Key questions we are addressing in the project are:
What have we found out so far
Since July, small discussion groups have taken place with Villa Maria management, staff, and friends who have residents living at the facility. Individual interviews were carried out with residents. A wide range of issues were raised across the different groups. Four main areas were identified as key themes:
· Communication
Good communication with staff is critical to families' experience of visiting. Families want to know who to approach about issues of concern and they want to feel comfortable asking questions.
· Getting the best quality of care and quality of life possible for residents
Families, staff and management want to see residents receiving the best quality of care and enjoying the best quality of life possible. Involvement in care planning and care plan reviews is an important starting point.
· Providing the right support and encouragement to families
Families need mechanisms for supporting each other. Support needs will be different at different stages of their association with Villa Maria. In some cases families need help to find the right level of visiting, others need encouragement to visit.
· Information and Education
Families need information about how the Centre operates, its policies and procedures. Families also want information on ageing and disease processes to better understand their relatives' changes in health status and behaviour.
Issues raised under each of these areas ranged from the relatively simple to address such as easier identification of staff and families, to the more complex. The more complex will involve policy development to reorient the culture of the organisation to one that is more inclusive of families and their needs.
Villa Maria management identified the importance of staff training to achieve this. At its most fundamental level this involves recognising that it is should be part of the everyday routine and duty of care for staff to talk to families. Families need to be included in care planning right from the start.
Staff recognised the invaluable contribution families make to residents' quality of life. As one staff member put it: We can do everything else but we can't substitute for families. Staff commented on the value of family involvement to their job satisfaction, resident's quality of life and the overall mood and life of the Centre. All agreed that family and friends including children, and visits by the family dog, gives everybody 'a lift'.
The difficult side of family involvement from staff perspective is the feeling of being on the defensive, and of families not trusting staff. Recognising the tension that can exist between some families and some staff, one staff member commented: getting to know families is very important - then we can enjoy the 'fun' side of families.
Families on the other hand recognised and appreciated the very difficult job that staff carry out and high quality care their relatives received at the Centre. When we ask questions, we don't want to feel as if we are nagging. Families wanted to know how to raise issues with staff, how to ask questions and who to ask.
What will be the outcome of the project?
The immediate outcome for Villa Maria is the development of a strategic plan which identifies specific issues that need to be addressed, proposed actions and timelines. The plan will feed into the Centre's overall policy development work for accreditation against the Residential Aged Care Standards in December 2000. The Family Participation Reference Group constituting family members, staff, management, residents and a representative from Carer's Association will oversee the development and the implementation of the Strategic Plan. The project will also culminate in an overall report published and disseminated by the Victorian Department of Human Services.
If there are families and carers with relatives in other residential Aged Care Facilities that are addressing this issue through the implementation of specific policies and procedures we would be very interested to hear from you. We are keen to hear of developments in other organisations.
Please contact Heather Russell Lincoln Gerontology Centre 03 9479 5826.
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