How to run effective resident council meetings

The second of a three-part series. To come:

Part Three: For Residents: Reclaiming the Resident Council

Resident Council Meetings, as I discussed in my previous post, “Why Most Resident Council Meetings in Nursing Homes Are a Sham,” often can be improved to become a powerful tool for change in nursing homes. Giving residents a true voice within their nursing home community creates meaning and purpose in their lives and reduces depression and acting out behavior.

In the one nursing home I've observed with effective Resident Council Meetings, residents actively campaigned for positions on the Resident Council and were voted into office. Meetings were conducted by a charismatic and enthusiastic staff leader, and concerns were seriously considered and acted upon by the administration. The residents felt they had a place they could bring their ideas, and the entire nursing home was a dynamic, thriving environment.

For Resident Council Meetings like that, try these steps:

Step One. As part of the administration, decide how open you'll be to suggestions for change from the residents. Is the nursing home willing to consider, for example, how to offer computer access to residents, if they request it, or to bring 12-Step meetings such as Alcoholics Anonymous into the facility? Or is the home more comfortable with smaller changes such as adding a week to the food rotation schedule to increase the variety of meals served? The group leader should be aware of how willing the administration is to work with the group in order to guide the meetings more effectively.

Step Two. Evaluate which person on staff would make the best group leader. A successful leader will be someone who is a strong resident advocate, has good rapport with both residents and other staff members, and either has the skill to run meetings or is willing to learn and practice.

Step Three. Recruit new group members. The staff leader and current resident attendees can, with the support of the facility, begin a community-wide campaign to "rehabilitate" the Resident Council Meetings. Speak privately with those residents who might be willing to attend improved meetings and get a commitment from them to give it a try. Ask them to talk to their friends in the home and then follow up with the friends. This process may take some time, so plan for the kick-off meeting to be a few months down the road, rather than the following month. Bring in many new, alert people at the same time, so the group is strong enough to encompass confused, off-topic, or quirky members.

Step Four. Educate the group members about how the meetings work, what types of issues can be addressed, and where other concerns can be brought. Spending group time discussing the process of the group is a worthwhile investment. For practical, rather than clinical, information on running groups, check out Robert's Rules of Order.

Step Five. As group leader, utilize group therapy techniques, such as creating an emotionally safe environment for discussion and ensuring that as many members as possible get a chance to express their opinions. Care should be taken to avoid a few members dominating the group. Leaders might consider reading about group process if they don't feel comfortable with their skills. My group therapy "Bible" is The Theory and Practice of Group Psychotherapy, by Irvin D. Yalom, which, while geared toward psychotherapy, offers many techniques which would enhance Resident Council Meetings and many other group activities. (If anyone reading this has other resources, please add them in the comments section.)

Step Six. Like all well-run meetings, issues raised by the group members should be addressed and followed up either within the current meeting or in subsequent gatherings, with a recording secretary so that items aren't lost.* If suggestions made by the group aren't able to be realized, give reasonable explanations so members understand their requests were seriously considered. Use the wisdom of the group to find ways to make things happen while working within the constraints and realities of the nursing home system.

Effective Resident Council Meetings are within the grasp of all nursing homes. I welcome further suggestions about how to make the meetings work, and I'd especially like to hear from those who currently participate in successful meetings. What makes them successful? How did you go about the process of transformation? What types of issues are you now addressing in your groups?

*Here's a question for readers: If surveyors read the meeting minutes, then nursing homes will be reluctant to list all the issues raised by the residents out of concern they will be pointing surveyors to potential deficiencies. Is it enough for facilities to show they're in the process of addressing concerns, or that they have good reasons for not fulfilling certain resident requests? For those with effective Resident Council Meetings, how do you handle this? Are there any surveyors out there who can shed some light on this?

Dr. Barbera is an author and a licensed psychologist consulting in long-term care facilities in the New York City area. She frequently lectures on subjects related to psychology, aging, and nursing homes. Dr. Barbera is available for private consulting with organizations, institutions, and individuals around eldercare issues. Visit her personal blog at www.mybetternursinghome.blogspot.com.


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