Table 1.

Research, Practice, and Policy Recommendations to Reimagine Family Involvement in Residential Long-Term Care.

Recommendation	Details
Practice
Enhance communication	Ensure that communication from healthcare professionals and direct care staff is transparent, accurate, and timely to ensure effective family partnership in key care decisions Establish communication mechanisms so that family members can report changes in a relative’s health status to the professional care team
Achieve family-centered care	Develop strategies to fully incorporate family members as part of care teams both in RLTC as well during key transitions to or from RLTC settings Discourage scripts (e.g., predetermined and inflexible agendas; use of clinical jargon) when meeting with families to ensure that care and services are more effectively person- and family centered
Policy
Family as policy driver	Move beyond the family council and develop/implement governance structures that allow family design of actual care processes and policies in RLTC Participatory representation Hybrid model (co-develop policies and partner with families to propose and advocate for policies where necessary)
Follow visitation recommendations	Adhere to visitation recommendations and family involvement in anti-microbial stewardship as outlined in recent JAMDA publications81,82 and others89
Research
Focus on understudied sociodemographic contexts	Conduct research that better captures the family involvement process in rural and other understudied sociodemographic contexts
Advance measurement	Continue to test valid and reliable measures of family participation in RLTC
Transitions to and from RLTC	Conduct ongoing descriptive research on family involvement in transitions to and from RLTC with the goal of advancing interventions to help families and RLTCs improve and better navigate these transitions, including: Advanced care planning; Transfer from hospital/emergency room to RLTC and vice versa; End of life care; and Admission to RLTC
Intervention development	Incorporate family members in the design and evaluation of interventions that improve quality of care and quality of life in RLTC
Triadic focus	Apply methodologies to better understand the resident-family-staff triad in RLTC
Longitudinal perspective	Conduct longitudinal analyses of change in family involvement to inform the timing and content of interventions Continue to examine how changes in family involvement are predictive of key family, staff, and resident outcomes in RLTC

NOTE: RLTC: residential long-term care; JAMDA: Journal of the American Medical Directors Association