Co-authors: Charles de Vilmorin, Dr. Jennifer Stelter and Bruce Roth

In senior living communities across the country, COVID-19 restrictions are being lifted as vaccination rates among residents, family members and staff continue to increase. It isn’t surprising that many of us are feeling tremendous relief and excitement for a brighter future as we emerge from the pandemic. As we begin this period of reopening though, community leaders should be directing time and resources to better understanding how this new chapter must prioritize staff empowerment if we are to truly realize our vision of person-centered and meaningful care.

In January of this year, PHI released their report entitled, “Caring for the Future: The Power and Potential of American’s Direct Care Workforce.” One key takeaway from this analysis of the direct care workforce was that when direct care workers are trained to become involved members of the interdisciplinary work team, care coordination increases which improves quality of life for residents and that in turn improves cost savings for providers. Successful reopening of senior living communities can of course be helped along by investing in technology solutions but more than that providers have to enable an interdisciplinary team approach in which staff members that interact most with residents are given the power to voice their input that is based on their deep knowing of the residents they care for.

Once a community begins to empower staff members, there are a number of positive changes that will take place. First, turnover will decrease as the workforce feels that their contributions are being acknowledged and that they have access to tools and resources to help them grow in their roles. This represents a huge cost savings for the community especially since according to a recent McKnight’s Long-Term Care News article, “Median turnover among nursing staff, factoring in data from virtually all U.S. nursing homes, was 94% in 2017 and 2018. Mean turnover rates for certified nursing aides were 129.1%.”

As staff members grow in their roles with this support, they will connect with residents in a meaningful and purposeful way that will increase quality of life across the board. Dr. Jennifer Stelter, a clinical psychologist and the co-owner and CEO of NeuroEssence who has served in the long-term care industry for over 11 years in creating programs and services for residents says, “Every interaction is an opportunity for engagement. From a nurse conversing with the resident or educating them on a new medication prescribed by their physician to a certified nursing assistant (CNA) singing to a resident while helping them get ready in the morning, each interaction can bring meaning, purpose, stimulation, and socialization to the resident population.”

When residents are engaged, ongoing in various aspects of their day, this helps increase socialization, decrease behavioral issues, and maintain skills needed to keep them as independent as possible. In turn, this can boost their mood and allow them to do things longer for themselves, ultimately improving satisfaction and quality of life. Dr. Stelter has seen first-hand that these positive reactions to engagement can also affect the clinical outcomes of the facility, like a decreased need for psychotropic use, less falls, and better return to hospital rates helping the census of the facility. She further explains that the side benefit is that staff feel more confident and competent at their jobs because of the positive reactions they see in their residents, possibly leading to staff retention and satisfaction. Therefore, the activity team can plan out a wonderful calendar of events each month, but to obtain a higher change for positive clinical outcomes and resident satisfaction, maintain census, and to increase staff retention, resident engagement should be provided through an interdisciplinary approach.

Reopening our communities using technology and an interdisciplinary staffing approach can improve staff turnover percentages.  Staff turnover (cited by McKnight’s) Is over 100% annually.  The cost to replace an employee (advertising, posting job, background checks, training/onboarding) averages over $3,500 per employee).  If a 100 employee community has a 100% turnover rate it is costing that community $350,000 in annual turnover cost.  If the community can implement software that engages both staff and residents both parties will be happier with the outcomes obtained.  If the implementation of this software can reduce turnover by just 5% that would equate to $17,500.00 in turnover reduction savings for the community.  During the staff onboarding process one could share the new technology the community is using to set it apart from competing communities looking to attract these same employees.   The concept of an interdisciplinary staffing approach that using technology to maximize resident engagement could please all parties wanting to improve resident clinical outcomes.

We are already seeing improvement in the resident experience in the form of increased attention, investment and elevation of the activity and life enrichment position. To maximize the return on investment, providers need to embrace resident engagement as an organization-wide strategy, invite Elders and team members to be citizens of their community and support their most valuable resource: the people actually showing up at work and collaborating with Elders every day.