Reimagining Family Involvement in Residential Long-Term Care.
Joseph E Gaugler, Lauren L Mitchell
PMID 34973167WHAT IT FOUND
Families remain central to care in nursing homes and assisted living, especially during transitions and end of life.
Proactive, respectful staff-family communication can reassure families and support resident care, but involvement can also bring guilt and conflict.
Key findings
01Family involvement does not end when a relative enters residential long-term care; it often changes shape and can include visiting, advocacy, personal care, and communication with staff.
02Family visits and involvement are associated with resident quality of life and care quality, but the associations are mixed and can include family guilt, conflict, or lower family-reported resident quality of life.
03During hospital-to-nursing-home transfers and end-of-life care, families often want proactive communication and a real role in decisions, but they can feel unprepared or excluded when information is poor.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
It reports associations and themes from existing studies, not a direct test of whether family involvement causes better care. The included studies used different designs, populations, and outcomes, so findings are hard to combine. The authors included additional references from an author's personal library, which may limit search completeness. The paper itself says the science on promoting family involvement is limited and intervention components are not well understood. Family involvement was associated with both benefits and harms, including guilt and conflict, so more involvement is not automatically better.
The easy way to misread this
Do not read this as proof that involving families improves resident care. It is a review of existing studies, not a new trial, and it reports that family involvement can also be associated with guilt, conflict, or lower family-reported quality of life.