Confronting the Fear of Retaliation

The fear of being retaliated against for voicing grievances is a very real fear for residents of long-term care facilities and their families.

Though retaliation is not exclusive to the long-term care setting, it is understandable that nursing home residents, who rely on staff for help with many daily needs and activities, can feel extremely vulnerable.

Too often families tolerate poor care for fear that if they complain, the staff will "take it out on them" or their loved one. Families also fear that if they complain, the caretakers of their loved one will be fired. Most often families complain about system issues, such as lack of staff, not about a single staff person. In fact, the fear of retaliation is the number one reason cited by families for not expressing their concerns and for not being being outspoken advocates for their loved ones. This retaliation can take different forms-subtle and overt. Retaliation can range from staff who suddenly treat a resident differently and are not as warm and friendly as before, to call lights being ignored, and even the recommendation of discharge.

Though the fear of retaliation can spawn an atmosphere of oppression, families must keep in mind that if things are going to change, and if care is going to improve, they must speak up and be a voice for their loved ones. One Michigan resident advocate explains, "I can't guarantee that retaliation won't take place. I can say that if they don't complain, nothing will change. So, while there's the possibility of retaliation, there is also the possibility of change" (Family Education and Outreach, NCCNHR, 1997, p.41).

Nursing home resident advocates recommend that the laws be changed to be more forceful in preventing retaliation and offering families recourse when retaliation does occur. Minnesota law is one example of a stronger law in which "any facility that retaliates against any person because of a report of suspected maltreatment is liable to that person for actual damages, punitive damages up to $10,000, and attorney's fees" (Minnesota Statutes 626.557, Subd. 17).

Being empowered as an advocate starts by being informed about one's rights. All residents have the right to safety and good care that meets their individual needs. They also have the right complain to anyone inside and outside of the facility and "be free of interference, coercion, discrimination, and reprisal from the facility in exercising his or her rights" (483.10 (a) (2)). All families have the right to meet as a group in a private place and voice their grievances.

Family councils can be an answer to the fear of retaliation families and residents feel. Family councils offer families anonymity. Council members can take concerns to the facility staff and administrator as a group. No one is singled out and 10 voices will always be stronger than one.