Family experience with resident cared for by the same staff

How family members rated how often their loved one was cared for by the same staff, in a 2019 survey. (see data dictionary)

What do you think?

  • Why does it matter if a resident is cared for by the same team of nurses and aides?
  • Are there differences between zones? Between providers? Between mainly rural and urban zones or sites? What factors could account for these differences?
  • Are results different for families with loved ones in designated supportive living? If so, why are they different?

Whether you’re a resident, family member, provider, or health system administrator, thinking about why these differences might exist can start or inform conversations and lead to solutions for improved quality of healthcare.

Understanding “family experience with resident cared for by the same staff”

In a survey conducted from May to October 2017, the HQCA asked family members of residents living in long term care:

In the last six months, how often is your family member cared for by the same team of nurses and aides?

Family members could choose “Never / Sometimes / Usually / Always”

If a resident is consistently cared for by the same staff, they often experience relationship continuity. Relationship continuity often indicates a trusting relationship with a care provider. How often family members feel their loved one is cared for by the same staff can impact the experience of care from the family member’s perspective. Family member comments from the HQCA survey indicate that when their loved one is not being cared for by the same staff over time, care and treatment plans are inconsistently followed.

Considerations when viewing the results

There are a number of factors providers and leaders can consider to better understand and improve family member experiences with residents being cared for by the same staff. Before taking action, consider the following:

  • Family members were asked specifically about how often their family member is cared for by the same “nurses and aides.” Family members may not be able to clearly identify the nurses and aides from other staff at their loved one’s site for a few reasons (e.g., staff dress code is casual attire and not uniforms, infrequent visits to the site, etc.). However, these results still provide insight into the family member’s perspective of their loved one’s consistent relationship with care staff. Therefore, it is important to consider: How are staff encouraged and supported to develop ongoing relationships with residents?
  • How important is consistency of staff to family members?
  • Can existing staff resources be used in different ways to improve this measure? What are sites with better results doing differently?
  • What are the reasons why staff change? How could these changes be managed to support both relationship continuity and operations? How might this be shared with family members?
  • Which Long Term Care Accommodation Standard(s) does this question help inform, if any?
  • Which Continuing Care Health Service Standard(s) does this question help inform, if any?
  • Who should be involved in discussions to improve these results? How could residents and/or family members be engaged to develop solutions (e.g., engage the resident and family council)? What other collaboration might be required to make improvements in this area?

For information about the HQCA’s long term care family experience survey, please visit the HQCA website.

The Health Quality Council of Alberta uses the Alberta Quality Matrix for Health as a way of organizing information and thinking around the complexity of the healthcare system. This measure can be used as input to assess long-term care’s performance in these dimensions of quality:


Dimensions of Quality

  • Acceptability 
  • Accessibility 
  • Appropriateness 
  • Effectiveness 
  • Efficiency 
  • Safety