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Pandemic Paradigm Shift

We can now begin to take a collective deep breath compared to the early days of the pandemic. We now have a few years of research, data, and results to guide our behavior. The International Council on Active Aging's Forum published a report on the future of senior living communities--post pandemic.

As always, your comments are welcome and encouraged.

EXECUTIVE SUMMARY Shift to an employee-first culture The senior living industry, like many other industries, is facing an acute staffing shortage that challenges the ability to deliver services. Senior living operations are complex businesses, ranging from hospitality to nursing care, which means employees are vital to the residents and customers being served. Senior living is a people business. Even before the pandemic, appropriately staffing the numerous positions in senior living was problematic, as was retaining workers. Recognizing that addressing the staffing challenge requires big, bold ideas, the International Council on Active Aging (ICAA) hosted an ICAA Forum think tank in December 2021. Over two days, senior living thought leaders identified issues, shared best practices and arrived at the boldest idea: Focus first on the employee, second on the resident and customer. The philosophy of focusing first on staff members instead of residents is a new approach for senior living. Yet the employee-first (or people-centric, people-centered workplace) concept is simply transferring person-centered care out of the hospital and into the daily lives of people in the workforce. Many organizations have adopted the employee-first culture, recognizing that engaged, satisfied employees take great care of their customers. (As an example, this is the formula used in the hospitality industry.) In a person-centered workplace, each person is respected and valued for their abilities, their needs are met, and their input acted upon. Colleagues at the ICAA Forum emphasized that frontline staff members—those who have regular in-person contact with residents, family members and customers—deserve to work in a person-centered, employee-first workplace because they deliver what the organization promises.

Employee-first philosophy and action items

As Forum colleagues thought about the employee-first concept, their own shift in mindset began to take place. The philosophy and action items to move senior living to an employee-first culture emerged during the ICAA Forum are: 1. Make employee wellness a fundamental value.

2. Empower local leaders and staff members. 3. Build a culture of trust with authentic communication and actions. 4. Shift the human resources function from transactional to transformational. 5. Update the recruitment philosophy and tactics.

6. Prioritize training, career paths and professional development. 7. Prioritize professional development of executives and managers. 8. Utilize technology to support staff.

9. Update the revenue model.

Building a new role for the workforce in senior living, as in all organizations, means changing the mindset of every leader and every worker. Senior living organizations have a track record of rapidly responding to the pandemic by changing the physical layouts and public interactions, and the way food service, lifestyle, fitness and nursing assistance are provided. Understandably, every staff member and leader in senior living is feeling the fatigue of constant change and stress. The operational changes over the past years were reacting to the pandemic. The rules of business-as-usual failed, and new rules need to be created. Isn’t it time for proactive change? The senior living industry is fortunate to have an incredible asset: talented, dedicated staff members who know what can be done to best enhance the quality of life of residents. When employees, managers and executives work together as equal partners in the success of the organization, each resident, family member, customer and supplier benefits. A person-centered, employee-first culture guides the future of the senior living model.


“We are moving toward person-centered solutions for our customer, our residents, so wouldn’t it make sense to focus more on person-centered solutions for our staff?” Colin Milner, CEO, International Council on Active Aging

Residents benefit in the person-centered workplace

As the pandemic progresses, many people are rethinking what they want from their lives and their work. Constraints such as family care, housing, illness, incomes and frustration are influencing people to stay in their current jobs or choose another one. The people who stayed in the senior living workforce faced all these challenges despite constant stress, heavy workloads and wrung-out emotions. Few outside the senior living industry recognize the complexities senior living providers face as they manage multifaceted business combinations of real estate, restaurants, lifestyle and care for older adults. ...

...The challenge of recruiting and retaining a high- performing workforce for senior living is not new. Nor did staffing challenges emerge because of the pandemic—the pandemic-related pressures only intensified the issue. It was evident that Forum colleagues have given thought to the staffing issues in senior living long before the pandemic. In particular, there was a lot of input on frontline workers, the people who have regular in-person contact with residents and their family members. And, there is pent-up demand for standard practices to change. The questions circulating during the ICAA Forum discussion focused on what needs to happen to build on the industry’s greatest asset: the people who work there. How can the philosophies and policies in senior living organizations enhance the employee value proposition—the combination of compensation and benefits that are exchanged in return for the person’s quality work? What will encourage a person to work with an organization providing services for older adults? What needs to change to aid the recruiting, hiring and retention of employees in all roles? There is a philosophy that could stabilize the senior living workplace: Focus on staff members first, and they will take care of the residents and customers.

The bold idea: Apply the person-centered philosophy to each worker

“Clients don’t come first. Employees come first. If you take care of your employees, they will take care of your clients.” Sir Richard Branson, Founder, Virgin Group

The number-one focus in senior living is typically the resident. Staff members are constantly reminded that the residents’ needs are the top priority. In assisted living and nursing environments, the “person-centered care” philosophy focuses on the resident by incorporating an individual’s preferences, goals and abilities into care decisions. What would happen if the concepts of person-centeredness are extended to each person working at the community? What if we acknowledge that the employee is the critical link between the resident and the organization’s purpose? By first taking care of each staff member, gains in productivity, job satisfaction and retention would in turn benefit the residents. The culture that engages staff members first is called employee-first and people-first, person-centered and person-centric. Advisory firm Gartner recommends that employers see “people” instead of “workers” in the pandemic environment and craft the employee value proposition with person-centric approaches rather than features.

In long-term care, an employee-centered culture can help reduce turnover and improve care. From the business point of view, organizations that prioritize the people who work there have higher profits and growth. The employee-first philosophy is a centerpiece of organizations such as Southwest Airlines, Starbucks and Darden Restaurants, each with a cadre of frontline workers, because happy employees provide excellent service, which leads to more customers,growth and profitability. The concept of a person-centered, employee-first workplace is not new, but focusing on the staff member before the resident or customer is a paradigm shift for many senior living organizations. In an employee-first workplace, staff members are equal partners with the employer in realizing the organization’s mission. Parallel to the concept of person-centered care, the needs, abilities and goals of each worker are discovered and respected, and the workplace makes adjustments to accommodate them.

The well-being of employees is paramount, whether in the design of physical spaces or daily interactions. The dimensions of wellness frame the employees’ experience to aid their physical, mental and emotional health. Each person is valued as a contributor and partner in the organization’s success. Open communication, trust and managers who model the employee-first culture are hallmarks. As a result, an employee-first culture creates an environment where people want to work.

An employee-first culture: • Recognizes staff members are the biggest company asset • Encourages and appreciates employees in all roles

• Acts upon employee suggestions • Measures employee behaviors against the organization’s values • Prioritizes people over profits, but gains in productivity lead to growth and profit • Makes managers accountable to employees

The employee-first approach does not mean residents are secondary; because staff members’ needs are taken care of, they focus on residents and customers. Changing the role of the workforce in senior living, as in all organizations, means changing the mindset of every leader and every worker. Strategies that set the direction will guide the future.

Develop the mission of an employee-first culture Why would a person want to work in senior living environments? What are the reasons beyond wanting to help others? How do staff members contribute to the success of the organization? Are staff members and the workplace included in your mission statement? Why or why not? What is the person-centered Employee Value Proposition (e.g., for wellness, self-care, satisfaction)? What would an employee-first culture look like?

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My next post will include how this paradigm shift will impact employees and residents and how implementing this philosophy can benefit us all.


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