Handling Difficult Family Situations: Practical Approaches

Abstract

Some of the most challenging calls that attorneys advising health care providers receive involve situations in which care of a resident is not problematic, but relations with the resident’s family or responsible party have grown intolerable. Providers are accustomed to families with high expectations. Issues can arise from how family members express those expectations. Sometimes, particular family members bring to their interaction with long-term care providers, including both facilities and clinical staff, behaviors that can only be characterized as unthinking, hostile, or rude. This may stem from frustration with the services rendered or with the nature of the resident’s condition, but it can also result from longstanding, interpersonal issues between the resident and the family member(s) that are exacerbated by the resident’s institutionalization, and the facility staff become the target of these issues rather than the resident. This can include demands for changes in clinical treatment with which the staff would otherwise disagree. Fearful of complaints, either to superiors or regulatory agencies, or of litigation, staff may simply acquiesce to demands. Or they may find themselves in a seemingly endless number of exchanges from which closure or resolution can seem fruitless. It is important to recognize the legal constraints within which facilities operate and to which they are subject. Staff members need to e