Monday, February 26, 2007

The Subtle Effects of Turnover
by Sharon Brothers, MSW

This morning I had an interesting conversation with a colleague, Benjamin Pearce, author of one of the best known books on the subject of developing and managing retirement and assisted living communities (Senior Living Communities), as well as himself a knowledgeable, experienced senior care community operator.

Ben asked if I knew what the current turnover rate in Assisted living happens to be – he believes it to be close to 90%. That means out of 100 caregivers in assisted living communities hired this year, 90 of them will leave before the end of the year.

For every family who is dependant on those individuals to provide care to their loved one, this is nothing short of a crisis.

Imagine if your mom has Alzheimer’s disease (the primary reason most individuals must seek assisted living or nursing home care). She is having difficulty finding the right words to express her feelings. Her caregivers learn to watch her behavior to see how she is acting, since they can’t rely on her words to express how she feels. The caregivers who have known your mom for months are able to instantly see when her behavior is different from usual. Perhaps she’s feeling pain, but can’t express it. Perhaps she is hungry or thirsty. Those experienced caregivers will notice that she is grimacing; that she’s fidgeting or restless. They’ll know that these subtle signs mean something isn’t right and they can quickly get to the bottom of the problem.

But what happens to your mother when all the caregivers who know her usual behavior leave? When the new caregiver interprets her restless behavior as agitation and asks the doctor for calming medication? When, instead of a simple over-the-counter pain medication – or a glass of water - your mother is prescribed a major psychotropic medication like Ativan.

Caregiver turnover suddenly becomes no longer an abstract “industry” problem, but a very personal problem.

We know some of the keys things we can do to reduce caregiver turnover: things like quality training, empowerment in decision-making, and improving the skills of mid-level supervisors to increase frontline workers’ job satisfaction.

It’s time to step up to the plate – to change those industry statistics so we can confidently talk about quality of care of our residents – and mean it.

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