Bulletin

Issue: April 2006

News

Nursing home dilemma for families and staff

It happens thousands of times a year. The family arranges for mum or dad, elderly and frail, to enter a nursing home where qualified staff will provide constant care.

While this brings relief to most families, it also gives rise to an unforeseen dilemma. What is the family’s new role in the care of their loved one now under the full-time-care of others?

To what extent should they get involved, offer advice or give directions to staff, or should they now leave the job to the ‘experts’?

Very importantly, should facilities be more ‘family friendly’?

La Trobe University specialist in aged care nursing, Dr Michael Bauer, a lecturer in the University’s School of Nursing, sought answers to these delicate questions in research for his PhD thesis.

Dr Bauer concluded that the problem would remain difficult until nursing homes develop better practices and programs to respond appropriately to relatives’ needs.

He said his research was based on the premise that it was sound nursing philosophy for nursing homes to work collaboratively with residents’ relatives. ‘We know that many families – but certainly not all – want to continue to be involved in some way once their loved one was in a nursing home,’ Dr Bauer said.

‘In addition, the Commonwealth Government acknowledges the benefits of family assistance and advocates it in its nursing home standards.

‘The quality of the experience, however, is frequently fraught with problems for both the family and staff.

‘Little research has focused on the nature of family involvement in nursing homes from the perspective of nursing home staff.’

To address this, Dr Bauer interviewed 30 staff members of eight nursing homes, large and small, public and private, in Melbourne and rural Victoria.

For many staff, family help was highly valued and arguably indispensable in maintaining high standards of care. Family members who visited regularly were respected for their dedication, and those who assisted staff with aspects of physical, emotional and social care were considered especially favourably.

However, the research found that many nursing home staff members regard the ‘assistance’ of the family of residents as a double-edged sword. They recognise that family have an important role to play and incorporate family in their activities – but only up to a point.

Families can easily become an annoyance to staff if they overstep the boundaries. Some families can cause staff a lot of grief by being seen as disruptive.

Many staff would like to control the family as they control the environment. The current nursing home model of care is often task-focused – the emphasis is on getting the work done and sometimes the family is seen as getting in the way of this.

While managerial staff is aware of the value of the family, staff at the coal face – those engaged in day-to-day care – are often not well informed of the needs of families. They are not well equipped to deal with families because they are too focused on schedules and routines and they have limited negotiation, or conflict resolution skills.