Workforce Engagement

Staff Turnover and the Effects on Person-Centered Care

AdobeStock_22892703

One of the biggest problems the senior living space faces at the moment is its incredibly high staff turnover rate. We’re all aware of the monetary costs that accompany a rotating staff door, but how does this affect the depth and breadth of care our staff are able to offer seniors? The Person-Centered Care (PCC) approach that we’re all trying to get on board with is dependent on the relationships between staff and residents. Let’s take a closer look at how staff turnover effects Person-Centered Care.

Pressure on Existing Staff Members

While seeking, hiring, and training new staff members on a consistent basis has it’s financial drawbacks, there are also negative implications for longer term staff members and residents alike. A rotating door of staff members means the caregivers that do stay in your community long term can face pressures that accompany new hires; these include shifting workloads, staff retraining, and not enough opportunities for community personnel to focus on each resident. An increase in workplace pressure, in any field, often results in employee burnout and an increase in staff turnover.

Relationships Over Time

The person-centered care approach leans heavily on the relationship between staff and seniors and it should be no surprise that deeper, more meaningful bonds take more time to form. Interacting with the same resident on a consistent basis builds a certain rapport that is mutually beneficial for both parties. This kind of constant attention from the same caregiver is called ‘consistent assignment’ and refers to the unvarying routine and care from one staff member to specific seniors. In a review by NCBI, the positive effects of consistent assignment were explored in senior living communities:

“The practice of consistent assignment of nursing staff to residents has intuitive appeal, and anecdotal reports suggest that it leads to better quality of care outcomes, stronger relationships between staff and residents, and a more stable and committed workforce”.

And this approach makes sense on a fundamental level: staff members can’t build relationships with the residents in their care if they’re not interacting with them regularly. Thus, the higher staff turnover rates in our field negatively impact the bonds, and ultimately, the quality of care we’re able to offer our seniors.

Staff and Senior Satisfaction

So what happens when our turnover rates are high, our staff members are stressed, and our seniors may not be getting the kind of care that could be getting? In a 2011 study, it was found that the rate at which patients recommended the hospital they were staying in “decreased by about 2 percent for every 10 percent of nurses at the hospital reporting dissatisfaction”. While this study was conducted in a hospital setting, there are certainly parallels that can be drawn when compared to the senior living space. As caregiver satisfaction goes down, there is potential for fewer referrals due to resident dissatisfaction. Additionally, the less satisfied both staff and seniors are with their time in the community, the more likely the quality of care will go down. So when staff retention rates are low, both caregivers and their residents feel the impacts of constant new hires.

The apparent answer to improving the quality of care is to reduce staff turnover, but as we’ve seen in the senior living space, there is no quick fix or broad spectrum solution. Instead, we have to look at why caregivers face burnout, which may be a more deeply rooted issue that differs from community to community. There’s a cyclical nature to staff retention, quality of care, and the resident’s quality of life, all playing crucial roles in the overall success in our communities. If we can provide better work spaces for our staff, they will, in turn, provide better care for our seniors.

How To's and Tips, Senior Living, Workforce Engagement, "Technology"

Implementing Person-Centered Care into Our Communities

TSOLife and Person-Centered Care

It’s generally accepted in the senior living space that Person-Centered Care (PCC) is an important facet in improving the lives of staff and seniors as well as raising the standards of the industry as a whole. But there are discrepancies between acknowledging the importance of PCC and implementing some of its practices into our communities. In this week’s blog post, we’ll look at how to implement Person-Centered Care into our communities.

Mindset Shift
One of the quickest and easiest methods for pushing your community toward more personalized care is to shift the outlook on residents from patients to people. This means considering each resident’s entire life story as a vital piece of what makes them who they are today. To contrast this, patient care is a rather truncated view of each person, looking at what is currently ailing them to fix it as quickly as possible.

This shift in perspective can also open up opportunities for insights that may be looked over otherwise. Trying to understand resident behavior at face value can prove to be difficult, as it is with anyone. But diving a bit deeper into personal history can help your staff understand why some of the out-of-the-ordinary behaviors exist.

The Little Things Matter
Similarly to shifting our mindsets, getting to know the intricacies of your resident’s lives can help your staff make decisions on how to best offer them the care that they need. Knowing a resident’s favorite food seems like such a trivial and insignificant tidbit of information, but if you have someone you're caring for in memory care who refuses food, knowing which foods they like or what food their mothers cooked growing up could help resolve their eating issues.

Even with residents who are mostly autonomous, having access to and being able to recall small things about them can help make them feel heard, that they have the support there if they need it. Mental health is just as important as physical health, and letting your residents know that they’re seen can help to bolster morale. Sometimes the little things can help in a tremendous way.

Easier Methods for Long-term Results 
One of the biggest hurdles the senior living industry faces when trying to focus more on personal care lies in how to implement these methods on a large scale, while also maintaining sustainability. Caregivers have a finite amount of time and energy to allocate to each resident, which makes personal care for every person a challenge. The answer lies in the newer systems and technology we can implement into our communities to make Person-Centered Care easier, thus making is a more long-term solution.

TSOLife’s Co-Founder and COO, Stella Parris, weighs in: "It's unrealistic for every single staff member to have an extended sit down conversation with every single resident right at move-in. So if you can get one person to have that conversation, but allow all staff to read, listen, share, and enjoy the information, it becomes possible for staff to get to know each resident to some degree."

Without implementing newer systems and tech, the industry as a whole won’t be able to achieve the best results when it comes to Person-Centered Care. Additionally, passing up opportunities for easier PCC will only perpetuate the cycle of caregiver burnout, staff turnover, and ultimately lower standards for the care for our seniors.

Of course, there are a number of ways to apply more personal methods into your community, but it’s important to employ a forward thinking mindset to help make Person-Centered Care an effective, long-term solution. Start with the ways you can start applying to your community today and go from there. We’re all in the business of improving the lives of our staff and seniors, so let’s help each other get there a little faster.

 

How To's and Tips, Senior Living, Workforce Engagement

Patient Care vs. Person-Centered Care

Person-centered Care

Although patient centered care and person centered care both have a resident's best interests in mind, they do have some differences that set them apart. In this week's post, we'll be looking at the differences between patient-centered care and person-centered care including what each means, and some of their key distinctions.

Defining Differences

Each of these avenues of care is important in its own right, but it’s important to note their differences. With patient-centered care, an individual’s overall physical health and health needs are at the forefront of any care they receive, but this is really only half of the equation. Person-centered care is based on the accumulated knowledge of people including both their personal and medical histories. We’re seeing a pull in the direction of person-centered care as an opportunity to view the seniors in our care more holistically, applying personal knowledge of each individual to the care they receive.

Longevity of Care

One of the most prominent factors in distinguishing these methods of care is its longevity. Treatment that centers more around a person’s symptoms and diagnoses can be intermittent or be short-term. Seeing people as patients can depersonalize them in order to maximize efficiency: find out what’s wrong, fix it, move on to the next. The reason the senior living space is pushing for more individualized care is to factor the actual person back into caregiving.

Personalized care often takes longer than patient-centered care, yes, but there are merits in establishing a relationship with our seniors. This allows caregivers to tie together someone’s physical health with their mental health, social health, and history: “A major failure of primary care... is the great underestimation of the importance of long-term relationships with patients.” (Starfield, 2011)

Additionally, care specific to each individual offers insights into the overall well-being of someone in your community. Taking into consideration all aspects of a person is crucial; this means their personal history and health as well as a general understanding of who they are. This is especially important as older adults sometimes have to maneuver from one health problem to another. A cumulative view of a senior’s health, rather than a snapshot, is much more effective at offering the attention they need.

Restoring Relationships

Individual, long-term care is commonly praised for its impacts on both seniors and staff. While patient-centered care can offer an environment for relationship building, it’s more likely that a stronger connection would develop between residents and caregivers that offer individual attention: “Patient-centered care also aims to improve clinical practice by building caring relationships that bridge demographic, social, and economic differences between clinicians and patients” (Epstein, 2010).

Not only is building relationships with your residents beneficial for their overall health, connecting staff with them helps to reduce staff turnover. There’s a positive feedback loop between person-centered care and the prosperity of a given community: look at residents holistically to offer better care, build stronger relationships between staff and seniors, have caregivers stay in their communities longer.

There are a lot of buzzwords and trends surfacing in the senior living space, but the reason we have to keep this conversation active is so we can continue to push for higher standards, better care, and happier people; staff, seniors, and families alike. Keeping up with our resident’s health is imperative, but seeing the whole person can help have positive impacts on the care that they receive.

Thank you so much for taking the time to read through our blog posts and for your support! Stay tuned for some of our next blog posts on how to implement more person-centered care in your communities. What are your thoughts on patient and person-centered care? Let us know on LinkedinFacebookTwitter, and Instagram!

 

Senior Living, Workforce Engagement

Increasing Resident Engagement through Lifestyle Activities

AdobeStock_175836851

Between our jobs, family, friends, home responsibilities, leisure time, and on-demand entertainment, it’s never been easier to have a few days slip by in the blink of an eye. Our schedules are so packed it can be hard to think about what a weekend with no plans would be like. Often times, this isn’t the case for seniors in assisted living communities. There is a lot of time that residents will have scheduled or use for themselves, but it’s up to the Activity Director to fill those down times with something to do. These activities are sometimes expected to be extensive field trips, expensive guests, or to have something scheduled for most days of the week. While having the time or resources to do everything residents want to see from their Activity Directors (ADs) would be ideal, the fact is, more times than not, this is not the case. In this week’s blog, we’ll be looking at how ADs can save time and provide more engaging, person-centered activates for their residents.

The Needs of the Many

While trying to provide activities and programs for as many people as possible is a noble pursuit, it might not be ideal for all of them, especially if they are vision or hearing impaired. There are activities that apply to lots of people, but just because you can plan these activities, doesn’t mean you should (looking at you 3pm bingo). Planning a full schedule that isn’t appealing to some of your residents could potentially worsen feelings of social isolation or depression. Instead, try to find out how your residents spend their free time and craft relevant activates based on preferences.

Leverage Technology

One of our past blog posts was on how integrating technology into senior living communities could benefit both staff and residents. Specifically, the TSOLife program can act as a time-saving measure for Activity Directors. All of your residents’ stories, preferences, and resident profiles are housed on the TSOLife platform and with searchable content, planning personal activities around the seniors in your community flows just a little bit smoother. Additionally, our service works with technology that your staff and seniors already know how to use like smartphones and tablets.

Provide the resources

Sometimes, the job of an AD isn’t to plan events or outings, but rather to provide seniors with the resources to plan their own activities. It’s important to help your residents be as autonomous as possible, letting them plan and carry out activities on their own. Working with local libraries to bring in new books every month is a great way to stir up some excitement as well as offering up opportunities for residents to take activity planning into their own hands. Aside from books, also think about a common area with computers, puzzles, or movies as resources to stimulate independent action.

Involve the Community

Getting the community involved is a two-pronged plan that could help you schedule different kinds of activities. Having your residents volunteer their time is both refreshing and meaningful. Helping with light activities like gardening and knitting for other organizations could help seniors feel more connected to a sense of purpose. The second facet of volunteerism is pulling in people to volunteer time in your community. They can help out in a number of ways even if it's just chatting and engaging with your residents. Drawing people into your community may not be the easiest thing, but positioning their volunteered time as a growing and nurturing experience can help. Ask volunteers about their interests to see if there’s potential to build any activities from them. Engaging both seniors and volunteers is a great way to keep people invested in your community.

Activity Directors often have too much to plan and manage with a budget that doesn’t reflect their overall ambition. By personalizing activities through tech, providing opportunities for autonomy, and getting the community involved, ADs might be able to streamline processes a bit more, saving time and money for your community.

How To's and Tips, Senior Living, Workforce Engagement

Why Families Choose a Community

Looking for assisted living community

Looking for assisted living communities to house your loved ones is never an easy decision, especially with all of its moving parts. Considerations could range from how much (or how little) care they’ll need, proximity, activities, and a host of other things to think about. While it’s important to make sure potential residents and their families like your community, it’s also important to make sure that you have the capacity to care for them. In this post, we’ll discuss some of the top things families look for when choosing an assisted living community and how we can help make yours more appealing.

Changing Needs

There are so many different facets of change when it comes to the aging process, it can be difficult to keep up with all of them. From mental and physical changes to nutritional changes, residents in your care, as well as potential residents, need assurance that their needs can be met as they change. To see some of the needs that families could be looking for, check out AARP’s caregiving checklist for insights.

Staff Turnover

This is one of the more important aspects families may want to know about: how often does your community go through staff? If there is a revolving door of caregivers, it could be reflected in the quality and quantity of the care they’re able to provide residents. We’ve mentioned before that the industry average for caregiver turnover is around 42%. Communities that have trouble with staff retention tend to give more generalized care to their residents, which could contribute to lower resident satisfaction as well as caregiver job satisfaction. The TSOLife platform can help lower turnover by providing opportunities to staff to forge meaningful connections with their residents.

Staff-to-Resident Ratio

A community’s staff to resident ratio is directly influenced by staff turnover rates; the more staff you have coming and going, the less caregiver face time residents will get. Each state has its own standards for what the minimum ratios are between caregivers and seniors under their care. In Florida, the minimum staff to resident ratio is 1:20 for CNAs and 1:40 for licensed nurses. By helping to increase staff in assisted living facilities, the TSOLife program can positively impact the ratio of workers to residents. Families and potential residents alike both want to see more quality time spent with caregivers, which we can help ensure through both storytelling and through useful resident profiles.

Staff Training and Personality

Another important aspect sought after by families looking for assisted care is the overall training and personality of the staff, from dining staff all the way up to community directors. Yet another facet to caregiving that ties in with staff retention, having well-trained and satisfied staff comes with time and vertical movement in your community. The longer you can hold onto any given staff member, the more likely they are to make lasting impressions on your residents.

Activity Diversity

Along with a genuinely good place to live, prospects want to see how they’ll be spending their time in your community. Our platform is a great alternative to traditional community activities and helps residents open up about their lives and preferences. By getting to know their residents better, caregivers can offer activites tailored to what seniors under their care actually want. Additionally, residents who participate in our program could potentially alleviate any late-stage depression through the means of life review therapy. Potential residents and families ultimately want to see that it’s not just a place to live, but also a community to be part of.

 

There are so many other aspects to consider when looking for an assisted living community, but what we’ve covered are a few of the heavier topics that people want to see. The TSOLife program can help your community be more effective in the care that it provides, while also drawing in new residents and staff alike.

How To's and Tips, Senior Living, Workforce Engagement

No One is Looking at Employee Retention Like This

ALC Outside smaller

Employee turnover is plaguing the senior living industry. According to recent surveys, the annual rates of staff turnover in assisted living range from 21% to 135% across states and reach a national average of 42%. This means increased costs and lowered community-wide satisfaction. It can even decrease occupancy.

When faced with this challenge, senior care providers are encouraged to offer competitive wages, proactively recruit, improve training, and provide a comfortable work environment, among other tangible things. Yet, no one is making substantial strides in increasing staff retention.

That’s why we need to look at employee retention through a new lens.


Organizational Commitment

Organizational commitment  is closely linked with staff turnover. Employees that are committed to their jobs are less likely to quit and perform better; it’s even a better predictor of turnover than job satisfaction. So how do senior living providers foster organizational commitment?

Organizational culture.

Culture is not just marketing ploy for companies. The power of its influence shapes how staff perceive their jobs and their commitment. Establishing an organization that values morale, teamwork, and participation in decision making doesn’t happen overnight. If being intentional about your company’s culture isn’t on your radar, Entrepreneur provides an article on building a strong company culture here.

 

Interpersonal Relationships

A common thread among employees in this industry is their fondness of the residents, and this unique relationship with the seniors can actually translate to job commitment. When staff engage with residents through meaningful conversation, a bond is created that directly contributes to retention. The residents become more than patients: they’re extended family. And saying goodbye to family is much more difficult than leaving for transnational purposes.

A study looked at employees who were considering leaving their jobs compared to those who actually quit. On the basis of their ranking of reasons for staying and leaving, the study suggests that “stayers” appeared to assign more importance to the intrinsic or people-oriented rewards of their jobs, such as relationships with residents, feelings about caring for sick people, and relationships with supervisors. Further, their fondness of the residents was a prominent reason for them staying, as exemplified by the typical comment: “they [residents] wrap around your heart”.

However, with all the must-haves in senior living, the stress of meeting regulations and staying compliant, and ensuring residents are happy and healthy, making time for “meaningful interaction” often slips through the cracks. That’s why it is critical that staff integrate these interactions into their daily routines. Simple tools and technology can help promote purposeful conversation.

Because of the therapeutic and cognitive benefits, there is a huge emphasis on storytelling for seniors. However, storytelling also gives context into the resident’ lives, and helps the staff view the residents as more than a task, they’re a grandfather/daughter/successful entrepreneur/world traveler with a rich history behind them.

Strong bonds and residents who feel celebrated mean happier employees. And happier employees stay longer.

 

Looking at Employee Retention in a New Light 

With the projected care staff shortage and the increasing need for services related to the growing elderly population, a focus on staff turnover is critical in meeting the needs of the aging population.

The success of your senior living organization greatly relies on your ability to attract and retain employees who are passionate about carrying out the company’s resident-centered philosophy into their daily routines.

A focus on increasing organizational commitment and employee-resident connection might be the missing link in your staff retention strategy.

 


 TSOLife Logo-2

TSOLife (The Story Of Life) focuses on preserving legacy and passing down life stories for future generations. We help senior living communities leverage technology to capture, preserve, and share the life stories of the residents in their care. It fostering purposeful engagement and providing a precious keepsake for the families.

Learn More