The dirty little secret about our business is that, despite a company’s size, corporate mission, experience, capital resources, quality brochures and even flashy media, this industry lives and breathes based on the actions of a caregiver, making $11.25 an hour, doing the right thing at 3 am…night after night.
As a 27 year veteran of the senior living industry, holding community level positions from Caregiver to Executive Director, and spending the last 13 years as COO for a mid-size national provider, I feel it’s time to let the cat out of the bag. The dirty little secret about our business is that, despite a company’s size, corporate mission, experience, capital resources, quality brochures and even flashy media, this industry lives and breathes based on the actions of a caregiver, making $11.25 an hour, doing the right thing at 3 am…night after night. For years I’ve been asked for advice by friends who are seeking placement in a senior community for a loved one. Beyond my opinion of the potential community, the fees and charges, etc., I strongly advise my friends to request to meet with at least two of the community’s third shift employees, even if it means a late night visit. I implore them to meet the staff members who will be assisting with medications, assisting with baths and bringing your loved their meals. Ask these folks how they like their jobs, how the process works, and ask them for their ideas for how things could be improved if they could make the decision. It’s a given that as a prospective family member you will meet and spend time with the Marketing and Executive Director, and maybe even be introduced to one or more other staff members. If that isn’t the case, your foul weather warning flags should be flapping in the breeze. But meeting community management should just be the “starting point” of your decision process. The critical “touch points” of your loved one’s life will occur during bath time, meal time and potentially, when there’s a problem, at 4 am.
These are the staff you should meet. Our business is dependent upon these individuals, and I’ve been blessed to know many who are dependable and dedicated and who accept this responsibility because it fulfills a need to live with a servant’s heart. A few minutes spent speaking to these staff members will illuminate whether or not these qualities exist. Unfortunately, all too often these positions are filled with individuals who do not possess these qualities. The fear for any family member should be the third shift employee who is battling their own personal demons, who has a full-time day job, and for whom caring for your loved one is a “second’ or ‘side job.” Remember that your tour of the community and meetings with the management and sales counselor are scheduled to accommodate your schedule – and theirs. Your loved one’s time with the community staff will run 24 hours a day. When the phone rings (or e-call button is pushed) at 3am, who will be answering? It’s worth finding out.
How would you react of a prospect wanted to come visit your community at 2 am in the morning? How would you feel if you discovered one of your hot prospects paid a late night visit?
Great info should any of my loved ones need such care.
Thanks for sharing John!
Jeff, thank you for commenting! One day, if we’re blessed, we’ll al through the difficult process of finding additional care for a loved one. I hope resources like this site, and my minor contribution will help. Thanks again.
The author’s perspicacity is an asset to this forum. I’m beginning to deal with this right of passage. I will not only return to this forum for information and advice, I am recommending this article and forum to my friends.
Thanks, Sergio. Appreciate the kind words.
John, this is one of the more insightful posts I have read recently. Thank you, my friend, for helping us in the assisted living business to stay focused. Best to you and your family. Jack West
Jack, you are too kind sir! Thank you. I know you and I share a desire to see our industry continue to grow and prosper, all the while maintaining a level of ethics and integrity beyond reproach. All my best to you.
You raised an excellent point. I don’t know if many people look past the facility and staff as seen during normal business hours. How many even consider who is running the show overnight and their quals, level of really caring about what they do and who they are doing it for. This piece is a real thought provoker for anyone looking into these facilities.
Thanks, Norm. Having been on the inside of our industry for nearly 3 decades I’ve seen a lot, and the vast majority of it good. I hope to continue sharing what my opened eyes have witnessed, and what I’ve learned with you all. Thanks.
Excellent advice! Thank you for these words of wisdom. When I take families on tours of various communities, it is very common to see them focus on the color of the walls, view from the window, amenities such as granite counters or crown molding, and I try to redirect them by saying none of those things matter if the care is not good. I encourage them to spend time meeting and speaking with the staff who will be caring for their loved one.
I have to confess, until I read this article, I have honestly never thought to consider the importance of the night staff. I would also suggest to ask how many employees are on duty at night, as I have seen places that appear well-staffed during the day, but at night there may be only one employee for over 100 residents, and those who need help may have to wait a long time for assistance.
Linda, balancing labor costs with rates is always a challenge. Having worked for both large and small, public and private companies, I am convinced it is a universal challenge. But one that can be balanced with the proper training, priority and oversight. Our industry is regulated by the individual states, but must always remember that the ultimate authority in this business is the resident – and their family. I believe that the more “involved” families are in any community, the better! Thanks.
John,
I enjoyed ready your thoughts on assisted living. As always, you have a way with words and think about things from many views. It is so true that at the heart of our business is our front line staff. I enjoy spending time with my staff and find at the end of life the front line staff are the ones the families build the strongest relationship with. Without the frontline we would not have a foundation to provide care to our residents.
Totally agree , Jessica. I’m sure your front line staff appreciates their leader’s acknowledgment of their importance! 😉
This is a very insightful, and accurate, article. Thank you for putting the word out there. This could help countless families during an extremely stressful and trying time.
Thank you, Melissa! I hope that it does help.
Yes, it does come down to the staff, but also to the leadership of the staff.
I’m a small ALF owner/operator, and we have at least one person, and some nights, two on duty to care for 4, 5 or 6 Residents, despending on their care needs and how much they’re awake at night. Usually one will do it, in a home ALF like ours.
Our staffing is two to four times the state required hours, however overall.
The number One thing I look for is Compassion. All else can be learned, given a reasonably adept person.
This is a nice forum, and I will be back.
Doreen, I agree: skills can be taught, but you have to hire the right attitude!
Doreen, Janis…what you both say is true. And this is another conundrum….if you seek out and hire the “right” people first, skills training (assuming you are able to provide it) is easily absorbed and employed. However, for many working in this industry (to say nothing if those residents and families who have no control whatsoever) you play the cards (or staff) you are dealt. Great dialouge…thank you both for your insight
Thanks for giving us a wake-up call!
We tend to not focus on key issues when all is well…..
Great article and advice John. In the healthcare industry, it is too often forgotten that the lowest paid work has the most important role in caring for our loved ones. It is worth the extra effort.
Andy, Lucinda, thank you bot for the kind words. To whom much is given, much is expected. I’ve been given an enormous amount of experience in this industry, sharing the knowledge is not a generosity of mine, but a responsibility. Thank you!
I would not have a problem with family visiting at 3 a.m. We are open 24/7 and ready to serve!
I ‘m glad to hear that you have no problem with your family.
I think in-person tours are also a must for caregivers who want to make sure a specific community is right for an elderly family member. Most elderly are looking for something that would let them accept a facility easier.
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