November 21, 2024 • 36 mins
Send me your feedback on this episode!
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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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Microphone (Yeti Stereo (00:00):
Welcome back to another episode of the
Aspire for More with Erinpodcast, where today you will
have just me as your podcasthost.
I met some amazing peoplerecently who gave me some
amazing feedback about mypodcast and I would love to For
you to send me a message, anemail, for some feedback for you
(00:24):
who listen to my podcast.
one of the feedback points thatI got was they really liked
where it was just me.
Talking and mentoring people onthe episode.
And I was honestly taken abackby that, and very honored to
receive that feedback.
So here it is.
And when I asked a topic of whatthis person wanted to hear, it
(00:47):
was helping the transition, Fromresidents and families, from
assisted living to memory care.
And this is a, an area that alot of us struggle with.
we have family members andresidents that struggle with the
transition and in my opinion,transitions are one of the areas
(01:07):
that we as leaders need to focusheavily on because it's the most
vulnerable time inside of acommunity.
It's the time where.
The most emotional turmoilhappens when a lot of insecurity
and vulnerability happensbecause of emotions.
And there are things that weneed to focus on if you have a
(01:29):
community that has assistedliving and memory care, or even
independent living assistedliving and memory care, you
understand how important thetransition to each higher level
of care is.
And there are things that we canfocus on.
And today we're going to talkabout three main areas that we
(01:49):
need to focus on through thosetransitions, because what
happens in this particularinstance was when we receive
great place to work surveys orcustomer satisfaction surveys,
we see how one like assistedliving may get higher scores.
Than memory care.
(02:10):
And you wonder why, or youwonder why a family who was so
happy in assisted living may bestruggling when they move into
memory care.
And I think that there arecertain areas that we can focus
on and certain things that wecan do.
And I'm gonna discuss thattoday.
So thank you for being here.
And here we go.
I wanna start it out with.
(02:31):
A personal story that is goingto give you some context because
I am a senior livingprofessional.
I helped manage transitions tohigher levels of care for years
upon years.
15 to 20 years inside of acommunity and I had the same
thing happen to me this pastsummer.
(02:54):
And so I'm going to tell you mystory and then we're going to
dive into it and look at it fromthe viewpoint of a senior living
leader.
My kids go to the YMCA summercamp every year.
If those of you who know that Ihave a son who is on the autism
spectrum, he is a uniquelychallenged little puzzle piece
that, certainly I compare him toa memory care resident who
(03:19):
constantly walks and likes topick things up and say the same
things over and over again inthe same tone of voice, with the
same inflection that yousometimes just wanna be like,
seriously.
Seriously, why do you keepsaying the same thing over to
me?
ADHD, OCD, autism, we're onthere.
We got it, right?
And then I have a daughter whois your typical child, probably
(03:42):
a little bit more adult than sheneeds to be as a younger sibling
of a special needs child, Theseare my kids.
Everything I typically try to dois very consistent and stable.
Everyone knows what to expect,because if everybody knows what
to expect, then we're not goingto suffer any big meltdowns,
right?
(04:03):
Mama forgot to register the kidsfor YMCA summer camp.
That was a very bad move on mypart, and I was in panic mode,
and so I had to start thinkingabout what the next steps are,
what can I do?
I know my daughter's going to beokay, wherever she goes, she's
going to be fine, but I reallyhave to be very conscious of
(04:25):
what I do with my son.
I make the decision to try tosign him up for a summer camp
for adults and kids withcognitive disabilities.
And I feel as if I can get himinto this camp, then I won't
have to worry.
I won't have to worry about anybad behaviors.
(04:46):
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 somepeace.
Because when you're notsuccessful in a certain
environment, all that anxietywill bubble up to the caregiver,
to the parent.
and so when we find the rightenvironment, things calm down
(05:06):
for everybody involved.
And so I was excited about that.
We got in, which I was superexcited about.
And it was around the same timeI had to leave to go and speak
at an event.
And so my husband was in chargeof dropping him off on this
first day.
His first day did not go well.
There were many reasons why myhusband forgetting to give him
(05:28):
his full dose of medicine wouldbe one of them.
the second one was they didn'tunderstand his unique needs.
He's very energetic, he paces,they didn't understand his level
of energy.
And when they tried to redirecthim or force him to do things,
they It did not go well.
And he was in a room that wasreally small with a lot of
(05:48):
people.
And if you're an energy personwho expands with high energy and
lowers and contracts with lowenergy, you understand if
there's 50 people in a smallroom that you're really going to
get really hyper and veryenergetic.
And typically I have mypreparation speech with every
(06:09):
new leader of a summer camp or adaycare or a babysitter, all
those things.
And I did not have it with thisparticular summer camp because I
assumed they would be able tohandle all the needs of uniquely
gifted and cognitively impairedkids and adults.
(06:34):
I was wrong.
I was wrong.
And what happened was, hesuffered, and they suffered, and
then I was caught in, instead ofproactively preparing, I was
reactively repairing asituation.
They were like deer inheadlights.
They didn't know what to do, andI was shocked because how can
(06:58):
you market yourself as a campfor special needs kids and
adults Cognitively impaired whenand not be prepared for
someone's first day transitioninto a new place Granted, I have
(07:18):
a career that prepared peoplefor the transition.
And so what happened was myexpectations were not met.
They were not correct.
They were not communicated and Idid not receive theirs.
There was not a lot of peopletrying to ensure success.
(07:39):
for me or my son.
Number two, there wascommunication that I didn't even
know where they were comingfrom.
I was receiving text messages,but I didn't know who this was
from.
And I assumed it was fromanother summer camp that my
daughter was going to.
So again, I assumed, and Ididn't communicate well and they
(08:00):
didn't communicate well with me.
And I didn't understand Whatthey didn't understand and they
didn't understand what Iexpected them to understand,
right?
The emotional intelligence ofthe ability to redirect people,
to understand that differentmeans different, and to have an
(08:22):
expansion of skill sets forcognitively impaired people, it
wasn't there.
And so I was caught completelyoff guard, just as they were.
So I tell you this because Iwant you to think about this.
Do you have you had similarsituations when your resident
(08:43):
from independent living orassisted living moves into a
memory care or when you'reindependent living person moves
into assisted living, right?
Or assisted living into memorycare, even into a higher level
of care, like skilled nursing orthrough the actively dying
process.
The three things that everyleader, director of nursing,
marketing director, andexecutive director needs to be
(09:06):
aware of is that to maketransitions go seamlessly, to go
seamlessly throughout thehospital.
The entire transition, there'sthree main things that we can
focus on, and they areexpectations management.
People need to know where yourboundaries are, what you can do,
what they can't do, what you'recapable of, what you're best at,
(09:31):
why they want to move intomemory care or assisted living,
and who is going to be workingwith them, right?
The second thing is proactivecommunication, and this starts.
With the first conversations ofa progression of an illness, a
disease, higher level of care,proactive communication is
(09:54):
directly tied in to expectationsmanagement and then really
understanding how the residentand family is feeling throughout
this entire process.
We have got to understand,identify and know how to use.
emotions and know which emotionsto avoid and how to calm each
(10:18):
emotion down.
The case for emotionalintelligence is very high
because most people want theirloved ones to be cared for,
respected, and loved.
And if they don't feel thatthose three things are happening
during the transition, thenwe're going to have a lot Of
(10:40):
overcoming that we're going tohave to do a lot of repairing
that we're going to have to do.
So we'll start with expectationsmanagement.
There is one sentence that youneed to remember.
And if you're driving, etch thisin your brain.
If you're sitting in front of adesk, make sure you write this
down.
What does success look like toyou?
(11:03):
Expectations management issimply knowing what somebody
wants to achieve.
This entire process to looklike.
So when they first move in, wewant to know what success looks
like to you.
What do you want from us on theday of move in?
What do you want us from us onthe second day of move in?
And then you listen to what theywant.
(11:24):
And then you're able to say tothem.
Yes, we can do that, or no, wecan't do that.
And you create the path thatboth of you agree on.
That should be happening everytime a resident moves in.
And now, think about that samething when we're talking about
transitions to higher levels ofcare.
It's very easy for us to say.
(11:45):
They have to move and then thefamilies have to go in and make
all those decisions and move allthe furniture And if we just do
that, if we say to them theyneed a higher level of care,
they need to move for theirsafety and then we're hands off,
then we create a big gap withexpectations management because
we didn't ask what they needfrom us.
(12:07):
Maybe we didn't really clarifywhy they needed to move.
Maybe they want more from us andwe don't know.
Maybe they wanted a bottle ofwater, right?
And we didn't offer it.
Maybe they felt like seeing ourface in that time of moving was
important.
And if we don't think it'simportant, then why would we do
it?
(12:27):
So it's important for us to ask,What does success look like for
you during this transition?
When can you come and move thefurniture?
Do you need a cart?
What do you prefer to do when wemove your loved one in?
Do you want to be here?
Do you want us to do it?
How, what is the story you'regoing to tell the resident so we
(12:49):
can make sure that we back youup with that?
Do you want to wait to tell themuntil the day of or do you want
to tell them a week before?
All of these scenarios are veryimportant with expectations
management.
When A loved one has to move toa higher level of care.
What happens is emotions startcreeping up.
(13:10):
And if we're not careful, thoseemotions will tell these family
members a story.
And then how they deal withtrauma in their life.
another phase of losing mymother, 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 startcreeping up.
(13:32):
And if we're not careful, all ofa sudden they create these
expectations that we're notaware of.
So that's why Making sure thatfamilies know what your
boundaries are with yourpolicies and procedures, with
your regulatory processes, whatyou can and cannot do, why the
reason for the change ishappening.
This is what we normally do, butwhat do you need from us?
(13:54):
And we'll make sure that we cando that.
All of those expectations beingcommunicated will help keep
families informed.
Emotions, stable, right?
Expectations management requiresproactive communication and
understanding the emotionalstate of your, of the family
(14:15):
member.
It requires it.
If you pay zero attention tothose things, then what happens
is a lot of resentments.
A lot of repairing that youdon't even know what you're
repairing for and why.
So the more that you talk aboutthe boundaries, the more that
you talk about what's neededfrom you, what success looks
(14:35):
like, how they want to handlethe move, the transition, the
more prepared you are to ensurea smooth transition.
transition.
So let me ask you this question.
What do families, what do youthink families expect when they
move into memory care?
Based on what you have seen inyour career or heard in your
(14:58):
career, what would theexpectations be of a family
member moving from assistedliving into a memory care?
we have told them that they haveto move into memory care because
their loved one needs a higherlevel of care.
So their automatic expectationis that the staff, the
associates inside memory care,are trained differently.
(15:19):
they are specifically trained todeal with people living with
dementia.
That means behaviors, that meansmore attention with activities
of daily That means morecommunication from the community
team because they can'tcommunicate and advocate for
themselves.
That means more patience.
(15:39):
They expect it to be moreavailable, more patient, and
highly trained.
That was my expectation of thesummer camp that my son went to.
And so it really threw me off.
When I get the first complaintabout something that they should
be able to manage or he took hisshoes off he struggled wanting
(16:03):
to put them back on and theycame to me and they said, he's
taking his shoes off and he hasto keep them on.
And I'm like, okay, I mean youshould be able to handle it.
He is 12 years old and you arethe director of the summer camp,
right?
The expectation was I pay you tohandle situations like this.
(16:26):
I don't necessarily need to beinvolved.
I will, but you should be ableto handle these situations.
And so this is what expectationmanagement is.
What can you handle, what can'tyou handle, and where is my
opportunity to come in and helpyou?
Because typically, familymembers think that they don't
(16:49):
have to get involved in smalldetails.
But do you, as a community, haveto?
What do you want them to?
Will you bring them in toalleviate a situation that may
be getting bigger?
So these are the underliningfactors that play into
expectations management.
(17:10):
And it starts honestly with onequestion.
What does success look like toyou?
Here is what success looks liketo me.
Here's what you can expect fromus throughout this process.
And let me talk to you about thepeople who work inside of our
community, That evens theplaying field.
(17:32):
Being very clear about what toexpect is your biggest tool in
creating a successfultransition.
The next topic plays equallyinto that, which is proactive
communication.
I'm just going to go throughsome of the processes that I had
whenever I had to haveconversations of transitions of
(17:52):
care with family members.
By working in Alabama, Ourresidents in Assisted Living
have to be able to protectthemselves from medication
error.
They have to know what medicinesthey take when.
So if Erin Thompson cannotidentify her name on that
medication card and say, no, I'mnot going to take that because
(18:14):
it's my nighttime medicine, notmy daytime medicine, Then, if
that's a consistent pattern, Icannot protect myself from
medication error, which means Myneeds are no longer being met
inside of assisted livingsafely.
So I have to have conversationswith people.
Moving into memory care quiteoften inside of senior living in
(18:38):
Alabama.
And when we start having theseconversations is when I start
planting the seeds about whatmemory care is.
It's a proactive communication.
We're seeing the growth.
A progression in your lovedone's disease process with
dementia.
We're seeing patterns that maybe in indicating to us that they
(19:02):
no longer are benefiting fromthe services that we offer
inside of our community and mayneed a higher level of care for
memory care.
Here is what we're seeing, andthen we list out what we're
seeing.
Here is why memory care can meetthese needs.
Better than assisted living canthat's my first seat.
(19:24):
I'm not saying that we're hereI'm saying that this is what
we're seeing and so anytime youwant to go and take a tour
inside of Memory care.
I'll be more than happy to andhelp you understand everything
that memory care has to offerBecause we want to make sure
that their perceptions and theirexpectations of what memory care
(19:45):
is and that they're not scary.
Because when we let fear dictateour decisions, it's never going
to be what it could be.
And so with proactivecommunication seed planning of
expectations management, we canhelp make that transition
better.
And then another conversation wehave is we have to have, because
(20:07):
an incident happened.
we sit down, we have anotherconversation 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 understandwhen you have these tough
conversations is proactivecommunication, which again ties
into the emotional state ofunderstanding what emotions are
(20:31):
telling you.
Okay.
Number one, the first thing thatpeople are going to want to do
is blame.
Expect it.
Okay.
If you're going to proactivelycommunicate, no one can blame
you because you're proactivelycommunicating.
Now, if you're reactivelyrepairing, like I was doing,
then blame is something that weneed to look at.
(20:53):
should I have talked about thissooner?
was I not aware of certainthings?
those types of questions youneed to ask yourself.
But blame is something that'sgoing to happen almost
automatically because They feelscared.
They feel vulnerable.
They feel out of control.
(21:14):
And they feel sad.
And the first thing, the firstact that you do, When you feel
scared, vulnerable, sad, out ofcontrol is discharge that pain
by blaming somebody else.
It's the first thing.
It doesn't mean that you'rewrong.
(21:36):
It doesn't mean that you didanything wrong.
And it doesn't mean that you'reto blame for the progression of
a disease.
And when you proactivelycommunicate, you understand that
you're not to blame.
You understand that you're doingexpectations management with
them.
And you understand, and you cangive them something to control.
By saying, let's go look atapartments, let's do a few other
(21:59):
things before we have to saythat 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 haveto do what's best for your loved
one, according to the rules thatwe are governed by.
We have to take action.
(22:20):
Let's decide what that actionis.
Because moving to memory carecan actually be life changing
for somebody who is strugglinginside of assisted living.
And it's our job to be able toexplain that to the family in a
positive way and not in anegative way.
We shouldn't be havingconversations with families and
(22:42):
talking about memory care as ifit's, A death sentence or
different from assisted living.
We should be talking aboutmemory care in a way that
offers.
An environment for our residentsto feel safe and engaged because
they're no longer feeling thatway inside of assisted living if
(23:04):
the disease is progressing, Sohaving proactive communication
with expectations managementsprinkled into it.
And then understanding theemotions that go into a loved
one needing higher levels ofcare allows you to make this
(23:26):
transition seamless for thefamilies.
But it takes you making thosethree things important
expectations management,proactive communication, and
understanding the emotionalstate.
So proactive communication isplanting the seeds of
(23:46):
progression be acknowledging,and becoming aware that we have
patterns that we need to betalking about and having these
conversations sooner rather thanlater, because the more prepared
people are, the easier thetransition is going to be.
I talked about blame already,but I want to get into the
(24:08):
emotional intelligence piece.
When you understand emotions,truly when you understand
emotions, you have such a toolto 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 thedifficult times of moving a
(24:31):
loved one, or losing a lovedone.
Because really, when a higherlevel of care is happening, we
are losing a loved one.
So we're losing and we'removing, which are two very
stressful things for families.
And if we're not careful, and ifwe're too closed off and we're
not involved in the transitions,this is where the resentment
(24:52):
will creep in and you will starthaving to climb a mountain that
you didn't even know was there,which is the hardest mountain to
climb.
So blame typically meansSomebody's feeling out of
control, somebody's hurting, andthey're discharging that pain.
Or you did something wrong,right?
(25:15):
You have to figure out which onethat is.
And if you can look back at yourcommunity and what's happening,
and you can know that you'vedone everything that you can do,
then it's not your fault.
It's not your fault.
So if somebody's blaming meabout a progression or the move
or something, I'm going toarticulate to them where my
(25:38):
boundaries are.
I know that this is hard.
I know that I don't want to behaving this conversation with
you, but according to our policyand procedure, according to the
rules and the regulations thatwe are governed by, these are
the decisions that we have tomake.
And now I don't want to promiseyou that I can meet the needs of
your loved one and then not beable to.
(26:01):
That's not who I want to be as aleader.
That's not who I want thiscommunity to be.
And that is definitely not whatyou want for your loved one.
This is hard.
Yes.
But it will be even worse if wechoose to do nothing and
something terrible happens thatwe could have avoided.
You are giving them something tocontrol.
Everything that I just said wastrue, right?
(26:22):
When we are, when family membersare fighting us, when they're
trying to pull every stop to notmove, that's not on us.
I can simply restate over andover again the facts, but I
cannot get them to receive it.
that's them.
And the more people fight andargue, the more I sit and
(26:43):
listen, and the more I tellthem, you're, you are advocating
for your loved one, and I seethat, and I appreciate it.
But here is where my hands aretied.
Here is where I feel like we'renot meeting the needs of the
loved one.
I want them here.
I want them to be here untilthey can no longer be here.
And we have that opportunityright now in memory care.
(27:06):
And then I, my, it's my job tohelp them understand that this
is the best decision for them,not the worst.
And I use stories and differentscenarios that have really
worked out in the resident'sfavor.
And then the other thing that wewant to talk about.
With proactive communication,expectations management, and the
(27:27):
emotional state is thesefamilies want to hear more from
memory care or whatever level ofcare they're moving into, want
to hear more from the new staff.
I'm going to be talking aboutthe new staff very quickly
because they don't know them andthey don't know the new staff.
(27:48):
One of the biggest complaintsthat I got, and maybe this is
for you too, when people movedfrom assisted living into memory
care was there wasn't a lot ofcommunication.
The expectation of Therelationships from Assisted
Living and if they were therefor three years or two years or
one year and they had theserelationships with caregivers
and nurses and me being on thatside of the community and all of
(28:11):
a sudden they move and theydon't know anybody.
So they feel disconnected.
And this is where theexpectations management and the
proactive communication comes inbecause a new team needs to be
aware that they need to becommunicating more.
And that's hard for a memorycare setting because they're so
busy They have to do a lot ofredirecting.
(28:33):
The details matter in memorycare.
they're they have to crush pillsor do all these special things
to get residents to take theirmedicine.
And so a new resident comes inand they don't realize.
That it's really important forthem to be connecting with the
family because that first 30days is very important.
(28:54):
And that's where theexpectations and proactive
communication comes in becausethey're expecting the same
relationship with differentpeople, which is a little
unrealistic, isn't it?
But in an emotional, illogicaltime, That's what they expect.
And so if we train our teams toreally make communication more
(29:19):
important, for new residents inthose first 30 to 45 days, I
think that we will find that thetransition and the customer
service score will bump back uppretty quickly.
When you're in memory care,you're in a different world.
Associates, nurses, they live inthe world of the resident.
(29:41):
And so when you have a familymember 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 requiremore of an awareness on the
memory care staff, the higherlevel of care staff to make
(30:05):
communication a priority and toask the question, what does
success look like to you?
What can I do to make youcomfortable quicker?
Which is a proactive way.
And it's not necessarilysomething that we're trained on
a lot.
So it certainly is a new way forus to think, but I believe, I
(30:30):
know based on my experience thatwhen I made that a point, a very
intentional, strategic effort,then the transitions went very
well.
When I lost sight or I didn'trealize how important and
powerful that was.
They didn't go as well as theycould have.
So being strategic about knowingwho's moving, who is having
(30:57):
those significant changes for usto be aware of and start
planting the seeds, proactivecommunication, and start
explaining what a transformationmemory care can be for residents
who are struggling in assistedliving.
All these compounding effortscan make the transition very
(31:17):
smooth.
No one likes to be surprised.
No one.
And if we avoid having the toughconversations when problems
start showing, and we have towait till the big problem
presents itself, we're going tohave a hard time overcoming the
(31:39):
family's expectations.
And expectations management isthe tool that we want to use to
have smooth transitions.
Transcription So it requiresstrategy, awareness from you and
the more people you have walkingthrough the transition with the
(31:59):
family, the better thetransition will be.
And when the family member tellsyou what success is to them,
it's your responsibility to goand tell that to the care staff,
to the nursing team, to thehousekeeping team, to the
maintenance team, because theyjust gave you the keys to the
kingdom.
(32:20):
The keys to success and now it'syour responsibility to go and
tell the associates how to besuccessful for this new resident
moving in.
And that my friends is how youdo two things at one time.
You bring confidence to thefamily member about the
associates who will be caringfor their loved one and you
(32:41):
bring.
And build confidence.
So when those transitionshappen, as a recap, you want to
start early, start plantingseeds early, start talking about
what you can and cannot do basedon your policies and procedures,
the rules that you are governedby, and what the needs are of
(33:02):
that loved one, start definingwhere the boundaries are, and
start planting the seeds aboutwhat you where the next level of
care, what the next level ofcare can provide for their loved
one and for them.
And then proactively communicatealong the way, know what success
is and then communicate that toyour team.
(33:26):
Communicate, make the memorycare, associates more aware of
the more communication they needto give.
To the loved ones so they canconnect because the loved one is
looking for the connection tothe team because they're losing
Connection in their resident, intheir loved one, because maybe
(33:46):
the resident can't tell themwhat's going on.
And now all of a sudden they'refeeling very vulnerable.
The emotional component ofmoving to a higher level of care
will cloud people's ability tothink and act appropriately.
And the more that we're aware ofthat, the better that we can be.
(34:07):
Because most people want theinstant connection that they are
leaving to happen.
And the other part to thinkabout is, if it was my mother or
my grandmother and they were inassisted living, they were once
(34:29):
able to communicate forthemselves and advocate for
themselves.
And if you're moving into memorycare, they can't do that
anymore.
So they are expecting us to dothat for them.
And if you know that you canmanage that expectation.
And then those things that wetalked about during this episode
(34:51):
will help you build thatconnection.
I hope this helps.
I hope this gives you strategyOn how to manage transitions in
your community, and I'll behappy to talk more about it.
Leave me some feedback, messageme on LinkedIn.
You can send a message, Ibelieve, even through the
(35:14):
podcast on the homepage, but I'dbe interested to see what your
best practices are.
That will be fun to discuss.
So if you are listening and youhaven't subscribed on Spotify,
iHeartRadio, Or on ApplePodcasts, do that for me, the
more subscribers, the morepeople will get reached and the
(35:35):
more we can learn and grow andcreate a great place to live and
work.
So thank you for your time.
I hope that you gained a lot ofinsights and as always aspire
for more for you.
Welcome back to another episode of the
Aspire for More with Erinpodcast, where today you will
have just me as your podcasthost.
I met some amazing peoplerecently who gave me some
amazing feedback about mypodcast and I would love to For
you to send me a message, anemail, for some feedback for you
(00:24):
who listen to my podcast.
one of the feedback points thatI got was they really liked
where it was just me.
Talking and mentoring people onthe episode.
And I was honestly taken abackby that, and very honored to
receive that feedback.
So here it is.
And when I asked a topic of whatthis person wanted to hear, it
(00:47):
was helping the transition, Fromresidents and families, from
assisted living to memory care.
And this is a, an area that alot of us struggle with.
we have family members andresidents that struggle with the
transition and in my opinion,transitions are one of the areas
(01:07):
that we as leaders need to focusheavily on because it's the most
vulnerable time inside of acommunity.
It's the time where.
The most emotional turmoilhappens when a lot of insecurity
and vulnerability happensbecause of emotions.
And there are things that weneed to focus on if you have a
(01:29):
community that has assistedliving and memory care, or even
independent living assistedliving and memory care, you
understand how important thetransition to each higher level
of care is.
And there are things that we canfocus on.
And today we're going to talkabout three main areas that we
(01:49):
need to focus on through thosetransitions, because what
happens in this particularinstance was when we receive
great place to work surveys orcustomer satisfaction surveys,
we see how one like assistedliving may get higher scores.
Than memory care.
(02:10):
And you wonder why, or youwonder why a family who was so
happy in assisted living may bestruggling when they move into
memory care.
And I think that there arecertain areas that we can focus
on and certain things that wecan do.
And I'm gonna discuss thattoday.
So thank you for being here.
And here we go.
I wanna start it out with.
(02:31):
A personal story that is goingto give you some context because
I am a senior livingprofessional.
I helped manage transitions tohigher levels of care for years
upon years.
15 to 20 years inside of acommunity and I had the same
thing happen to me this pastsummer.
(02:54):
And so I'm going to tell you mystory and then we're going to
dive into it and look at it fromthe viewpoint of a senior living
leader.
My kids go to the YMCA summercamp every year.
If those of you who know that Ihave a son who is on the autism
spectrum, he is a uniquelychallenged little puzzle piece
that, certainly I compare him toa memory care resident who
(03:19):
constantly walks and likes topick things up and say the same
things over and over again inthe same tone of voice, with the
same inflection that yousometimes just wanna be like,
seriously.
Seriously, why do you keepsaying the same thing over to
me?
ADHD, OCD, autism, we're onthere.
We got it, right?
And then I have a daughter whois your typical child, probably
(03:42):
a little bit more adult than sheneeds to be as a younger sibling
of a special needs child, Theseare my kids.
Everything I typically try to dois very consistent and stable.
Everyone knows what to expect,because if everybody knows what
to expect, then we're not goingto suffer any big meltdowns,
right?
(04:03):
Mama forgot to register the kidsfor YMCA summer camp.
That was a very bad move on mypart, and I was in panic mode,
and so I had to start thinkingabout what the next steps are,
what can I do?
I know my daughter's going to beokay, wherever she goes, she's
going to be fine, but I reallyhave to be very conscious of
(04:25):
what I do with my son.
I make the decision to try tosign him up for a summer camp
for adults and kids withcognitive disabilities.
And I feel as if I can get himinto this camp, then I won't
have to worry.
I won't have to worry about anybad behaviors.
(04:46):
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 somepeace.
Because when you're notsuccessful in a certain
environment, all that anxietywill bubble up to the caregiver,
to the parent.
and so when we find the rightenvironment, things calm down
(05:06):
for everybody involved.
And so I was excited about that.
We got in, which I was superexcited about.
And it was around the same timeI had to leave to go and speak
at an event.
And so my husband was in chargeof dropping him off on this
first day.
His first day did not go well.
There were many reasons why myhusband forgetting to give him
(05:28):
his full dose of medicine wouldbe one of them.
the second one was they didn'tunderstand his unique needs.
He's very energetic, he paces,they didn't understand his level
of energy.
And when they tried to redirecthim or force him to do things,
they It did not go well.
And he was in a room that wasreally small with a lot of
(05:48):
people.
And if you're an energy personwho expands with high energy and
lowers and contracts with lowenergy, you understand if
there's 50 people in a smallroom that you're really going to
get really hyper and veryenergetic.
And typically I have mypreparation speech with every
(06:09):
new leader of a summer camp or adaycare or a babysitter, all
those things.
And I did not have it with thisparticular summer camp because I
assumed they would be able tohandle all the needs of uniquely
gifted and cognitively impairedkids and adults.
(06:34):
I was wrong.
I was wrong.
And what happened was, hesuffered, and they suffered, and
then I was caught in, instead ofproactively preparing, I was
reactively repairing asituation.
They were like deer inheadlights.
They didn't know what to do, andI was shocked because how can
(06:58):
you market yourself as a campfor special needs kids and
adults Cognitively impaired whenand not be prepared for
someone's first day transitioninto a new place Granted, I have
(07:18):
a career that prepared peoplefor the transition.
And so what happened was myexpectations were not met.
They were not correct.
They were not communicated and Idid not receive theirs.
There was not a lot of peopletrying to ensure success.
(07:39):
for me or my son.
Number two, there wascommunication that I didn't even
know where they were comingfrom.
I was receiving text messages,but I didn't know who this was
from.
And I assumed it was fromanother summer camp that my
daughter was going to.
So again, I assumed, and Ididn't communicate well and they
(08:00):
didn't communicate well with me.
And I didn't understand Whatthey didn't understand and they
didn't understand what Iexpected them to understand,
right?
The emotional intelligence ofthe ability to redirect people,
to understand that differentmeans different, and to have an
(08:22):
expansion of skill sets forcognitively impaired people, it
wasn't there.
And so I was caught completelyoff guard, just as they were.
So I tell you this because Iwant you to think about this.
Do you have you had similarsituations when your resident
(08:43):
from independent living orassisted living moves into a
memory care or when you'reindependent living person moves
into assisted living, right?
Or assisted living into memorycare, even into a higher level
of care, like skilled nursing orthrough the actively dying
process.
The three things that everyleader, director of nursing,
marketing director, andexecutive director needs to be
(09:06):
aware of is that to maketransitions go seamlessly, to go
seamlessly throughout thehospital.
The entire transition, there'sthree main things that we can
focus on, and they areexpectations management.
People need to know where yourboundaries are, what you can do,
what they can't do, what you'recapable of, what you're best at,
(09:31):
why they want to move intomemory care or assisted living,
and who is going to be workingwith them, right?
The second thing is proactivecommunication, and this starts.
With the first conversations ofa progression of an illness, a
disease, higher level of care,proactive communication is
(09:54):
directly tied in to expectationsmanagement and then really
understanding how the residentand family is feeling throughout
this entire process.
We have got to understand,identify and know how to use.
emotions and know which emotionsto avoid and how to calm each
(10:18):
emotion down.
The case for emotionalintelligence is very high
because most people want theirloved ones to be cared for,
respected, and loved.
And if they don't feel thatthose three things are happening
during the transition, thenwe're going to have a lot Of
(10:40):
overcoming that we're going tohave to do a lot of repairing
that we're going to have to do.
So we'll start with expectationsmanagement.
There is one sentence that youneed to remember.
And if you're driving, etch thisin your brain.
If you're sitting in front of adesk, make sure you write this
down.
What does success look like toyou?
(11:03):
Expectations management issimply knowing what somebody
wants to achieve.
This entire process to looklike.
So when they first move in, wewant to know what success looks
like to you.
What do you want from us on theday of move in?
What do you want us from us onthe second day of move in?
And then you listen to what theywant.
(11:24):
And then you're able to say tothem.
Yes, we can do that, or no, wecan't do that.
And you create the path thatboth of you agree on.
That should be happening everytime a resident moves in.
And now, think about that samething when we're talking about
transitions to higher levels ofcare.
It's very easy for us to say.
(11:45):
They have to move and then thefamilies have to go in and make
all those decisions and move allthe furniture And if we just do
that, if we say to them theyneed a higher level of care,
they need to move for theirsafety and then we're hands off,
then we create a big gap withexpectations management because
we didn't ask what they needfrom us.
(12:07):
Maybe we didn't really clarifywhy they needed to move.
Maybe they want more from us andwe don't know.
Maybe they wanted a bottle ofwater, right?
And we didn't offer it.
Maybe they felt like seeing ourface in that time of moving was
important.
And if we don't think it'simportant, then why would we do
it?
(12:27):
So it's important for us to ask,What does success look like for
you during this transition?
When can you come and move thefurniture?
Do you need a cart?
What do you prefer to do when wemove your loved one in?
Do you want to be here?
Do you want us to do it?
How, what is the story you'regoing to tell the resident so we
(12:49):
can make sure that we back youup with that?
Do you want to wait to tell themuntil the day of or do you want
to tell them a week before?
All of these scenarios are veryimportant with expectations
management.
When A loved one has to move toa higher level of care.
What happens is emotions startcreeping up.
(13:10):
And if we're not careful, thoseemotions will tell these family
members a story.
And then how they deal withtrauma in their life.
another phase of losing mymother, 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 startcreeping up.
(13:32):
And if we're not careful, all ofa sudden they create these
expectations that we're notaware of.
So that's why Making sure thatfamilies know what your
boundaries are with yourpolicies and procedures, with
your regulatory processes, whatyou can and cannot do, why the
reason for the change ishappening.
This is what we normally do, butwhat do you need from us?
(13:54):
And we'll make sure that we cando that.
All of those expectations beingcommunicated will help keep
families informed.
Emotions, stable, right?
Expectations management requiresproactive communication and
understanding the emotionalstate of your, of the family
(14:15):
member.
It requires it.
If you pay zero attention tothose things, then what happens
is a lot of resentments.
A lot of repairing that youdon't even know what you're
repairing for and why.
So the more that you talk aboutthe boundaries, the more that
you talk about what's neededfrom you, what success looks
(14:35):
like, how they want to handlethe move, the transition, the
more prepared you are to ensurea smooth transition.
transition.
So let me ask you this question.
What do families, what do youthink families expect when they
move into memory care?
Based on what you have seen inyour career or heard in your
(14:58):
career, what would theexpectations be of a family
member moving from assistedliving into a memory care?
we have told them that they haveto move into memory care because
their loved one needs a higherlevel of care.
So their automatic expectationis that the staff, the
associates inside memory care,are trained differently.
(15:19):
they are specifically trained todeal with people living with
dementia.
That means behaviors, that meansmore attention with activities
of daily That means morecommunication from the community
team because they can'tcommunicate and advocate for
themselves.
That means more patience.
(15:39):
They expect it to be moreavailable, more patient, and
highly trained.
That was my expectation of thesummer camp that my son went to.
And so it really threw me off.
When I get the first complaintabout something that they should
be able to manage or he took hisshoes off he struggled wanting
(16:03):
to put them back on and theycame to me and they said, he's
taking his shoes off and he hasto keep them on.
And I'm like, okay, I mean youshould be able to handle it.
He is 12 years old and you arethe director of the summer camp,
right?
The expectation was I pay you tohandle situations like this.
(16:26):
I don't necessarily need to beinvolved.
I will, but you should be ableto handle these situations.
And so this is what expectationmanagement is.
What can you handle, what can'tyou handle, and where is my
opportunity to come in and helpyou?
Because typically, familymembers think that they don't
(16:49):
have to get involved in smalldetails.
But do you, as a community, haveto?
What do you want them to?
Will you bring them in toalleviate a situation that may
be getting bigger?
So these are the underliningfactors that play into
expectations management.
(17:10):
And it starts honestly with onequestion.
What does success look like toyou?
Here is what success looks liketo me.
Here's what you can expect fromus throughout this process.
And let me talk to you about thepeople who work inside of our
community, That evens theplaying field.
(17:32):
Being very clear about what toexpect is your biggest tool in
creating a successfultransition.
The next topic plays equallyinto that, which is proactive
communication.
I'm just going to go throughsome of the processes that I had
whenever I had to haveconversations of transitions of
(17:52):
care with family members.
By working in Alabama, Ourresidents in Assisted Living
have to be able to protectthemselves from medication
error.
They have to know what medicinesthey take when.
So if Erin Thompson cannotidentify her name on that
medication card and say, no, I'mnot going to take that because
(18:14):
it's my nighttime medicine, notmy daytime medicine, Then, if
that's a consistent pattern, Icannot protect myself from
medication error, which means Myneeds are no longer being met
inside of assisted livingsafely.
So I have to have conversationswith people.
Moving into memory care quiteoften inside of senior living in
(18:38):
Alabama.
And when we start having theseconversations is when I start
planting the seeds about whatmemory care is.
It's a proactive communication.
We're seeing the growth.
A progression in your lovedone's disease process with
dementia.
We're seeing patterns that maybe in indicating to us that they
(19:02):
no longer are benefiting fromthe services that we offer
inside of our community and mayneed a higher level of care for
memory care.
Here is what we're seeing, andthen we list out what we're
seeing.
Here is why memory care can meetthese needs.
Better than assisted living canthat's my first seat.
(19:24):
I'm not saying that we're hereI'm saying that this is what
we're seeing and so anytime youwant to go and take a tour
inside of Memory care.
I'll be more than happy to andhelp you understand everything
that memory care has to offerBecause we want to make sure
that their perceptions and theirexpectations of what memory care
(19:45):
is and that they're not scary.
Because when we let fear dictateour decisions, it's never going
to be what it could be.
And so with proactivecommunication seed planning of
expectations management, we canhelp make that transition
better.
And then another conversation wehave is we have to have, because
(20:07):
an incident happened.
we sit down, we have anotherconversation 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 understandwhen you have these tough
conversations is proactivecommunication, which again ties
into the emotional state ofunderstanding what emotions are
(20:31):
telling you.
Okay.
Number one, the first thing thatpeople are going to want to do
is blame.
Expect it.
Okay.
If you're going to proactivelycommunicate, no one can blame
you because you're proactivelycommunicating.
Now, if you're reactivelyrepairing, like I was doing,
then blame is something that weneed to look at.
(20:53):
should I have talked about thissooner?
was I not aware of certainthings?
those types of questions youneed to ask yourself.
But blame is something that'sgoing to happen almost
automatically because They feelscared.
They feel vulnerable.
They feel out of control.
(21:14):
And they feel sad.
And the first thing, the firstact that you do, When you feel
scared, vulnerable, sad, out ofcontrol is discharge that pain
by blaming somebody else.
It's the first thing.
It doesn't mean that you'rewrong.
(21:36):
It doesn't mean that you didanything wrong.
And it doesn't mean that you'reto blame for the progression of
a disease.
And when you proactivelycommunicate, you understand that
you're not to blame.
You understand that you're doingexpectations management with
them.
And you understand, and you cangive them something to control.
By saying, let's go look atapartments, let's do a few other
(21:59):
things before we have to saythat 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 haveto do what's best for your loved
one, according to the rules thatwe are governed by.
We have to take action.
(22:20):
Let's decide what that actionis.
Because moving to memory carecan actually be life changing
for somebody who is strugglinginside of assisted living.
And it's our job to be able toexplain that to the family in a
positive way and not in anegative way.
We shouldn't be havingconversations with families and
(22:42):
talking about memory care as ifit's, A death sentence or
different from assisted living.
We should be talking aboutmemory care in a way that
offers.
An environment for our residentsto feel safe and engaged because
they're no longer feeling thatway inside of assisted living if
(23:04):
the disease is progressing, Sohaving proactive communication
with expectations managementsprinkled into it.
And then understanding theemotions that go into a loved
one needing higher levels ofcare allows you to make this
(23:26):
transition seamless for thefamilies.
But it takes you making thosethree things important
expectations management,proactive communication, and
understanding the emotionalstate.
So proactive communication isplanting the seeds of
(23:46):
progression be acknowledging,and becoming aware that we have
patterns that we need to betalking about and having these
conversations sooner rather thanlater, because the more prepared
people are, the easier thetransition is going to be.
I talked about blame already,but I want to get into the
(24:08):
emotional intelligence piece.
When you understand emotions,truly when you understand
emotions, you have such a toolto 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 thedifficult times of moving a
(24:31):
loved one, or losing a lovedone.
Because really, when a higherlevel of care is happening, we
are losing a loved one.
So we're losing and we'removing, which are two very
stressful things for families.
And if we're not careful, and ifwe're too closed off and we're
not involved in the transitions,this is where the resentment
(24:52):
will creep in and you will starthaving to climb a mountain that
you didn't even know was there,which is the hardest mountain to
climb.
So blame typically meansSomebody's feeling out of
control, somebody's hurting, andthey're discharging that pain.
Or you did something wrong,right?
(25:15):
You have to figure out which onethat is.
And if you can look back at yourcommunity and what's happening,
and you can know that you'vedone everything that you can do,
then it's not your fault.
It's not your fault.
So if somebody's blaming meabout a progression or the move
or something, I'm going toarticulate to them where my
(25:38):
boundaries are.
I know that this is hard.
I know that I don't want to behaving this conversation with
you, but according to our policyand procedure, according to the
rules and the regulations thatwe are governed by, these are
the decisions that we have tomake.
And now I don't want to promiseyou that I can meet the needs of
your loved one and then not beable to.
(26:01):
That's not who I want to be as aleader.
That's not who I want thiscommunity to be.
And that is definitely not whatyou want for your loved one.
This is hard.
Yes.
But it will be even worse if wechoose to do nothing and
something terrible happens thatwe could have avoided.
You are giving them something tocontrol.
Everything that I just said wastrue, right?
(26:22):
When we are, when family membersare fighting us, when they're
trying to pull every stop to notmove, that's not on us.
I can simply restate over andover again the facts, but I
cannot get them to receive it.
that's them.
And the more people fight andargue, the more I sit and
(26:43):
listen, and the more I tellthem, you're, you are advocating
for your loved one, and I seethat, and I appreciate it.
But here is where my hands aretied.
Here is where I feel like we'renot meeting the needs of the
loved one.
I want them here.
I want them to be here untilthey can no longer be here.
And we have that opportunityright now in memory care.
(27:06):
And then I, my, it's my job tohelp them understand that this
is the best decision for them,not the worst.
And I use stories and differentscenarios that have really
worked out in the resident'sfavor.
And then the other thing that wewant to talk about.
With proactive communication,expectations management, and the
(27:27):
emotional state is thesefamilies want to hear more from
memory care or whatever level ofcare they're moving into, want
to hear more from the new staff.
I'm going to be talking aboutthe new staff very quickly
because they don't know them andthey don't know the new staff.
(27:48):
One of the biggest complaintsthat I got, and maybe this is
for you too, when people movedfrom assisted living into memory
care was there wasn't a lot ofcommunication.
The expectation of Therelationships from Assisted
Living and if they were therefor three years or two years or
one year and they had theserelationships with caregivers
and nurses and me being on thatside of the community and all of
(28:11):
a sudden they move and theydon't know anybody.
So they feel disconnected.
And this is where theexpectations management and the
proactive communication comes inbecause a new team needs to be
aware that they need to becommunicating more.
And that's hard for a memorycare setting because they're so
busy They have to do a lot ofredirecting.
(28:33):
The details matter in memorycare.
they're they have to crush pillsor do all these special things
to get residents to take theirmedicine.
And so a new resident comes inand they don't realize.
That it's really important forthem to be connecting with the
family because that first 30days is very important.
(28:54):
And that's where theexpectations and proactive
communication comes in becausethey're expecting the same
relationship with differentpeople, which is a little
unrealistic, isn't it?
But in an emotional, illogicaltime, That's what they expect.
And so if we train our teams toreally make communication more
(29:19):
important, for new residents inthose first 30 to 45 days, I
think that we will find that thetransition and the customer
service score will bump back uppretty quickly.
When you're in memory care,you're in a different world.
Associates, nurses, they live inthe world of the resident.
(29:41):
And so when you have a familymember 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 requiremore of an awareness on the
memory care staff, the higherlevel of care staff to make
(30:05):
communication a priority and toask the question, what does
success look like to you?
What can I do to make youcomfortable quicker?
Which is a proactive way.
And it's not necessarilysomething that we're trained on
a lot.
So it certainly is a new way forus to think, but I believe, I
(30:30):
know based on my experience thatwhen I made that a point, a very
intentional, strategic effort,then the transitions went very
well.
When I lost sight or I didn'trealize how important and
powerful that was.
They didn't go as well as theycould have.
So being strategic about knowingwho's moving, who is having
(30:57):
those significant changes for usto be aware of and start
planting the seeds, proactivecommunication, and start
explaining what a transformationmemory care can be for residents
who are struggling in assistedliving.
All these compounding effortscan make the transition very
(31:17):
smooth.
No one likes to be surprised.
No one.
And if we avoid having the toughconversations when problems
start showing, and we have towait till the big problem
presents itself, we're going tohave a hard time overcoming the
(31:39):
family's expectations.
And expectations management isthe tool that we want to use to
have smooth transitions.
Transcription So it requiresstrategy, awareness from you and
the more people you have walkingthrough the transition with the
(31:59):
family, the better thetransition will be.
And when the family member tellsyou what success is to them,
it's your responsibility to goand tell that to the care staff,
to the nursing team, to thehousekeeping team, to the
maintenance team, because theyjust gave you the keys to the
kingdom.
(32:20):
The keys to success and now it'syour responsibility to go and
tell the associates how to besuccessful for this new resident
moving in.
And that my friends is how youdo two things at one time.
You bring confidence to thefamily member about the
associates who will be caringfor their loved one and you
(32:41):
bring.
And build confidence.
So when those transitionshappen, as a recap, you want to
start early, start plantingseeds early, start talking about
what you can and cannot do basedon your policies and procedures,
the rules that you are governedby, and what the needs are of
(33:02):
that loved one, start definingwhere the boundaries are, and
start planting the seeds aboutwhat you where the next level of
care, what the next level ofcare can provide for their loved
one and for them.
And then proactively communicatealong the way, know what success
is and then communicate that toyour team.
(33:26):
Communicate, make the memorycare, associates more aware of
the more communication they needto give.
To the loved ones so they canconnect because the loved one is
looking for the connection tothe team because they're losing
Connection in their resident, intheir loved one, because maybe
(33:46):
the resident can't tell themwhat's going on.
And now all of a sudden they'refeeling very vulnerable.
The emotional component ofmoving to a higher level of care
will cloud people's ability tothink and act appropriately.
And the more that we're aware ofthat, the better that we can be.
(34:07):
Because most people want theinstant connection that they are
leaving to happen.
And the other part to thinkabout is, if it was my mother or
my grandmother and they were inassisted living, they were once
(34:29):
able to communicate forthemselves and advocate for
themselves.
And if you're moving into memorycare, they can't do that
anymore.
So they are expecting us to dothat for them.
And if you know that you canmanage that expectation.
And then those things that wetalked about during this episode
(34:51):
will help you build thatconnection.
I hope this helps.
I hope this gives you strategyOn how to manage transitions in
your community, and I'll behappy to talk more about it.
Leave me some feedback, messageme on LinkedIn.
You can send a message, Ibelieve, even through the
(35:14):
podcast on the homepage, but I'dbe interested to see what your
best practices are.
That will be fun to discuss.
So if you are listening and youhaven't subscribed on Spotify,
iHeartRadio, Or on ApplePodcasts, do that for me, the
more subscribers, the morepeople will get reached and the
(35:35):
more we can learn and grow andcreate a great place to live and
work.
So thank you for your time.
I hope that you gained a lot ofinsights and as always aspire
for more for you.
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