Caregiver Retention and Turnover: Are You Ready for the Recession Rebound?

The caregiving profession is notorious for turnover. The nature of the business dictates it, and human resource professionals hear every day "I need to work." Although we do our best to keep good employees with as much work as they'd like, it isn't always possible. Due to the recession, however, caregivers have stayed with their employers as active, steady clients have been few and far between for all home care companies. The total employee turnover rate in the U.S. was 16% in 2007, and only 8% in 2009.

The economy is going to recover though. Economists predict a slow, steady recovery, and we have already seen signs of hope. The last piece to regain strength will be employment, but employers need to get ready. Two-thirds of U.S. employees are expected to turnover as the recession deminishes, and that number is even greater for professional caregivers. All those caregivers who have been faithfully sticking by their employers, will start looking elsewhere if they can't get a steady case. Do you want to keep your key employees? What can you be doing to ensure good caregivers don't seek employment at the agency down the street?

We have spoken in this blog before about employee engagement and satisfaction. It's time to start developing a company culture that makes caregivers want to stay, because the economic impact of losing solid, top employee is too great. The most successful retention strategies encompass many factors, including employee engagement, high employer communication, and decentralized management involvement. When employees hear consistent and constant feedback from all levels of the organization, it creates a high sense of belonging and in turn, reduces the desire to seek employment elsewhere. Do your employees know what the company mission and vision is? Are you soliciting ideas from your caregivers on how they can help the growth of the company? We have all heard of exit interviews, but how about STAY interviews?

Employee retention and turnover is a process, not an event. Making sure employees know how essential they are in the success of the business will undoubtedly make them feel valued. Caregivers who are treated as professionals and feel valued and a senses of belonging are the ones that will stay.

National Flu Vaccination Week

January 10th - 16th has been declared National Flu Vaccination Week. The Department of Health and Human Services has reported that in 2009 there were:

• 47 million cases of H1N1
• 200,000 hospitalizations
• nearly 10,000 deaths

Thankfully, the number of flu cases has declined in recent weeks, however experts warn we should get ready for a third wave of H1N1. National Flu Vaccination Week was named to remind Americans to get vaccinated. Vaccinations are now open to everyone in most parts of the country. You can find more information here.

In San Diego county, US Healthworks Medical Group clinics are now offering flu vaccinations for $15. We encourage you to use the link above to learn more about patient eligibility and find the clinic nearest you. If you have your own doctor and insurance, inquire about a special rate for flu vaccinations this week and take charge of your health!

Holiday Night at Liberty Station

Elder Care Guides was happy to participate in the Holiday Night event at Liberty Station this weekend. It gave us the opportunity to contribute to our fellow Liberty station residents, and serve the Point Loma community with a craft activity for the families. Being a tenant at Liberty Station allows us a central location to our clients, and a giving community of restaurants, retailers, and businesses alike.

Holiday Night was filled with crafts for the kids, a tree lighting ceremony, and a visit from Santa. On stage were dancers from San Diego Ballet, gymnists from San Diego Gymnastics, a karate demonstration from US Karate Academy, and the dancing waitresses from the Corvette Diner.



Elder Care Guides enjoyed having children draw a picture of their grandparent, then take a craft sheet home to interview their grandparent about what life was like growing up for them. We made an effort to bridge the generation gap, and children really enjoyed the activity. We hope you will join us at the next Liberty Station community event.

National Home Care Aide Week

November is National Home Care and Hospice month, and although Elder Care Guides is not a home care company, we want to recognize and illuminate our wonderful employees, the professional caregivers. The National Association for Home Care and Hospice has named November 8th - 14th National Home Care Aide week, with the theme "Home Care Aide: Loving Hands and Compassionate Hearts." This special month and week was announced to bring attention to and celebrate those to spend their lives caring for others. A noble profession, caregiving doesn't often get the attention it deserves. Care Management support, a personalized care plan, and the expert care of a professional caregiver is what allows the growing elderly population to stay at home much longer than originally thought possible.

There are many ways to contribute to and acknowledge that special caregiver in your life, and we encourage you to branch out this month to increase awareness of this much valued career.

• Educate yourself about Care Management and Caregiving by requesting books and materials on the topic at your local library.


• Pass out small gifts or tiny treats to volunteers and caregivers at a local assisted or independent living retirement communities.


• Talk about Care Management with your neighbors and friends who may be struggling in the sandwich generation and don't know where to find help.

As you go about your days in November, stop and notice all the caregivers that surround you. These amazing people are sitting with an elderly person at a restaurant, helping them with their meal. They are reaching for an item on a high shelf at the grocery store for a person in a wheelchair. Every day, they are giving of themselves physically, emotionally, and spiritually, all to assist another person to live with dignity and purpose. To the professional caregivers, we salute you. Happy National Home Care Aide week!

Looking "Up"

On a recent cross-country flight, I enjoyed the opportunity to watch Disney/Pixar's most recent animated feature, "Up." The main character, Carl, is an elderly and childless man who, upon losing his wife Ellie with whom he'd led a long and happy life, finds himself being forced out of their beloved little house and into a retirement home when he is deemed a "public menace." He and his wife had an unfulfilled, lifelong fantasy of moving to a place called Paradise Falls in South America, and on the day the staff from the retirement home come to take him, Carl ties hundreds of balloons to his house and flies away in pursuit of his and Ellie's dream. Once in the air, he realizes he's accidentally taken along a neighborhood boy, Russell, who had been on his porch attempting to earn a merit badge for "assisting the elderly." The movie is focused on the adventures that Carl and Russell experience while in South America (and I won't spoil the plot, for those who haven't seen it!), but it brought to light some issues and themes about which I often reflect both as a professional geriatric care manager, and as a person who cares deeply about the inner lives of our elders.

Carl is a cantankerous old grump of a character, and Russell is a loud, high-energy schoolboy and "Wilderness Explorer" scout. Through the course of their journey, we learn that Russell is being raised by his single mother, and wishes he spent more time with his re-married father. Russell eventually endears himself to his aged traveling companion, and a deep friendship is born. They learn about the world and about life from one another, and fulfill important roles in each other's lives. It is a sweet demonstration of the value of intergenerational relationships, and I hope that "Up's" younger audiences will internalize this lesson and seek out friendships with the elders in their communities, and value time spent with their own parents, grandparents, aunts, and uncles.

When Carl and Russell's balloon-powered house lands in South America, they realize that they've made it close to Paradise Falls, but have an arduous journey ahead of them, to relocate the house to the precise spot about which he and Ellie had dreamed. When faced with a difficult choice, Carl comes to the realization that "it's just a house." Until then, he had been very focused on it, and the things therein, as essential to his happiness and to the fulfillment of this particular dream. This brings to mind the complex relationship that many elders have with their family homes, as symbols of independence and a source of connection to memories and former roles and relationships. For my own grandmother, leaving her house meant not only accepting a new type of dependence on others, but relinquishing an important role - her home would no longer be the gathering place for celebrations and holidays, and she would no longer be able to provide a warm meal or a bed for visiting friends and family. Warm hospitality was a central feature of my grandmother's character, and looking back with hindsight, I wish we'd found more ways as a family to continue to foster that part of her after she moved into her assisted living apartment. For my grandmother, and for many others, letting go of her house felt like a loss of independence, but was in reality only a shift to a new type of interdependence.

The most important message I received from "Up" was that setting goals and achieving dreams is an ongoing process that should take place throughout our lives. Carl and Ellie had dreamed of children - and did not have them. They had dreamed of Paradise Falls - and did not get there. But they adapted to their circumstances, set new goals, and lived a happy and full life together. When things are looking grim in South America, Carl finds a message that Ellie had left for him before her death, which reads "Thanks for the adventure - now go have a new one!" and is renewed in his efforts. Carl's dreams of a life in South America with his beloved Ellie were not realized, but through the journey and his friendship with Russell, a new purpose for his later life was revealed. We see this in our work with our clients, and know it to be true: we are always growing, it is never too late to set and achieve goals, and there is purpose in every moment lived.

Flu Season is Here

The new strain of the flu virus, H1N1, is making headlines. On the radio, on the television news, in the newspaper, and online we are told the nasty virus is coming, and it's time to get ready. Just like any disease, the best way to battle it is prevention. Here are a few helpful tips on how to battle the flu, before it reaches you.

• Wash your hands: Hand washing is the number one way you can prevent the spread of disease. Wash frequently, for at least 20 seconds. If a sink is not nearby, an alcohol based sanitizer will do the trick.



• Take Vitamin D: Exposure to the sun helps in getting your daily dose of this important vitamin, but winter makes that more difficult. Make sure vitamin D is in your daily dose, as it has been proven to reduce the likelyhood of the flu.



• Eat Probiotics: Probiotics are good bacteria found in fermented food such as yogurt and soy. Promoting a healthy balance of bacteria will help in digestion, and boost immune fighting chemicals in your body.



• Eat Fruits and Veggies: This is a good idea all year round, but loading up your body with immune fighting phytochemicals found in these foods is essential during flu season.



• Get Vaccinated: Although the National Institutes of Health does not have the H1N1 vaccine ready for widespread use, you can still get the general flu vaccine now.

The new Dr. Oz Show recently featured the flu on a recent broadcast, and gave several more helpful suggestions on how to prevent it. The three most important groups of individuals who should get the flu vaccine immediately are pregnant women, young children, and those in the healthcare industry. Elder Care Guides is doing what we can to inform our clients and caregivers of this important information, and encouraging them to incorporate these preventative measures. Sending out a flyer of information, offering to reimburse for the cost of the vaccine, and reminders during home visits are a few ways we have helped.

Here's to your health!

Care Management Featured in the New York Times

An article titled "When Elder Care Problems Escalate, You Can Hire an Expert" appeared in Saturday's New York Times Health Section (9/26/09). It provides some excellent, concrete examples of situations in which the interventions of a professional geriatric care manager can make a positive impact on the lives of elderly parents and their adult children who are caring for them. The author provides some guidelines for identifying a good match, and a list of questions to ask when interviewing a professional geriatric care manager.

We encourage families to call Elder Care Guides with their list of concerns, and the particular criteria they seek in a care manager for their aging parent. We welcome the opportunity to meet face-to-face at our office or in a parent's home at no charge, to discuss the needs and how the services of a care manager may be of assistance, and to determine whether there is a good personal "fit" between the family and the care manager.