Let’s face it: front line dementia care workers have a difficult job. Whether providing dementia care in a home care environment or senior living, it can be both rewarding and challenging. There are likely much easier ways to earn a living. Those who are recruiting and working to retain staff should keep top of mind that senior living or home health care team workers likely selected elder care because of some intrinsic rewards/benefits.
Working through that thought, someone who chose to become a nurse, social worker, CNA, or activity team member likely had job and career choices, and we know they have many workplace options in today’s labor shortage environment. But for some personal reason, they chose to work in health care with elders, many of whom have dementia.
As an example, I chose to be an Occupational Therapist, specializing in geriatrics and dementia care, because I wanted to help. I wanted to make a difference. Fortunately, I had many other career choices but this one spoke to me for those primary reasons. The Occupational Therapy career found me—it stood out when I was thumbing through a vocational guide so many years ago. I have given the profession all I have because helping those living with dementia to experience quality of life matters so much.
So, let’s identify recruitment and retention strategies that tap into this awareness that many who work in health care—and more specifically dementia care workers—have chosen this work not because it is easy, but because it matters.
I don’t want to underestimate fair compensation. That certainly matters, but compensation isn’t the only piece of the recruitment and retention puzzle. I like to think about the following strategies as helping to connect the many things that matter to employees to successful staff recruitment and retention.
5 Recruitment and Retention Strategies that Matter
1. Mission forward
What is your mission? Do you know it? Do you live it?
A mission statement can be the beacon that helps people to find a place of employment. Don’t underestimate its value. But it truly needs to be palpable to have lasting impact. If the mission statement is simply words on the company web page, the smoke and mirrors will be evident during interview or employment. The value will quickly dissolve. But if everyone in the organization understands and embodies this mission at an emotional level, it will guide all actions and interactions. The mission will help attract the right people for the right reasons. A lived mission will help employees to develop a commitment to the organization and those it serves- going far beyond what a paycheck alone can accomplish.
2. Set the team up for success
How does the organization train, mentor and develop the team to care for those with dementia?
To my knowledge, most CNA curriculums include little if anything about how to provide cognitively supportive care for persons at all stages of dementia. Amazingly, the same could be said for professionals such as nurses or therapists. Often there is little practical training provided at the preparatory level, hence employees are dependent upon employers to provide the dementia training.
Don’t get me started or I won’t be able to get off my soap box about what appears to be an unbelievable disregard for the statistics of dementia prevalence. The numbers are so staggering, I question why preparatory programs and institutions aren’t mandating inclusion of quality training for dementia care workers. But for now, that is the unfortunate reality of the situation, and this leaves employers to fill this training gap. But here we can find opportunity. Employers can position the offering of quality dementia training to not only prepare staff but to also help recruit and retain.
Here is a brief example of the basic minimum competencies those providing care to individuals who are living with dementia should have to be effective and safe on the job.
- How to adapt communication to gain trust, understanding and agreement.
- How to adapt care approach and the activity to the just right level of challenge that promotes highest level of independence and successful participation.
- How to adapt the environment so it is a support and not a hinderance.
- How to prevent, recognize and deescalate distress behaviors to keep all safe.
- How to provide person-centered care.
I don’t consider watching a video or hearing tips to be training. Training involves learning something new and becoming confident in applying that knowledge and skill on the job through feedback and mentorship.
All dementia care workers, no matter what their role, should know how to provide person-centered, cognitively supportive care, or they will be overchallenged and fail on the job.
What do I mean when I say they will fail on the job?
- They will be ineffective and inefficient—using wrong approaches and wasting valuable time.
- They will constantly battle with the person in care.
- They won’t feel as if they made a difference.
- They will feel frustrated.
- They will feel unsafe.
- They may get physically injured if they unknowingly escalate a distress behavior to a crisis.
- They may be the victim of emotional abuse.
Don’t take my word for it. A 2006 Long-Term Care Minnesota Nurses’ Study stated 77% of those surveyed said “I expect assault as a possible consequence of the job”, and this could lead to a reason for leaving the job.
If you experienced these failures or assault on the job, would you stay? Why would we think others would stay?
Instead, let’s think about what can happen when dementia care workers are prepared and empowered with quality dementia care knowledge and skills. There is a very good chance the serious problems named above can be greatly minimized and the ability to be and feel effective will go way up. Now this becomes a great place, and a safe place, to work!
3. Recognize achievements
I think of two things regarding the high value of recognition of achievement:
- Training Accomplishments. Employers should select quality training programs that offer a certification or credential for successfully completing training. Many dementia training programs, like our Dementia Capable Care Training, 2nd Edition, offer a credential, such as our Dementia Capable Care Specialist credential.
We all want to have our hard work and learning accomplishments acknowledged. Earning a credential in a program like Dementia Capable Care is one way to do so.
- Performance Accomplishments. Employers should prioritize methods to recognize the successes of the team, no matter how small those successes may seem. When a success story happens, celebrate! Shout it from the rooftops! This creates a positive work environment and culture.
At a memory care senior living community where I worked as the head of dementia training, programming, and research, I started each team meeting by reiterating that we were a team and an organization dedicated to our mission of creating a community of well-being. Next, I’d say, “Tell me something good that has happened to support our mission.” Not only did staff come to these meetings excited to share a story from their own care experience, but they were also quick to recognize the good care a team member provided. They saw their workplace as energizing, fun and supportive.
4. Encourage growth/career path
I like to think learning never stops, especially in dementia care. We can all learn something new to help us in our work, but again, we may feel more motivated if we can achieve, and earn recognition or a reward. Employers who follow this motivation methodology can see great results in developing their staff. Create career paths and reward with salary increases, even if modest. Create new titles, use badging, provide certificates of achievement, or simply surprise with rewards. Recently I learned about the Caribou Perks rewards program. It sounds interesting and I think it would be worth checking out.
5. Take care of one another—we are more than coworkers!
My mentor, Ellen Friesen, used to own a rehab therapy contract company. It seemed everyone wanted to work for Ellen and almost no one left. I don’t think it was because Ellen paid so much more than others, but Ellen embodied all the principles we’ve been exploring in this blog. And the one thing I remember most is how well Ellen took care of her employees. I believe this was Ellen’s secret sauce for great success in recruitment and retention.
Ellen started by listening and getting to know her team. Her door was always open. She showed she cared by sending flowers with a personal note when one of her team had an illness or had a loved one pass away. I could go on with many more examples, but the point is that Ellen knew her team, and the team felt cared for and respected as a person first and an employee second. Looking back, I guess you could say Ellen taught me that person-centered care applied to the team members employed as well as the patients and clients served.
Employers should think about the things their team members struggle with most and figure out how they can help. As examples:
- Many new employees want or need to start earning right away. Help them. Can onboarding training be paid time? Can training also include on-the-job training and coaching?
- Many have children who need childcare. Can the employer offer an innovative childcare solution?
- Many need flexible work shifts. This could be due to childcare issues, or the older worker may want flexible hours, part-time in semi-retirement. Can the employer move beyond the typical shift rigidity and think outside the box to accommodate?
- Many staff experience stress due to a loved one living with dementia. Can the employer offer education to help support them and their family, through employee assistance program or other means? As an example, we have created Dementia Capable Care at Home: for Families, 12 online video webinars to educate and support families. We’ve rolled it out to our own employees and some of our clients have said this is exactly what their staff needs.
Taking care of one another is valuable, and let’s not forget the importance of having fun together. As an example, Ellen always threw the best holiday parties. Social time can build lasting relationships and create deeper bonds. This can pay dividends when the going gets tough on the job. Close teams are more likely to support one another and stay together.
Get Creative With Recruitment and Retention
I don’t have all the answers, but I do know we have never faced a more dire staffing situation in my 30+ year career. So, it’s time to get innovating when it comes to staff recruitment and retention strategies.
I believe the majority of health care workers chose this work path because it’s personal. It means something, something more than a paycheck. Collaborating around an authentic shared mission, being successful together and celebrating success, and caring for one another as more than work colleagues can go a very long way for recruitment and retention.
If you’re an employer, why not try this approach? What do you have to lose? What do you stand to gain? As an employee, what do you think? Do you find these approaches meaningful? Would they help you to select an employer and encourage you to stay?
I like to think of recruitment and retention strategies for dementia care workers as just getting back to basics. No magic bullet—just good people doing good work and taking care of one another. Not really sure when these basic values became innovative, but they are definitely relevant again, and can have tremendous positive impact on both employers and employees.
Kim Warchol, OTR/L, is the founder and President of Dementia Care Specialists at Crisis Prevention Institute.
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