A hard-earned lesson
Ken Tack, Founder, Quality Life Services
It is often said that you cannot teach an old dog new tricks, but that is not totally true. You can teach an old dog new tricks; it's just difficult. In the case of this old dog, it took a near-death experience.
Here I am in my 40th year of long-term care. That is an eternity when you spend it in a field that has had so many changes. Last year, I was looking forward to a comfortable time, having recently stepped down from the CEO position of a regional group of homes that I had helped to found many years ago. The next generation was doing a good job of running the company, and I was 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 a regional hospital. After surgery and some observation, I volunteered to transfer to one of our company's nursing homes, where I was for a month. I had never dreamed of being a resident in a nursing 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 with my eyes, heard with my ears, and felt with my heart the low level of compassion the care staff was experiencing. All the hopes and dreams of making life better that filled them when they first started had been slowly sucked from them. They were running on empty and I was very much a part of the problem.
Before I proceed further, let me publicly profess that I am deeply grieved by the callous manner I have treated the caregivers in our organization. Although I have never knowingly hurt any staff member, I have been neglectful of many as an individual and as a person. All my training and the volumes of regulations have helped to create this inappropriate conduct. With one eye on the bottom line and the other on the regulating bodies, I never saw what was occurring in front of my nose.
Our people, the backbone of each organization, our caregivers, are hurting. The stress of holding to tightly tailored PPD numbers, conflicts with co-workers and family members, coupled with a career that forces you to have relationships that end in death, can suck the air 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 of compassion.
Disturbing status quo
The thing that is most disturbing to me is how we have accepted this in the profession as “just the way things are.” We say that this attitude on everyone's part is simply a part of our business. But I believe it does not have to be this way. When we open our eyes to this practice of devouring our own limited resources we begin to see it. What happens when a caregiver begins to lose their compassion and then their performance slips? Our traditional response is to have a discussion with them about their performance, reminding them how important they are to our elders' lives. When that doesn't correct the problem, and it rarely does, we give them a second, sterner warning. Finally, exasperated with their poor showing, we are forced to terminate them only to begin the process over and hope we achieve a better result.
We see this every day when we see employees having attendance problems, leaving an elder in a mess, talking over the elder's head, and taking too frequent breaks. We label them a bad employee and place them on the “do not rehire” list when they resign or we terminate. Did we ever see this caregiver, once filled with hopes and dreams of what they might do for these aging individuals, as a person in need of a compassion refilling? For the first time I was able 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 we can begin by caring and letting employees know that we do that we care about them. We can spend as much time preventing the problem of compassion bankruptcy as we do in fixing the results. We still try to find good applicants, interview them, process them, train them and direct them. But we also can look them in the eye every day and see the person that is there. We can ask them how things are doing and actually take the time to hear what they have to say. When they have a problem, whether it is work-related or not, we can make an effort to give them the support and caring we ask that they give our elders.
The most important thing we have tried to do is let care partners know that we truly care about them. We are attempting to celebrate the joys and sorrows of our employees, praise them for what we had just taken for granted, and understand when they are struggling. It's not our goal to be their closest friend, but we can be inflate their balloon of compassion when it starts to shrink.
Forty years of doing something wrong can make change a little difficult, but this is now the earliest I can begin to make the change. I have begun making rounds with an entirely different objective.
As one who contributed far more than my share to the draining of this compassion, I did a 180-degree turn. If I am to ever be remembered by the long-term care industry, I pray that it will be for helping to put compassion back, not just the financially successful company I helped to build.
Ken Tack is one of the founders of Quality Life Services. A longer version of this article appears at www.mcknights.com (search “Tack”).