Residents may have many friends and family members. They may have few significant others and rely on community visitors or staff for social support. Whether there are many or few persons involved in their welfare, it is for the resident to decide who should be informed about changes in their health status and included in discussions about their care.
If the resident is unable to give direction, their substitute decision maker may do so. All staff need to be aware of the following when talking about residents.
- The resident's right to privacy and autonomy.
- Facility policies and relevant legislation.
- The Charter of Residents Rights and Responsibilities.
- While the resident is the focus of care, families and friends also require support and information.
- Holistic care of the resident recognises the importance of maintaining family connections and acknowledges the role of family in the care of the resident.
- A cooperative relationship between families and staff can lead to better outcomes for residents.
A recent review of the evidence for constructive staff-family relationships in aged care concluded that effective staff-family relationships :
- are built on respect, trust, familiarity and empathy
- are supported by education for staff that includes:
- communication skills training
- building relationships with families
- understanding issues of power and control.
- require management support with defined processes and systems to facilitate
- are supported by interventions that involve the multidisciplinary health team.
The family carers of people dying of dementia may have special needs. They are often required to make health care decisions on behalf of the person with dementia. A review revealed the concerns that arise when families do not receive information.  These include:
- poor or inadequate communication resulted in families viewing palliative care negatively, as giving up
- family carers felt they lacked knowledge of the dying process and did not understand what was happening
- lack of information contributed to families opting for active treatment when comfort care was more appropriate
- families did not recognise dementia as a terminal illness.
- they tended to focus on small day to day changes in their relative but did not associate the changes with dying.
The same review also found effective communication has positive benefits.
- Active communication and shared decision making with health care professionals enabled family carers of people with dementia to make care decisions with confidence.
- Supportive and caring responses from staff may reduce the stress and grief of family care givers.
There is information throughout the RAC Hub and CareSearch that will assist staff to meet the information needs of families. Sometimes families have specific questions about the care and management of their relative at the end-of-life.
There is information and resources that may help in the Care Issues pages. The many people who work in RAC will find information on how they can help residents and families in the For People who work in RAC section.
The period of time surrounding admission of a loved one to RAC can be stressful for family caregivers. Research from Alzheimer’s NSW,  suggests that good communication with staff can ease the transition to residential care for residents and their families. Families feel supported by:
- a welcoming atmosphere
- staff who engage with and work alongside families to provide person centred care of the person with dementia
- structures that promote communication and information sharing.
RAC facilities are complex organisations. The constant flow of information between many levels of staff, residents, their family and friends can often give rise to misunderstandings.
Developing effective communication skills requires training, reflective learning, practice and a supportive working environment.