Tips for organising an effective Resident Support Group (RSG)

Meet With the Manager of the Nursing Home

When you and other family members or friends decide to start a Resident Support Group (RSG), ask for a meeting with the manager to discuss the date(s), a mutually agreed upon time, the place where you can post notices, the designated staff liaison and the process for submitting and responding to concerns of the RSG. You don't need the cooperation of management, but it helps if you want to reach out to other family members and new ones, and if you really want to see changes rather than resistance. In addition, it's better to start out on a cooperative basis, as things may heat up soon enough. If management won't discuss it, send a letter and start the RSG without his/her cooperation.

*Management are prohibited from interfering with, or preventing the organisation of Resident Support Groups.

Involve Facility Staff

Too often facility staff feels threatened by RSGs. They see them as "gripe" sessions that separate family members from the staff. While RSGs, by necessity, have to allow for family members to gripe and voice their concerns, this should be done during the private council meeting. While at least some part of every meeting should allow for the RSG to meet in private, staff should be invited to specific meetings at specific times to discuss specific concerns. For example, if one of the council's concerns involves dietary issues, invite the dietician to talk to the council, answer questions and address these concerns. It's always better to have the staff on your side, if possible, since they are the ones who provide the direct care.

Put It in Writing!

Someone should take notes during the meeting and be responsible for relaying the specific concerns of the RSG in writing to the management or designated staff liaison officer. The issues and/or concerns should be agreed upon at the end of the meeting, and the format and tone of conveying the message should be agreed upon. If you don't put it in writing, don't expect a timely response. Be concise and direct. Be specific and give examples of the problem, without naming residents' names.

Pick Your Battles!

RSGs usually form because of a serious problem(s) at a facility. Thus, the family members and friends who initially get involved are usually pretty upset by the time of the first meeting. However, it would be a good tactic to lay out all of the issues and prioritise. Pick one or two less serious issues first, and see how management responds. Or pick the one issue that has the collective most direct effect on the residents. Then you'll know what you're up against, and you'll have an idea how hard or easy making changes will be. It's also unrealistic to expect all of your concerns to be dealt with at once. At the end of each meeting, one or two concerns should be submitted in writing, with suggestions, if appropriate, as to how the concerns could be addressed.

Do Your Homework!

Find out the laws and regulations regarding the particular issue or issues the RSG selects. If you don't know your rights or the residents' rights, you won't know if the response is appropriate or not.

Prepare an Agenda

Although some time needs to be set aside for free discussion of concerns, the meetings should have some structure. You don't need to over-formalise it, but you should have a plan for each meeting. For example, there should be time for introductions of all attendees, follow-up from the last meeting, guest speakers, if any, and setting the time and dates of the next meetings at a convenient time for as many as possible.

Don't Be Too Formal!

With the exception of making sure you put all correspondence from the RSG in writing, the meetings should not be too formal. They should be a place where family members, representatives of residents and the residents can feel free to talk about what they need to talk about; where they can give and receive emotional support and important information; and where they feel welcome. Have some refreshments. Nothing increases attendance like the smell of fresh-baked chocolate chip cookies! Some facilities will provide cookies, coffee and soft drinks, but don't count on it. Bring your own or take turns bringing refreshments.

Involve the Residents

Invite any residents who can or want to attend. Sometimes, family members will bring the residents to the meetings. That way they can combine their visits with the meeting. Most residents probably won't want to attend, but make them welcome. Their voices are the ones that seldom get heard.

Reach Out!

One of the first orders of business for a RSG should be organising an outreach program at the facility to make sure all the current family members and the new ones know about the meetings. If management are cooperative, your job will be easy. That is not always the case, however, and you'll need to be innovative in meeting family members. Have special, short get-togethers on a weekend. Bake some cakes and have a "coffee." If you can't get new family members involved, the RSG won't last.

Try Not to Control

A lot of RSGs fail because the person who organised it, put in all the time and energy and took control, doesn't want to give up control. This is a difficult dilemma and requires a careful balance of addressing members' real fear of retaliation and empowering them at the same time. They only way you can do this is by letting them talk, educating them and showing them, through results, that RSGs can be effective tools for improving care. Change in leadership can be healthy, as long as the leader is in sync with the RSG's and residents' concerns.