RCFE / Assisted Living Fact Sheets:
Self-Advocacy Approaches
for Residents & Family Members

Self-advocacy is an act of empowerment! Here are some principles and practical tips to put assertiveness to work in your advocacy efforts.

Rights: Know your rights as a resident. (Refer to Resident's Rights Fact Sheet.)

• At the time of admission, the facility should explain your rights as a resident. The facility must post and make available to all residents and visitors a copy of the resident rights and how to make complaints.
• You have a right to express concerns, to offer suggestions or to make complaints and to do so without fear of retaliation.
• Contact the Ombudsman Program to assist you in exercising your rights. The Ombudsman is your advocate. A poster with the telephone number for the local Ombudsman Program must be clearly displayed in every Residential Care Facility for the Elderly.

Facts: Document your concerns.

• Write down important facts by answering who, what, when, where, and how questions. Keep a small notebook to record your observations.
• Describe what happened. Be as specific as possible. State the facts and avoid making conclusions.
• Organize events in chronological order, i.e., what happened on a certain date, followed by the next date, and so forth.
• When appropriate, refer to important documents, e.g., Admission Agreement.

Outcomes: Clearly define the results that you want. 

• Define your desired results by answering the following questions: What do you really want?  What can you live with? What is unacceptable?
• State your desired results in simple declarative sentences.
• Present the outcome in positive terms.

Options: Create one or two acceptable options for each concern that you raise.

• Act as a problem-solver or option creator, not a complainer.
• Come with solutions or options that will achieve your outcomes.
• State your options in terms of needs or preferences.

Negotiation:  Plan a meeting or meetings to achieve your desired results.

• Identify the person(s) who can resolve your concern(s). 
• Set up a meeting with the appropriate staff, e.g., Administrator or Manger, Activities Coordinator, cook, etc.
• Bring in allies who can support the outcomes and options that you want or who can give you moral support, e.g., family member or friend, Ombudsman, pastor, social worker, etc.
• During the meeting, focus on the outcome(s) that you want - don't get distracted.  Listen to build understanding and to gain information. 
• Establish a sense of cooperation. Don't personalize the argument or put down the person whom you are communicating with.  This usually produces defensiveness rather than the cooperation necessary to achieve a positive outcome. 
• Find points of agreement or compromise—build on these points before dealing with more difficult issues. 
• Insist on using objective criteria. If applicable, demonstrate the uniqueness of your situation and ask for an exception.
• Summarize your understanding of the agreed upon outcome(s) before ending the meeting.
• Insist on a date for resolution or a timetable for changes to be made. 
• If possible, put your understanding in writing.  This creates a permanent record of the agreement in case there are any misunderstandings in the future. It can also be a tool to promote accountability by measuring progress against agreed upon outcomes and timetables.

Appeal: If you are not satisfied with the outcome of the meeting, appeal the decision.

• One approach is to go up the "chain of command" to find a positive resolution.  Ask to speak with the person's supervisor or the person in charge of the department or the facility.
• If this doesn't work, call or write a letter to the owner or to corporate headquarters.

Formal Complaint: When problems are persistent or serious, file a formal complaint.

• Complaints are investigated by persons who do not work for the facility and may be able to see the situation more objectively, offering new alternatives. 
• Contact the local Ombudsman Program; and/or
• Call, write or fax Community Care Licensing, the agency that regulates Residential Care Facilities for the Elderly or Assisted Living Facilities. (Refer to the Fact Sheet on Filing Complaints.)

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