Presentation on theme: "Resident and Family Councils"— Presentation transcript:
1Resident and Family Councils Office of the State Long-Term Care OmbudsmanProgram Field Representative, Kathryn WhiteA council can be a powerful force for change in a facility, but starting one can be tremendously difficult. Creating a new council can require a lot of time and energy. Ombudsman can play a critical role in providing assistance. The Older Americans Act requires local ombudsmen to support the development of resident and family councils. The role of the ombudsman is consumer empowerment, you can provide information and suggestions. Give them the tools to take the next step.We are going to go over things that we can do as ombudsman to assist in resident and family council. We will talk about regulations, laws, preparing for a council, leadership, structure (ex. bylaws, agenda), promoting council, problem solving, communication, benefits, obstacles, resources, and examples on packet. But most important what role as the ombudsman.
2Why have a council?Image 1: Goodwin House Alexdria Resident CouncilThe lives of the residents are heavily controlled by laws, rules, and policies set by the government and nursing home. Compromises in lifestyle become necessary due to health problems and living conditions. These compromises and controls can make nursing home residents feel their opinions and preferences do not matter. A council gives the residents an active role in their life and a chance to influence decisions that affect them.Ask Ombudsman why have a council?Going to a nursing home is change…health, lifestyle, surroundings, family, belongings, privacy, roommate..The purpose of the council is to provide a forum for the residents to express themselves and suggest positive changes, many voices are stronger then one. An effective council reflects and meets the needs. Residents want to be heard and that they matter. This gives them a chance to share with each other and devise strategic wants. This can be a place for family council members to constructively channel their anger and concerns as an alternative to filing a complaints with outside agencies. The facility can focus on common facility-wide concerns. It builds a trusting relationship with the facility staff, while maintaining open communication. Council members can come up with creative ideas how to address concerns. Can give validation. Research has shown that when residents are encouraged in maintaining a sense of autonomy and control over their own life-there is less mental confusion and physical dependency (study by Elaine Brody of the University of Southern California Gerontology Center). Residents may fear retaliation, and the council provides support.Going back to Residents Rights
3What is a resident council? Resident Council-Resident councils are organized, self-governing, decision-making groups of long-term care residents meeting regularly to voice their needs and concerns and to have input into the activities, policies, and issues affecting their lives in the facility.There is no typical council, depending how it is set up. The structure can vary and how it is organized. A council gives resident input into their daily lives, and give them a sense of purpose.Ask: How many have set up or assisted with a family council? Who did you invite or did the residents or nursing home?
4What is a family council? Family Council- A family council is a self-led, self- determining group of consumers - families and friends of nursing home residents that:• Works to improve the quality of care and quality of life of the facility’s residents.• Provides families with a voice in decision-making that affects them and their loved ones.Usually 5-10 membersSupport for familiesEducation and informationServices and activities for residentsJoint activities for families and residentsAction on concerns and complaintsLegislative action and many othersPurposes vary greatly from council to council, depending upon the interests of council members. A general set of purposes should be agreed upon when a council is new and revised as the goals and interests of members change.Resident and family councils should work together and family council find out resident’s needs.
5Policy Understand Voice Advocate Education Communication Providing general information about long -term care.EducationEffective way between staff and residents/ families.CommunicationDepartments as they relate to the resident’s care and service needs.UnderstandPresent ideas, suggestions, and concerns and to work cooperatively towards a solution.VoiceLearn reasons for proposed changes in policy and procedures and promote feedback concerning potential changes.PolicyHelp individuals speak out about concerns and help overcome fear of retaliation.AdvocateWhat can a council provide?Education- Regulations, policies, and resourcesCommunication-Building trust, understand how things work, staff know what to look forUnderstanding-ex. CMA and CAN-helping know staff and duties, may get reported to wrong department, complaint log on shifts so current person gets complaint when staff busy forget to tell or write down.Voice-ValidationPolicy-Know how things work, copy of policy ex. Prairie WindsAdvocate-make a differenceSurroundings-Tension, avoidance with staff and family, only resident suffers.Friendship- Common concern, understand struggleSurroundingsImprove the atmosphere.FriendshipPromote support.
6Family council is not….FAMILY NIGHT is a name used in many facilities for occasional educational or social functions planned and hosted by nursing home staff for families and friends of the home’s residents. While these programs may be beneficial, they are not substitutes for family councils.A RESIDENT COUNCIL: Many homes have resident councils. It may seem at first glance that the two groups are the same. Combining the home’s resident and family councils into one group may even be considered. However, this ignores the fact that residents and their families have different interests, needs and abilities. Combined resident/family councils are usually dominated by the families, who are quicker and better able, in many cases, to express themselves. Residents and families need their own councils geared to their special situations and interests.A VOLUNTEER GROUP OR AUXILIARY: Occasionally, a family council will be started to meet a need within the facility. Family councils provide many valuable services to residents, but they must never be replacements for adequate staff. Also, a council should not provide items or services that the home is required by law to provide.Family Night- Hosted by staff with purpose for social or educational ex. Staff appreciationResident Council- Different interest, needs, or abilitiesGuardians or legal representative at meeting-regulations say they have a right to be there, the health dept. has a history of not overriding that.Volunteer Group-Auxiliary-additional, supplements, substitute in case of needReplacing things facility needs to do, don’t realize could be problemEx. Feeding other residents
7Where to start? Do they want a council? Are staff and administration willing to help the council get started?How to introduce members to the council?How to participate?Any interest, leave time slot open on calendar, residents know there is one if they want to start. Ex. ElmcroftProblems in the past-what happen, staff not informed, new administratorNo guidance, not sure where to start, too much work, don’t want to tell people what to doWhat it encompasses and timeImage 2: avoidance300.jpg
8Laws and Regulations Older Americans Act Omnibus Reconciliation Act of 1987 (OBRA ’87)Federal RegulationsState Nursing Home RegulationsAssisted Living RegulationsNursing Home Care ActEnforcementDifferent laws, regs, and enforce. To protect residents rightsGo over areas related to resident and family councilDifferent laws, regulations, and enforcement to protect residents rightsGo over areas related to resident and family councils.
9Older Americans ActEvery State Required to have a Long-Term Care Ombudsman Program.The OAA set out specific objectives for maintaining the dignity and welfare of older individuals and created the primary vehicle for organizing, coordinating and providing community-based services and opportunities for older Americans and their families.Section STATE LONG-TERM CARE OMBUDSMAN PROGRAM.(H)(i) provide for training representatives of the Office;(ii) promote the development of citizen organizations, to participate in the program; and(iii) provide technical support for the development of resident and family councils to protect the well-being and rights of residentsEnacted in 1965 fund critical services healthy and independent –services. Meals, Job Training, Senior Centers, Caregiver Support, Transportation, Health Promotion, B.enefits EnrollmentOAA was response to congressional concerns about lack of community social services for senior citizens.First federal level initiative-provide comprehensive services for older adultsAct divided into seven titles (1992 amendments to OAA) address need for strong advocacy to protect and enhance the basic rights and benefits of vulnerable older peopleVII creates grants for “vulnerable elder rights protection programs”.
10OBRA ‘871987 Congress passed the Nursing Home Reform Law as part of the Omnibus Reconciliation Act of 1987 (OBRA 87).Established national standards for care and residents’ rights for people in nursing homes.Each resident be provided with services sufficient to attain and maintain his or her highest practicable physical, mental, and psycho- social well-being.New federal requirements were established, including: a resident assessment process leading to development of an individualized service plan, the right to organize and participate in family or resident councils, the right to be free of unnecessary restraints (physical or chemical), and specific requirements for those most responsible for resident dignity and care.Establish basic rights and services for residents of NHRequire that state and federal government to inspect NH and to enforce standards by using a range of sanctions.In 1987 Congress passed the Nursing Home Reform Law as part of theOmnibus Reconciliation Act of 1987 (OBRA 87). Passage of this law was awatershed event in our country’s approach to nursing home standards.Following an Institute of Medicine report to Congress which identifiedwidespread problems of abuse, neglect and inadequate care, the lawwas promulgated to protect nursing home residents and to put an end towidespread, unnecessary suffering.OBRA 87 established national standards for care and residents’ rights forpeople in nursing homes. At its heart is the requirement that each residentbe provided with services sufficient to attain and maintain his or herhighest practicable physical, mental, and psycho-social well-being. Torealize this mandate, many new federal requirements were established,including: a resident assessment process leading to development of anindividualized service plan, the right to organize and participate in familyor resident councils, the right to be free of unnecessary restraints (physicalor chemical), and specific requirements for those most responsible forresident dignity and care - nursing home inspectors (surveyors), long termcare ombudsmen and direct care workers.The impetus for the present study lies in the failure to achieve so many ofthe promises codified in OBRA 87. As we approach the 20th anniversary of
11Federal regulation 42 C. F. R. § 483 Federal regulation 42 C.F.R. § explains the role of the resident and family council:(c) Participation in resident and family groups.(1) A resident has the right to organize and participatein resident groups in the facility.(2) A resident's family has the right to meet in the facilitywith the families of other residents in the facility;(3) The facility must provide a resident or family group, if oneexists, with private space;(4) Staff or visitors may, attend meetings at the group'sinvitation;(5) The facility must provide a designated staff personresponsible for providing assistance and responding to writtenrequests that result from group meetings;(6) When a resident or family group exists, the facility mustlisten to the views and act upon the grievances and recommendationsof residents and operational decisions affecting resident care and lifein the facility.A facility must care for its residents in a manner and in anenvironment that promotes maintenance or enhancement of eachresident's quality of life.
12State Nursing Home Regulations OSDH 310: Resident’s Advisory CouncilEstablish CouncilConsist of all current NH facility residents or their designated representative, facility coordinate and assist , and respond to requestNo one from facility memberPrivate spaceMinutes prepared/ maintained by staffCommunicate to administrator opinions/ concerns
13Assisted Living RulesOSDH 310: Residents RightsObserve all residents rights and responsibilities enumerated under Title 63 O.S. Section (B)Nursing Home Care Act Title 63 O.S.State Statue Rights and Responsibilities2. Every resident shall have the right to have private communication, including…..and meetings of family and resident groups……….3a (1) Present grievances…….3b The family of residents shall have the right to meet in the facility with other residents’ families.
16Preparation for Meeting LeadershipWho will facilitate?LiaisonRegular Meeting TimeGoals/ Ground RulesMeeting LengthPlanning the Introductory MeetingWhen considering the creation of a resident/family council, it is important to hold a meeting to which all residents and families of residents are invited. The purpose of the meeting is to explain the concept of resident/family councils, determine the level of interest in having a council, and to begin organizing one, if the residents and families are interested in forming a council.The introductory meeting should include the following components:1. The purpose of a resident/family council, including identifying common goals, outlining a proposed structure, and the processes and supports available to make the resident/family council successful.2. Identifying the level of interest residents and family have in forming a council.3. Identifying residents and family interested in taking a council position.4. Determining the frequency and structure of future meetings – deciding on regular or as needed meetings, and how information about the meetings will be circulated, and how residents and families will be kept informed about discussions at the meetings.Your role as ombudsman is to guideOffer assistance to steering committee/ introductory meetingPoints on planning processDevelop AgendaLet them decide your roleAfter the meeting…Check with steering committee see how things are goingMake sure they are getting the support they need from facilityPublicize…contact families you have worked with in the pastProvide training to staff liaisonGround Rules:Discussions confidential, discuss ideas, not individuals, protect resident’s privacy, disagree with respectTopics: Pick 3 things liked changedConfirm Meeting Room/ RefreshmentsMinutesTopic/Guest Speakers/ PresentationMeeting ProceduresBy-LawsAgendaImage3: clipart_people_desk_meeting_19909_1920x1200.jpg
17Participation and Sharing Initial MeetingAgendaSign-in SheetNext MeetingGuest SpeakerHandoutsInviteEnthusiasmInvite-Notice of meeting posted and get information outAgenda-Formalize the meeting/ timelineHandouts-People can only absorb so much info, handouts deliver message and reminders, people who can’t attendNext Meeting-What will work for peopleSign-in Sheet-Feedback/ who to talk to about future meetingsGuest Speaker-First hand of experienceEnthusiasm-Ensure positive experienceParticipation and Sharing- Generate information questionsParticipation and Sharing
18Leadership & Structure Models Of LeadershipTraditional/Town Meeting-Chair Person/ President, Vice-Chairperson/ Vice-President, Secretary, and Treasurer.Co-Leaders- Two members share responsibility.Leadership Committee-several family members share responsibilities, or for first few months then have formal election.Leadership committee with rotationAlternating LeaderRepresentative-residents bedfast, serving as liaison for other residents.Representative-speaks with individual residents prior to council mtg .(ex. on each floor)Suggestion box for anonymous –suggestions and complaintsHighly Structured – has bylaws, officers, committees & Informal Structure – no bylaws, officer, committee, and can be led by a staffperson who believes residents should be express concerns and wishesTown Meeting Model – effective in smaller homes where each resident isconsidered a member and encouraged to attendRepresentative Model – effective in larger homes where representatives fromvarious areas of the facility are elected to represent other residentsCommittee Model – six to ten residents serve on committees that functionsimilar to the representative modelb. Co-chair model.This model involves sharing offices between 2 members. This can be a helpful modelwhen one person does not want to fill a position alone, but will do so along with anothercouncil member. In this way, members can split the duties between them or perform theduties of the office in whatever way works best for them. This model provides moralsupport and encouragement to those who want to play an active role, but are somewhathesitant.c. Leadership committee modelThis model involves leadership by a small group of family members who divide up dutiesamong themselves. This model distributes the work among more people and can lightenthe load for any one individual. In a small council, everyone could serve on theleadership committee in some capacity. See Appendix 3 for more information about thismodel.d. Rotational modelIn this model a leadership committee is formed, but leaders rotate the duties amongthemselves on a regular basis.2. Important points about leadership and structure.a. You can mix and match the above models to form a hybrid that works for yourcouncil, or you can create a totally different model. The important thing is to havesome system for leadership that is recognized and followed by the council. Thispromotes more effective organization and lets the nursing home know whom to talkto when it wishes to communicate with the council.b. An important key to council success is to distribute tasks and leadership roles aswidely as possible among members. This is critical for several reasons:• It lightens the load on the leaders.• It develops abilities and skills in those who could become future leaders.• It is what the spirit of the council is all about – everyone pulling together in the samedirection.Organized strength comes from working together, not from one person doing it all!!c. The role of the leadership committee is to work with the council to determine the typeof leadership structure the council would like and to oversee the council untilelections have been held and new leaders are in place.d. As a council changes in size over time, it may need to change its structure.
19Leadership & Structure ElectionsJob DescriptionTraining for LeadersTerm LimitsOfficers are not required to ensure success, what is important is that members are given a chance to volunteer, be elected, or appointed to their position.Elections should be well-planned. Usually take more than one meeting as several steps are involved. Members should be notified in advance of the upcoming nominations and elections.There is no right or wrong model of leadership; the council should develop a structurethat works for its members.At this point the council has developed some temporary leadership structure to see itthrough to its first election. The council may wish to make this structure permanent.There is nothing wrong with that if the structure is working.HOLDING ELECTIONS.There are many different ways to hold elections. The following is one way in whichelections can be conducted.A. Before The Elections.The preparation process for elections should start at least a month in advance of theelection date.1. Develop a system for coming up with a slate of candidates. This can be done bycreating a nominating committee or by setting aside time at a council meeting.Whatever approach is taken, it is important to be clear about how council members,or preferably any family member, can present nominations. Give families advancenotice about the nomination process and deadlines.2. Ask the selected nominees to write a paragraph about themselves. Distribute the listof nominees along with the candidates’ description to council members, and ifpossible, to all family members prior to the election. Make sure the date of theelection is clearly publicized.B. On Election Day.1. Conduct the voting by secret ballot at a council meeting.2. Have a neutral third party, such as the ombudsman, count the votes and announce thenew officers.C. After The Election.1. Ask the outgoing officers to orient the new officers to their duties.2. Ask the ombudsman to meet with the new officers to see if they need or wanttraining.3. Acknowledge the work of the outgoing officers at a meeting and thank them. Givethem some token of appreciation, such as a plaque, to recognize their contributions.
20What makes a good leader? IdentifyPersonal QualitiesRelate to PeopleLifetime LearnersSeek AssessmentHow to Identify a Good LeaderA leader is someone who has influence over a group of people. This can be an executive, a pop star or an employee who has the ability to influence coworkers' thoughts, feelings, beliefs and actions. A leader does not necessarily have a specific title. You can tell a leader by his influence over others.Personal Qualities of a Good LeaderPersonality theories of leadership identify five major leadership qualities, called the Big Five: conscientiousness, agreeableness, neuroticism, openness and extroversion, according to Michelle C. Bligh in "Personality Theories of Leadership." However, according to Bligh, more specific research findings indicate that intelligence, self-confidence, determination, sociability and integrity are more consistent characteristics of a good leader. It doesn’t have to be someone outgoing, could be quite person.Good Leaders Relate to PeopleGood leaders listen, motivate, delegate and provide vision. Leaders can improve listening skills through practice and education. A leader motivates those under her to work hard, and she inspires productivity. Knowing when and to whom to delicate tasks is an important leadership skill, along with providing a vision that is clear and comprehensive.Good Leaders are Lifetime LearnersAlthough leaders may be born with qualities that make them effective at influencing others, good leaders are always learning. Good leaders involve themselves in accountability groups, attend leadership conferences and read books that strengthen leadership skills. Good leaders are self-motivated, set personal and professional goals and plan ahead, says Bob Pearce in his article, "Leadership -- What Makes a Good Leader," published on SelfGrowth.com.Good Leaders Seek AssessmentTo improve his leadership skills,, a leader's strengths and weaknesses are identified and an action plan is developed to address needs in both personal and professional concerns. Have council evaluate meetings and take survey.An effective resident council leader-understands that the council represents every resident-has an understanding of the resident council’s goals and responsibilitiesIs capable of fulfilling the job description of the particular leadership role-has a steady interest in the resident’s quality of life and care issues.-is willing to speak up on behalf of residents with enthusiasm and confidence-is able to validate and draw out other resident’s interests-has an understanding and knowledge of resident rights-can work effectively with the council advisor.Image 3: Does it look like what makes up a good leader.
21Duties of OfficersChairperson/ President-Presides over meeting, seeing by- laws and procedures are followed, keeping control over meeting, maintaining impartiality, coordinates activities, maintain communication with staff.Vice Chairperson/ Vice President-Fill in when chairperson is unable to fulfill duty.Secretary-Taking notes at meetings, recording and maintaining a file of the minutes, maintaining correspondence, and having by-laws handy at meetings in case of questions.Treasurer- Receiving and dispensing funds, maintaining proper financial records, and reporting to the council on status of treasury.President-Responsible for much more than facilitating the meetings and the contact person. They are the main advocate and oversee program issues. It is common for the president to be the organization’s check-signer.Vice President- Or be readily available as a permanent replacement should the president step down. The vice needs to be aware of everything that goes on and able to step in and work in partnership with the president when needed.Secretary- General mailing list, databases in safe place, cleaning up rough meeting notes that will become part of the permanent record of the organization. , website current, and anything else that involves communication, and creates reports within a regular time frame.Treasurer- Basic checkbook and balancing and bill paying. The official check-signers and has access to any bank accounts, prepare yearly financial report, and fundraising efforts. They need to be comfortable handling money and working with numbers.* Duties are separate intentionally which provides a minimal level of checks and balances with the organization.
22Liaison/ Staff Assistant A facility appointed staff advisor or liaison is required to support the council and respond to written requests/concerns arising from the council meetings. The liaison may or may not be invited to attend the meeting. In the beginning be clear of the role of the assistant.Help to tell families/ new residentsAdvise council on changes in facilityExplain the facility's policies and proceduresHelp council communicate its questionsHelp to book guest speakersProvide refreshments and make copiesShare informationEducate staffEnthusiasmNo…NoPlanning and running meetingsSpeaking on behalf of residentsSelecting meeting times and dates, topics, activities…Facilitator-make easier, to assist of helpThere are many ways staff can provide assistance or advice without violating their right to self-determinationExample of advice meetings disorderly and no decisions made, staff might be able to train council officersStaff-Run council are rarely effectiveStaff are not council membersInvite staff only when neededHave them come to only part of the meetingWalk a fine lineImportant skill of an effective advisor is keeping communication objectiveAbility to walk a fine line between loyalty to employer and fairness to councilCouncil advisor understands meaning “ resident-directed care, upholding resident rights, and allowing councils the opportunity to influence and recommend changes to quality of life ad nursing home policiesPositive attitude-sincerity is reflected in actions“ The Art of Listening”-good toolImage 4: Runnells Hospital Staff Members Honored by Resident Council
23Parliamentary Procedure Robert’s Rules of OrderThe Standard Code of Parliamentary Procedure ( formerly the Sturgis Standard Code of Parliamentary Procedure)Why Do Groups Use Parliamentary Procedure? To give everyone a chance to be heard To allow members to participate in an orderly group To establish and maintain order in a meeting To prevent confusion when discussing club business To keep things movingDepending on how structured they want the meetings….Methods of VotingRoll callBallotStanding or showing of handsVoiceGeneral consentVoice Vote The chair asks those in favor to say, “Aye” or “Yes.” Those who are opposed are asked to say, “Nay” or“No.” The president should not ask those who are opposed to “respond with the same sign.”Show of Hands This method is recommended for small groups. Chair asks members who are in favor to raise their right hands. After the count is taken, those who areopposed are then asked to raise their right hands.Rising to Vote This method should be used to verify a voice vote and on motions requiring a 2/3 majority vote. Chair asks those in favor of the motion to rise. After counting, these members are asked to sit. The chairthen asks those opposed to rise.Ballot Vote This method involves writing a vote on a slip of paper. This is a good way to vote for officers, or to vote upon controversial motions. The chair should appoint individuals to distribute, collect, and tally the ballots.In all of the methods of voting, the chair should always say what happened as result of the vote.Parliamentary procedure is the body of rules, ethics, and customs governing meetings and other operations of clubs, organizations, legislative bodies, and other deliberative assemblies.Five Basic Principles of Parliamentary Procedure Discuss one subject at a time. Allow full and free discussion of each idea presented. Treat all members with justice and courtesy. Carry out the rule of the majority, and respect the rights of the minority. Bring together the wishes of all group members to form a cooperating, united club.
24Opening Activity-Roll call/ name tags everyone becomes acquainted Image 6: graphics-agenda jpgOpening Activity-Roll call/ name tags everyone becomes acquaintedRead Minutes from last meeting-what has happened sinceReceive Reports-discuss needs, concerns, and activities of residents they representUnfinished Business- review from previous meetingNew Business-New concerns and ideasResident ConcernsFacility News-information to share from department headsSocial Time-Wind down/ refreshmentsPlanning and Preparing an agenda is an essential first step in conducting an effective meetingIs a sequenced list of matters to be attended to in the meetingInformed on topicsExpectedOutcomesKey components-date, place, time, purpose, list of topics, time allocated, person responsible for each topic, outcomes expectedStaff advisor may assistAllocating time on items needed itemsSome things should be on the agenda routinely-minutes of previous meeting, old business and new businessSend out ahead of time, post, , copies availablePerson brings up something not on agenda, ask them if it can be put on next agendaEnd on positive notPut most important things in in middle, since that is when most people will be there
25MinutesWHAT: Accurate record made of all happenings at each meeting, who served, facility’s actions in response to concerns of the council.WHY: Communication tool/sharing outcomes and useful written record.WHO: Secretary takes minutes or designate someone.Brief, Legible, and for anyone to understand, typed and copies made for distribution (given to all residents or posted).The name of the person presidingMembers presentWho took minutesDate and time of the meetingAll items discussed, actions takenDate and time of next meetingTask involveTaking notes, formalizing notes, distributeWhat to write downStart/ end of mtg.AttendeesAmendments to previous minutesActionsDecisions madeSummarize discussionItems to be held over for further discussionProduce concise minutesImpractical to write everything downEnd-asked what should be minutedRecord all decision and actionsTIPS:clarificationSkeleton of minutesAlert any task assigned
26Formality of Structure Ensure that the council knows where it is heading and that there is a democratic and fair way for the council to do its work and make decisions. Suporting-Family-Councils.pdfBy-lawsPolicies
27By-Laws Written guidelines by which the group operates. Name Purpose/ Mission StatementMembership (criteria)Officers and committees (tiles, responsibilities, terms)Meetings (when and how is conducted)Elections (nomination, procedures)Rules of Order (raise hand, talking stick)Future AmendmentsEach council unique, tailor them to fitMake sure language clear and simplePurpose ensure council knows where it is heading and it is a democraticand fair way to make decisions.Infrastructure in place-ombudsman can help with thisEach article should be concerned with only one ideaWhen thinking of structure think of size, style and needs of the facilityBe amended in futureDraft given to council to look overDistribute, refer oftenDon’t put them awayPost
28Policies Communication with administrator/staff Communication of concerns to administrator/ staffCommunication with other family membersCommunication with residentsHandling individual concerns
29Problem SolvingWill this help improve resident care and residents’ lives?Narrow down and pinpoint the specific problemsLearning current policy on a facility issueLearning what laws and regulations requireThe role of the council is not just to identify problems, but to offer ideas and suggestions about how to resolve them.Identify problemDevelop concrete and factual statement of the problemIdentify the result the council is seekingThink about causesIdentify possible solutionsIdentify possible obstacles and ways around them.Might raise broad concerns ex. Complaints about food, probed for more information-revealed that problem is over cooked vegetables, cold oatmeal, and hard butter.When the problem starts out vague and elusive, it is difficult to find a solution. Once primary issue identified it is usually easier to find workable solution.5 Basic Steps to Problem SolvingIdentify the problem or concernDecide on a solution-possible solutions, recommended solutionImplement the plan of action-solutionEvaluate results-recommendation implemented, action by administrationSeek outside advocacy-solution not agreed upon or no action taken by administration, outside assistance may be necessaryImage 7: Problem-Solution-Magnifying-Glass jpg
30PromotingMany family councils have active participation of 10% of families of the residents.FlyerNewsletterMembership FormPermission to ContactGreeter in lobbyMailingsStaffWhat to say?…………….Meet with administratorNot run by facilityBenefitsOmbudsman involvementConcerns or ObjectionsWhat the council will need (liaison, private space, support, respond and listen to concerns)Ask staff liaison if they know family members to connect you with families (release phone number and speaking directly)Do a presentation and ask if any interested-residents rightsCan meet you outside facilityWhat to say to initial family members..Explain what council isPoint out benefits to them and their love onesLet them know they were I identified due to their active involvement and leadership skillsAsk if they would be willing to serve on a steering committee to organize a family council introductory meeting in the facilityIf they agree…Obtain contact infoProvide them with the resourcesSet up first steering committee to plan introductory meetingIf not…..Know any families that might be interestedEncourage them to participate in the family council as a memberGive out fliers to family members if family members interested in family councilSponsor activity-cookout or teaWelcome letterButtons-ask me about our family councilContact person and numberWelcome table-hand out materialsBadges to wear so residents can identify them if they have issues or concernsAsk staff if they know of anyone interested-nurse, social workers, and other staffCouncil members contact information included in monthly billingSponsor activity cookout or teaGive little card to other family membersImage 8 megaphone.png
31Ombudsman Role Coach Educator/ Trainer Connector Mediator Yes! Encouragement!(Yoga instructor from Couples Retreat Movie)CoachEducator/ TrainerConnectorMediatorCoach-provide encouragement and support to councilMotivate and give successful stories of other facilities.Inspire to keep up good workSuggest strategies, techniques, and approachesMotivate staffProvide suggestionsRemind about professional demeanorPoint out accomplishmentsCome up with new ideasEducator /TrainerImportant Info and KnowledgeEducate staff- “Did You Know” included with staff checks and employee newsletters, employee bulletin boards about councilsTrain council on topicsEx. CommunicationRunning effective meetingProblem Solving ProcessGoal Setting/ PrioritizingRecruitmentEffective LeadershipNegotiation TechniquesAssertiveness TechniquesLegislative ActionConnectorStaff, members, resources in community, other councils, residents, families, speakers/ trainers, long-term care system networkMediatorGo-b/w prompt and communication with facility staff and members
32Communication/ Meeting RespectTrust, Care, and ConcernGood ListenerObservationGive/ Receive/ Share InformationConfidentialityRecognitionPatienceSense of HumorCriticismMistakesLaugh at SelfPeople’s Well-BeingAdmit not knowingAlternativesPraise(Retrieved from Resident/Family Council folder in Ombudsman Office)Do I Know How to Work with People?A two-way communication process is essential in the establishment of working relationships. Often, with the helping process, non-verbal communication is equally as important as verbal communication. You will establish positive relationships with people when you show:1.Respect for the dignity of the person.2.Trust in the individual.3.Care and concern for people.4.Readiness to share purpose of visit or conversation.5.Good listening habits.6.Good techniques of observation.7.Willingness to give requested information or help.8.Willingness to request needed information or help.9.Willingness to share information on a realistic and truthful basis about what can’t be done.10.Assurance of confidentiality.11.Recognition of the strengths of a person.12.Patience.13.A sense of humor.14.Ability to take criticism.15.Capacity for admission of mistakes.16.Ability to laugh at one’s self.17.Capacity for saying, “I don’t know, but I’ll try to find out”-like in ombudsman program18.Regard for people’s physical and emotional well-being.19.Ability to offer alternatives.20.Readiness to give praise whenever appropriate.
33Communication/ Processing Concerns Officers having regular monthly meeting with administrator/ keep members informed (make an appointment in advance).Allow reasonable time for complaint to be resolved.Hear constructive input/ get all facts.Address small concerns before they become major problems.Work toward meaningful change, avoid unreasonable demands.Present ideas in a non-threatening way (friendly, but firm).Avoid generalities and exaggerations.Show appreciation.Facility clear on the purposes and rights of your council / value of cooperation.(Retrieved from Resident/Family Council folder in Ombudsman Office)Stress to members of handling common concerns, not individual problems, ombudsman let family/ resident know you are available for problems not shared by others.Encourage members to prioritize their concernsNegotiation-(Family Guide to Effective Family Councils page 65)New administrator
34Obstacles FEAR OF RETALIATION LACK OF INTEREST LACK OF TIME LACK OF INFORMATIONLACK OF SUPPORT FROM THE FACILITYDISCOURAGED EASILYLOW PARTICIPATIONNOT WANT LEADERSHIP ROLEWhat to do on chart (page 51 Family Guide to Effective Family Council)Time-Begin and end meetings on timeShare leadership responsibilities and delegate small tasks toMembersSchedule meetings at times that are convenientInterest-Family members will respond to a personalinvitation more readily than a letter or flier.Explain the rights of family councilsconcept of a family council in a positive wayRetaliation-meeting off-sitePresented as groupInformation-unaware how council works or how they can help themNot willing to commit time to the meetingStaff not considering important and respectingOfficers, others can substitute for themuse ombudsmanAsk facility about guest speakersConsumer voiceSupport-few members meet with management, introduce councilCommunicate constantly and with positive attitudeKnow rightsSeek assistance from outside agenciesGet follow up in writing also with verbal communicationStaff not run council, but offer tools, and ombudsman available to assist with trainingLow participation-resident bedfast, mentally impaired, unable or unwilling to attend (make sure residents with wheelchairs have staff available for assistance)People dieAddress crisis issues, things ok not as concernedFamily barely has time to see residents
35Benefits In-service training Improve staffing assignments and stopped staff rotationSurvey, improvements to facilityBetter service to residents (food, daily care, bathing time, activities, etc...)Grievance Forms at nurses stationStaff appreciation and educational programsBilling/ Delivery issue with pharmacyCouncil put in admission packetOpen lines of communication(Family Guide to Effective Family Councils page 61)Example of other councils changesIncrease staff satisfaction- concerns expressed to whichever staff member available and may or may not get acted upon with council concerns can be addressed more efficiently concerns communicated to advisor to address staff reducing burden on direct care staff.
36ResourcesHow to Organize and Direct an Effective Resident Council: A Technical Assistance Manual of the Missouri Long-Term Care Ombudsman Program. Emmelene W. Kerr. Missouri Long-Term Care Ombudsman Program. This manual covers all aspects of council work – from forming a new council to improving an existing council Written by a former coordinator in the Missouri Ombudsman Program who draws upon many years of ombudsman experience with resident councils, ombudsmen will find straight forward information and tips to use when assisting in the formation or strengthening of a resident council. Family Guide to Effective Family Councils Prepared by Robyn Grant for The Legal Assistance Foundation of Metropolitan Chicago and the Evanston Commission on Aging Additional copies: Kathy Swanson c/o Legal Assistance Foundation of Metropolitan Chicago 111 W. Jackson Boulevard 3rd floor Chicago, IL Long Term Care Ombudsman Guide to Developing and Supporting Family Councils Prepared by Robyn Grant for The Legal Assistance Foundation of Metropolitan Chicago 111 W. Jackson Boulevard 3rd floor Chicago, IL Parliamentary Charts and Handouts