How can I deal with problems with the residential care facility where my loved ones live?

By Amy Goyer

When loved ones live in residential care facilities, a crucial part of your caregiving role is advocating for their quality of care. Disagreements with staff may arise. Some issues are simple and quickly resolved; other problems are more complex and may take longer. Building positive relationships with staff can be extremely helpful. Always remember, though, that your top priority is to advocate for your loved ones, not to be best friends with the staff. So don’t hesitate to call attention to unacceptable care or conditions at the facility.

I had many complaints when my grandparents and parents were living in facilities. I have also worked in facilities. So, I’ve learned a lot about how to deal with difficult situations. Complaints may range from inconveniences, frustrations, and attitude problems to very serious issues like mismanagement of medications, abuse, or neglect. Regardless of the problem, don’t be afraid to bring it up and work toward a solution. Here are tips to help navigate these challenges.

Visit and monitor care very frequently: It is vital that a family member or paid helper visit loved ones in facilities very often. I recommend visiting every day if possible. Problems can arise and get out of control so quickly for older adults; it’s crucial that someone is paying close attention. Additionally, in my experience, people get better care when the staff knows their family could show up at any moment, so vary the times of your visits and make some of them unscheduled.

Provide clear information: If a problem arises, document your concerns, including times/dates and precisely what happened (or didn’t happen). Explain exactly how your expectations for your loved ones’ care are unmet. Take photos and videos, especially if your complaint involves abuse or neglect, as they are compelling and serve as evidence if the problem escalates.

Propose solutions: With a collaborative spirit, propose acceptable solutions or approaches to resolve your complaint. Remember that compromise may be necessary in terms of approaches, but compromising your loved ones’ quality of care is never acceptable. Remember that many staff want to do a good job. If they see you as part of their team bringing up possible solutions rather than as an adversary, they are more likely to work with you.

Keep your emotions under control: This can be difficult when you are, rightfully, very upset. Do not hesitate to express the strength of your feelings about the situation with your words and firm countenance. Do keep your outward emotions in check. Yelling, accusations, and sentences that start with “you” can cause staff to be defensive, making a resolution much harder. Instead of saying, “You are not taking good care of my loved one.” Try using “I” statements, such as, “I am extremely concerned and upset about the pressure sores my loved one has developed.”

Go up the chain of command: First, try to work out a solution collaboratively with direct care workers because that could provide the most straightforward resolution. If that doesn’t work, then talk with the director of nursing, facility doctor, social worker, or other staff in charge of your loved ones’ care. If you still do not have an acceptable solution, go directly to the facility administrator.

There are times when you may opt to go directly to the administrator; for example, if the complaint is exceptionally egregious, it has happened repeatedly, or if lower-level staff refuse to work with you. Remember that good facilities also have a family council for family caregivers of residents, and that’s another good place to talk about your complaint. If the families present a united front, it may have more weight with staff.

Contact the long-term care ombudsman: If your efforts to work with facility staff have not been successful, contact your long-term care ombudsman office. Ombudsman offices in all 50 states, including the District of Columbia, Puerto Rico, and Guam, are focused on residents’ rights, safety, health, welfare, and quality of life. They will listen to your complaints and help advocate for residents. They can visit the facility, investigate the circumstances, and help you work to resolve them. They are particularly vested in addressing neglect and abuse. The ombudsman can also help you decide if you need an attorney if the facility is not willing to work with them toward a resolution. Find your long-term care ombudsman office using the search tool provided by the National Consumer Voice for Long-Term Care, or you can use the Eldercare Locator online or call 1-800-677-1116.

Follow up and reinforce a good response: Monitor your loved ones’ care to see if the facility follows up on agreed-upon changes. While certain changes may take time and compromise, compromising your loved ones’ safety is never acceptable. As changes are made, be sure to acknowledge the improvements and continue to build relationships with staff.

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Amy Goyer is a nationally known caregiving expert and author of Juggling Life, Work, and Caregiving. A passionate champion for caregivers, she has also been one her entire adult life, caring for her grandparents, parents, sister, and others. Connect with Amy on Facebook, Twitter, and LinkedIn.