6 steps to manage post-election reactions in LTC

Dr. Eleanor Barbera
Dr. Eleanor Barbera

The 2016 presidential election has revealed a deep rift in our country, and quite possibly in our long-term care facilities as well.

While some employees and residents are pleased about the election results, it's likely that others in your community are considerable less so.

An informal survey of my fellow geropsychologists revealed the following situations occurring in their nursing homes:

•  Staff arguments regarding politics.

•  Anger in residents, some of whom are misdirecting their anger.

•  Residents and staff members who are dismayed, distraught or depressed regarding the election results and the direction of the country.

•  Residents reporting that staff members told them they voted for Trump but asked them to keep this secret because they don't want their Clinton-supporting coworkers to know.

•  Staff who openly voted for and are discussing their Trump votes with clients as a point of pride, without recognizing the impact on their disabled clients after Trump's mocking of a disabled person.

•  Transgender residents concerned they are going to be “outed” and refusing the medication they've been taking for years to maintain their health.

•  Aides and other staff (housekeeping, kitchen workers) crying in staff lounges out of fear that some of their family members might be deported and that they, too, would have to return to their country of origin because they wouldn't be able to afford to stay here on their own. As they shared their fears with their respective residents, the possibility that their beloved aide might leave them added to the anxiety the resident might have already felt about the election results.

•  Staff concerned about their jobs and the future of healthcare; residents fearful they will no longer be eligible for Medicaid if the laws change.

Certainly not every facility is experiencing such reactions — a psychologist working in a VA home indicated that the veterans seemed generally positive about the prospect of President Trump.

Another psychologist reported that a Romanian Holocaust survivor was pleased with Trump's win because he'd feared the country was moving toward a socialist model he'd unhappily lived through previously.

With our diverse population of residents and staff members, however, it's likely there are at least some people in our communities who are experiencing distress and would benefit from reassurance and support from those in charge.

Here are 6 ways to accomplish this:

1.  If you haven't already done so, send a memo requesting that staff members refrain from discussing politics, especially in front of residents.

2.  Reiterate to staff members the corporate policies regarding discrimination and express a commitment to a fair and bias-free environment.

3.  Reassure residents and family members of the same. Do this in recreation programs, resident council meetings, facility newsletters and perhaps through a memo or on the recreation calendar. People will need to hear this reassurance multiple times and through multiple sources.

4.  Consider offering the opportunity for community members to take concrete positive actions to help them feel more in control. Discuss with your team what's right for your population. Some ideas include:

   a. Hold a campaign to write letters to President-Elect Trump to express support for his presidency and to encourage him to focus on promoting unity.

   b. Raise money for organizations that benefit causes that resonate with your community. They don't necessarily have to be focused on social justice if that's too politically sensitive — the idea is to help people actively do good in the world, whether it's knitting blankets for needy children or donating to a local animal shelter.

   c. Hold special prayer or meditation sessions that focus on loving kindness.

   d. Create programs that encourage “unusual kindness.” As author Karen Ehman puts it, “Kindness holds the door open for an elderly person leaving the grocery store. Unusual kindness willingly carries their groceries all the way to their car, puts them in the trunk, and sends them on their way with a ‘My pleasure.' when thanked.” What would unusual kindness look like in your facility?

5.  Support those in your community who may be struggling with concerns about the deportation of a family member. Perhaps your organization can hold an information session or establish a fund to help with legal and other expenses.

6.  Turn off the television news loop in the day room. Show more comedies on movie nights.

Monitor the emotional tenor of individuals and the group as a whole. Distressed residents can be referred to the consulting psychologist; workers can be encouraged to make use of their employee assistance program or other supports.

For indications of group distress, use more of the activities noted above and discuss other possible interventions with your team, including your religious leaders and consulting psychologist.

None of us knows what to expect from our new president and his administration in the next few months and years, but there is much we can do as organizations to reassure our community members that we're all in this together.

Eleanor Feldman Barbera, Ph.D., author of The Savvy Resident's Guide, is an Award of Excellence winner in the Blog Content category of the APEX Awards for Publication Excellence program. She also is a Gold Medal blogger in the American Society of Business Publication Editors Midwest Regional competition. A speaker and consultant with more than 20 years of experience as a psychologist in long-term care, she maintains her own award-winning website at MyBetterNursingHome.com.

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