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Unlike some in the senior care sphere, Denise Boudreau has been in the trenches.
Denise Boudreau - President - Drive |
While in college, she worked as a home health aide, tending to an elderly man named Chuck. She knows what it feels like to celebrate the little successes that make up an effective care plan for a patient. But she’s also experienced the frustrations that can arise when an organizational culture needs improvement.
Looking at organizations across the country “how is it that one company can hire and retain workers and another cannot? It comes down to whether or not your workers feel they’re being respected. If they truly believe they have a voice,” says Boudreau, president of Drive, a firm that specializes in improving the work culture of senior care organizations.
At around 65 percent, home health care has one of the highest turnover rates of any industry in the nation, with one study showing that between 80 and 90 percent leave in the first year of employment. So the anxiety that many industry executives have about staffing makes sense, given worker shortages in the face of skyrocketing demand due to soaring increases in Baby Boomers entering retirement, who overwhelmingly want to age in place.
Some leaders in the senior care industry have called for a re-imagination of caregiver culture, like Honor CEO Seth Sternberg, who wrote in June that caregivers should be treated like the professionals they are, with respect being the main core value home health leaders should look to nurture.
Honor's Care Professionals
It’s going to take more than just pay raises or bonuses to entice workers into the space and keep them. Home health leaders need to take a holistic look at their on-the-ground workers’ needs, many of whom come from challenging backgrounds themselves.
Almost one in five live below the poverty line. Nearly half are people of color. Almost one in three are immigrants. As well as the unique challenges that come with these socio-economic and demographic realities, caregiver work is challenging on several fronts:
- It pays low wages: On average $13 per hour, with few providers offering benefits or transportation vouchers, even though public transit is used by many direct care workers.
- It’s dangerous: Even before pandemic-related health scares, CNAs and other caregiver jobs were some of the most dangerous in the nation, passing even coal mining and trucking, mostly due to the lifting of patients that’s required. It can also be an emotionally taxing job, too, with the verbal and physical abuse they sometimes experience.
Boudreau has learned a lot from the hundreds of providers her firm has helped over the past decade. Based on Drive’s research, depending on their turnover rates, providers should focus on the following strategies as they seek to sustain a high-quality workforce:
- Up to 25 percent turnover: Facilitate employee development and problem-solving by building a culture of coaching and mentoring.
- 26 to 50 percent turnover: Focus on accountability. Identify what it means in the organization, then facilitate it, seeking to inspire rather than dictate its implementation.
- 51 to 75 percent: Foster employee recognition, which will improve retention rates and sets the groundwork for other values down the road.
- 76 percent and above: Create a culture of respect. This will not only improve the organization’s overall culture, but also improve employee engagement.
If you listen, they will come
Lenbrook, an Atlanta-based senior living non-profit, was one of those providers Drive worked with. COO Felecia Sveda remembers Lenbrook leadership members talking several years ago about the coming “Silver Wave” of Baby Boomers entering retirement age. Like many providers, they were having issues with caregiver turnover and were looking to improve their work culture. 
Lenbrook's concierge
Lenbrook had always done a good job attracting and retaining residents, Sveda says, so they thought: why not take their model of creating living experiences informed around residents’ values and expectations and reflect it onto their hiring and retention strategies?
“We spent a lot of time and resources learning how to retain residents,” she says. “Why not take that same knowledge and best practices and use it with our employees.”
More than just offering higher wages, Lenbrook looked to ask their employees what they wanted out of their work experience. When they heard back, employees said they wanted to feel connected, appreciated, part of a team. It might sound simple, but simple acts of kindness and acknowledgment go a long way toward creating a culture where caregivers feel they are a critical component and not just a cog in a wheel, she says.
In recent months, 95 percent of Lenbrook’s new hires have come from referrals from current employees. That means they are doing something right, Sveda says. A program that offers a bonus to those who successfully refer another employee also helped.
“It’s a journey, and we still have a long way to go, but we are excited about the future,” Sveda says. “I am floored by the passion these people have for the work they do, and we need to support them.”
Nurture your caregivers’ compassion
Because of the nature of the work, many home health care workers can experience a sense of isolation, Boudreau says, and providers would do well to create a culture of community amongst their employees.
But even more than that, it helps to understand them on a deeper level, taking into account their personal motivations for working such a demanding job, knowing full well that they could make more money in other retail or service roles. Succinctly, senior living workers choose the job because they care.
At the core of many caregivers is a compassionate heart and a deeply held desire to serve. They cling to relationship-based values of honesty, accountability, and respect. In turn, they expect that those values will be reciprocated by their employer.
“We have to care about these people and understand why they are drawn to these jobs…and it’s also important to them that they feel they’re receiving that care as well,” Boudreau says. “It’s not enough to just say we can replace them if they leave. You want to find a way to ensure your workers don’t get to the point where they say, ‘This just isn’t worth it.”
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