Healthcare Areas

In a survey conducted in 2022-23, Health Quality Alberta asked family members of residents living in continuing care homes – type B (formerly called designated supportive living):

In the last three months, did you ever stop yourself from talking to any supportive living facility staff about your concerns because you thought they would take it out on your family member?

Family members could choose “Yes / No”

At times, family members do not feel comfortable speaking up about concerns related to their loved one’s care. One reason may be a fear of retribution or retaliation, and that by sharing concerns, their loved one’s care experiences might be negatively impacted or even become unsafe.

There are a number of factors providers and leaders can consider to better understand and improve family member confidence to share concerns. Before taking action, consider the following:

• If family members are not comfortable expressing concerns, how might this impact their loved one’s quality of life or safety?
• What are some of the reasons why a family member may fear retribution or retaliation? How might the process to address concerns be improved to help family members feel safe to share concerns?
• What is the difference between the family and resident experience around sharing concerns?
• How might embracing the key principles of a Just Culture as it relates to family concerns impact this result?
• How might the presence of a resident and family council impact this result? How could a resident and family council be engaged to better understand this result and help make improvements?
• If family members do not feel safe to speak freely, how might this impact the site or organization’s ability to learn about opportunities for improvement?
• Which accommodation standard(s) does this question help inform, if any?
• Which Continuing Care Health Service Standard(s) does this question help inform, if any?
• Who should be involved in discussions to improve these results? How could residents and/or family members be engaged to develop solutions (e.g., engage the resident and family council)? What other collaboration might be required to make improvements in this area?
• A site may only be directly accountable for one type of staff. For example, in continuing care homes – type B (formerly designated supportive living), case management and sometimes nursing care are delivered by Alberta Health Services, while other services like care aides and housekeeping are managed by a housing provider or site operator. How can providers collaborate to make sure improvements are embraced by all staff?

For information about Health Quality Alberta’s Facility-based Continuing Care Survey, please visit Health Quality Alberta’s website.