Dr. El

Earlier this month, I took some much-needed time off to go on a cruise. I came home to a LinkedIn notification about “The big cost of not taking vacation,” reflecting on a CNN article regarding the vast number of vacation days forfeited by Americans. The author notes that people who travel tend to be happier with their jobs and companies than those who don’t.

It got me thinking (and researching) more about burnout and long-term care staffing problems. Certainly one piece of the puzzle is taking scheduled time off in order to refresh and gain perspective.

As I’ve noted in the past, there are many tactics employers can use to decrease burnout and turnover. In The keys to reducing turnover in LTC, I outlined the causes of the alarming rate of staff turnover in LTC, which can range from 55% to 75% for nurses and up to 100% for aides.

Preventing burnout in long-term care addressed training, staff scheduling and other adjustments that have been shown to reduce turnover. In another piece, I focused on ways to make long-term care jobs appealing enough to compete with less stressful jobs in the same salary range.

In my recent perusal of the research, I came upon a study that looked at factors contributing to the levels of anxiety experienced by staff members. The study suggested that the two biggest contributors to staff anxiety were “guilt about the care offered” because it wasn’t up to the standards of the individual workers and the “poor quality of the relationship with the residents’ family.”

Many of the suggestions I’ve offered in the articles noted above can improve the quality of care, but I was intrigued by the notion that improving relationships with residents’ families could have a significant impact on the anxiety levels of workers and thereby reduce burnout and turnover.

A treasure trove of research on family-staff relationships has been conducted at the Australian Centre for Evidenced Based Aged Care. In one project, author Michael Bauer, Ph.D. and his colleagues identify eight domains that affect the quality of the relationship between families and staff members:

•  Recognition of the uniqueness of the resident

•  Information sharing between staff and families

•  Familiarity, trust, respect and empathy

•  Family characteristics and dynamics

•  Collaboration in care

•  Staff-family communication

•  Organizational barriers to positive relationships

•  Promoting positive relationships

Their additional research led to three main recommendations to improve relationship quality:

•  Increase education for both staff and families on relationship development, power and control issues

•  Improve communication skills and negotiation techniques for staff and families

•  Strengthen engagement from administration and management staff with collaborative care models and assistance with staff workloads

Those looking for ways to enhance staff-family relationships can also implement practical suggestions offered by the Pioneer Network in this article. In addition to including recommendations for ongoing interactions, the authors make the important point that family-staff communication begins prior to the resident moving into the facility, when the team has the opportunity to gather information from family members and to show them on the move-in day that the information is being used to personalize care.

Readers seeking more structured and formal guidance on improving collaboration between family and staff might consider the free Partners in Caregiving Program offered by Cornell Institute for Translational Research on Aging. This is a research-based “cooperative communication program” which entails two parallel workshop series with a full-day in-service training for staff members, three weekly two-hour workshops sessions for family members, and a final, joint session with “families, staff, and facility administrators to brainstorm new facility practices and policies to promote better family-staff relations.” It might be the jumpstart your facility needs to repair fractured family-staff relationships.

Burnout and staff turnover are serious problems that affect every aspect of care and increase operating costs. Research shows that improving interactions between family members and staff can lead to higher quality care while improving retention of staff, making it a worthwhile investment.

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 the Gold Medalist in the Blog-How To/Tips/Service category of the American Society of Business Publication Editors Midwest Regional competition. A speaker and consultant with over 20 years of experience as a psychologist in long-term care, she maintains her own award-winning website at MyBetterNursingHome.com.