Thinking about how to manage families that are at war.
I first read about the lawsuit against Silverado last week in an article titled Silverado Visitation Dispute Prompts Social Media Policy Talk. This story poses some interesting social media issues, and yet, I was fascinated by the question of how a senior living community responds when stuck in the middle of warring family members?
Two Impressions
Over the long weekend I spent a fair amount of time reading various online articles and court filings about this story and came away with a couple of impressions.
- There are two groups of family members who are seriously at war with each other, but it is impossible to tell if one is righteous and the other is not, or something else.
- The senior living provider (Silverado Senior Living) is in an impossible position.
I sent prominent senior living attorney Joel Goldman an email asking if he would be willing to chat with me about how senior communities can best protect themselves and the residents when families are at war. We talked yesterday and this is what he had to say:
Disclaimers
Disclaimer One: While this discussion was prompted by the Silverado Sugarland lawsuit, what follows are general guidelines. Disclaimer Two: In the area of access to residents, state law has much variance. This means if you get stuck in the middle you need to make sure you have a good understanding of the codes for your state.
What to Do
These disputes tend to be focused in three flashpoints areas:
- How assets are being managed, which only indirectly involves the senior living community
- Care decisions/end of life protocols
- Visitation, which is the arena where it is easiest to fight and is most likely to trap the senior living community in the middle
Joel had these suggestions:
- Get family members together – Remind them that they are all working to accomplish the same thing, which is great care for their loved one.
- Use your Ombudsman – While many times senior communities don’t have a great relationship with their Ombudsman, this is an ideal place to use them. They are charged with only caring about the best interests of the resident and will be seen by the warring family members as being a neutral and authoritative figure.
- Work for a compromise – It is likely the best you can do is find a compromise that allows all family members and friends to visit at separate times that do not overlap.
- Free access to visitors and resident safety are both legally required and can be in conflict – If these principals are in conflict, resident safety has to come first. That could mean banning access; but banning access is an extreme last effort action and depending on state law, it may take a court order to ban any visitor. Every effort should be made to avoid doing this, but ultimately it is easier to defend legally than allowing access to a resident by someone who might abuse the resident.
- Push the problem up the chain – This is where regional and corporate leadership earns their keep. They will have access to additional resources and may well engage internal or external legal help. It becomes extremely important that the organization speak with a single voice. As a practical matter it protects the local executive director/administrator.
Have you faced this problem? How did you handle it? Part Two tomorrow will take a look at why you need to be so careful about taking sides and the special considerations for residents with dementia. Steve Moran
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Hold on here — What about Silverado — that admitted her with an assessment of her mental status, no doubt documented in their intake notes? Perhaps that is the issue here — not so much the families, and how was Silverado forced (against their will) to place her in memory care, if she didn’t require it? This individual resident must have interacted with staff members at every meal and snack, with a nurse who administered meds, who could have contacted an adult protective services organization if they felt the family was placing her incorrectly. Seems like a variety of Silverado folks could lose their license (nurse, facility). And if any of the allegations about medicating (as with the actual prescriptions and recording of dosages) were true, who is protecting the resident? And don’t tell me the ombudsman.
And once again — every state ‘protecting’ residents differently — makes no sense.
Thank the intensive lobbying of the industry to make California different from Virginia from Texas, and so on.
The experiences and entrance conditions of residents — no different.
Laurie Orlov
“Yet, this lawsuit alleges that the Defendants have repeatedly and routinely denied Ruby access to her mail or a phone, taken the cell phones purchased by her sons from her, diverted mail she wrote to her sons, and even humiliated her by having two large women strip her nude and shower her when they knew she could do this alone in the privacy of her own room. What seems rather clear under Texas law and Ruby’s case is that Silverado is in trouble.”
Hi Laurie: The problem here is that we are only seeing one side of the story and it’s the side that is committed to making Silverado look bad. I suspect that when this resident was first moved into the community Silverado had no idea as to the level of conflict. With respect to the medication issue this a story that was told by a family member. Again I would sure like to know the other side of the story.
I actually spent considerable time on the phone with the attorney for the family suing Silverado and came away feeling that I just could not comment on the merits of the legal action one way or the other because I have only heard one side of the story.
By way of full disclosure I do know a number of leaders at Silverado (though no business or financial relationship with them) and I like them and feel like they have a real commitment to high quality care, which makes me feel fairly protective of them, but with good reason.
Steve