Senior Care Risk: Lack of Resident/Family Collaboration and Engagement

Susan Lucot, MSN, RN, MLT (ASCP), CPHRM

Senior care settings differ significantly from acute care settings in that they serve as residents' homes. As such, residents and their families might grow attached to the surroundings and the staff, and they may view the center or facility much as they would a private home (in terms of independence and autonomy). As a result, senior care leaders and staff may face complex challenges in balancing residents' rights with their safety.

Negotiating these challenges requires maintaining professional boundaries and engaging in effective communication. To meet these professional duties, it's crucial that senior care centers provide timely guidance to residents/families about organizational policies and procedures as well as keep families updated about their loved ones. Additionally, having resident/family agreements in place can help manage potentially problematic or emotional situations. Examples might include:

• If staff need to transfer a resident to a higher level of care because their needs have surpassed the scope of the facility's offerings
• If staff need to hold family members accountable for safety issues, such as putting a resident at risk for falls, providing foods that pose choking hazards, supplying the resident with over-the-counter medications or supplements that are potentially harmful, or bringing tools or substances (e.g., cleaning supplies) to the facility that are potentially hazardous

Failure to address these types of issues, as well as others, can lead to resident injuries and increase liability exposure for the organization. Thus, each senior care center should adopt an agreement between the center and residents/families. The agreement should include:

• Information regarding admission and discharge criteria
• Notifications and communication opportunities (such as periodic care plan meetings) to discuss resident status and any related changes
• Scope of services and limitations of the center
• Expected family participation and assistance in meeting residents' needs and keeping them safe
• Cooperation with ensuring a safe environment for all residents
• Respectful behavior towards leadership, staff, other residents, and visitors
• The proper procedure for communicating complaints or grievances

Senior care organizations may want to incorporate additional aspects into agreements based on business practices, scope of services, and resident needs. Leaders and staff can adjust agreements as necessary to address any specific concerns related to safety or quality of care.

Senior care centers also should identify ways to provide more frequent and meaningful communication with residents' families or significant others. Conducting periodic in-person and/or virtual town hall meetings can help provide essential information. These sessions could include details about how to avoid bringing items into the facility that are potentially harmful or dangerous, safety concerns for residents who have certain physical issues (such as chewing or swallowing difficulties), education regarding behavioral health disorders and dementia, and more. Tapping into local area experts for meetings and educational sessions may enhance communication and facilitate question-and-answer sessions.

For additional insights on communication risks in senior care settings and ways to mitigate these issues, click here.

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