Building a relationship with a professional care community

Although most Americans choose to care for their loved ones at home, many do not or cannot, but choose to entrust the task to an Assisted Living Facility (ALF), a Memory Care Community, or a Skilled Nursing Environment. While these differ in cost and services, for the sake of our discussion we will use the term ALF.

There is a lot at stake when you choose placement for a loved one. The cost is significant, and you have essentially placed your loved one in the hands of strangers. The purpose of this column is to highlight some ways to build a relationship of respect and mutual trust with the ALF you have chosen.

• Read the contract and take it seriously – You will be presented a contract that may be as long as 60 pages. Read it and ask questions about anything you do not understand. Take it to an attorney if you feel you do not understand it. This will lay the foundation for a relationship of mutual respect since ALF management will see that you do not take your decision lightly.
• Your initial dialogue with when you are making a decision about placement will be with a Marketing representative. This is the time you should ask any questions you have about the contract, and it is also the time when you should make your expectations known about what your person needs and how you expect him/her to be cared for. This will lay the ground work for your relationship with the ALF’s top management.
• Once you have selected your loved one’s new home, establish a relationship with is top management. Insist on meeting the Executive Director, and let him/her know that you intend to build a productive and team-based relationship.
• Don’t be demanding or pushy. Be friendly, polite, and business-like. Again, you are laying the groundwork for a successful experience for your loved one.
• Prior to your initial meeting with the E.D., be sure you understand the Patient’s Bill of Rights and Responsibilities? It should be in your contract, and law requires the ALF to post it in public view.
• Create a history of your loved one. This can be a ring-binder containing information about their career, their family, their religion, their favorite things, etc. It should include photographs and relevant news clippings. Present this binder to the E.D. on the occasion of your first meeting and let him/her know that the individuals in charge of your loved one’s care are expected to know what it contains. Again, be friendly, humble, and businesslike. Don’t be demanding or pushy. Your goal is to build mutual respect within your team.
• Ask the E.D. how often the ALF routinely reviews and updates a patient’s Care Plan, or what kind of events or problems might trigger a review of the Care Plan. Emphasize again that you want your loved one to be considered a unique person with a unique history and unique needs, not just “Mr. Room 305.” Let it be known – again, in a businesslike manner – that you expect to be involved in meetings where the Care Plan is reviewed and updated. Keep emphasizing that your loved one’s care will be a partnership between you and the ALF’s management.
• Do not interfere with the subordinate care staff. During your visits, be friendly, polite, and reinforce or praise their efforts when appropriate. But if you see something that concerns you, do not confront the care staff involved. Take your concerns to the E.D. who may encourage you to dialogue with the Director of Nursing. But do not involve yourself in the chain-of-command below the management level.

What if your best efforts do not get positive results? You have the option to file a complaint with the Florida Agency for Health Care Administration, or you can ask to describe your concerns to an ombudsman who serves under the Florida Department of Elder Affairs.

But, let us emphasize again that Job One is to build a productive and mutually respectful relationship with your chosen ALF. If you resort to AHCA or Elder Affairs, that relationship is probably already broken, or at least it will be! This is the course of last resort and should never be considered until you stand convinced that your best negotiating and interpersonal skills have failed.

As you work to establish a productive relationship with your chosen ALF, keep my favorite slogan in mind: “We all deserve the best!”

Until next time remember: “We all deserve the Best”

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