New research by Karl Pillemer, the Hazel E. Reed Professor in the Department of Human Development and senior associate dean for research and outreach in the College of Human Ecology, has demonstrated an effective approach to reduce staff-family conflict in assisted living facilities – an important aspect of ensuring the well-being of residents in care.

“Staff members and relatives of residents can sometimes experience communication problems and interpersonal conflict with one another leading to distress on the family side and an increase in burnout and the likelihood of leaving the job on the staff side,” said Pillemer. “In some cases, problems between families and staff can negatively affect the residents’ well-being.”

Although forging partnerships between families and staff in assisted living is desirable, said Pillemer, few programs exist that promote such positive relationships. In response to this need, Pillemer and colleagues at the Cornell Institute for Translational Research on Aging developed the Partners in Caregiving in Assisted Living Program (PICAL).

Credit: Cornell Brand Communications File Photo

“We designed PICAL to address these problems by enhancing communication skills, fostering empathy between families and staff, and engaging individuals in discussions about how their assisted-living community could help break down barriers between the two groups,” Pillemer said. “It is based on extensive evidence that communication training in health care settings has a positive impact on patients.”

The program was tested in assisted-living centers across eight states where facilities were assigned either to receive the program or to a control group. PICAL involves two workshop series, one for assisted-living staff and one for residents’ family members. Training, averaging three hours in length, was primarily structured around advanced listening skills, communicating clearly and respectfully, and handling blame, criticism and conflict.

Upon completion of the training, staff and family members met to discuss their concerns and to identify at least one issue for change within the facility and a plan for next steps.

A total of 576 staff members and 295 family members from the control and treatment groups provided survey data on their relationship. Data were collected from the treatment group pre- and post-training to help show its impact.

The findings confirmed that family-staff relationships are sometimes challenging in assisted living, similar to nursing homes, and that an intervention can improve these relationships. Family members and staff reported they felt the program was highly effective and led to improved communication and improved relationships. The study found the strongest effects on staff, who reported a significant reduction in conflicts with family members and lower rates of burnout over the study period. Similar patterns were found for families, although the results did not reach statistical significance.

For Pillemer and PICAL, communication between both parties involved is vital for success.

“Assisted-living communities can enhance the experiences of both families and staff by providing training in communication skills and conflict resolution, which is likely to lead to improved care for residents,” he said. “Such efforts should increase the likelihood that family and staff see themselves as partners – and not as opponents – in the care of their loved ones.”

The study, which was funded by a research grant from the American Seniors Housing Association, was published Oct. 17 in Seniors Housing & Care Journal, where it won the Outstanding Research Paper of the Year award.

Stephen D’Angelo is assistant director of communication in the College of Human Ecology.