“What if everything I’ve been reading in the news about long-term care is true, and they don’t take good care of my mom?”

“What if everything I’ve been reading in the news about long-term care is true, and they don’t take good care of my mom?”

This is the concern families have when they’re faced with the tough decision of moving their loved one into long-term care.

Families are coming in, before even meeting you, with skepticism, doubt, anxiety and fear about the long-term care system and capacity. They already have a narrative; limiting beliefs and assumptions about all the things that could go wrong with this new and unknown arrangement. This means you’re starting this key connection in what I call a Relational Deficit.

Now mix in the guilt and grief families feel when they recognize that long-term care is the only option left, even though friends and families are asking why they are ‘doing this’ to their loved one (“surely you can continue to take care of them at home, can’t you?”).

The admission day, as overwhelming and heartbreaking as it is, also represents a shift in identity for the family. But they haven’t been given a new job description to outline this shift, and their new role and responsibilities.

Families are coming in with a lack of knowledge, are feeling overwhelmed with a myriad of emotions, and likely don’t even realize how much their role is about to change.

I’ve never had a long-term care staff person look at me in shock when I say “Most if not all your families really don’t want to be here. No one typically says when my loved one grows old or can’t take care of themselves, I WANT to put them in a long-term care home with a bunch of other people they don’t even know.”

That by no means diminishes the value and the love that you provide to your residents and their families. It’s just that you’re starting the relationship with people who would rather not have to NEED you and your team in long-term are.

On the flip side, care team members also have their own narrative about families. They’ve been burned before with “demanding, passionate, unreasonable, think we can perform miracles” families so they worry and wonder what the new family is going to be like. Will they be pleasant to work with…or a pain in the neck?

Both families and staff are contributing to this Relational Deficit.

The good news is, since you are a contributor to the deficit, you can also shift your perspective and actions. You can start the relationship RIGHT from the start by making deposits into your relational bank account and build trust, respect, and partnership with your families. Here’s three ways to start.

1. Validate your families and their feelings.

This is a huge, heartbreaking and life changing day for them. Take a few moments to ask them how they’re doing, how they’re feeling. Let them know what they’re feeling is normal. For most families, this is likely their first and maybe only time moving a loved one into long-term care. Validating their emotions and assuring them they’re in good hands, you’ve GOT them, will help ease their anxiety and build connection. This will also help assure them about their decision to move their loved one into your home.

2. Educate your families.

Families don’t know what they don’t know about LTC, and it’s not their fault. LTC is a complex system and until you need it, there’s no need to know about it. What they think they know is usually influenced by media reports, and they form beliefs and assumptions that can lead to unmet expectations, disappointment, and complaints. In my latest book “Now What? Managing the Emotional Journey of Long Term Care for Families” Chapter 15 has 20 common misconceptions that can help avoid those pitfalls of misunderstanding and frustration. If you’ve ever had a family member say “but I thought you had 24/7 one on one care” I address that with misconception #1. Educating your families builds their confidence in you and your team, and within themselves in their new role as partner in care.

3. Relate – build a relational (versus transactional) connection with them.

You probably know that LTC can get caught up in the ‘task orientation’ with all the checkboxes that must be completed. There’s a lot of clinical data that needs to be gathered. For you and your team, it’s another admission during an already busy day. For your families, this may be one of their worst days that’s life changing. They will likely remember how they feel on admission day for the rest of their life. Be intentional with relating and connecting with them on a human level. You CAN take a few moments before meeting your new family to take a breath, reset, and commit to being a present and a calm, reassuring partner in care.


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