Long-term care staffing shortages and crippling rates of turnover have been a part of our industry for so long many people believe “this is just the way it is” in senior care. According to the Alzheimer’s Association, 11 to 20% of long-term care jobs are vacant and the situation is expected to get worse now that the baby boom generation has started moving to senior care communities.
The Institute for the Future of Aging Services cites 7 factors for the retention and recruitment difficulties in long-term care:
- The economy: When the economy is strong and workers have choices, many choose to work in other industries
- Negative public perception of nursing homes and the tendency to equate all long-term care with nursing homes
- Low pay and benefits despite high levels of responsibility, heavy workloads, and high injury rates
- Poor working conditions with low rates of mentoring and teamwork
- Inadequate training programs that do not address the special needs of elders
- Limited data that hampers workforce planning, policy development, and quality improvement efforts
- Limited funds for adding additional personnel
That’s a long list, and it’s not particularly flattering. Nor is it really surprising. Most of us could have probably guessed several of these factors based on our experiences working in long-term care. Given the demands of state and federal regulations, medical regimens, and tight budgets, it is all too easy to let staff shift for themselves until there is an incident that cannot be ignored, but that is a costly mistake.
In the absence of leadership, staff is forced to manage for themselves, whether or not they have the knowledge or ability. Organizational values and standards are neglected as staff tries to meet the minimum expectations in a chaotic environment. Expensive mistakes get made and benchmarks get missed. Residents don’t get the service they deserve, “behind-the-scenes” bickering is actually happening right out in the open, and the company’s reputation with residents’ families is constantly suffering. All too often, someone from the direct care staff calls at the last minute and a premium must be paid for an untrained temp to fill in. No one, least of all residents, feels respected or like part of a community.
Excellent staff members end up burnt out, discouraged, and seeking employment with a “winning team” across town, preferably in another industry. Mediocre and poor performers have no reason to improve and every reason to treat their job with indifference. Many job seekers, even those who value their elders and providing good care for the aged, take jobs in long-term care as a last resort.
The majority of these problems can be resolved with effective leadership. To overcome your staff shortages:
- Train staff in the knowledge, skills and attitudes they need to be successful and find meaning in their jobs. When they connect with the importance of the work they do—for residents, your organization, and their future—they will value their jobs and your community more.
- Support and mentor your teams to work cooperatively and achieve on-going success. It’s not enough to just show a video during the all-staff meeting. Great coaches invest of themselves, guiding, inspiring, and staying in touch with issues that affect everyone.
- Improve communication between departments, management and staff at all levels, staff and residents, and with the greater community of families you serve. Appropriate communication demonstrates respect for others and promotes teamwork.
- Build relationships among all stakeholders. Remember, your organization is a community. For residents, it is home. The same hospitality you demonstrate in your personal home and neighborhood needs to be present and fostered in your senior care community.
Resident-centered care is really about the staff. If you create an environment that nurtures your staff and teaches them how to provide the care and service residents rightfully expect in their homes, you will find your staffing problems are reduced and your community is an enviable place to live and work.
About the Author
Cindy Heilman, MS, DTR has over 30 years of experience enhancing hospitality and food service quality. She is CEO of Higher Standards, LLC, author of Hospitality for Boomers: How to attract residents, retain staff, and maximize profitability, and creator of Kind Dining® curriculum, her unique program that improves serving staff in senior living communities. She’s active in Oregon’s culture change coalition, has been recognized as Oregon’s Dietetic Technician of the Year, and received the American Dietetic Association (ADA) National Award for Excellence in Dietetic Technology. She speaks, trains, and consults nationally on raising service standards in senior living communities.