The First of a Three-Part Series
(Part Two: How to Run Effective Resident Council Meetings; Part Three: For Residents: Reclaiming the Resident Council)
*If you don’t know what a Resident Council Meeting is, see the Prequel, posted earlier today.
I must confess, the only time I’ve actually been to a Resident Council Meeting was when I was invited to speak about psychological services. Aside from invitees, the only people allowed at the meetings are the residents and the staff person in charge of running the group. My information about them comes from the residents themselves and sometimes from the staff leader, who is often the Recreation or Social Work Director. With one notable exception, the consensus on Resident Council Meetings is that they are a sham.
Why are the meetings a sham? There are two answers to that question. The first has to do with group dynamics. Often, the residents attending the meetings are the “regulars” who attend all activities. They tend to be the most accommodating residents and the ones who are generally satisfied with nursing home life, so their observations about the nursing home are less often geared toward change. Members of the group may have varying levels of dementia, and varying levels of familiarity with organizational dynamics. A well-attended Resident Council Meeting can absorb confused or off-topic residents, but frequently there is not enough of a critical mass to do so. Astute, alert new residents attending the meetings for the first few times encounter an ineffective group and quickly decide not to continue. Contributing to the ineffectiveness of the meetings is the fact that the staff person assigned to run the meetings generally doesn’t have true support from the administration, so the complaints and suggestions of the group are not met with a resolution. This creates a disheartened leader and a demoralized, depressed, and sometimes acting-out resident population.
Why are the meetings a sham? The second answer is that the administration doesn’t realize and/or know how to utilize the potential power and value of the Resident Council Meetings. The residents are the eyes and ears of the nursing home. They see things the administration can’t possibly know about, but should. The residents have years of experience in jobs, families, and society. They know a thing or two about how things work and how they can be fixed. The current cohort of residents is, generally speaking, a congenial bunch, not accustomed to bucking the system. The upcoming cohort of residents, the first of the Baby Boomers, is used to promoting change, and they will. Look around facilities now, and the early arrivers can be seen, angry, demanding, and knocking on the doors of the administrators. They can see things aren’t as they should be, or could be. The administration can harness their experience and fervor for change by offering them an avenue to discuss concerns and to be part of the treatment team, not just in their own care, but in the overall quality of life offered at the facility. Empowering the residents leads to happier, more satisfied residents, families, and staff, and to a better nursing home.
13 thoughts on “Why Most Resident Council Meetings in Nursing Homes Are a Sham”
Perhaps it is difficult for me to be objective about this topic considering I am one of Recreation Directors who has been appointed the liason between the Council and facility Administration. Please note, Resident Councils are (at least in theory) independently functioning groups. A staff member may (and usually is) appointed facilitator/liason by the Council. As you stated, all others may attend by invitation only. Your statement regarding group dynamics of the Resident Council is accurate. However, I find it offensive that you use the word "sham" to make your point. I see myself as a strong resident advocate, but being a Director also puts me on the other side of the fence. I encourage all residents to resolve issues, complaints etc. prior to attending the Council meeting. No one should be waiting for a facility meeting to get a problem solved. Meetings should be forum for improving life in the facility, resolving problem trends. Unfortunately, many residents, even representatives of the Resident Council are unable to differentiate between the two. Empowering the residents both individually and as a group is important, however, there are ways to do this without the formation of an angry, rabble-rousing group. I believe good Administrators, too, operate on both sides of the fence and that change is coming, despite the systemic problems with our health care system.
I do not feel Resident Council Meetings are a sham, when facilitated properly they give the opportunity for empowering residents with diverse abilities and disabilities.
I've seen many Resident meetings end with disappointment or anger because nothing was resolved. The admin person who is at the meeting always had to say something along the lines of "I'm sorry, you'd have to take that issue to the Director." The Director was seldom available or only took a few minutes to listen then reply with a general statement such as "I'll see what I can do." Then the matter would eventually 'go away' due to lack of empowerment or disdain.
Very seldom was anything actually accomplished.
Since it is impossible for most staff facilitators to be able to answer all questions or concerns that arise, many facilities require involved Department Heads to respond to the Resident Council regarding the issue at hand either in writing or in person. This procedure insures ongoing communication and hopefully, resolution to problems in a timely manner. Of course, many issues may be complicated and involve more systemic problems that can be addressed by a simple response or "fix" but this process keeps residents in the loop and reduces frustration.
As a resident, I've attended several Resident Council Meetings and left feeling like I hadn't contributed anything and that nothing had been accomplished. I felt the group leader could have done more to encourage new group members to say something, whether it was good, bad, or indifferent. The group was dominated by several of the long-time members.
The group leader/facilitator can make a huge difference in both group satisfaction and the effectiveness of the Council.
Thanks, Sue, Senior Safari, and Anonymous, for your comments. I'm glad to see this post is generating discussion, both here and on the Long Term Living Magazine site.
I do believe the players involved are trying to do their best, from the residents involved, to the staff leaders, to the administrators of the facilities. It's the systemic problems that get in the way, and which I'll address in upcoming posts. These include group dynamics and lack of a facility-wide understanding of and support for what the meetings can accomplish.
The sham, and shame, is that most Resident Council Meetings have yet to realize their potential to be a powerful, positive force for improvement in nursing home life.
I want to revise our Constitution and By-Laws. Anyone know of sample texts I can make use of?
St Peter Manor has about 260 residents (mostly over 62 yrs of age)
Anonymous, I just tried Googling "nursing home bylaws" and came up with some leads. You could also try contacting some nursing home organizations listed in my sidebar, such as the American Association of Homes and Services for the Aging or the Coalition of the Institutionalized Aged and Disabled.
In reply to Anonymous and other interested parties, I have a copy or our Resident Council Bylaws in MS Word format. These bylaws are for an almost autonomous council and include various committees. Someone could use this file to revise to their individual circumstances. Just let me know how to include a copy of the file. Thanks.
Anonymous, I'm sure readers would find that helpful. I'm not sure how to add a copy of the file, but if you wouldn't mind emailing it to me via the Contact Me button, then those who are interested in it can email me and I'll send it to them. Thanks!
In my nursing home it is very difficult to get residents who are cognitively intact to participate in resident council. Our long term population functions at a very low level and are unable to participate much. When they do attend they say very little and rarely if ever complain. Short term rehab residents aren’t interested due to their focus on discharge. In my 30 yr career this has changed very little. It is frustrating for me, but doesn’t seem to concern the residents.
Activity Director, that’s been my experience too. As a psychologist talking to individual residents, though, I often hear complaints about the procedures in the facility that would be perfect to bring up in the resident council meetings if the meetings were effective. Addressing the issues would help the facility improve care and resident satisfaction.