Effective Advocacy in Nursing Homes: Understanding Motivations

Advocating for a loved one in a nursing home is a responsibility that carries great weight. To be an effective advocate, it’s crucial to understand the motivations and realities that govern nursing homes and their staff. All advocacy begins with an understanding of what motivates the people we are advocating to. 

As Marcus Cicero once said, “If you wish to persuade me, you must think my thoughts, feel my feelings, and speak my words”. 

To be an effective advocate in a nursing home setting you must understand the two primary motivators driving action in a nursing home: 

  1. To the management, a nursing home is a business. 
  2. To the staff, it is their job.
A nurse assists a smiling elderly woman with a cane, indicating care and support.

Nursing Homes as Businesses

First and foremost, it’s essential to acknowledge that nursing homes are businesses. They operate with the primary goal of profitability, which can significantly influence their decisions and actions. Understanding what motivates nursing home ownership and administration can help you tailor your advocacy efforts effectively. Here are some key considerations:

  1. Profitability: Nursing home owners aim to run their facilities profitably. They want to provide care efficiently while managing costs.
  2. Regulatory Compliance: Nursing homes strive to avoid government regulatory interventions, citations, and fines, as these can disrupt their operations and reputation.
  3. Reputation Management: Positive online reviews and word-of-mouth referrals are essential for a nursing home’s success. They are motivated to maintain a good reputation in the community.
  4. Legal Liabilities: Nursing homes aim to minimize legal liabilities, including the costs associated with lawsuits, deductibles, and increased liability insurance rates.

When advocating to upper management or a nursing home administrator you should voice your advocacy in terms of their business. Some examples include: 

“I think this is an issue we should be able to resolve without lawyers or reports to the licensing agency”. 

Understanding Staff Perspectives

While it’s important to consider the motivations of nursing home businesses, it’s equally vital to understand the perspective of the staff who provide direct care to residents. Staff members view their work as a job, and recognizing their needs and concerns can guide your advocacy strategies. Here are some insights into staff motivations:

  1. Fair Compensation: Staff members desire fair wages for their work and may be discouraged by low pay or inadequate compensation.
Nurse in scrubs and mask reviews a chart on a tablet in a medical room.
  1. Work-Life Balance: Just like anyone else, they want a work environment that allows them to maintain a healthy work-life balance.
  2. Job Security: Staff members prefer job security and aim to avoid disciplinary actions or job loss.
  3. Respect and Recognition: They seek respect and recognition for their efforts and appreciate acknowledgment when they excel in their roles. 

When advocating to aides and nurses remember what truly motivates them relative to your loved one – job security and satisfaction. When you ask them for their name they assume you have a reason for doing so that might threaten their employment. When you ask for their supervisor they assume you intend to report them. Whatever your communication to staff you should always consider how it will impact them in the context of their job security. 

Effective Advocacy: Carrots and Sticks

Effective advocacy for nursing home residents involves a balanced approach that combines persuasion and, when necessary, the threat of intervention. It’s about providing incentives (carrots) and applying pressure (sticks) where appropriate. By understanding the motivations of both nursing home administration and staff, you can tailor your advocacy efforts accordingly.

  1. Positive Reinforcement: Recognize and praise staff for their hard work and dedication. Positive feedback can go a long way in motivating them to provide better care.
  2. Threat of Legal Action: If necessary, don’t hesitate to invoke legal action or the threat of it when advocating for your loved one. Nursing homes are motivated to avoid costly lawsuits and negative legal repercussions.

Elderly man in wheelchair outside with woman pointing at park.


Advocacy in nursing homes requires a nuanced approach, taking into account the business-driven nature of these facilities and the job-oriented perspectives of staff. By understanding what motivates nursing homes and their employees, you can better navigate the intricacies of advocating for your loved one. Remember, effective advocacy can be a powerful tool in ensuring that your family member receives the care and attention they deserve.

If you or a loved one has suffered serious injuries in a nursing home, please don’t hesitate to reach out to us for a free case evaluation at 757-547-5555. Your advocacy can help prevent abuse and neglect from happening to someone else.