long-term care

Enhancing Care, Enhancing Life: Looking closer at Long-Term Care Councils

Enhancing Care, Enhancing Life - Long-Term Care Councils
Click here to download Enhancing Care, Enhancing Life.

Stephanie Hylmar 

In Ontario, more than 620 long-term care homes provide round-the-clock nursing, medical, social and personal care for more than 78,000 residents at any one time. In recent years, long-term care homes have been increasing their efforts to work collaboratively with system partners, staff, residents and families to enhance the quality of care and quality of life for their communities.

One of the patient engagement models used to do this is Residents Councils and Family Councils. However, due to being mandated under the Long-Term Care Homes Act (2007), these Long-Term Care Councils have caused some to question their authenticity and contribution.

Spurred on by our work on patient and family advisory councils in hospital settings, the Foundation felt it was time to learn more about these councils and their impact on long-term care home life.

After surveying over 2,500 long-term care residents, family members, council staff assistants and administrators, the Foundation found that these councils are perceived positively by their communities and are seen as having real impacts as reported in Enhancing  Care, Enhancing Life.

Specifically, four key findings emerged from the surveys:

  • Enhancing the quality of life, enhancing the quality of care, and information sharing we identified as the three main roles councils played;
  • Residents and family members participating on councils have a much clearer understanding of what the councils accomplish and believe that they fulfil their roles;
  • Despite councils being mandated by the provincial government, council staff assistants and administrators see the value, importance and impact of having a council; and
  • Improvements in relationships are mainly seen between residents and staff.

These four key findings are an overview of some of the important big picture matters that councils address and deal with. These findings are also significant because no other independent or arms-length organization has reviewed the state of these councils in such detail.

Long-Term Care CouncilsHowever, resident’s councils and family councils may only be an initial step in the long-term care sector’s patient- and family-centred journey.  In Insights into Quality Improvement: Long-Term Care, Health Quality Ontario (HQO) suggests that truly listening to residents and families means “moving beyond the existing resident and family councils to more co-leadership and participation in quality improvement activities” (pg. 29, HQO, 2016). Furthermore, a key component of continuous quality improvement is incorporating the “voice of the customer”—i.e. residents and families (HQO, 2016). Knowing the degree to which councils are able to provide this voice, and where successes and pitfalls lie, can inform others on how to optimize their councils and experiences for residents and family members.

The findings from Enhancing Care, Enhancing Life and HQO’s recent report set the tone for the next phase of our Long-Term Care Resident Councils and Family Councils project.

Through a series of five case studies with long-term care homes from across Ontario, the Foundation will address a number of key questions that emerged from the surveys such as: why are councils fundraising, how are councils fundraising, what does quality look like, and how do councils contribute to quality improvement.  Selected from an open call to the sector, homes being featured in the case studies are currently participating on a voluntary basis through one-on-one interviewing and focus groups.

Although this work won’t be completed until Spring 2017, be sure to learn more about Residents’ Councils and Family Councils in Ontario by downloading Enhancing Care Enhancing Life today: https://changefoundation.ca/enhancing-care-long-term-care-report/.

Enhancing Care, Enhancing Life

Increased and meaningful patient and family engagement is a major priority in Ontario’s health, home and community care sectors. In 2013, The Change Foundation published a comprehensive three-part report on the development and best practices surrounding patient and family advisory councils in Ontario. This work left us wanting to investigate other engagement models that were being used to advance patient- and family-centred care. Namely, Residents’ Councils and Family Councils in Ontario’s 622 long-term care (LTC) homes.

Enhancing Care, Enhancing Life showcases key findings from phase one of the Foundation’s Long-Term Care Resident Councils and Family Councils Project. The report summarizes and compares results from three surveys to long-term care residents, family members, and administrators/staff assistants to give an overview of the actions the councils are currently taking within LTC homes, the time commitments involved, and how their role, effectiveness and impact are being perceived.

Overall, the report summarizes four key findings from phase one:

The councils are seen as performing three main roles

Survey respondents identified three predominant roles being played by the Residents’ and Family Councils: enhancing the quality of life for residents, enhancing the quality of care for residents, and information sharing. These roles were chosen in varying frequency and proportion by the different survey groups, but were consistently the top three.

People who take part see the councils as more effective than those who don’t

For both Residents’ Councils and Family Councils, a strong majority of participants believe their council is fulfilling its role—but more than one-third of non-participating residents and more than half of non-participating family members felt otherwise.

Administrators believe the councils are important; so do the staff who work with the councils

When asked about the importance of the councils, a majority of administrators and staff assistants consistently said the councils are either extremely or fairly important to the function and operation of the home and to its culture.

The councils’ impact on relationships varies

Respondents say there is a greater tendency for Residents’ Councils to improve relationships between residents and staff than there is for Family Councils to improve relationships between family members and staff.

Findings from Enhancing Care, Enhancing Life will drive a limited number of case studies which will build on the results of the surveys as part of the project’s second phase. Sites for each case study have been selected from survey participants.

For more information on phase two of the Foundation’s Long-Term Care Resident Councils and Family Councils Project, click here: https://changefoundation.ca/long-term-care-project/.

Report and Sub-Reports


For more information, please contact:

Communications at info@changefoundation.com

Lori Hale, Executive Lead, Research and Policy, at 416-205-1315 or lhale@changefoundation.com

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