• The look on the face of the five-year-old as he boards a school bus for the first time and the look of apprehension on the face of his mother.
• The last lingering touches of two lovers who cannot bear to let each other go.
• The moment when one must board that jet and fly off to a new life elsewhere.
• The apprehension that this could be the last time they shall see each other and that chill of final separation.

The following is an excerpt of a discussion I had several years ago with the daughter of a man (her father) who had recently passed away.

“The last time I saw my father I guess I knew it might be the last time. We talked a little about this and that…nothing important. It was as if we both had agreed to keep it that way because we both knew, and we knew that we knew.

Definition: Perspective “a view of things (as events) in their true relationship or relative importance” (The Merriam Webster Dictionary)

Some years ago I had a conversation with a resident in a facility where I was the head of the Nursing department. She was close to her 100th birthday. I asked her what she made of her life in general. She promptly replied: “Can’t tell yet! I am still making my life!”

A person who appears demented may be tormented by grief and anxiety. His demented behavior may have been brought about by emotional pain. A grieving person at any age is less able to pay close attention to everything that happens around him. He takes less care in grooming and dress. He has less emotional energy to welcome new opportunities or to respond to challenges. He feels uncomfortable with his body. His mind may be constantly uneasy or tortured.

Loss and grief are common in old age as death removes loved ones. An old person may have suffered other significant losses, of occupation, residence, physical mobility, belonging, or usefulness – all of which produce a grief response.

Without question, working in long term care is demanding and stressful. In addition to the intrinsic stressors staff must face daily in nursing homes, often they must also struggle with managers who add to the stress. It takes only one thoughtless supervisor to create a work environment that goes from bad to worse in an instant.

Unfortunately, there are managers and supervisors in long term care who may lack self-awareness or the desire to evolve into better leaders. They may intentionally create “power distances” between themselves and their employees. This distance may also signal that they may be unapproachable.

A few weeks ago, I had the pleasure of sitting in on an orientation for our client, Rowntree Gardens, a faith-based Continuing Care Retirement Communities (CCRC) that provides a full range of integrated onsite services to meet the changing needs of people as they age. Randy Brown, CEO, engaged Drive in our services because he understands the importance of their rich history and deeply rooted culture.

Together we are working to enhance their already strong culture and create a sustainable program to retain their top employees while also finding new ways to recruit the right candidates.

Have you ever heard an employee utter the words, “That’s not my job?” Or maybe you’ve secretly wished the ground would open up and swallow you when you heard how an employee spoke to a customer. Have you ever been on the receiving end of, “That’s not how we do things around here?”

What do all these things have in common? Culture.

Is it necessary that our lives place so much emphasis on employment, productivity, earnings?

Both disengagement and conflict theories give a lot of attention to the meaning of work. This I believe, is justifiable. The achievements and social status associated with occupation are major ingredients in the way we judge ourselves and others. When asked who we are, don’t we often answer in terms of our work?

Mobile mobility, on-demand access, and instantaneous communication have forever changed how individuals interact; changing how we define “membership.” The reality is that individuals no longer join an association because it is expected as a professional; they want to know that they are spending money on something that will be of value to them.  ACHCA recognizes this shift in membership perception. 

ACHCA leadership strongly believes that a foundational part of our member’s value proposition is their chapter infrastructure. Chapters should be where our members find community throughout the year, where they can engage at a local level and often where they can hone or strengthen their leadership skills through volunteerism. 

The new year brings new opportunities and challenges to the senior living industry. With all the changes in process, it’s a good time to revisit your strategy and evaluate what decisions can make you successful in 2018.

Investment in Senior Living

Def: Muse - to become absorbed in thought - Merriam Webster Dict.

For more than fifty years I’ve cared for countless sick elderly and disabled individuals in my capacity as a Registered Professional Nurse.

A new year is a great time to set goals (both big picture future goals and SMART goals for the current year). Here are DRIVE's top 10 must do’s for creating and sustaining a strong culture in 2018.  (Blog reprinted with permission.)

As you navigate these first few weeks of 2018 we recommend that you sit down with your team and consider what on this list you do really well and what you need to work as a team this year. If you need help getting starting let us know. We have facilitators who can not only help lead this discussion, but they can work with your team throughout the year to help you all achieve your goals.

“You’re looking pretty tonight.” Her eyes warm to the compliment. Automatically she checks her hair, newly washed and cut. Even after all these years she is still slightly nervous. But a date is still a date even when you are seventy-and-more. For his part, any tentative feelings are covered with pride and pleasure at being seen out with such a fine woman – much as he felt fifty years and more ago.

“Shall we go?”

Far too often, labeling a person as ‘senile’ is a thoughtless expression steeped in prejudice. ‘Diagnosing’ a person as ‘senile’ is accurate only when we mean there is a continuing pattern of progressively deteriorating thought and behavior coupled with a medically proven diagnosis of an irreversible brain disease. Careless use of this single word (senile/senility) suggests that we think we know what is wrong and there is nothing more to understand or to be done. This attitude is not justified even when the person is, in fact, suffering some form of a progressive cerebral change. But the attitude is particularly destructive when the individual is troubled, yet far from ‘senile’.

Even professionals are capable of making such errors. International mental health teams and researchers in the field of gerontology who have been studying this problem have discovered that many elderly persons who were labeled with the term senile/dementia have come to realize that the problem is, in fact, functional in nature. If this can happen, then people without professional or scientific training may be even more prone to error. Any sign of confusion or mental lapse in an elderly person may be erroneously taken as ‘proof’ of senility.

Definition: keen-minded – “mentally alert” – (Merriam-Webster Dictionary)

Why are some elderly people more keen-minded than others? In youth and middle age some people are more mentally alert and vigorous than others. Keen-mindedness tends to be habit forming: a combination of fortunate genetic endowment and a lifestyle that keeps the intellect well honed.

Despite the obstacles, love can triumph for the old as well as for the young. The importance of a sustained love relationship in old age is hard to overestimate. Sex brings more than direct physical gratification, although this by itself is not to be slighted. It also reaffirms each partner’s identity as a person who can offer something worthwhile, and who can be someone worthwhile to another person. The body is still a means of giving and receiving pleasure.

But there is another important function of sexual intimacy in old age. The old person is all too often ‘typecast’ to the outside world. He is the secondary character, belonging on the fringe of the real action.
We tend to remain at an emotional distance from him. Every day we walk past, almost through old people on the street, without clearly registering their existence as individuals.

Be Prepared!   The motto of the Boy Scouts of America has never been as true for many Nursing Home Administrators as it has during the recent events of the nursing home tragedies that have occurred in Texas and Florida during Hurricanes Harvey and Irma. For many nursing home Administrators, being prepared for an emergency, or disruptive event, is the ultimate responsibility; a high priority. The CMS final rules of participation on Emergency Preparedness which takes effect on November 15, 2017 will only add another layer of regulations to an already heavily regulated environment for the Administrator.

One certainty that will face all Nursing Home Administrators (in the wake of Florida) will be that the CMS and State surveyors will be reviewing (in detail) a facility’s emergency plan, and in some cases “ripping” it to shreds.  How can Administrators be sure that the emergency plan they have will meet requirements?  Until we begin to see how deficiencies will be cited by surveyors, this question remains to be answered. Regardless of outcomes, the Administrator must have an emergency plan and documented exercises that have tested the plan.

Several decades ago two prominent psychologists wondered whether giving institutionalized elderly people a tiny amount of control over something in their lives would have a positive influence on their personalities.

What they did was to give a house plant to each resident in a nursing home. Half of the residents were told that the plants would be cared for by the nursing staff. The other half were told that they were responsible for the care of the plants. They were to decide when to water the plant and how much sun it should have. At the beginning of the study, the two groups were similar in physical and mental vigor. Three weeks later, there was no difference in the health of the plants, but there was a lot of difference in the psychological adjustment of the residents who were put in charge of caring for their plants. The group given personal responsibility rated themselves as more alert, active and vigorous.

A grim choice confronts some people when they face problems associated with advancing age.  Do they have to accept insecurity and deprivation? Must they surrender much of their independence and integrity in order to be helped?

Elderly men and women may prefer to go it alone instead of taking advantage of available resources to which they may appear as stubborn and unrealistic.  But they many feel life would no longer be worthwhile if they were to become too dependent on others for their needs.

I believe in the sanctity of those who are older than me, and the significance of supporting them to continue writing their life’s story to the very end, regardless of where they may reside. For post-acute and aging services organizations, this requires enlightened leaders who are amply equipped to adapt their organization to fulfill each of their residents’ narratives.

In this rapidly evolving environment, I know that I can’t be successful by going it alone. I need collaboration, support, quality education and information. I also need a network of like-minded peers, who through formal and informal interactions, afford me the recognition and validation I need to stay inspired.

Our society will continue to insist on using chronological age for many purposes. We can live with this practice if we recognize that to set up a chronological checkpoint for calling a person ‘old’ is simply a matter of administrative or statistical convenience. It is an unfortunate usage but difficult to avoid. We can, as a society, minimize the negative impact of this practice by making a clear distinction in our own minds between chronological age and the individual’s actual physical, mental and social situation. We can also refuse to be swept along by the implicit relationship between chronological age and human value. ‘Ten years older’ does not mean ‘ten years worse’ or ‘ten years less valuable.’

            Age-grading emphasizes society’s interest; functional age emphasizes the direct facts about the individual.