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Family Councils in Nursing Homes

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Families of nursing home residents often find the placement of a relative in a home to be very difficult. Guilt, confusion about the home's policies and procedures, and financial worries are only a few of the concerns families experience. Even after a relative has moved into a home, problems and concerns may continue and new ones occasionally arise. Some of these problems may never be resolved. However, families working together can provide each other with support, share their experiences, and seek solutions to their common problems. This is the purpose of the Family Council.

A Family council is an organization run by and for families and friends of nursing home residents. A typical council is made up of fine or more family member who meet monthly. Officers are elected to plan and chair meetings, take minutes, attend to finances, and, in general, direct the ongoing activity of the group. Nursing home staff and administration, and NHRAC, lend support and assistance as the council requests. However, an effective council is self-determining and organized to meet the particular needs and interests of that family group. For this reason, each council is unique.

At Family Council meetings, families decide what their needs and interests are, what they want to accomplish, and how they plan to accomplish it. For example, families may decide that they wish to know more about the regulations that govern nursing homes. One way to accomplish this is to invite speakers from government regulatory agencies to their meetings.

Benefits to family members and the nursing home are numerous:
1.Families get to know other families. Because of their shared experiences, family member can give the kind of support to each other that no one else can.
2.Families get to know the long-term care system. Learning more about the long-term care system and the role of regulatory agencies can relieve much of the anxiety and confusion family members experience.
3.Families get to know the nursing home staff and administration. Many councils invite the administrator, social service staff, and department heads to speak at meetings, to explain their responsibilities and how their departments operate. If the meetings are conducted in an open, friendly atmosphere, families feel free to ask questions and discuss their concerns. Nursing home staff have the opportunity to learn how the family members really think and feel, and to resolve many of their concerns. Both groups come to know each other better, as individuals, which leads to more open communication in the future.
4.Families have input into nursing home decisions. Family Councils can share ideas with staff and administration on such things as remodeling plans, family nights, or the problem of lost clothing. The nursing home benefits by having a group of involved individuals they can come to for advice and support. Families, by being part of the decision-making process, are more involved in the lives of their loved ones who live in the home.
5.Groups can be more effective than individuals working alone. Many decisions are made in the legislature and elsewhere which affect the lives of nursing home residents and their families. An organized group of family members can influence these decisions by lobbying, letter writing, etc.
6.Nursing home residents benefit from increased involvement in families. Discussing what's going on in the home, sharing activities, and working together on various projects can help to draw families and residents closer together.

There are many factors which need to be considered in forming a Family Council. How these factors are dealt with can make the difference between success and failure.

The initial impetus for organizing a Family Council usually comes from nursing home staff or administration, or from the concerns of a particular family member or group of families. Only in rare cases is a Family Council started because of an adversary situation between families and the nursing home. More frequently, the nursing home recognized the benefits of a Family Council and approaches family members with the idea. Although Family Councils can and have been organized without the cooperation of the nursing home, this is not the ideal. The most effective councils are those that operate with the support and cooperation of the home. Therefore, the first step is often for staff, administration, and concerned families to sit down and discuss the Family Council concept. NHRAC provides assistance, when requested, to nursing home staff and fm who wish to learn more about Family Councils or need assistance in planning and presenting their first meeting.

1.Notifying family members. An effective council only needs a small number of active members. Some have only five or six members. Nevertheless, it is advantageous to let as many families as possible know about the first Family Council meeting. Nursing home personnel are often very helpful with this.
2.Planning the first meeting. The first Family Council meeting is very important in determining how the council will develop. A first meeting can be somewhat social in nature, allowing families an opportunity to get to know each other, but should include other things as well: an explanation of Family Councils, a discussion among the family members of their needs and concerns, a decision by the family members on whether or not they are interested in having a council, selection of temporary officers (volunteers might be appropriate if families do not know each other very well), and set date, time, and topic for the next meeting. If these decisions are made at the first meeting, the concept of self-determination is established form the start. Often, if staff decides to run the meetings "for a while", the families become used to that arrangement and are very reluctant to take responsibility for the council later.

After family members have decided that they want to organize a Family Council, further factors remain to be considered:
1.Establishing purposes and goals. Clearly defining the goals of the group will pride a direction and help eliminate confusion or inertia later.
2.Establishing an ongoing relationship with nursing home administration. What kinds of support will the administration provide (meeting space, mailing costs, etc.)? What assistance might the council provide to the home?
3.Establishing relationships with staff. Do the families want staff to attend meetings? What would they like to learn from staff?
4.Establishing a relationship with the home's Resident Council. How can the two groups work together?
5.Choosing a first project. What are families most interested in? Is the project simple and achievable?

A newly-formed Family Council should begin with a project that is easy to plan and implement. Later, as members gain experience, the projects can become more complex. Even a simple project takes preliminary planning and work. The council should anticipate what tasks will need to be done and delegate these duties. Some good beginning projects include:
1.Educational Meetings. It is typical for a new council to want to learn more about their home and the nursing home system in general. Speakers from inside or outside the home can be invited to talk about their areas of responsibility and to answer questions.
2.A Welcoming Committee. Many councils have a Welcoming Committee to contact the families of new residents and offer their assistance and support. Not only is a Welcoming Committee very appropriate to the purpose of a Family Council, but it will also tend to increase Family Council membership and participation at the same time. New families learn of the council and receive a personal invitation to join and the project is one that can involve many current council members.
3.Visits to residents. Many nursing home residents have no one to visit t hem or look out for their interests. The Family Council could, with help from the home's Social Service Department, put together a list of residents who do not have regular visitors. Council members who are able could visit one or two of these residents when they visit their own relatives.
4.Getting involved in existing activities and projects within the home. Each nursing home is a unique environment, and the council should attempt to develop projects that are appropriate their home. A new Family Council might begin by plugging into projects already happening in the home, such as helping plan Family Nights or assisting the Resident Council in fundraising projects.
5.Outreach. A bulletin board and/or information table could be set up to make news on the Family Council and information of value to family members available to anyone who is interested. A Family Council newsletter, or a regular column in an existing nursing home newsletter, can also be very effective.
6.Other ideas: sponsoring a social event for families and residents, involvement in legislative issues, writing a handbook for families, fundraising for special projects, presenting an "Employee of the Month" award, and finding ways to involve the community in the home and the home in the community. The possibilities are endless!

Be creative with your Family Council!


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