The future lifeline of skilled nursing facilities is plagued with uncertainty according to a recent report that revealed that one-third of operators had a zero total margin or net loss, even before sequestration occurred.
Net income margin for skilled nursing facilities was sliced in half between 2010 and 2012 to 0.99%, according to a report from consulting firm van der Walde & Co., released by the Partnership for Quality Nursing Home Care.
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“This new examination of SNF total margin performance and access to capital is as worrisome as it is insightful to helping define the growing threat to SNFs and, by extension, their patients and their workforce,” said Alan G. Rosenbloom, president of the Alliance.
Three factors including low profitability, stricter access to capital, and constriction of Medicare and Medicaid payment rates hint that skilled nursing facilities won’t be able to make key infrastructure investments necessary to treat increasingly older, higher acuity patients under the current environment.
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“If profits are low, and little cash flow is generated to reinvest in the enterprise, the business will have difficulty providing its service and may not survive,” said Lamber van der Walde, the report’s author and president of the van der Walde.
If low profitability and limited access to capital weren’t enough, the report additionally finds that skilled nursing facilities capital is expensive and limited to certain types of debt financing, despite interest rates receding to levels last seen before the 2008 financial crisis.
Skilled nursing facility bonds come at a higher risk as a result of the debt mark and government payment risk, which in turn have produced increased borrowing costs.
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According to van der Walde the rain continues to pour on skilled nursing facilities, as current margin pressures are likely to deteriorate by continued federal cuts from the Medicare program in 2013 and beyond.
An abundance of financial pressures could force skilled nursing facilities to cut labor to reduce expenses, in addition to limiting technology investments, and make cutbacks to facility renovations and new equipment.
“When total margins recede to the levels they are today, staffing and investments in the new technology needed to sustain positive quality trends are the first key variables to be negatively impacted,” said Rosenbloom.
Rosenbloom does offer a silver lining in the report’s ability to sustain focus on devising a proactive, rational Medicare acute payment system to replace more cuts, more staffing and decrease greater threat to elder patients.
The post Skilled Nursing Facilities Face Harsh Reality and Financial Pressures first appeared on SEONewsWire.net.]]>Health systems are re-examining their post-acute care strategies and SNF partnerships.
By Julie Schulz, MD
After steadily migrating out of the skilled nursing facility (SNF) market over the past decade,health systems are re-examining their post-acute care (PAC) strategies and the potential value of SNF partnerships. This renewed consideration is directly tied to health systems’ growing accountability for the quality and cost of services delivered across the care continuum, including the need to improve care continuity, reduce readmissions and improve patient and family satisfaction.
Aside from discharges to home, SNFs are the most common post-acute destination, representing 19 percent of PAC transfers. Partnerships with freestanding SNFs provide an effective option for hospitals to improve PAC quality and efficiency without the financial risk of ownership.
Readmission penalties and a shift toward bundled payment for full episodes of care will require hospitals to more actively oversee the services their patients receive after transfer to a SNF. Congestive heart failure and pneumonia, two of the three conditions for which readmission penalties began in 2012, are among the top 10 diagnostic-related groups for SNF admissions.Additionally, joint replacements likely will be among the first procedures to be reimbursed through bundled payments that include PAC, given their high volumes and expenditures among Medicare patients.
New Care Pathways
Cost per case, length of stay and readmission rates vary significantly across SNFs. Even compared with other PAC sites, SNFs have notoriously high risk-adjusted readmission rates. The most effective health system-SNF relationships will have both the right partnership structure and care delivery model to avoid readmission penalties and improve PAC. To begin, there areseven major building blocks that can optimize the role SNFs play within a system of care(clinical alignment and resource effectiveness). How an individual system prioritizes these building blocks will depend on its service portfolio and local market dynamics.
Care pathways: Ensure that hospitals and SNFs work together to develop evidence-based protocols that standardize and optimize care across acute and PAC settings.Care coordination: Form cross-continuum teams that cover both PAC and acute care sites to identify and address problems in care transitions, using coordinators to bridge both settings.Quality rehabilitation: Ensure that inpatient discharge planners are familiar with the therapy staff and technology available at area SNFs to select destinations that best meet patients’ rehabilitation needs. Alignment strategy: Inventory area PAC facilities to determine SNF supply and alternate PAC options. Identify top performers in quality metrics to help patients make educated SNF choices.This may include the decision to create a formal SNF network. Handoffs/communication: Engage hospital physicians to increase their accountability for handoffs and any subsequent read missions. Better link patients’ primary care physicians with emergency department physicians to avert avoidable admissions. Create comprehensive medication and personalized care records for all patients.Information technology: Explore software applications that enable discharge planners to search electronically for area SNFs that best match patients’ care needs. Automate data sharing with SNF medical directors on key quality metrics.Transfers/access: Utilize a standardized transfer form, formalize a referral system with area SNFs and facilitate real-time information on bed availability. Future Considerations: A number of variables must be considered when determining how SNFs factor into your system’s ability to optimize care across the continuum and respond to changing market conditions and payment models. Begin by determining your organization’s short- and long-term strategy for working with — and possibly within — the PAC sector (i.e., partnership, ownership, conversion to becoming a PAC provider). Along with this, evaluate whether your organization intends to pursue bundled payment projects or risk-sharing models that will include PAC services. Next,assess your current case mix of patients discharged to SNFs to determine the demand for rehabilitation services vs. medically complex services. Hold regular forums for collaboration between hospital and SNF medical directors, as well as chief nursing officers and PAC nursing staff. Forums should include the sharing of data on potentially avoidable admissions and readmissions and root cause analyses for problematic trends.
Giving Positive Feedback to Staff Nurses managers can empower staff to advocate for quality care.
By Joan M. Lorenz, RN, PMHCNS-BC
When Mildred Jones, RN, became the nurse manager on an acute psychiatric unit that had experienced a lack of leadership for many years, her goal was to raise the quality of patient care by advancing the staffs’ knowledge and empowering them to advocate for themselves and their patients. Each time Mildred walked through the unit her critical-thinking mind went into overdrive thinking about how much work needed to be done. Occasionally, she pulled staff aside to alert them to the problems she noticed and shared with them the best practices for the current patient care situation. Her intent was to use point-in-time learning to raise awareness and provide guidance; however, some staff saw her actions as condemnation and ridicule. What could Mildred do? She asked for help from a trusted colleague and set about developing ways to give positive feedback.
Many nurses are like Mildred. Nursing education emphasizes critical thinking. Nurses are taught to approach patient care situations with an eye for what is out of place or needs attention. This makes us excellent observers and keen problem solvers. It becomes natural for us to enter a patient care situation and begin immediate analysis, often taking action and giving direction at the same time. Being able to do this is a great asset. But like any asset it can also be a liability as Nurse Manager Jones found out. Her critical thinking mind, allowed to dominate, looked for and found problems and immediately began to problem solve. However, this had negative consequences on her relationships with others.
Use Your Critical Eye to Find What Works
Giving positive feedback to others is crucial to any nurse’s work success and collegialrelationships with co-workers. But many of us find that it does not comes naturally. Indeed, ifwe allow our critical thinking minds to take over, constantly seeking out problems, we often donot even see what is working well. Giving positive feedback to others takes practice. Whennurses become aware of an overactive critical thinking mind they can begin to practiceredirecting themselves to look for what is going well in addition for looking for what needsattention. So the road to giving positive feedback is to develop a more balanced approach to ourwork and relationships with co-workers. Allow your critical thinking mind to see what areas needto be addressed at the same time that you ask it to seek out what is going well and needs to beacknowledged and praised. There are a variety of ways that you can balance your point of viewat work and help your critical thinking mind to become a more appreciative mind. Four things topractice include:
1. Developing an attitude of gratitude.
2. Actively looking for what is going well.
3. Letting people know how much you appreciate them
4. Using a gentle positive approach when giving constructive criticism
Develop an Attitude of Gratitude
How do you develop an attitude of gratitude? It’s simple – start by saying ‘thank you’.
In a work situation you can start by noticing the little things that people do each day. A simple’thank you’ can mean a lot. Go ahead – try it. Thank the CNA for making up the bed, combing the patient’s hair, changing the bed linens, or passing out the water for the patients. Thank a colleague for giving out medications on time, talking with a distraught family member, or taking the time to answer a patient’s question (even though it wasn’t his patient). At the end of the day,express thanks to your team members for making it a pleasant day. It is especially helpful to thank others when things haven’t gone so well, “Thanks for holding your cool today when everything seemed to break loose at the same time.” When you do this you might see a smile creep across your colleague’s face – that in itself is a simple reward for your efforts. Of course,some might be suspicious of this new behavior. Reassure them by letting them know that you are trying to acknowledge what you have always noticed by kept to yourself. When you begin to say’thank you’ you might find too that you begin to notice more and more things to be thankful for.And who knows – it might become contagious.
Actively Look for What is Going Well
When you walk into a patient’s room remind your critical mind to look for what is going well notjust for what is not. Do not passively wait for something to strike you as going well. Seek it out.Some teams use a three-part evaluation for debriefing urgent work situations which can easily beapplied to any work situation. The evaluation asks the group to answer these questions:
What went well? What didn’t go well? What can we do differently next time?
This three-part evaluation helps give balance to the situation. By starting out with what went well we shift the emphasis to the positive and that gives us the opportunity to tell others know that we noticed their contributions. Using this evaluation also models for others a way to give positive feedback. After a stressful staff meeting, the team leader asked the group to list what went well. Members were able to list that even though there were a lot of differing opinions they liked that everyone was given time to express themselves and others were polite enough to listen.
Let People Know How Much You Appreciate Them
How do you show your appreciation of others? Are you genuine in your approach to those you work with? How often do you express appreciation to your team leaders, your Nurse Manger,you nursing administrators for a job well done? A simple “thanks for representing our views” at a hospital wide meeting can go a long way in letting your supervisor know that you appreciate her effort.
Use a Gentle Approach to Constructive Criticism
We all know there are times when we need to offer constructive criticism to others. Following these guidelines suggested by Susan M. Heathfield in “How to Hold a Difficult Conversation”might help make it go smoother. Seek permission to provide the feedback, saying for example: “May I offer a suggestion that might make that go easier for you?” Don’t just dive right in. Let the person know that you need to provide feedback that is difficult but important to share. Share what you’ve noticed in a kind way. Keep it centered on being helpful and on you and the other person. It’s counterproductive to say something like, “Everyone is talking about it.” Keep it simple, e.g.: “I am talking with you about this concern because it impacts patient safety (goes against policy, seems to cause anxiety for the patient, causes confusion on the unit, etc.).” Let the nurse know the positive impact her behavioral change will have on the situation. For instance, to a charge nurse staff complains is too aggressive, a nurse manager might say: “You understand the importance of staff working together in an efficient manner. But by lowering your voice and asking others for their opinions you can gain cooperation, reduce anxiety, and help us all get the job done faster”. After applying some of these techniques to provide positive feedback Jones walks though the nursing unit with a better-tuned appreciative mind. Because she acknowledges the good she sees the staff are more receptive to her guidance because they now hear praise along with the instruction.
Vascular PRN now offers custom sewn pneumatic garments for bariatric patients
By Greg Grambor
Fitting a bariatric patient, particularly a very large patient, with lymphedema sleeves can be quite a challenge. Therapists, LTC and hospital personnel go through a great deal of trouble, sometimes without a good outcome. Leg and arm sleeves are zipped together, two or three extension inserts are tried, often with little or no success in some of the largest patients. This is no longer a problem! Medical professionals can now contact Vascular PRN for custom sewn lymphedema sleeves. The company provides a measuring guide, measuring advice from trained experts, and in a few weeks, the patient’s lymphedema is being properly treated with pneumatic compression. Custom sleeves for amputees are also available, so now, no patient with lymphedema, no matter what the complication, needs to go without adequate treatment.
Prescribers are reminded that compression therapy should not be used during the inflammatory phlebitis process or during episodes of pulmonary embolism, congestive heart failure, pulmonary edema, suspected deep vein thrombosis or in any instances where increased venous and lymphatic return is undesirable. Vascular PRN may be reached at 800-886-4331.
Elderly woman stuck in nursing home elevator for 29 hours
by Robert Walker
As the holidays of 2012 wrapped up, millions of families across North America gathered to enjoy each others’ company, exchange presents and enjoy sumptuous food. But for one woman living in a Canadian nursing home didn’t have the chance to spend the holidays with friends; instead, she spent 29 hours stuck in the home’s elevator. As reported in the Sun News Network, 87 year-old Rosalie Rowsell, a resident of Malton Village Long Term Care Facility, a Toronto assisted living community, returned to the community in the evening of December 23 after spending time with family. It was then Rowsell is believed to have been stuck in an off-duty residential elevator, and although she did not return to her room that evening, staff believed she was still with her family. Rowsell was found 29 hours, still in the elevator, after her family realized she never made it home. The news source reports that she could not reach the elevator’s emergency button to call for assistance. She was eventually found on December 25 in the elevator, and after being taken to hospital, she was released the same day. As a result of the incident, the Ontario Ministry of Health and Long-Term Care is conducting an investigation to determine what went wrong. The assisted living community is apologetic, and vows to prevent any such incidents in the future. “We sincerely regret that this gap in our duty resulted in endangering a resident and causing her family distress,” Emil Kolb of the Region of Peel, which operates the facility, told the news source.
Mean Girls in Assisted Living. What happens to bullies? Some of them become old bullies.
By Paula Span
When Rhea Basroon’s mother moved into a New Jersey assisted living facility a few years ago,she found a good friend in an new neighbor named Irene. Her daughters, long concerned that their widowed mother had become isolated and depressed, were initially delighted. “She and Irene were inseparable,” Ms. Basroon told me. “Whenever there was an activity, they’d both go.Whoever got there first saved a seat.” The two even discouraged others from joining them: “It was just her and Irene.” Then, disaster. Irene was lured away by another resident, abandoning Ms. Basroon’s mother. “She was so lonely. There was no one else she’d bonded with,” Ms. Basroon recalled. “She was completely devastated.” But wait! The third woman apparently eventually tired of her prize, or perhaps moved on to other prey. “She dumped Irene, and Irene came back to my mother,” Ms. Basroon said. They remained fast friends until Irene’s death several months later. In senior residences, Ms. Basroon concluded, “it’s like junior high, with that cliquishness, that excluding” of others. This phenomenon, a sort of social bullying, apparently comes as no surprise to administrators of senior apartments, assisted living facilities, nursing homes and senior centers. “What happens to mean girls? Some of them go on to be come mean old ladies,” said Marsha Frankel, clinical director of senior services at Jewish Family and Children’s Services in Boston, who has led workshops (innocuously called “Creating a Caring Community”) for staff and residents. What sort of behavior are we talking about? Ms. Frankeland Robin Bonifas, an assistant professor of social work at Arizona State who has begun research on senior bullying, described various situations:
Attempts to turn public spaces into private fiefdoms. “There’s a TV lounge meant to be used by everyone, but one person tries to monopolize it — what show is on, whether the blinds are open or shut, who can sit where,” said Dr. Bonifas.
Exclusion. “Dining room issues are ubiquitous,” said Ms. Frankel. When there’s no assigned seating, a resident may loudly announce that she’s saving a seat, even if no one else is expected,to avoid someone she dislikes. In an exercise class, added Ms. Frankel, who has gathered examples from administrators at several Massachusetts facilities, “one resident told another, in a condescending way, that she was doing it all wrong and shouldn’t be allowed to take the class.”General nastiness. “People loudly and publicly say insulting things. ‘You’re stupid.’ ‘You don’t know what you’re talking about.’” Ms. Frankel said. In a Newton, Mass., facility she observed, a resident actually discouraged her daughter from visiting, because the daughter was obese and her mother didn’t want her subjected to disparaging gossip. Racial and ethnic differences can also set off malicious comments.
Could all this be a consequence of cognitive impairment? Sometimes, Ms. Frankel said. Dementia can lead to disinhibition, and people say things they might once merely have thought.But social manipulation and exclusion seem to have more to do with acquiring power, a feeling of control, at a point in life when older people can feel powerless. (Adolescence is another of those points, of course.) “Perhaps people don’t have ways to get that sense of control in healthy ways, so it’s done by dominating others,” said Dr. Bonifas, a former nursing home social worker.“It gives them a sense that they’re important.” Some intended victims can shrug off this petty tyranny, but others suffer. They withdraw from activities and social situations, perhaps experience anxiety or depression, want to move out. “It can get pretty nasty, and these are vulnerable people,” Ms. Frankel said. She hasn’t found her caring community workshops very effective at getting mean seniors to behave better, since nobody considers himself or herself a bully, but they do appear to embolden the staff to intervene. That can make a difference: At a Massachusetts class in conversational English, five of the regulars — all elderly Russian women with scientific backgrounds — turned on a less-educated newcomer from Hong Kong. They rolled their eyes when she spoke, and they sniped in Russian. The instructor, a social work graduate student and former teacher, finally announced that she would not tolerate abusive behavior in the classroom and threatened to end the session the next time it happened. “That worked,” Ms. Frankel reported. But bolstering old people’s ability to stand up for themselves might also work. Dr. Bonifas has undertaken a pilot research program on bullying in two Phoenix senior apartment complexes and has noticed that, as with youth bullies, not everyone is equally likely to be a target. She’s contemplating how to teach someone to say, “You’re not going to treat me like that. Every chair here is available to anyone, and I’ll sit where I want.” That way, she thinks, “the bully doesn’t derive power from the interaction.” Perhaps it shouldn’t startle us that this behavior arises in senior residences — people are people, after all, wherever they live — but I’ll admit to some surprise. We all remember this harassment from the cafeteria, but we’d like to think that people learn something in the intervening seven or so decades, right? “We have expectations that as we grow older we become more mature — the stereotype of the wise old person who knows how to conduct herself,” Dr. Bonifas said. “That’s not necessarily the case.”
This week, the OIG released the results of a study just completed on the billing practices ofskilled nursing facilities to Medicare. The study located a stunning amount of “inaccurate,medically unnecessary, and fraudulent claims.” The main focus of the study was to focus onbilling practices for therapy provided skilled nursing facilities. The study located over a billiondollars in inappropriate billing in 2009 alone. The recommendations of the study included:
Increase and expand reviews of SNF claims,
Use its Fraud Prevention System to identify SNFs that are billing for higher paying RUGs,
Monitor compliance with new therapy assessments,
Change the current method for determining how much therapy is needed to ensure appropriatepayments,
Improve the accuracy of MDS items, and
Follow up on the SNFs that billed in error.
Skilled nursing facilities are certain to come under more scrutiny regarding billing practices forMedicare services. Make certain your organization has procedures in place to prevent codingerrors as well as other prohibitied billing practices including employing individuals listed on theOIG exclusion list.
Know How to Have the Right Family and Job Balance to Have Fulfilling Family Life
We are all living in a fast paced work environment and this makes it very difficult for us tobalance the family and job in the way it has to be done for getting greater degree of harmony andfulfillment. But this is not easy and not everyone in a high demanding career is able to giveenough time to their families. Usually it is the family life that suffers in case of a high payingcareer that takes away the time you have to allot for the family. In the present days the mobilephones and the tablet computers, and the laptops are stealing the time you are spending with yourfamily and are effectively bringing down the quality of time you spend with your spouse and yourkids.
This is not a healthy situation for the present day executives who have to be very efficient andhave to fulfill their awfully demanding job requirements. This makes them unable to devote asmuch time they want to their families straining the relationships, and bringing down the qualityof their family life. But this must be avoided at all costs and maintaining good balance of thefamily and job is necessary for a perfectly happy life. You must not forget the fact that all yourearnings and the hard work you put in your office is for giving a better life to your family and assuch it is the family that must have the priority over your work pressures.
There are many ways of making a good balance of family and job and this must be done rightfrom the day of entering your first job so that it becomes a way of life. Once you forget to do thisit may be very difficult to achieve this later in life. To avoid personal unhappiness and a hollowpersonal life create a clear demarcation of your family and business life. There are many socialand cultural factors that come in the way of creating that balanced family and business life. Yetyou must strive hard to create one and stay with it so that you are able to become a good spouseand father in your home as you become a good worker in your business place.
A perfect balance in family and job can be achieved by adhering to certain basic principles thatgives a better understanding of your priorities and that of each one of your family. This gives theright ways of getting them arranged in the order of importance so that you can easily find theways to achieve them. You can make way for the resources required in terms of your time andpersonal attention so that everyone in your family gets what they value most in a natural way.Plan ahead and make it a habit to have time to be together with all of the family each day. Shareyour thoughts for the day and this will really boost the way to enhance the feeling of togethernessin the family.
Taking part in your kid’s activities and devoting a part of your time towards this will give a betteropportunity to understand your kids well. Planning ahead and setting apart time for this is sure tomake your time at your office more efficient as you try to leave your office in time to be withyour kids you will be able to find the right balance for your family and job. Leave work at yourwork and be free at least for some time without your ringing mobile phone or that laptop waitingfor your attention when you are spending your time with your family. Thus do not sacrifice yourfamily life for your business life and always try to have that perfect family and job balance tohave a fulfilling life.
Have you every been a resident in your own building?
By Ken Tack
Here I am in my 40th year of long-term care. That is an eternity when you spend it in a field thathas had so many changes. Earlier this year, I was looking forward to a comfortable time, havingrecently stepped down from the CEO position of a regional group of homes that I had helped tofound many years ago. The next generation was doing a good job of running the company, and Iwas hidden away in one of the campuses as an executive director. I was back doing what I loved:running a nursing home, and interacting with the elders.
On April 15, my world changed. I was involved in a motorcycle collision. I was flown to aregional hospital. After surgery and some observation, I volunteered to transfer to one of ourcompany’s nursing homes, where I was for a month. I had never dreamed of being a resident in anursing home, at least at this age, but here I was. With little to do but observe, I had the greatest educational experience of my career. I saw withmy eyes, heard with my ears, and felt with my heart the low level of compassion the care staffwas experiencing. All the hopes and dreams of making life better that filled them when they firststarted had been slowly sucked from them. They were running on empty and I was very much apart of the problem.
Before I proceed further, let me publicly profess that I am deeply grieved by the callous manner Ihave treated the caregivers in our organization. Although I have never knowingly hurt any staffmember, I have been neglectful of many as an individual and as a person. All my training and thevolumes of regulations have helped to create this inappropriate conduct. With one eye on thebottom line and the other on the regulating bodies, I never saw what was occurring in front of mynose.
Our people, the backbone of each organization, our caregivers, are hurting. The stress of holdingto tightly tailored PPD numbers, conflicts with co-workers, family members, and the occasionalspouse, coupled with a career that forces you to have relationships that end in death, can suck theair from anyone’s compassion balloon. When you mix in the stress of being a parent, spouse,family financier, chauffeur, and referee, you can end up with a person who is bankrupt ofcompassion.
The thing that is most disturbing to me is how we have accepted this in the profession as “Justthe way things are.” We say that this attitude on everyone’s part is simply a part of our business —it’s nothing personal. But I believe it does not have to be this way. When we open our eyes to thispractice of devouring our own limited resources we begin to see it. What happens when acaregiver begins to lose their compassion and then their performance slips? Our traditionalresponse is to have a discussion with them about their performance, reminding them howimportant they are to our elder’s lives. When that doesn’t correct the problem, and it rarely does,we give them a second, sterner warning (a written warning in many cases). Finally, exasperatedwith their poor showing, we are forced to terminate them only to begin the process over and hopewe achieve a better result.
We see this every day when we see employees hiding in a room, having attendance problems,leaving an elder in a mess, talking over the elders’ head, and taking too frequent breaks. We labelthem a bad employee and place them on the “do not rehire” list when they resign, or we terminatethem. Did we ever see this caregiver, once filled with hopes and dreams of what they might dofor these aging individuals, as a person in need of a compassion refilling? For the first time I wasable to see employees in this new light.
When we have epiphanies like these we may ask, ‘What can we do about it?’ The answer is wecan begin by caring and letting employees know that we do that we care about them. We canspend as much time preventing the problem of compassion bankruptcy, as we do in fixing theresults. We still try to find good applicants, interview them, process them, train them and directthem. But we also can look them in the eye everyday and see the person that is there. We can askthem how things are doing and actually take the time to hear what they have to say. When theyhave a problem, whether it is work-related or not, we can make an effort to give them the supportand caring we ask that they give our elders.
Here are some suggestions of various ways we have attempted to support and care about ourmost precious asset:
Nourishment station in the staff lounge. We offer various fruits, crackers, bagels, ice cream,Popsicles, etc.Wider variety of scheduling options to permit an improved mesh of personal life with workA monthly dish day where we provide the main course and the caregivers bring their favorite sidedish or desert. (The kitchen staff does not prepare the main course: remember they are a part ofthe caregiver team.)Surprise gifts, including door prizes and other giveaways at in-house in-servicesAdministration and department supervisors are encouraged to take an employee out to eat, alongwith a caregiver’s family member. We cover the meals and the time it takes them for a leisurelyvisit.We send birthday cards to the caregiver’s house.Training supervisors to look for signs of compassion fatigue and then supporting them as theyassist their staff.The most important thing we have tried to do is let each care partner know that we truly careabout him or her. We are attempting to celebrate their joys and support employees in theirsorrows, praise them for what we had just taken for granted, and understand when they arestruggling. It’s not our goal to be their closest friend, but we can be a support and inflate theirballoon of compassion when it starts to shrink.
Forty years of doing something wrong can make change a little difficult, but this is now theearliest I can begin to make the change. I have begun making rounds with an entirely differentobjective.
As one who contributed far more than my share to the draining of this compassion, I have done a180-degree turn. If I am to ever be remembered by the long-term care industry, I pray that it willbe for helping to put compassion back in our caregivers, not the financially successful company Ihave helped to build.