Strategies to Better Retain Residents in Your Senior Care Community

Eboni Green, Ph.D.

Residents may leave senior care communities for a variety of reasons, but sometimes a decision to leave could have been prevented. In addition to focusing on lead generation and attracting new residents, senior care communities can also benefit from an increased focus on resident retention strategies and efforts to reduce turnover.

The Effect of the Pandemic on Resident Retention

The pandemic had a notable impact on client and resident retention. Glenn Lane, founder of Westchester Family Care in Mamaroneck, New York, saw an impact in Westchester Family Care’s census from late 2019 through May of 2020. “We saw clients who didn’t need a lot of care, and their adult children were home from work or nearby from work. Many people decided that even with all of the infection control protocols, they wanted to cut back services,” he says.

Factors That Contribute to Resident Transfers

Eboni Green, Ph.D., faculty member in Walden University’s Doctor of Healthcare Administration program, is a registered nurse and licensed long-term care administrator. She notes that some of the challenges of the pandemic may cause families to weigh their options when deciding on the right care situation for a family member. “With restrictions in place, it is in some ways very difficult for families, and they’re having to make the choice of if they need to put a loved one in long-term care, are they then not going to be able to visit them?”

In some instances, residents may need to be isolated for safety, so it’s important for long-term care facilities to look for ways to still be able to provide connections with family members. “Make sure that the residents’ individual needs are all met and there’s really good communication with the family and staff, especially when it comes to restrictions. Some families are very frustrated by those restrictions, and that might be a reason why they choose to take a loved one home.”

Other factors can also contribute to residents or their families making the decision to transfer elsewhere. Dr. Green highlights that poor communication between a hospital and long-term care setting might result in a gap in medication and room setup, making for a poor-quality transition for a resident. “With a good system in place, you’ll have an intake nurse who will come in, even on weekends, to make sure everything runs smoothly for the resident and family.”

She explains that it’s important for administrators and directors of nursing to carefully think through the whole admissions process to makes sure that it’s as smooth as possible.

Best Practices in Resident Retention

The good news is that senior care facilities have control over many of the factors that might prompt residents to transfer elsewhere. Lane explains that he works to ensure consistency in the caregivers who see clients. This both reduces the number of people who are coming and going, and serves to build relationships and familiarity between clients and caregivers.

He also relies on his caregivers to report any concerns to the office immediately. “Our caregivers on the front line, and we want them to overcommunicate and overreport any change, especially with a senior where they’re most fragile,” he says. “Small things that might be nothing for you and me, like a scrape or sniffle, those things can escalate quickly for a senior. Beyond retention, it’s keeping seniors out of a hospital. It helps with their longevity on service, but it’s also the best thing for them when we can reduce interactions with a hospital or ER.”

Dr. Green highlights the importance of how staff and caregivers can make residents feel welcomed. If a new resident will have a roommate, staff should make sure that they find the right pairing of residents who are as compatible as possible. “Food is really important for socialization, so make sure that there’s a warm and engaging environment for mealtime,” says Dr. Green. “Those are things that families and residents are looking for when they’re seeking out long-term care. If one of those three legs of a good admission or retention strategy is missing, you’re probably going to have residents looking for other options.”

She encourages facilities to keep lines of communication open, particularly when it comes to receiving information from multiple teams. “Our first line of defense is always the direct caregivers who are our eyes and ears,” she says.

Additionally, people in housekeeping or on the dietary team may hear about dissatisfaction before other staff will. “Really take into account what they have to say. That might be facilitated through staff meetings, but it’s not always intradisciplinary like we’d like it. If a dietary aide hears something, she’s probably going to take it to her supervisors in the dietary team.” Dr. Green notes that it’s important to give these teams the ability to easily communicate with others, so that messaging gets back to the people who need to hear it.

Keeping residents and their families satisfied is a big ask, particularly given the challenges of the pandemic. “A lot of time, the staff gets the brunt of the concerns,” says Dr. Green. “We’re all trying to do our best. The biggest thing is to remember why we’re in this field, and that we’re trying to help, and to try to not be defensive and work to solve a problem or potential problem. If one resident is feeling that way, there’s likely going to be others feeling the same way.”

Paige Cerulli

Paige Cerulli is a contributing writer to i Advance Senior Care.