Why most resident council meetings in nursing homes are a sham

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

Part Two: How to run effective resident council meetings; Part Three: For residents: Reclaiming the resident council

I must confess, the only time I've actually been to a Resident Council Meeting was when I was invited to speak about psychological services. Aside from invitees, the only people allowed at the meetings are the residents and the staff person in charge of running the group. My information about them comes from the residents themselves and sometimes from the staff leader, who is often the Recreation or Social Work Director. With one notable exception, the consensus on Resident Council Meetings is that they are a sham.

Why are the meetings a sham? There are two answers to that question. The first has to do with group dynamics. Often, the residents attending the meetings are the "regulars" who attend all activities. They tend to be the most accommodating residents and the ones who are generally satisfied with nursing home life, so their observations about the nursing home are less often geared toward change. Members of the group may have varying levels of dementia, and varying levels of familiarity with organizational dynamics. A well-attended Resident Council Meeting can absorb confused or off-topic residents, but frequently there is not enough of a critical mass to do so. Astute, alert new residents attending the meetings for the first few times encounter an ineffective group and quickly decide not to continue. Contributing to the ineffectiveness of the meetings is the fact that the staff person assigned to run the meetings generally doesn't have true support from the administration, so the complaints and suggestions of the group are not met with a resolution. This creates a disheartened leader and a demoralized, depressed, and sometimes acting-out resident population.

The second answer is that the administration doesn't realize and/or know how to utilize the potential power and value of the Resident Council Meetings. The residents are the eyes and ears of the nursing home. They see things the administration can't possibly know about, but should. The residents have years of experience in jobs, families, and society. They know a thing or two about how things work and how they can be fixed. The current cohort of residents is, generally speaking, a congenial bunch, not accustomed to bucking the system. The upcoming cohort of residents, the first of the Baby Boomers, is used to promoting change, and they will. Look around facilities now, and the early arrivers can be seen, angry, demanding, and knocking on the doors of the administrators. They can see things aren't as they should be, or could be. The administration can harness their experience and fervor for change by offering them an avenue to discuss concerns and to be part of the treatment team, not just in their own care, but in the overall quality of life offered at the facility. Empowering the residents leads to happier, more satisfied residents, families, and staff, and to a better nursing home.

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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