We were discussing the objectives of our training program, especially the caregiving training program. Our newest team member, Ken, asked, “What behavior do you want to see in a well-trained caregiver?”
The first thing that came to my mind was excellent observation skills. A good caregiver – a well-trained caregiver – should be able to walk into a room first thing in the morning and say, “Good morning, Mrs. Smith.”
A good caregiver should stop and listen for a response, and instantly identify the well-being of the client.
She should notice the slightly slurred words, and take the time to ask another question: “Did you sleep well last night?” and listen for the response. Maybe the person is in pain – ask a probing question. Maybe the person is ill – check her temperature and pulse.
In short, a good caregiver should know her clients so well that she can instantly tell when something isn’t quite right – and take the appropriate follow-up action.
Ken, our newest employee, looked up at me abruptly and said, “That really hits home.” He shared the experience of visiting the hospital to see his mother-in-law. His wife asked the nurse, “How’s my mom today?”
The nurse responded, “She’s doing fine.”
As they walked into the room, his wife said, “Good morning, mom,” and heard her garbled response. She was clearly not “fine;” in fact, she died a short while later.
At my book club, we were discussing the current dire state of healthcare in America. One of my neighbors had been talking with a British friend who said, “The trouble with you Americans is that you do too many tests. Doctors, nurses and caregivers are no longer trained to really listen to the person and observe. Just send out for another test – that’ll tell you what’s wrong.”
Another neighbor shared, with passion, her experience during the last few hours of her mother’s life. During that final hour, three specialists had come into the room, each reporting, “Good news!” One specialist reported that her mother’s blood work was good – “Do you have any questions for me?” An internist reported that a bone scan looked good – “That’s great news.”
All the time, the family knew their mother was dying, as she lay unresponsive in the hospital bed. They felt angered and frustrated that so many people looked at only a part of their mother’s condition; not one of the physicians involved looked at their mother as a whole person.
When I think of a caregiver I’d like to clone, I think of Dianne. She only had a high school education, but had worked as a caregiver for her entire career. When she worked for us, we promoted her, ultimately (after about 12 years) to Resident Care Manager for one simple reason: Dianne knew her residents. She knew exactly what was “normal” for each of them, and her observation skills were second to none.
Dianne could tell, in just a couple of minutes, when someone what not quite right. She knew when to probe with more questions, with a touch or quick vitals check, and when to call the doctor, nurse or family and say, “Something isn’t right. You’d better come right away.”
She knew that family members felt guilt and anxiety, especially initially. She would often call just to say, “Your mom had a really good day today.”
Dianne would sit and comfort the dying person; she’d stay and comfort the grieving family, too, sometimes well into the night. She would never, ever leave a dying resident in the care of a lesser-trained caregiver.
She wasn’t a trained nurse, but she was the best I’ve ever seen at knowing her residents and making sure they got the very best care possible, from every single member of the team. When my own mother was in acute care, I often wished for a nurse, a caregiver, or anyone as compassionate as Dianne.
Dianne was certainly an extraordinary caregiver by nature. Her commitment and dedication was intrinsic to her personality; and that’s not something that we can train into people.
But her focus on knowing each person in her care, as well as she could possibly know them, is something we can do a better job training into caregivers. Her keen sense of observation and her skill in communication – these are the traits I believe we can train.
Training to grow the very best caregiver possible isn’t a one-time shot. It’s a process that continues throughout the person’s career. We can start it with our online courses, but it takes ongoing supervision and training to really strengthen these skills.
Monday, October 31, 2011
Monday, October 24, 2011
Census and the Economy
From the word on the street, if your census is strong consider yourself lucky.
It’s not enough that the economy and poor housing market is driving people to care for their own family members rather than seek care elsewhere. We’re also caring for a market sector that has other inherent issues, namely longevity. Not to be indelicate, but our residents are vulnerable. And, it seems, we lose them in groups.
My mother-in-law had excellent end-of-life care in a brand new assisted living community. She was the first person in the apartment, and the caregivers were incredibly kind and attentive. They only had a few residents – how few I don’t really know. What I do know is that on the day my mother-in-law died, two other residents also passed. I’m guessing that may have constituted as much as 25% of their occupancy, in one fell swoop.
In this situation, it’s the small details that count. For our family, the attention to detail was incredible. The staff not only were attentive and caring, they openly grieved with us at the loss of our mother. One of the employees even gave the eulogy at the memorial service – and it was absolutely pitch perfect.
Were we satisfied customer? Absolutely. We’ll tell everyone we can about the fabulous care provided to our family. We’ll tell you what a great company Leisure Care is, and how happy we are with the care provided by their team.
We’ve had other experiences with our family elders. We’ll tell you about those, too – and warn you away from some communities that didn’t meet our basic expectations, let alone exceed them.
Benjamin Pearce, author of the excellent book “Senior Living Communities: Operations Management and Marketing for Assisted Living, Congregate, and Continuing Care Retirement Communities” (and a member of our instructor team) developed a course on Customer Service for managers for CEU credit. Ben says, “Quality is simply the difference between what you expect and what you get. When you get more than you expect, you perceive that you’ve gotten something of value.”
If you feel you or your managers could use a little tuning up in this area, check out this course on our EasyCEU website.
With everything else working against us having a strong census today, customer service is one area we can control and improve.
It’s not enough that the economy and poor housing market is driving people to care for their own family members rather than seek care elsewhere. We’re also caring for a market sector that has other inherent issues, namely longevity. Not to be indelicate, but our residents are vulnerable. And, it seems, we lose them in groups.
My mother-in-law had excellent end-of-life care in a brand new assisted living community. She was the first person in the apartment, and the caregivers were incredibly kind and attentive. They only had a few residents – how few I don’t really know. What I do know is that on the day my mother-in-law died, two other residents also passed. I’m guessing that may have constituted as much as 25% of their occupancy, in one fell swoop.
In this situation, it’s the small details that count. For our family, the attention to detail was incredible. The staff not only were attentive and caring, they openly grieved with us at the loss of our mother. One of the employees even gave the eulogy at the memorial service – and it was absolutely pitch perfect.
Were we satisfied customer? Absolutely. We’ll tell everyone we can about the fabulous care provided to our family. We’ll tell you what a great company Leisure Care is, and how happy we are with the care provided by their team.
We’ve had other experiences with our family elders. We’ll tell you about those, too – and warn you away from some communities that didn’t meet our basic expectations, let alone exceed them.
Benjamin Pearce, author of the excellent book “Senior Living Communities: Operations Management and Marketing for Assisted Living, Congregate, and Continuing Care Retirement Communities” (and a member of our instructor team) developed a course on Customer Service for managers for CEU credit. Ben says, “Quality is simply the difference between what you expect and what you get. When you get more than you expect, you perceive that you’ve gotten something of value.”
If you feel you or your managers could use a little tuning up in this area, check out this course on our EasyCEU website.
With everything else working against us having a strong census today, customer service is one area we can control and improve.
Monday, October 17, 2011
Corporate Learning is Undergoing a Transformation
Corporate training is undergoing a transformation. Resources are getting a little tighter, and expectations are higher. The focus is on employee engagement, retention and building the dream team that will carry the company to success.
In the process, Corporate America has its eyes on training.
“Much of the daily chaos [in senior care] can be decreased when carefully selected staff receive proper orientation, training and ongoing education,” notes culture change expert Susan Gilster in her article published (with Jennifer Dalessandro) in the July/August Advance for Long Term Care Management. Gilster goes on to list some of the positive effects of focusing on training: better care, better decision-making, better family relations, improved feelings of job security.
As training starts to get increased emphasis, other transforming forces are changing the way employees are being trained:
Increased requirements for training and documentation. No longer is a “read and sign” inservice considered adequate. Most states are moving toward requiring “evidence of learning” (read “test”) and a documentation of passing the test. Meeting these new, higher standards requires extra time, money and staffing on the part of many companies. Many companies are urgently looking to solutions that can help them meet 100% compliance, while not increasing their bottom line expenses.
Increased risk of lawsuits. Missing training documentation is a big red flag for lawyers. Sign-in sheets are worth a little; individual training records, complete with test scores and certificates are worth considerably more. With assisted living increasingly in the sights of wrongful death, elder abuse and similarly focused attorneys, evidence of staff training that meets and exceeds requirements is an essential.
Increased OSHA inspections. How well is safety training being done? OSHA has begun targeting senior care facilities for inspections – and violations of standards come with hefty, mandatory fines.
Increased access to technology. Not only is e-training more affordable than ever, but internet connectivity is more accessible. New hires often come with skills in using computers, email and the internet; computer equipment is affordable to even the smallest provider. Suddenly, what seemed a technological barrier is not an approachable – and substantial – resource.
If it’s time for a transformation in your company, take a close look at training. The benefits are significant and the access to quality resources is better than ever before.
In the process, Corporate America has its eyes on training.
“Much of the daily chaos [in senior care] can be decreased when carefully selected staff receive proper orientation, training and ongoing education,” notes culture change expert Susan Gilster in her article published (with Jennifer Dalessandro) in the July/August Advance for Long Term Care Management. Gilster goes on to list some of the positive effects of focusing on training: better care, better decision-making, better family relations, improved feelings of job security.
As training starts to get increased emphasis, other transforming forces are changing the way employees are being trained:
Increased requirements for training and documentation. No longer is a “read and sign” inservice considered adequate. Most states are moving toward requiring “evidence of learning” (read “test”) and a documentation of passing the test. Meeting these new, higher standards requires extra time, money and staffing on the part of many companies. Many companies are urgently looking to solutions that can help them meet 100% compliance, while not increasing their bottom line expenses.
Increased risk of lawsuits. Missing training documentation is a big red flag for lawyers. Sign-in sheets are worth a little; individual training records, complete with test scores and certificates are worth considerably more. With assisted living increasingly in the sights of wrongful death, elder abuse and similarly focused attorneys, evidence of staff training that meets and exceeds requirements is an essential.
Increased OSHA inspections. How well is safety training being done? OSHA has begun targeting senior care facilities for inspections – and violations of standards come with hefty, mandatory fines.
Increased access to technology. Not only is e-training more affordable than ever, but internet connectivity is more accessible. New hires often come with skills in using computers, email and the internet; computer equipment is affordable to even the smallest provider. Suddenly, what seemed a technological barrier is not an approachable – and substantial – resource.
If it’s time for a transformation in your company, take a close look at training. The benefits are significant and the access to quality resources is better than ever before.
Monday, October 10, 2011
Great leaders excel at everything?
Great leaders excel at everything?
”Our goal for today is to help our audience become better leaders by simultaneously excelling in four areas of their lives: work, home, community and self.”
This is the introductory sentence to the Harvard Business School interview with Steward Friedman, author of a number of leadership books and articles (view here on YouTube).
I don’t know about you, but that intro sentence alone makes me choke. “Excel?” How about “survive?”
I’m busy running my company, and, yes, I do identify my own success with the success of my business, but, really, am I excelling at work and home, let alone community and self?
Steward (and the interviewer, by the way) assume that our life’s goal is to become the best leaders we can be. Learning to excel at the other three areas – home, community and self – will help us become better leaders.
And on MY tombstone, I want to see the words, “She pulled it all together. She excelled at everything. But at the end of it all, she was a Great Leader.”
Perhaps I’m being a little harsh. It does grate, just a little, that the reason we might want to join a non-profit board is that, ultimately, it benefits the company. The main reason we may want to pay attention to our mind, body and soul is to improve our “performance at work.”
I’ll let you watch the video to hear the rest of his argument, but his recommended exercises – determining your core values and the legacy you’d like to leave, among others, are worthwhile activities, no matter if you’re struggling for survival or on the verge of excellence.
As managers, even mid-level managers, we ARE leaders. The people around us watch us. Whether we like it or not, we set the tone of at least some aspects of our work.
We have the power to make coming to work a high point of someone else’s day; or the thing they least enjoy doing.
Our praise and words of encouragement can shape the behavior of the people around us as certainly as the sound of the doorbell shapes the behavior of my dog.
We are all leaders. Whether excelling at this task should be our biggest aspiration in life is certainly debatable, at least to me.
But I do agree with Stew on this: When we are true to ourselves; when we know clearly what is important to us in our lives; when we have focus, commitment and passion, we’ll be awesome, powerful leaders.
Even if my tombstone just reads, “Beloved wife and mother.”
”Our goal for today is to help our audience become better leaders by simultaneously excelling in four areas of their lives: work, home, community and self.”
This is the introductory sentence to the Harvard Business School interview with Steward Friedman, author of a number of leadership books and articles (view here on YouTube).
I don’t know about you, but that intro sentence alone makes me choke. “Excel?” How about “survive?”
I’m busy running my company, and, yes, I do identify my own success with the success of my business, but, really, am I excelling at work and home, let alone community and self?
Steward (and the interviewer, by the way) assume that our life’s goal is to become the best leaders we can be. Learning to excel at the other three areas – home, community and self – will help us become better leaders.
And on MY tombstone, I want to see the words, “She pulled it all together. She excelled at everything. But at the end of it all, she was a Great Leader.”
Perhaps I’m being a little harsh. It does grate, just a little, that the reason we might want to join a non-profit board is that, ultimately, it benefits the company. The main reason we may want to pay attention to our mind, body and soul is to improve our “performance at work.”
I’ll let you watch the video to hear the rest of his argument, but his recommended exercises – determining your core values and the legacy you’d like to leave, among others, are worthwhile activities, no matter if you’re struggling for survival or on the verge of excellence.
As managers, even mid-level managers, we ARE leaders. The people around us watch us. Whether we like it or not, we set the tone of at least some aspects of our work.
We have the power to make coming to work a high point of someone else’s day; or the thing they least enjoy doing.
Our praise and words of encouragement can shape the behavior of the people around us as certainly as the sound of the doorbell shapes the behavior of my dog.
We are all leaders. Whether excelling at this task should be our biggest aspiration in life is certainly debatable, at least to me.
But I do agree with Stew on this: When we are true to ourselves; when we know clearly what is important to us in our lives; when we have focus, commitment and passion, we’ll be awesome, powerful leaders.
Even if my tombstone just reads, “Beloved wife and mother.”
Monday, October 3, 2011
Assisted Living Challenges: Making the Most of High Unemployment
Two sectors of our economy seem to be thriving: education and health care. My company (aQuire Training Solutions) happens to be nicely poised in the intersection of these two sectors; yours is likely more in the health care/senior care sector.
Unless your census has suffered significantly with the economic downturn, you’re likely in the hiring mode, not the lay-off mode.
Applicants may be, for the first time, plentiful and qualified.
If you’re lucky, you may have this edge in hiring for the next several months.
Taking advantage of it, however, it not a slam-dunk. It may take a little more thought and consideration to be able to hire the best and keep them into the economic recovery.
What can you do? Here are some thoughts taken from a wide range of studies and industries that seem to apply to this environment:
While other companies are laying off employees, most of us are still hiring. Take advantage of this change of pace, and build up your team to become the very best it can be.
Unless your census has suffered significantly with the economic downturn, you’re likely in the hiring mode, not the lay-off mode.
Applicants may be, for the first time, plentiful and qualified.
If you’re lucky, you may have this edge in hiring for the next several months.
Taking advantage of it, however, it not a slam-dunk. It may take a little more thought and consideration to be able to hire the best and keep them into the economic recovery.
What can you do? Here are some thoughts taken from a wide range of studies and industries that seem to apply to this environment:
- Spend some extra time thinking about the kind of person you’d love to hire for each opening you have. Look at current employees who are your stars in similar roles. What makes them so great? Consider personality, character and other factors that may be independent of experience and training. You may have the opportunity to hire individuals with similar personality traits and train them to become equally valuable members of your team.
- Get plugged into technology to help you with the hiring process – now. Never used craigslist before? Give it a shot now. Look for other online job boards you can use. Consider utilizing an online application option to allow those interested in your positions to apply online, without needing to develop a resume or fax/mail/drop off an application.
- Select carefully. You may have the opportunity to interview several candidates for a position – a delightfully new situation for many providers. Involve individuals who will be working with the new hire in the interview process and don’t hesitate to take your time to interview twice, check references, and slow down the process. Hiring carefully now can save you time and money in turnover later.
- Think about career advancement opportunities you can offer in-house. If you hire individuals who may be somewhat overqualified for their new position, offer these employees extra training to be ready to advance as openings occur in your own internal career ladder. Perhaps you don’t foresee any management openings; offer training anyway to keep the motivated hire interested and engaged.
While other companies are laying off employees, most of us are still hiring. Take advantage of this change of pace, and build up your team to become the very best it can be.
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