Family Communication Challenges: What should you do?
Strong communication with families is essential to providing quality resident-centered care. Challenging conversations often occur during times of stress, unexpected changes, or misunderstandings. Effective communication techniques promote trust, empathy, and collaboration. Below are some scenarios and suggested responses.
Q: Mrs. Smith’s daughter arrives at the facility upset because her mother experienced a fall overnight and states “I shouldn’t have to find out when I walk in! Why didn’t anyone call me?”
A: Suggested response:
“I understand why you’re upset, and I’m sorry this has caused frustration. Your mother’s safety is very important to us. Let me explain what occurred, the care she received immediately after the fall, her current condition, and review our notification process with you. If we missed your expectations for communication, we want to address this with you.”
Q: Mrs. Jones has bruising on her arm and states a nurse aide on night shift handled her roughly. Based on the allegation, reporting and investigative procedures are implemented. What is the best way to communicate with the resident’s representative?
A: “I’m calling to let you know that a concern involving possible abuse was reported regarding your mother. The allegation involves some bruising on her arm. I want to assure you that she is reporting no pain, has no other evidence of changes in her condition and is being seen by the Nurse Practitioner. We take all allegations very seriously. Our first priority is your mother’s safety, and we have begun a thorough investigation and completed all required notifications. At this time, we are gathering facts and want to avoid speculation before the investigation is complete. We will keep you informed and are available to answer any questions.”
Remember, when communicating with families, some effective communication strategies include:
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- Actively listen – no interrupting
- Acknowledge emotions
- Avoid defensiveness
- Focus on shared goals
- Speak calmly and respectfully
- Review next steps
- Document discussions and involve the interdisciplinary team, when appropriate
Q: Siblings disagree about their mother’s care during a care plan meeting. One wants to focus on comfort care and the other is pushing for aggressive treatment.
A: Suggested response:
“Our goal is to ensure your mother’s wishes are at the center of every decision. Let’s review her Advance Directives, physician recommendations, and discuss everyone’s concerns respectfully so we can determine the best way to proceed. Can you each share what your understanding of your mother’s condition is?”
Communication tips for inter-family conflict:
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- Remain neutral
- Redirect discussions to resident preferences and goals
- Involve social services and medical providers, when appropriate
Families often remember how they were treated, rather than the specific details of a situation or conversation. Even when outcomes cannot be changed, respectful communication, transparency, empathy, and timely follow up can strengthen relationships and reduce conflict.
Contact Proactive for consulting support and staff training for effective care planning, grievance process management, and family/resident representative engagement program assistance.
Written By:
Liz Wheeler, BSN, RN, CHPN, IPCO, QCP, CDP
Clinical Consultant
Proactive LTC Consulting
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