I was a real estate broker. By age 21, I owned my own real estate company, had agents working alongside me and was enjoying a profitable business. I loved my job — I loved to help people find the perfect home.
Then my grandmother was diagnosed with Alzheimer’s disease.
I watched her slowly decline in her home, and then in an assisted living facility, and in a nursing home. I watched her try to heal from broken limbs from falls, when she couldn’t remember her hip was broken.
I listened to aides tell my family it took multiple people to shower her, despite her frail frame. I watched my family struggle with understanding her diagnosis and how it took her, as we knew her, away from us slowly. I watched her bang on the door of the facility when she couldn’t go home with us.
When she died, I didn’t know anything about the medical field, nursing homes or taking care of people. What I did know, though, was that I could do better than that.
I hung up my real estate license and went to the Red Cross for nurse aide training. I immediately got a job in a nursing home and worked in a locked wing for people living with dementia (not a “secure memory care neighborhood” — a literal locked hallway where they kept people with dementia).
Where the other aides struggled, got bitten, kicked and spit on, I thrived. I found my true calling — I had always loved helping people, but this made my heart sing. Solving the puzzle of the expressions of my residents, assisting people with meals that would otherwise not be able to feed themselves, taking the pain and struggle out of personal care and bedtime rituals, these things spoke to me and lit my fire in a way nothing else ever had.
I tried hard to share my approach with my peers, to teach others how to provide exceptional care with compassion.
There was only one problem: “That’s not your job. You’re an aide, you don’t make the rules.”
Well, that was no good for me! I decided that if I wanted to make a real difference, to really be able to show people what great care looks like, to change the face of an industry plagued by negativity, I would have to become an administrator.
I put myself through a bachelor’s degree program at Saint Joseph’s College of Maine, one of the few NAB-accredited colleges in the country offering a degree in Long-Term Care Administration. I focused every ounce of myself on learning the minutia of administration — finance, quality improvement methodology, leadership strategy. I carefully catalogued this knowledge for when I finally became an administrator, stringing together what I thought would be a game-changing strategy for excellence in long-term care.
Fast-forward to reality: It’s a game-changer, alright. I’ve had to change MY game almost every step of the way. I’ve had to navigate endless regulations. I’ve had to battle penny-wise but pound-foolish policies. I’ve had to try to lead staff members who don’t want to hear that there’s a better way. I’ve ended the day wondering how I could possibly go on in this crushing industry.
And I will keep showing up.
Every day, I have to find ways to stay engaged, to remember I am fighting the good fight. I have to constantly remind myself that I chose this, that my residents and team members are better every day for my leadership and my drive, and that there is hope … because there is!
Regulations are hard. It can be discouraging to have to change something you’ve been doing for years or even decades. But it’s what we do. We evolve. We learn new rules and we find ways to make them our own.
Reimbursement is hard! How insulting to know how hard we work, and then find our reimbursement is cut because some politician doesn’t think we’re worth it. But it’s what we do.
We get lean. We become efficient. We find creative ways to do more with less.
Negative, burned-out industry professionals are hard! They seem to take pleasure in reminding us new administrators that we haven’t seen anything yet, that we will lose our shiny newness, that we too will realize that there’s just too much stacked against us to be successful. But it’s what we do. We smile, we rise up and we say we chose this road.
We, nursing home administrators, chose this. We came to lead, we came to evolve, we came to care for those who can’t care for themselves. We fight, we advocate, we press on.
With administrators leaving this profession faster than new administrators are coming in, we must ask ourselves what we are doing to attract young, bright leaders to this career. If we give up, who will be the voice of the elders who need us? Who will fight to protect them when they can no longer protect themselves? Who will comfort them when they lose everything they worked their whole lives for? Who will tirelessly work to improve the care delivery and quality of life of people in nursing homes if we give up?
I will. I commit to fight on. I will commit to owning the regulations, and finding ways to strike harmony between regulation and real life. I will look for ways to make my organization efficient and cost effective so I have revenue to invest back into my facility.
I will show my team how to cultivate such a powerful culture of excellence that referral sources will beg for beds, and residents and families and community members will proudly recommend us to their friends and loved ones. I will surround myself with like-minded leaders in my professional association who will fill my cup when it starts to run dry, so that I can fill the cups of others.
I will recognize my team for a job well done, a day well spent, and lives made better with our compassion, dedication, and quality improvement. I will walk the halls of my building and hold the precious hands of the aged, share their smiles, and hear their words.
I will find gratitude in small wins, even when I feel as if I’m standing in the shadows of looming challenge. I will share the message of hope, I will spread the impact of positivity, and I will stay. Because I chose this.
I am a nursing home administrator.
Christin Delahay, LNHA, CDP, is an administrator in the Greater NYC area. She is passionate about excellence in long-term care and is an active member of the American College of Health Care Administrators (ACHCA).