Family Engagement In Care Bolsters Quality

Family members are a crucial part of a team approach to patient care. When a family member is serving in a health care proxy role it is critically important for care providers to work collaboratively with family members. A systems approach to family collaboration is one in which the care provider organization as a whole and each of its components, such as administration, caregivers (providing direct care in terms of activities, housekeeping, and therapy), take an interdependent approach to caregiving.

A care provider that implements a systems approach to family collaboration examines the overall structures, patterns, and cycles in systems, rather than seeing only specific events in the system. Focusing on the entire system can help care provider leaders identify solutions that address as many problems as possible in the system.

The Family’s Viewpoint
Family members see only the care provided during the part of the day they are present. While this may seem obvious, caregivers working eight or more hours a day sometimes fail to appreciate that a family member’s impression may be based on the observations of only a few moments of care. Viewing this from a systems perspective, what a person sees today at 1:00 p.m. is all he or she can know about the care provider organization as a whole. This makes every moment important, but it also helps staff understand why it is sometimes hard for family members to believe their mother or father was cheerful all week, when what they see today does not support that claim.

A systems approach means that care providers provide families with specific information about what takes place when they were not present. Documenting and sharing specific anecdotes about events, attitudes, physical and emotional changes that take place at times when they are not there.

It is also important to listen to family members questions and concerns and address these in care notes and communications. This can be very reassuring for families, especially when they feel their views have been heard. It is also helpful to understand that family members are going through their own struggles. Adjusting to the move of a mother, father, husband, wife, or other loved one into long term care is a major life transition. In meeting the challenge of appreciating a family member’s viewpoint, it is helpful to understand that the individual is someone who cares a great deal. Developing a connection with him or her will help to support the overall care.

Think Holistically
In addition to seeing only moments of the full range of care, it is important to understand that family members who visit do not usually think separately about the different care venues. For example, family members see individual caregivers, administrative staff (Human Resources, Care Managers, care team coordinators/schedulers, and agency leadership) as part of the whole organization, and the actions of one staff member in one area will affect the family member’s perception of the entire organization.

Thinking of the whole organization as part and parcel of the solution is key to successful collaboration with family members.

Mission Should Reflect Culture
Midwest Home Care has a stated vision or mission for how we expect to support our clients and their family members - “We work with our families to develop a personalized plan of care to ensure they receive comprehensive, compassionate care that fits their needs.”

We strive to fulfill this mission by welcoming family members to be engaged with their loved one’s care. All members of the Midwest Home Care organization impact the family members’ experience as does the thoroughness of staff in carrying out care plans, completeness of care notes and professionalism demonstrated by all personnel.

All of these things contribute to the family members’ positive feelings about the care we provide their loved one. A systems perspective suggests that supporting a culture that is inclusive, engaged, communicative, and upbeat will be most likely to support the best patient care and the best community for all involved.

A Midwest Home Care Adaptation of: 
A systems approach to working with family members can improve resident care and boost customer satisfaction
by Jeannette L. Gerzon, EdD

Care: A full-Circle Experience

I am not a huge part of your Team, but I think my little contribution, with my client on Sunday mornings, has made a huge different in this man's life!! I don't mean to be patting myself on my back at all (!) ....I just love to share that his demeanor has turned around 180 degrees since I first started - I know of course that it is a combination of things...with all the wonderful caretakers he has...and that he has been healing and gaining strength since his Fall two summers ago....but just his personality...his love of life..he looks so forward to our chats (and from the sounds of it reading the notes he keeps personally – like a diary - he enjoys all of the Caretakers very much!) He just has a whole new positive attitude!! I love it!!! He loves to talk (!) and share not only historical experiences - he has a wealth of knowledge about history, etc. he loves to reminisce and share his Life Stories....and he is totally cognitively engaged in "today"....reading the newspaper cover to cover...a trait we share...he reads so much....when I first started with this client he was kind of"down" not happy....would always seem sad.....didn't have much to talk about.....and he would always talk about how awful his life is....how lonely he was....Now he is cheerful - laughs -

His passion is his garden and with his physical limitations he had not been able to accomplish much last year. This year - his yard worker fellow has helped him to plant - he goes out in the yard - loves to sit on his nice patio - and oversee the operations (!) ....on Father's Day we had a great morning together - I watered and I watered...and he watched and directed me from his Perch - he was so happy - smiling - very talkative - and his daughter was here visiting and he seemed very Proud to introduce me to her, and we had a lovely time together - he just is a new man!!!!! She said, if his new spirit has anything to do with the Care he gets from Midwest Home Care - then your Organization should get a five star rating!!!

That is what I love about doing home care. That is the model I had with my Mom - the caregivers I had working with me in caring for my Mom - all became friends of me/Mom, our family. They sat together with me at Mom's funeral and gave a Eulogy speech about their anecdotes. I know I only touch a small piece of the Families that are part of Midwest - but my experience with this client and giving him a "will to look forward to each week" has been inspiring. He just realizes that I/we are invested in him - care about him - are interested in him as a 90 year old person - not just push him aside and not honor his intellect, etc....and to me that is what Caring for the Elderly and the life circle is all about.

Ann D. (Caregiver for Midwest Home Care)

Last week Don Malchow left Madison bound for St. Louis with goal of fundraising for Parkinson's research. This week he arrived in St. Louis, met his fundraising goal, and in his own way showed us all the importance of family. His Dad has been living with Parkinson's since 2006. Don's ride honors his Dad and reminds us all of the importance of family.