Communication with Clients and Family
Jeannine LeCompte, Compliance Research Specialist
Although the communications prerequisites as detailed by Section 483.95 (a) of CMS’s “Requirements for Long-Term Care Facilities” do not specify the exact nature of communications between staff and clients and their families, it is worthwhile to consider the essential points of such communication as part of a compliance program.
Staff should always be respectful, and pose requests as suggestions to make everyone’s life easier and safer, rather than condescendingly insisting that only the resident is at risk because of potential clumsiness.
If a resident has a speech impediment, it is important to give them the fullest attention, and not to interrupt or finish their sentences.
The more frequent the contact and communication between a facility and the families of residents, the easier it is for families to be told unwelcome news about health issues.
The communication used with families is vital to building trust. Experience has shown that family members are more likely to resort to legal action over incidents (falls, pressure wounds, cold food, lost clothing, etc.) if they do not have an established and trusted communication line with the facility.
The information given to a family must be honest and in language they can understand, not filled with medical terms they do not know, which can give the impression of detachment and lack of caring.
No one wants to be involved in legal complications, so careful thought must be given to all communications with family regarding incidents or resident health.
Don’t lie, but it is also important not to make incriminating statements. The facts must speak for themselves. Regret that an incident has taken place is perfectly in order, but not in a way that places blame on the facility or a staff member.
Body language is equally important when communicating with family. Crossed arms, bored expressions, and general distraction can be incorrectly interpreted as lack of concern or interest in a resident.
When communicating in person, staff must be conscious of their body language and give their full attention to the matter at hand.
No matter how heated a family member may become, it is important that staff always remain professional and courteous. A calm demeanor is the only way to deal with an angry member of the public.
Staff should be aware of cultural differences. Some cultures avoid eye contact, some are loud and boisterous, others expect communication will be directed to the acknowledged family leader. Respect must be shown to each family’s distinct customs, without rendering judgement based on these differences.
Finally, all important communication should be timely, as any delay can worsen a family’s perception of the care being provided. It is vital to bring up any safety issues as soon as possible.
Following these basic guidelines in interacting with clients and their families can provide a better service to the public—and reduce institutional exposure in the event of a dispute.
