Nursing home care: Handling tension and daily conflicts

Submitted by Emma Hamilton on Tue, 21/02/2012 - 11:19am

Nursing home care

When a loved one enters a nursing home many caregivers feel relieved knowing a loved one is receiving 24 hour nursing care. But often after the initial settling in phase, new challenges emerge.

Research has shown that many caregivers feel they have no control over the care of a loved one in residential care and that their concerns are not heard by nursing staff.

Studies have also found that aged care nurses can be quick to label family as intrusive, troublesome and problematic. It's no wonder that in many nursing homes an us versus them relationship can develop.

When a loved one enters a nursing home, family carers have to adapt to the routines and rules of nursing home life. And as homelike as a nursing home can be, an aged care home simply can't function without some kind of structure and daily routine.

Adapting to a new care routine can be exasperating for residents and carers. Tensions often arise. So why do these conflicts occur and how can we avoid them?

Adapting to change in a nursing home

Unfortunately many daily routines can exacerbate tension between family and nursing staff.

For instance, a busy aged care nurse will prioritise care and often attend the residents most in need first.

When a resident is waiting for hours for a shower family may perceive the nurses rigid approach to care as impersonal and uncaring.

Guided by their emotions, and overcome by feelings of helplessness, a family member may take their frustrations out on nursing staff.

Aged care staff on the other hand will be working to strict time frames and routines. Their workload will be more task orientated.

And as much as they try to accommodate the personal preferences of residents in their care, an aged care nurse may interpret the requests of family as unrealistic.

Aged care nurses may also avoid carers if they feel out of their depth and unable to provide the emotional support that family members need.

Communication is key

Like many situations problems in residential care between carers and nursing staff often occurs due to poor communication.

Fear of being labelled as trouble makers or being discriminated against may mean many residents and families simply don't complain.

Factors such as language barriers, facility protocols, staff resistance to change and different cultural beliefs and attitudes can also play a role.

So how can caregivers and nursing staff overcome these barriers?

Firstly if you're a caregiver put time aside on admission to talk about the daily routine in a nursing home, what are your expectations and values? What's most important to you and your loved one?
Recognise that there will be some bad days when things will not go to plan.
Whilst venting your frustrations can help your wellbeing try not to be too quick to point the finger at busy aged care staff.
Time it! Don't dwell on something for days, it will only add to your frustrations. Set time aside to complain to staff or management when you can be fully heard. Is it best to complain via the phone or in person?
Instead of accusing aged care staff start a conversation by saying, " I get upset when I come everyday and Mum is in the same clothes" or " It makes me sad that Mum is sitting alone in her room"
Access to a social worker, pastor or counsellor can help fuse an emotionally charged situation.
Talk to someone in charge that you trust to act, follow up on the situation and if necessary follow formal procedures for making a complaint.
Keep a record of your complaint, sometimes it's a good to idea to write things down. What happened, what nursing staff were involved and any actions promised. Were they followed up?