With so many unknowns with reimbursement, regulation interpretation and broad spectrum of needs older adults have, it is no wonder Assisted Living has become a broad spectrum and all-encompassing service model. The one key component that does not change however is the need of focusing on the person being served.
In every organization I have worked, there is an element of assisted living. There are clinical models, hospitality models, versions of mini-nursing homes, respite, end of life, memory care and so much more. There is a balance of those that work in this industry – those who enjoy and thrive with structure and organization and those that enjoy living in the moment and moving through whatever may come at them throughout the day. It is important to have a blend of folks that complement one another.
Being invited into the homes of the residents we serve is a privilege and gift. It allows for us to establish relationship, build rapport, learn from one another and fill a need for that person that allows them to fully embrace their life and the activities they enjoy. For some, it may mean assisting to help with physical needs to preserve their energy to do the things they love. For others, it may be simple reminders to take their medication while they are able to cook and navigate their daily routine as they choose. There is a sharing of emotions and experiences that happen in assisted living – loss of a friend who has been kind and a part of the fabric of the community, a celebration of news of a new grandchild or maybe pain and a sense of accomplishment as someone overcomes an acute injury and is able to resume normal life.
People do not choose to go to assisted living. In most cases they begin the journey of seeking this resource because they have an unmet need. It is our job as providers to ensure we are meeting and hopefully exceeding the expectations our residents have and promoting resident centered and directed care. Family members are savvy about what they are looking for to promote a sense of independence, well-being, safety and overall home-like environment for their loved ones.
Listening, taking time to understand and learn what a resident enjoys and adapting our approach to meet them where they are is not an engrained skill and often times elements get lost in the hustle and bustle of staffing challenges, demands of clinical needs and outside forces causing these things to be compromised. I have seen the most celebrated caregivers be the ones who are present in the moment and truly know their residents – these are also typically the caregivers who do not rush through their tasks or go into their day hoping to accomplish everything they plan. I have also seen these same caregivers receive negative feedback from leaders who only focus on tasks and not the quality and positive impact they have on their residents. As leaders we need to model and help our teams navigate both in realistic ways.
Many communities and assisted living organizations do not have the ability to afford or invest in ways to enhance the quality of life and ability to allow resident choice – this is where the value of volunteers and the openness to integrate residents into choosing their routine comes into play. COVID taught us a lot of things and an important one is how critical socialization and connection is for our residents. I have been blessed to be in organizations with great volunteer strength. People who love interacting and being with others – reading books to residents, providing music, pet visits, reminiscing, helping with shopping and general conversation. This not only positively affects the residents but also creates a partnership and support for the staff working side by side to create the best environment possible for the residents who are living in the community.
My grandmother lived in an assisted living prior to COVID and as a family, my parents, my husband and I and our kids visited her regularly – almost daily. We would go for walks, bring her treats to share, watch shows with her and just “be” present. It was a gift to be able to do this, to be welcomed in and be able to extend her “family” of folks who cared and loved her to the people who worked at her new home. I cannot imagine what it may have felt like for any of our residents during COVID having to be told they could not have visitors, eat with friends, socialize or be contained to a room or pod of people with no voice to share what they really want or need. This created an environment that relied heavily on creativity, extra support, hugs and time of the staff working in those homes to fill the role of family in new ways. That time has reshaped how we approach our residents – makes us weigh the pros and cons of navigating illness, isolation and whether or not to consider a congregate setting for our loved ones.
Staff challenges have become a larger reality making it even more difficult to implement, maintain and have full adoption of resident centered care. In my 29 years of experience, the best organizations offering assisted living have figured out a way to provide staffing that offers support to the residents, the caregivers and families. Having on site nurse oversight, a social worker to provide support, life enrichment staff to promote activities and solicit and manage volunteers while offering the basic needs of housekeeping, maintenance and dining produce a robust team of people who are able to fully orchestrate being present and ready to focus on the person vs the task. If these roles are not affordable then there is opportunity to seek out volunteers and others to help fill needs that may be cost restrictive.
Having worked in a variety of roles from Life Enrichment to Administrator and now CEO, I have an appreciation for all the lives touched in this unique environment. There are always moments, people and actions that I am grateful for each day – some of them lessons to learn from and some rewarding and reinforcing of my passion for this field.
