed and chair, ambulation, toileting, and eating (as discussed above).

The Family Council through its family members can provide factual accounts of care concerns at the facility and request that the facility provide adequate staff to attend to their vulnerable patients.

If cooperation isn’t forthcoming, the Council should then request the Arizona Department of Health Services to investigate the inadequacy in the facility’s level of care.
 

Family Councils in Nursing Homes: Resident Protection

The adage “there is safety in numbers” is particularly true in the nursing home setting. Federal nursing home regulations provide a vehicle for enhancing patient safety, by requiring nursing homes to have “family councils”.

Family councils are made up of resident’s family members that meet regularly to discuss issues pertaining to resident care at the facility.

The nursing home must assist the council by making a “private” space available for the families to meet. In addition, a facility representative may only attend the meeting by invitation of the council, and must respond to council concerns.

If you have a loved one in a nursing home, participating in the family council is a must. If there isn’t an active council, start one!
 

The Nursing Home Family "Toolkit"

Placing a family member in a nursing home is painful and difficult, yet necessary when the medical and physical demands make other options unacceptable.

The nursing home environment and staff procedures may be overwhelming for the family as well as the patient. In order to function in this new environment the family must learn a new set of rules and procedures.

The Nursing Home Family “Toolkit” is a structure that families can utilize to get their bearings in an otherwise confusing situation.

The “Toolkit” is a protocol for gathering information about the facility, its caregivers, management, and the other residents and their families.

Caregivers, Management, Residents and Families

There are many caregivers in the nursing home setting. It’s important for the family to know the names, positions and shifts of all caregivers in order to understand which caregiver is responsible for the delivery of care during each shift.

To the extent possible, it is advisable for the family to meet each of the patient’s caregivers to establish a personal relationship between the family and the facility staff.

Obtaining the names of all supervisory staff and their shifts enables families to understand the chain of command.

The family should learn the name of the Director of Nursing, the Medical Director, and the Administrator and the times they are in the building.

Since there is considerable turnover in nursing homes, the information should be updated quarterly.

Finally, the name of the treating physician, the days and times he is usually in the building is also important.

Other Residents and their Families

You and your loved one are now in the new “community” with other residents and their families. There is a lot to learn and the other residents and families can be very helpful.

They will have information and opinions about the staff and administration which they can share with you. They can keep an eye on your loved one when you are not there and call potential problems to your attention.

Make sure to get the complete names of the other residents and their families, as well as their addresses and phone numbers.

Keeping a Diary

As a lawyer, I review many nursing home neglect and abuse cases. It is very helpful to visit with a family that has kept a diary of the events surrounding the care of their loved one. Details about the problems confronting the family and their efforts to obtain necessary care can go a long way in establishing nursing home accountability.