The lives of long-term care community residents are heavily controlled by laws, rules, and policies set by the government and the nursing facility. Residents often have to undergo significant lifestyle changes due to health problems and the close quarters within which residents live. These changes and the rules of care facilities can make nursing facility residents feel like their opinions and preferences do not matter. Many residents struggle with adapting to life in a care community despite the best efforts of the staff and leadership of the community.
Earlier this month we coordinated an effort to have Governor Gary Herbert declare October as National Long-Term Residents Rights Month. We are focused in particular on the right of residents to form resident councils in their communities because we believe in the power of democracy to create consensus, build community, and solve problems.
We all want an active part in life and the chance to influence decisions which affect us – long-term care community residents are no different. A resident council gives them that chance.
A Resident Council is an independent, organized group of people living in a long-term care facility who meet on a regular basis to discuss concerns, develop suggestions, and plan activities. If the nursing facility does not already have a resident council, it must try to establish one.
Resident councils generally have four main goals:
- To offer suggestions about the community’s policies and procedures.
- To plan resident activities and promote community culture.
- To provide and organize activities designed to educate or inform the community.
- To define activities that will improve the quality of life in the community.
These are only a few of the traditional goals of resident councils and it is important to remember that each resident council defines its role differently. Resident councils are a powerful way to harness the power of democracy to promote community improvement for the residents of long-term care communities.
Many state and federal leaders recognize the value of resident councils. As a result, many important laws exist to establish clear guidelines for facility leadership to protect the rights of residents within their community. One of the most important laws is the Nursing Home Reform Act of 1987 which establishes the right of residents in long-term care communities to participate in a resident council, specifically:
- Long-term care community leadership must protect and promote the rights of each resident, including the right of the resident to organize and participate in resident groups in the community.
- Residents have the right to voice grievances with respect to treatment or care. Leadership is prohibited from responding with discrimination or reprisals.
- Residents have the right to prompt efforts by the nursing facility to resolve grievances a resident may have.
The staff and leadership are required to inform new residents of their right to establish a council if one does not exist or to participate in the activities of a council which is already operating. The facility’s leadership must also provide space for meetings and assistance to residents who need the facility’s staff, relatives, friends, or members of community organizations to participate in the meetings. Leadership must also designate a staff person to serve as liaison to the council, to attend council meetings as requested, and to provide needed support services and assistance such as typing of minutes and correspondence.
The structure of a resident council can be the key to its success. The structure to choose depends upon the size of the care community and the abilities and needs of the residents. In small nursing facilities, resident councils are frequently operated as open meetings for all interested residents. There may be a steering committee to help plan meeting agendas and to follow up on decisions made by the council. Larger nursing facilities often have councils made up of representatives either elected or recruited from different sections of the nursing facility. In this style, council representatives are responsible for seeking the concerns and suggestions of residents in their area and for bringing this information to the meetings.
We work with care communities and residents to strengthen their resident councils and ensure that council meetings are successful and meaningful. When we imagine a model resident council – we think of the following criteria:
- Residents run the council and receive support - not interference - from community staff and leadership. This includes having access to information that the council requests.
- Residents are treated in a dignified manner, and their issues and concerns are taken seriously and promptly addressed. They should feel comfortable speaking freely; raising issues and concerns without fear of retribution.
- Councils have elected leadership and established council subcommittees that address the issues and concerns raised and then follow up at the next meeting. While councils do not have to have officers or subcommittees – we recommend that they do.
- Council meetings should be well-organized and structured so that residents experience success. Meetings should focus on improvements and recommendations – not only complaints. Confidence in the council will make it more successful.
When resident councils are structured effectively, they are a powerful way of harnessing the power of democracy to solve problems. When resident councils work, they:
- Improve communications within their nursing facility; they are known as places to get the facts and dispel rumors.
- Identify problems early when it is easier to do something about them; they are an important part of the grievance process and help avoid the necessity of discussing problems with outside sources.
- Serve as a sounding board for new ideas; they allow participants to review and comment on proposed nursing facility policies and operational decisions which affect resident life and care.
- Help individuals speak out about what is bothering them and help overcome a fear of retaliation.
- Improve the atmosphere of the communities where they are active; staff members appreciate having residents share in some of the responsibilities of planning activities and events.
- Build community by giving residents the chance to work together in small groups and get to know each other well.
As we reflect on National Long-Term Residents Rights Month we are committed to supporting resident councils. We recognize that these neighborhood democracy initiatives are an important vehicle to bring about lasting and critical change for all residents in the nursing facility.
We work hard every day to ensure that every community throughout the state has access to resources, support, and assistance in implementing neighborhood democracy initiatives. We’re here to provide assistance and support to established initiatives or those looking to create them.
Reach out to us today at (801) 820-0714 or firstname.lastname@example.org if we can support neighborhood democracy initiatives in your community.
We would like to thank the Nursing Home Ombudsman Agency of the Bluegrass for their contribution to this post. Much of this post was developed with their support and information.