Imagine walking with popcorn kernels in your shoes, Vaseline smeared on your glasses and sensory deprivation gloves that prevent you from feeling. In the Virtual Dementia Tour, Cathy Boenig’s staff walks in the shoes of the residents they serve at Argent Court, a group of assisted living communities in Texas. Staff love this training, she says. It helps them empathize with the facility’s aging population, many of whom suffer from dementia.
“One of my biggest challenges today is finding care providers who have empathy for our population,” said Boenig, vice president of operations at Argent Court. “Instead of hiring someone who looks good on paper, I look for someone with a good heart. Empathy and compassion are not something you can teach.”
Cultural Risk Management
K&B Underwriters agrees. That’s why K&B’s DigniCare program goes beyond analytical risk management to a cultural risk management approach to senior living. This approach puts caregivers and residents front and center.
“I believe in a different approach to risk management, a cultural approach that engages the caregiver and fosters an environment of compassion among the staff, that will also translate to those for whom they care,” said Bryan Baird, president of K&B Underwriters.
In order to witness this type of environment in action, Baird and his team have visited successful models of care from faith-based senior living providers such as the Little Sisters of the Poor and the Schwartz Center for Compassionate Healthcare in Boston, where building employee engagement and organizational culture change are key. Baird said for-profit providers can integrate the same principles in their organizations, by using similar training and delivery models.
“It has become very clear that unless we first help the caregivers, any clinical assistance we provide is going to fall short,” Baird explained. “The key is in investing the time and resources in building and nurturing the caregivers themselves. Employee engagement is the single biggest driver of quality care, resident satisfaction and ROI.”
Over the past two years, DigniCare has not only helped Boenig develop a culture of empathy among her staff, they’re also a phone call away in times of need, providing minute-by-minute access over a support line.
“Even with 15 years in this business, there are going to be issues you don’t know how to deal with. It’s good to have another person to talk with, to pick their brain,” Boenig said. “When you’re a small provider, you don’t have access to a lot of resources without paying a lot of money. I wish I’d had DigniCare 15 years ago when I first started in the long-term care business.”
Thousands of Resources at a Moment’s Notice
Access to 24/7 risk management support was also the main reason Ron Regan chose K&B Underwriters. Regan manages four California care facilities with residents that range from independent assisted to level three memory care. As the owner and CEO, he was looking to improve staff education and risk assessment. Both were a strong point in K&B’s proposal.
“Prior carriers failed to provide adequate training, never spoke with or interviewed staff and did not make site visits,” Regan said.
Before signing on with DigniCare, one of Regan’s four senior living facilities experienced a legal issue over fall prevention where lack of documentation resulted in a loss.
“The facts of the loss showed that medical malpractice by a co-defendant was the approximate cause, but settlement was recommended due to the lack of documentation on a fall prevention plan at the time,” explained Regan.
He learned that DigniCare provides extensive fall prevention plans that can be customized to each institution, as well as thousands of easy-to-access forms, tools and training materials to make risk management easier.
Since signing on with DigniCare, Regan’s four residential facilities have received support related to HIPAA compliance and family communication, fall management, training to prevent abuse and neglect, and tools and processes to protect the facilities’ interests in regard to hiring practices and exit interviews.
“K&B has provided a program of downloads along with interviews of our staff and site visits to each community,” Regan said. “The material was well received by our staff and they continue to use it in the training of new hires.
Providing easy access to resources as well as deploying “cultural risk management” strategies yields positive results for long-term care facilities. “No claims or losses have resulted in our communities since K&B took over. Our staff is far more educated on the risks, which has yielded great results to date.”
Support in Tough Times
Sometimes caring for the caregivers extends to long-term care managers, too. Darrell Hicks, owner of Hicks Golden Years Nursing Home in Monticello, Ky., said K&B helped him through a tough time both personally and professionally.
“It’s been a hard year for me personally,” Hicks said. “I’ve had back problems and my wife had a hip replacement. But Jeff Pettersson (DigniCARE field representative) never gave up on me. He really cared. He saw that I needed help and came with some real encouraging words.”
This is Hicks’ 26th year as administrator of the facility. Instead of getting easier, his work has gotten three times harder with all of the new government regulations. A high percentage of Hicks Golden Years’ residents are on Medicare (part A) or Medicaid. And the state of Kentucky plans to take on more than 300,000 more people on Medicaid.
“It’s a shame,” Hicks said. “A lot of mom and pop nursing homes are going out of business. We plan on staying in business, but it is scary. After 26 years of work, one regulation comes along and everything goes down the drain.”
Pettersson continued to correspond with Hicks, not just to tell him about the resources that DigniCare offered, but to lend an ear in tough times. He sent information on corporate compliance that helped Hicks and his team persevere through a busy year, as they moved to electronic health records.
“They are a fine group that helps at every turn,” Hicks said. “You can use their forms and policies and tweak them in any way you want to suit your needs.”
Caregivers Come First
In a cultural risk management approach to senior living, caregivers must come first to transform the type of care given to residents. And that means going beyond providing a one-time seminar or training session.
“Going forward, we need to teach empathy,” Boenig noted. “I often ask my staff to pretend a resident is their grandmother. We need to take care of their needs in a manner that brings compassion to our whole facility.”
“It’s this type of approach we need to look at, where there is support therapy for caregivers and staff,” Baird said. “I’m always thinking about what could be done to change the culture, to make a real transformation.”
Baird’s hope is, like the Schwartz Center, K&B Underwriters can help its clients promote compassionate care so that patients and their caregivers relate to one another in a way that provides hope to the patient, support to caregivers and sustenance to the healing process.