Aspire for More with Erin
Aspire for More with Erin
Navigating Transitions: Leading Senior Care with Compassion and Strategy
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Seamless Transitions: Managing Moves in Senior Living
In this episode of 'Aspire for More with Erin,' host Erin discusses feedback from listeners and dives into the sensitive topic of transitioning residents from assisted living to memory care. Erin emphasizes the importance of managing expectations, proactive communication, and understanding the emotional state of residents and their families. Using her personal and professional experiences, she provides actionable strategies for senior living leaders to ensure smooth and compassionate transitions. Erin also invites listeners to share their best practices and feedback to foster a better community.
00:00 Introduction and Listener Feedback
00:42 The Importance of Transitioning in Senior Care
02:29 Personal Story: Lessons from Summer Camp
08:59 Key Areas for Smooth Transitions
10:44 Expectations Management
17:39 Proactive Communication
24:05 Emotional Intelligence in Transitions
34:54 Conclusion and Call to Action
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Welcome back to another episode of the Aspire for More with Erin podcast, where today you will have just me as your podcast host. I met some amazing people recently who gave me some amazing feedback about my podcast and I would love to For you to send me a message, an email, for some feedback for you who listen to my podcast. one of the feedback points that I got was they really liked where it was just me. Talking and mentoring people on the episode. And I was honestly taken aback by that, and very honored to receive that feedback. So here it is. And when I asked a topic of what this person wanted to hear, it was helping the transition, From residents and families, from assisted living to memory care. And this is a, an area that a lot of us struggle with. we have family members and residents that struggle with the transition and in my opinion, transitions are one of the areas that we as leaders need to focus heavily on because it's the most vulnerable time inside of a community. It's the time where. The most emotional turmoil happens when a lot of insecurity and vulnerability happens because of emotions. And there are things that we need to focus on if you have a community that has assisted living and memory care, or even independent living assisted living and memory care, you understand how important the transition to each higher level of care is. And there are things that we can focus on. And today we're going to talk about three main areas that we need to focus on through those transitions, because what happens in this particular instance was when we receive great place to work surveys or customer satisfaction surveys, we see how one like assisted living may get higher scores. Than memory care. And you wonder why, or you wonder why a family who was so happy in assisted living may be struggling when they move into memory care. And I think that there are certain areas that we can focus on and certain things that we can do. And I'm gonna discuss that today. So thank you for being here. And here we go. I wanna start it out with. A personal story that is going to give you some context because I am a senior living professional. I helped manage transitions to higher levels of care for years upon years. 15 to 20 years inside of a community and I had the same thing happen to me this past summer. And so I'm going to tell you my story and then we're going to dive into it and look at it from the viewpoint of a senior living leader. My kids go to the YMCA summer camp every year. If those of you who know that I have a son who is on the autism spectrum, he is a uniquely challenged little puzzle piece that, certainly I compare him to a memory care resident who constantly walks and likes to pick things up and say the same things over and over again in the same tone of voice, with the same inflection that you sometimes just wanna be like, seriously. Seriously, why do you keep saying the same thing over to me? ADHD, OCD, autism, we're on there. We got it, right? And then I have a daughter who is your typical child, probably a little bit more adult than she needs to be as a younger sibling of a special needs child, These are my kids. Everything I typically try to do is very consistent and stable. Everyone knows what to expect, because if everybody knows what to expect, then we're not going to suffer any big meltdowns, right? Mama forgot to register the kids for YMCA summer camp. That was a very bad move on my part, and I was in panic mode, and so I had to start thinking about what the next steps are, what can I do? I know my daughter's going to be okay, wherever she goes, she's going to be fine, but I really have to be very conscious of what I do with my son. I make the decision to try to sign him up for a summer camp for adults and kids with cognitive disabilities. And I feel as if I can get him into this camp, then I won't have to worry. I won't have to worry about any bad behaviors. I won't have to worry about, people not understanding him, bullying him, all these things. I won't have to worry. This is going to give me some peace. Because when you're not successful in a certain environment, all that anxiety will bubble up to the caregiver, to the parent. and so when we find the right environment, things calm down for everybody involved. And so I was excited about that. We got in, which I was super excited about. And it was around the same time I had to leave to go and speak at an event. And so my husband was in charge of dropping him off on this first day. His first day did not go well. There were many reasons why my husband forgetting to give him his full dose of medicine would be one of them. the second one was they didn't understand his unique needs. He's very energetic, he paces, they didn't understand his level of energy. And when they tried to redirect him or force him to do things, they It did not go well. And he was in a room that was really small with a lot of people. And if you're an energy person who expands with high energy and lowers and contracts with low energy, you understand if there's 50 people in a small room that you're really going to get really hyper and very energetic. And typically I have my preparation speech with every new leader of a summer camp or a daycare or a babysitter, all those things. And I did not have it with this particular summer camp because I assumed they would be able to handle all the needs of uniquely gifted and cognitively impaired kids and adults. I was wrong. I was wrong. And what happened was, he suffered, and they suffered, and then I was caught in, instead of proactively preparing, I was reactively repairing a situation. They were like deer in headlights. They didn't know what to do, and I was shocked because how can you market yourself as a camp for special needs kids and adults Cognitively impaired when and not be prepared for someone's first day transition into a new place Granted, I have a career that prepared people for the transition. And so what happened was my expectations were not met. They were not correct. They were not communicated and I did not receive theirs. There was not a lot of people trying to ensure success. for me or my son. Number two, there was communication that I didn't even know where they were coming from. I was receiving text messages, but I didn't know who this was from. And I assumed it was from another summer camp that my daughter was going to. So again, I assumed, and I didn't communicate well and they didn't communicate well with me. And I didn't understand What they didn't understand and they didn't understand what I expected them to understand, right? The emotional intelligence of the ability to redirect people, to understand that different means different, and to have an expansion of skill sets for cognitively impaired people, it wasn't there. And so I was caught completely off guard, just as they were. So I tell you this because I want you to think about this. Do you have you had similar situations when your resident from independent living or assisted living moves into a memory care or when you're independent living person moves into assisted living, right? Or assisted living into memory care, even into a higher level of care, like skilled nursing or through the actively dying process. The three things that every leader, director of nursing, marketing director, and executive director needs to be aware of is that to make transitions go seamlessly, to go seamlessly throughout the hospital. The entire transition, there's three main things that we can focus on, and they are expectations management. People need to know where your boundaries are, what you can do, what they can't do, what you're capable of, what you're best at, why they want to move into memory care or assisted living, and who is going to be working with them, right? The second thing is proactive communication, and this starts. With the first conversations of a progression of an illness, a disease, higher level of care, proactive communication is directly tied in to expectations management and then really understanding how the resident and family is feeling throughout this entire process. We have got to understand, identify and know how to use. emotions and know which emotions to avoid and how to calm each emotion down. The case for emotional intelligence is very high because most people want their loved ones to be cared for, respected, and loved. And if they don't feel that those three things are happening during the transition, then we're going to have a lot Of overcoming that we're going to have to do a lot of repairing that we're going to have to do. So we'll start with expectations management. There is one sentence that you need to remember. And if you're driving, etch this in your brain. If you're sitting in front of a desk, make sure you write this down. What does success look like to you? Expectations management is simply knowing what somebody wants to achieve. This entire process to look like. So when they first move in, we want to know what success looks like to you. What do you want from us on the day of move in? What do you want us from us on the second day of move in? And then you listen to what they want. And then you're able to say to them. Yes, we can do that, or no, we can't do that. And you create the path that both of you agree on. That should be happening every time a resident moves in. And now, think about that same thing when we're talking about transitions to higher levels of care. It's very easy for us to say. They have to move and then the families have to go in and make all those decisions and move all the furniture And if we just do that, if we say to them they need a higher level of care, they need to move for their safety and then we're hands off, then we create a big gap with expectations management because we didn't ask what they need from us. Maybe we didn't really clarify why they needed to move. Maybe they want more from us and we don't know. Maybe they wanted a bottle of water, right? And we didn't offer it. Maybe they felt like seeing our face in that time of moving was important. And if we don't think it's important, then why would we do it? So it's important for us to ask, What does success look like for you during this transition? When can you come and move the furniture? Do you need a cart? What do you prefer to do when we move your loved one in? Do you want to be here? Do you want us to do it? How, what is the story you're going to tell the resident so we can make sure that we back you up with that? Do you want to wait to tell them until the day of or do you want to tell them a week before? All of these scenarios are very important with expectations management. When A loved one has to move to a higher level of care. What happens is emotions start creeping up. And if we're not careful, those emotions will tell these family members a story. And then how they deal with trauma in their life. another phase of losing my mother, another phase of losing my father. I've already lost one parent. I've lost a brother. I've lost a kid. all these feelings start creeping up. And if we're not careful, all of a sudden they create these expectations that we're not aware of. So that's why Making sure that families know what your boundaries are with your policies and procedures, with your regulatory processes, what you can and cannot do, why the reason for the change is happening. This is what we normally do, but what do you need from us? And we'll make sure that we can do that. All of those expectations being communicated will help keep families informed. Emotions, stable, right? Expectations management requires proactive communication and understanding the emotional state of your, of the family member. It requires it. If you pay zero attention to those things, then what happens is a lot of resentments. A lot of repairing that you don't even know what you're repairing for and why. So the more that you talk about the boundaries, the more that you talk about what's needed from you, what success looks like, how they want to handle the move, the transition, the more prepared you are to ensure a smooth transition. transition. So let me ask you this question. What do families, what do you think families expect when they move into memory care? Based on what you have seen in your career or heard in your career, what would the expectations be of a family member moving from assisted living into a memory care? we have told them that they have to move into memory care because their loved one needs a higher level of care. So their automatic expectation is that the staff, the associates inside memory care, are trained differently. they are specifically trained to deal with people living with dementia. That means behaviors, that means more attention with activities of daily That means more communication from the community team because they can't communicate and advocate for themselves. That means more patience. They expect it to be more available, more patient, and highly trained. That was my expectation of the summer camp that my son went to. And so it really threw me off. When I get the first complaint about something that they should be able to manage or he took his shoes off he struggled wanting to put them back on and they came to me and they said, he's taking his shoes off and he has to keep them on. And I'm like, okay, I mean you should be able to handle it. He is 12 years old and you are the director of the summer camp, right? The expectation was I pay you to handle situations like this. I don't necessarily need to be involved. I will, but you should be able to handle these situations. And so this is what expectation management is. What can you handle, what can't you handle, and where is my opportunity to come in and help you? Because typically, family members think that they don't have to get involved in small details. But do you, as a community, have to? What do you want them to? Will you bring them in to alleviate a situation that may be getting bigger? So these are the underlining factors that play into expectations management. And it starts honestly with one question. What does success look like to you? Here is what success looks like to me. Here's what you can expect from us throughout this process. And let me talk to you about the people who work inside of our community, That evens the playing field. Being very clear about what to expect is your biggest tool in creating a successful transition. The next topic plays equally into that, which is proactive communication. I'm just going to go through some of the processes that I had whenever I had to have conversations of transitions of care with family members. By working in Alabama, Our residents in Assisted Living have to be able to protect themselves from medication error. They have to know what medicines they take when. So if Erin Thompson cannot identify her name on that medication card and say, no, I'm not going to take that because it's my nighttime medicine, not my daytime medicine, Then, if that's a consistent pattern, I cannot protect myself from medication error, which means My needs are no longer being met inside of assisted living safely. So I have to have conversations with people. Moving into memory care quite often inside of senior living in Alabama. And when we start having these conversations is when I start planting the seeds about what memory care is. It's a proactive communication. We're seeing the growth. A progression in your loved one's disease process with dementia. We're seeing patterns that may be in indicating to us that they no longer are benefiting from the services that we offer inside of our community and may need a higher level of care for memory care. Here is what we're seeing, and then we list out what we're seeing. Here is why memory care can meet these needs. Better than assisted living can that's my first seat. I'm not saying that we're here I'm saying that this is what we're seeing and so anytime you want to go and take a tour inside of Memory care. I'll be more than happy to and help you understand everything that memory care has to offer Because we want to make sure that their perceptions and their expectations of what memory care is and that they're not scary. Because when we let fear dictate our decisions, it's never going to be what it could be. And so with proactive communication seed planning of expectations management, we can help make that transition better. And then another conversation we have is we have to have, because an incident happened. we sit down, we have another conversation and we say, I think we're here. I think due to this situation, it's telling me that it's time to move. And what you have to understand when you have these tough conversations is proactive communication, which again ties into the emotional state of understanding what emotions are telling you. Okay. Number one, the first thing that people are going to want to do is blame. Expect it. Okay. If you're going to proactively communicate, no one can blame you because you're proactively communicating. Now, if you're reactively repairing, like I was doing, then blame is something that we need to look at. should I have talked about this sooner? was I not aware of certain things? those types of questions you need to ask yourself. But blame is something that's going to happen almost automatically because They feel scared. They feel vulnerable. They feel out of control. And they feel sad. And the first thing, the first act that you do, When you feel scared, vulnerable, sad, out of control is discharge that pain by blaming somebody else. It's the first thing. It doesn't mean that you're wrong. It doesn't mean that you did anything wrong. And it doesn't mean that you're to blame for the progression of a disease. And when you proactively communicate, you understand that you're not to blame. You understand that you're doing expectations management with them. And you understand, and you can give them something to control. By saying, let's go look at apartments, let's do a few other things before we have to say that this move has to take place. I understand that you're upset. I understand that. This is frustrating. And this is sad. All of that's true, but we have to do what's best for your loved one, according to the rules that we are governed by. We have to take action. Let's decide what that action is. Because moving to memory care can actually be life changing for somebody who is struggling inside of assisted living. And it's our job to be able to explain that to the family in a positive way and not in a negative way. We shouldn't be having conversations with families and talking about memory care as if it's, A death sentence or different from assisted living. We should be talking about memory care in a way that offers. An environment for our residents to feel safe and engaged because they're no longer feeling that way inside of assisted living if the disease is progressing, So having proactive communication with expectations management sprinkled into it. And then understanding the emotions that go into a loved one needing higher levels of care allows you to make this transition seamless for the families. But it takes you making those three things important expectations management, proactive communication, and understanding the emotional state. So proactive communication is planting the seeds of progression be acknowledging, and becoming aware that we have patterns that we need to be talking about and having these conversations sooner rather than later, because the more prepared people are, the easier the transition is going to be. I talked about blame already, but I want to get into the emotional intelligence piece. When you understand emotions, truly when you understand emotions, you have such a tool to help you not get burned out, to not absorb the negativity, but just to observe the negativity, and help change it. Family members work through the difficult times of moving a loved one, or losing a loved one. Because really, when a higher level of care is happening, we are losing a loved one. So we're losing and we're moving, which are two very stressful things for families. And if we're not careful, and if we're too closed off and we're not involved in the transitions, this is where the resentment will creep in and you will start having to climb a mountain that you didn't even know was there, which is the hardest mountain to climb. So blame typically means Somebody's feeling out of control, somebody's hurting, and they're discharging that pain. Or you did something wrong, right? You have to figure out which one that is. And if you can look back at your community and what's happening, and you can know that you've done everything that you can do, then it's not your fault. It's not your fault. So if somebody's blaming me about a progression or the move or something, I'm going to articulate to them where my boundaries are. I know that this is hard. I know that I don't want to be having this conversation with you, but according to our policy and procedure, according to the rules and the regulations that we are governed by, these are the decisions that we have to make. And now I don't want to promise you that I can meet the needs of your loved one and then not be able to. That's not who I want to be as a leader. That's not who I want this community to be. And that is definitely not what you want for your loved one. This is hard. Yes. But it will be even worse if we choose to do nothing and something terrible happens that we could have avoided. You are giving them something to control. Everything that I just said was true, right? When we are, when family members are fighting us, when they're trying to pull every stop to not move, that's not on us. I can simply restate over and over again the facts, but I cannot get them to receive it. that's them. And the more people fight and argue, the more I sit and listen, and the more I tell them, you're, you are advocating for your loved one, and I see that, and I appreciate it. But here is where my hands are tied. Here is where I feel like we're not meeting the needs of the loved one. I want them here. I want them to be here until they can no longer be here. And we have that opportunity right now in memory care. And then I, my, it's my job to help them understand that this is the best decision for them, not the worst. And I use stories and different scenarios that have really worked out in the resident's favor. And then the other thing that we want to talk about. With proactive communication, expectations management, and the emotional state is these families want to hear more from memory care or whatever level of care they're moving into, want to hear more from the new staff. I'm going to be talking about the new staff very quickly because they don't know them and they don't know the new staff. One of the biggest complaints that I got, and maybe this is for you too, when people moved from assisted living into memory care was there wasn't a lot of communication. The expectation of The relationships from Assisted Living and if they were there for three years or two years or one year and they had these relationships with caregivers and nurses and me being on that side of the community and all of a sudden they move and they don't know anybody. So they feel disconnected. And this is where the expectations management and the proactive communication comes in because a new team needs to be aware that they need to be communicating more. And that's hard for a memory care setting because they're so busy They have to do a lot of redirecting. The details matter in memory care. they're they have to crush pills or do all these special things to get residents to take their medicine. And so a new resident comes in and they don't realize. That it's really important for them to be connecting with the family because that first 30 days is very important. And that's where the expectations and proactive communication comes in because they're expecting the same relationship with different people, which is a little unrealistic, isn't it? But in an emotional, illogical time, That's what they expect. And so if we train our teams to really make communication more important, for new residents in those first 30 to 45 days, I think that we will find that the transition and the customer service score will bump back up pretty quickly. When you're in memory care, you're in a different world. Associates, nurses, they live in the world of the resident. And so when you have a family member come in who's still in an old world, those two languages, those two experience may not translate very well. And so it's going to require more of an awareness on the memory care staff, the higher level of care staff to make communication a priority and to ask the question, what does success look like to you? What can I do to make you comfortable quicker? Which is a proactive way. And it's not necessarily something that we're trained on a lot. So it certainly is a new way for us to think, but I believe, I know based on my experience that when I made that a point, a very intentional, strategic effort, then the transitions went very well. When I lost sight or I didn't realize how important and powerful that was. They didn't go as well as they could have. So being strategic about knowing who's moving, who is having those significant changes for us to be aware of and start planting the seeds, proactive communication, and start explaining what a transformation memory care can be for residents who are struggling in assisted living. All these compounding efforts can make the transition very smooth. No one likes to be surprised. No one. And if we avoid having the tough conversations when problems start showing, and we have to wait till the big problem presents itself, we're going to have a hard time overcoming the family's expectations. And expectations management is the tool that we want to use to have smooth transitions. Transcription So it requires strategy, awareness from you and the more people you have walking through the transition with the family, the better the transition will be. And when the family member tells you what success is to them, it's your responsibility to go and tell that to the care staff, to the nursing team, to the housekeeping team, to the maintenance team, because they just gave you the keys to the kingdom. The keys to success and now it's your responsibility to go and tell the associates how to be successful for this new resident moving in. And that my friends is how you do two things at one time. You bring confidence to the family member about the associates who will be caring for their loved one and you bring. And build confidence. So when those transitions happen, as a recap, you want to start early, start planting seeds early, start talking about what you can and cannot do based on your policies and procedures, the rules that you are governed by, and what the needs are of that loved one, start defining where the boundaries are, and start planting the seeds about what you where the next level of care, what the next level of care can provide for their loved one and for them. And then proactively communicate along the way, know what success is and then communicate that to your team. Communicate, make the memory care, associates more aware of the more communication they need to give. To the loved ones so they can connect because the loved one is looking for the connection to the team because they're losing Connection in their resident, in their loved one, because maybe the resident can't tell them what's going on. And now all of a sudden they're feeling very vulnerable. The emotional component of moving to a higher level of care will cloud people's ability to think and act appropriately. And the more that we're aware of that, the better that we can be. Because most people want the instant connection that they are leaving to happen. And the other part to think about is, if it was my mother or my grandmother and they were in assisted living, they were once able to communicate for themselves and advocate for themselves. And if you're moving into memory care, they can't do that anymore. So they are expecting us to do that for them. And if you know that you can manage that expectation. And then those things that we talked about during this episode will help you build that connection. I hope this helps. I hope this gives you strategy On how to manage transitions in your community, and I'll be happy to talk more about it. Leave me some feedback, message me on LinkedIn. You can send a message, I believe, even through the podcast on the homepage, but I'd be interested to see what your best practices are. That will be fun to discuss. So if you are listening and you haven't subscribed on Spotify, iHeartRadio, Or on Apple Podcasts, do that for me, the more subscribers, the more people will get reached and the more we can learn and grow and create a great place to live and work. So thank you for your time. I hope that you gained a lot of insights and as always aspire for more for you.