Guest Columns

Combat Frontline on the front lines

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Anthony Cirillo
Anthony Cirillo

Unless you have been totally disconnected from the long-term care world, you are familiar with the Frontline Special, “Life and Death in Assisted Living,” that has caused quite a stir! (Read my take on it here.)

While I contend that ultimately this is a culture issue born from a crisis of leadership, nonetheless, the quality of care or the non-quality of care is delivered on the front lines by resident/patient facing staff. Consider the following.

The experience of care IS the marketing for the organization.

Therefore, everyone in the organization is both chief experience officer and chief marketing officer.

That is quite a responsibility for a CNA, dietary aide or environmental services staff member.

Experiences become stories, which really are perceptions of the actual experience translated. Stories spread by word of mouth, amplified by social media. Stories make people fall in love, or hate, with a product or service. Stories are the marketing. Marketing impacts revenue.

Leaders in long-term care must communicate to employees that not only do they have a tremendous privilege and responsibility for caring for patients/residents, but that their every action or inaction, spoken or unspoken word, facial reaction all reflect on the organization. You must draw this full circle analogy. And that cannot come from edicts from on high but by leading by example.

Let's look externally now

You may have been salivating over the World Alzheimer's Report that revealed that nearly half of all seniors need some form of long-term care have dementia. The AP quoted Marc Wortzmann, executive director of Alzheimer's Disease International, which commissioned the report: “What many countries try to do is keep people away from care homes because they say that's cheaper. Yes, it's cheaper for the government or the health system, but it's not always the best solution.”

Who would have thought that aging in place would get some push back from such an unusual source? We can debate the best settings for care and whether the care is better in one or another.

All things being equal on that level, the real issue is financing. In the rest of the world aging care is PAID for by the government.

The industry has a two-prong consumer challenge.

First, you have to figure out how to convey the need for residential care in an aging in place world.

Second, you have to get them to choose YOUR care.

After people come around to the notion that at some point, residential care may still be needed, they do the research. No two places are alike. With so many emerging and existing transparency tools to measure care quality, well people can and will do their homework and make decisions based on it.

Yet all that homework can be circumvented with one PR disaster.

I'll say what I think the leadership of the organization targeted by Frontline is feeling in the pit of their stomach. That is this. The first reaction from anyone who watched that show is an automatic disqualification of this chain's facilities from the list of choices. Even seasoned healthcare professionals make these knee-jerk decisions based on perceptions and experiences. I have done it with my mother's hospital provider and when she needed care last month, we picked a different hospital.  

That is a lot to overcome. You may already be hedging bets by extending your brand into other areas to capitalize on aging in place. That is smart. But in the here and now, you need to be out in your communities educating them about long-term care options and financing while telling your great resident stories.

And that means you also have to reach people younger than who you are targeting now. Because unless the financing mechanism changes, few will be able to afford what the industry offers. I know it is extremely hard to get younger people to even acknowledge aging yet alone prepare for it but someone has to paint the whole societal picture. It's no different than the Affordable Care Act scenarios. If young people do not buy in, it does not work. This is a societal issue. And remember that the new sandwich generation is Generation X.

And we continue to create new PR disasters as a result of not addressing the financing part. I am increasingly hearing of scenarios where people go into assisted living and once the money runs out, they have to leave. Not qualified for skilled care, family caregivers, unprepared, have to take them in.

I am not encouraged on the financing front. When five members of the national Commission on Long Term Care issued a separate report in September outlining alternative recommendations from the full Commission, before I ever read it, I was thinking “BAD IDEA.” It is hard enough in today's world to establish credibility. So when a supposed bipartisan Commission issued its report, you would figure, OK, united front, they did their best even if they did not agree.

But when you have a splinter group in essence say, “Oh, we didn't mean it before. Here is what we really mean …” Well, who really wants to pay attention?

It makes it look like once again no one is working together and sends a signal to the public that it is hard to know whom to believe.

The long-term care associations need to get their heads together as one. In an every organization for themselves world, it is time to unite around a battle plan on the front lines of these PR wars.

Anthony Cirillo, FACHE, ABC is a healthcare expert, elder advocate and expert blogger for Wellsphere in the area of aging and senior health. 
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Guest columns are written by long-term care industry experts, ranging from academics and thought leaders to administrators and CEOs.

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