Rest Home Retention

Is paying more money without training really going to improve the care and retention in the Aged care Sector?

Geoff Harper asks whether we are warehousing our elderly for profit?  (NZ Herald 27/07/10)

Having been involved in aged care for some 35 years now, I have watched the changes take place over the years.  While the care may not yet be where we would like it to be, there is at least a good attempt to skill the workforce that care for the elderly and frail. 

It is true that we have seen some large organizations enter the market with some being very cost driven for shareholder returns however it is not so much being profit driven that concerns me.  It is the values difference.

This not only pertains to owners it is also to caregivers. 

We are a bi-cultural country living in a multi-cultural environment.  Where we have to spend time, is getting caregivers to understand the culture of the person they are caring for. 

We cannot expect people to understand our welfare culture if they have come from a survival culture.  New Zealander’s are very fortunate.  Our forefathers had the foresight to set up a system, albeit minimum levels, that would give us a hand up in case of need.  Many of the people who are looking after our frail elderly come from countries that are not so fortunate. 

Therefore it is up to us Kiwi’s working in the Aged Care industry to ensure migrants know the culture of the people they are looking after.  If we fail here, we will not get the care we want or our older people deserve. 

From my experience, having been a rest home owner and manager myself, there is always provision for people to have their wishes met and that includes having daily showers.  All that needs to happen to have it written on the individuals care plan. 

People admitted to an aged care facility are interviewed by a RN who writes up a Care Plan on admission.  This includes such preferences.  It only falls down in faciites that do not operate a Client Centred facility, but rather one that is Staff driven which is contrary to the Health & Disability Services Standards guidelines.

Where values and facility philosophy of care differ from the recipient idea of care, the there will always be problems.  Hence the perception of care becomes blurred and the person or their family become unhappy.

So how do you overcome this.

As a trainer, I take every opportunity to explain to Caregivers that the facility is the resident’s home.  And being their home, they are actually being paid by the resident.  The organization who pays their wages are merely the filter for the income that is generated.. 

This may not be how the business owner sees it, but it is in fact true.  Many business owners also often see training as a cost rather than an investment too.  Some places have such meager budgets it is almost impossible to offer good training.  Managers or Registered Nurses are suppose to schedule it in to their already busy day.

So, if the residents are paying the staff wages, then every day a caregiver, manager or business owner, enters the building they are entering the residents home who in fact are renting a room from the facility.  The resident then is contracting the staff to assist with them with their care so they can live. 

Therefore business owners, whether they are large corporations or small owner operators have to change their philosophy and realize that the power is in the hands of the people receiving care not the board office or the owners . 

So is paying higher wages actually going to improve care?  Unfortunately no it won’t.  While I am the first to agree caregivers deserve more to be paid more, if Geoff Harper thinks by raising the wages the care will improve he is deluded.  All you will get is higher paid workers given unsatisfactory care. 

What will improve care is higher wages attached to training.  We cannot blame the caregivers for not knowing what they don’t know.  We have to teach them what we know so they will be better caregivers;  what it is like to live in a bi-cultural society and then they will understand how to live in a multi-cultural society.

So lets stop the bashing of rest homes.  On the whole I believe they do a pretty good job.  Yes I do agree they can do better but that will only come with training their caregivers.  Lets have some compassion for their short comings too. 

Let training be an investment not a cost.  That is what will improve retention of staff and yes reward the training with wage increases and acknowledge those who put in the hard work and do the learning.  It will come back in less complaints, less media bashing, happier residents, families and of course staff.

I too have my mother in care but unlike Geoff Harper I am extremely happy with the care she is receiving.  I know she can have a shower ever day if she wants one.  I know we will be kept informed on any health changes that occur. 

I know I am welcome in the home – and none of this has anything to do with the fact that I am a Registered Nurse and an independent Nurse Educator.  It is because the place she is in really care for her.  For that my sisters and I are eternally grateful.


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