Family Councils Help Nursing Homes Maintain Quality Care

By Rich O'Boyle, Editor
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A family council in a nursing home is a consumer group composed of friends and relatives of the home’s residents. Although each family council is unique, a typical council has 5-10 active members; meets monthly at the nursing home; is run by relatives and friends or residents; has an advisor (usually a staff person at the nursing home) who assists the council but is not a member; and has a variety of activities.


The main purposes for having a family council are: (a) to protect and improve the quality of life in the home and within the long-term care system as a whole, and (b) to give families a voice in decisions that affect them and their resident loved ones. Beyond the general goals, specific purposes exist, such as support for families; education and information; services and activities for residents; joint activities for families and residents; action on concerns and complaints; and legislative action, among others.

Purposes vary greatly from council to council, depending upon the interests of council members. A general set of purposes should be agreed upon when a council is new and revised as the goals and interests of members change.


Effective family councils benefit families, residents and the homes in which they are involved.

Families benefit in many ways. No one knows as well as a family member how difficult it is to place a loved one in a nursing home. Even after placement, families continue to share similar concerns, problems and questions.

Family councils allow families to give each other the support, encouragement and information they need. Council involvement helps to resolve feelings of helplessness because families have a channel to express their concerns and ideas and a way to work for positive change. Being involved in issues that affect their resident loved ones, families feel less isolated and powerless.

Studies have repeatedly shown that residents receive better care in homes where families and friends visit and are involved. In addition, family involvement makes a nursing home more like a home and less like an institution. Because family council activities benefit all residents, even those who do not have concerned families are helped. Family involvement also protects residents who are physically unable to voice their concerns and needs for themselves.

The nursing home also benefits. Councils allow administration and staff to deal directly with family concerns and ideas, to convey needed information to families and to decrease resident and staff turnover by creating workable ways to deal with family dissatisfaction.

Many administrators have shared instances when they were unaware that families had a concern, but because the concern was raised at a council meeting it was easily resolved. Administrators have also shared examples of problems that were solved because of the good ideas or assistance of a council.

Family councils also give families, administrators and staff opportunities to get to know each other better and to establish meaningful lines of communication.

A Family Council is NOT:

* FAMILY NIGHT is a name used in many homes for occasional educational or social functions planned and hosted by nursing home staff for families and friends of the home’s residents. While these programs may be beneficial, they are not substitutes for family councils.

*A RESIDENT COUNCIL: Many homes have resident councils. It may seem at first glance that the two groups are the same. Combining the home’s resident and family councils into one group may even be considered. However, this ignores the fact that residents and their families have different interests, needs and abilities. Combined resident/family councils are usually dominated by the families, who are quicker and better able, in many cases, to express themselves. Residents and families need their own councils geared to their special situations and interests.

*A VOLUNTEER GROUP OR AUXILIARY: Occasionally, a family council will be started to meet a need within the home. Family councils provide many valuable services to residents, but they must never be replacements for adequate staff. Also, a council should not provide items or services that the home is required by law to provide.


The nursing home staff should only be involved at your invitation. Some resident and family councils invite staff as observers or presenters. They are sometimes asked to leave the room for a period of time to allow for unobserved discussion. At any rate, the staff should not be voting members of the council, facilitators or group leaders. Try to have some off-site meetings if the staff involvement proves to be problematic, or talk with your Long-Term Care Ombudsman. Make sure that your Ombudsman is invited to the meetings.

An Ombudsman usually has the advantage of managing conflict through negotiation and mediation.. This can help provide information and encouragement to family councils. There might be occasions when the family council and the Ombudsman can jointly work on problem resolution. The Ombudsman is a consumer advocate responsible for investigating and attempting to resolve complaints made by, or on behalf of, residents of long-term care facilities. In most parts of the country there is an Ombudsman assigned to every nursing home. This keeps all aspects of the nursing home industry equal and makes sure that standards for patients are being met. It is important in this industry to have a middleman in place to hold the industry accountable for providing the best possible care. Make sure when you are choosing a nursing home for a loved one that they have an Ombudsman on staff. This can help to guarantee a properly maintained facility.

Start by identifying the Ombudsman for your facility. Usually there is a sign with the Ombudsman’s name and phone number posted in the facility. If you can’t locate it, ask the nursing home’s director of social services for the information. Or contact your state Long-Term Care Ombudsman. The state Long-Term Care Ombudsman will identify the right person to contact. Links to state Ombudsman programs and Area Agencies on Aging are located in ElderCare Online's Neighborhood Network.

Additional information on Family Councils can be obtained from The National Citizens' Coalition for Nursing Home Reform at 1424 16th St.,NW,Suite 202, Washington, DC 20036.


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