Annals of Long Term Care

Families are integral members of the healthcare team in LTC facilities, and the evaluation of their satisfaction has become an increasingly valued measurement. In the authors’ project, a review of the literature was conducted to identify key areas for improving family satisfaction. Two categories were identified as the most important influences on family satisfaction: direct care and family-staff interaction. Families were most satisfied with direct care that was provided with empathy and in a timely and accurate manner. Family-staff interactions were often a source of dissatisfaction that could be addressed by consistent communication. Communication strategies such as contacting family members with general updates instead of only contacting them when an adverse event occurred was one method for improving family satisfaction. (Annals of Long-Term Care: Clinical Care and Aging 2009;17[4]:25-28)

Selecting a long-term care (LTC) facility for an impaired loved one is one of the most difficult decisions that family members face.1 In order to facilitate such decisions, consumer reports or report cards are being utilized by state and private organizations to provide information about the quality of healthcare in LTC settings.2 Such information can be valuable to families not only in choosing a facility, but also in assessing the ongoing quality of care after the placement has been made.2

The nature of the information contained in the consumer report is critical to its usefulness in helping families make informed decisions. In particular, consumers value information about satisfaction rates and perceptions of quality from people like themselves.2 Recognizing the importance of family satisfaction ratings, states are beginning to include this information in their consumer reports.2 However, the value of family satisfaction ratings extends beyond facilitating consumer decisions; these evaluations provide important data for the LTC facilities’ quality improvement practices.3

Family satisfaction measurement embraces the fact that families are a part of the long-term caregiving system, having the opportunity to be involved in all phases of care delivery. Perceptions of quality and satisfaction are established, challenged, and reinforced through the multiple interactions between families and staff within the environment of the facility, from pre-admission through discharge. The everyday interface between the LTC facility and families shapes and molds their overall perceptions—perceptions that are often shared with others as informal report cards of quality.

Families, therefore, can be viewed as powerful consumers who have the potential to generate positive or negative reports in their broader social networks, thus impacting the community’s perceptions of quality care.4 Family members who are satisfied with the nursing home provide positive feedback in conversations, providing a valued perspective sought by families who ultimately may face placement decisions. These insights shape the facility’s quality image and can generate future referrals. The converse is also true; negative word of mouth may be one of the most challenging marketing dilemmas faced by LTC facilities.

This consumer power gives the LTC facility a strong incentive to focus quality improvement efforts on building or sustaining family satisfaction. Generating a positive image of the LTC facility cannot only strengthen referrals, but may diminish the threat of litigation.5 Given the importance of family satisfaction with LTC facilities, we sought to identify factors influencing family satisfaction in LTC facilities and related strategies to enhance satisfaction as cited in recent literature. The overarching goal of this article is to summarize key points for consideration in ongoing quality improvement activities.

Our literature search was limited to articles written in English and published within the last ten years.