The Truth About What We Do — And Why It Matters

by Kally Hoffman, BSN, RN | Director of Nexus On Call Care

Over the years, working in and leading triage departments across long-term care, one theme has never left me:

People don’t need just a service — they need support.

In this space, urgency is real. When I say clients need help "tomorrow or next week," I mean it literally. That’s the reality many DONs and nurse leaders are living in right now.

The DON role has evolved. What used to be a position that could pause at night has turned into a 24/7 responsibility. And with the growing complexity of healthcare — the constant flow of new treatments, medications, regulations — it can feel like the work never ends. The pressure is real, and it’s taking a toll: staff burnout, turnover, and overwhelm that’s not always said out loud, but is deeply felt.

So when facilities partner with us for after-hours triage, it’s never about promising, “You’ll never get another call again.” That’s not honest — and truthfully, it’s not what most DONs even want.

What they want is peace of mind. To know that when they step away, their team and residents are still being taken care of. To know there's another experienced nurse — someone outside their organization — who they can trust, collaborate with, and lean on.

That’s what we’re building.

It’s Never Just One Thing

What usually starts with burnout or a staffing shortage often becomes something deeper.

Because we don’t just “take calls.” We take the time to see the whole picture.

We regularly bring in other departments from our team to help support a facility holistically — not in silos. Why? Because in long-term care, nothing exists on its own. A staffing gap impacts communication. A compliance issue stems from systems that are stretched thin. When you only fix one piece, the pressure just shifts somewhere else.

So our support evolves into:

• Helping cover vacations or trainings

• Providing real-time reports, documentation, and communication tools

• Offering leadership support during audits or transitions

• Identifying recurring problems — and helping solve them before they grow

Our role goes beyond just being there in urgent moments. We walk alongside leadership to create a partnership that is steady, thoughtful, and lasting. It’s deeply felt every day in the assurance, consistency, and confidence we bring to those we serve.

When Big Doesn’t Mean Better

One trend I’ve noticed lately is larger healthcare organizations trying to create their own internal triage programs — and while the intention is good, the result isn’t always what they hoped for.

Even with internal resources, many of them are still facing burnout — and sometimes even faster than before.

Why? Because internal nurses are deeply invested. They care so much, they carry the weight of the role in ways that go beyond the job description. They’re tied to the outcomes, the people, the pressure. And without outside perspective, it becomes hard to separate personal from professional — which only adds to the burnout.

What I’ve found fascinating in our work is how our nurses can step in, care deeply, and offer real solutions — without the emotional entanglement. That creates clarity. It creates calm. It allows our team to truly help in the moment, without bringing in workplace dynamics or long histories.

This is something no one really talks about — but it makes a big difference.

Fresh eyes bring fresh energy. No internal politics. No tension between co-workers. Just support.

And that translates to less burnout for leadership, too.

Let’s Be Honest

There isn't always a simple fix. Healthcare is far too complex for that.

But I am here to say: support can look different than you think. It doesn’t have to be transactional. It doesn’t have to be “one-size-fits-all.”

Because what I’ve seen — over and over — is that the strongest partnerships are built on trust, flexibility, and collaboration.

When leaders finally feel seen, heard, and supported — not just covered — something changes. They get to exhale. They stop surviving and start leading again.

And that? That’s what our industry needs more of.

If you’re a DON, a nurse leader, or someone who’s been feeling overwhelmed — we see you. You’re not alone. And you don’t have to keep doing this without support.

Let’s keep having the real conversations.

Celebrating Purpose: Rediscovering Meaning in Elder Care Work

In the daily rhythm of assisted living and long-term care, it’s easy to feel overwhelmed by routines, regulations, and the weight of responsibility. But beneath it all is a deeper current: purpose. This blog honors the quiet heroism of caregivers who find meaning in each hand-held, each story listened to, and each life dignified.

1. The Quiet Impact of Daily Care

Small acts—adjusting a blanket, remembering a birthday—are where purpose lives.

These moments build trust, belonging, and identity in communities that often feel forgotten.

2. A Classroom of Humanity

Assisted Living and LTC settings offer profound lessons in vulnerability, resilience, and interdependence.

Care teams serve as both educators and students, learning from residents' wisdom while modeling compassion for one another.

3. Purpose as a Buffer Against Burnout

When staff reconnect with the "why" behind their roles, their emotional resilience strengthens.

Educational programs that emphasize gratitude and reflection can transform the culture of care.

4. Highlighting the Wins

Showcase real stories from your facilities—staff who went the extra mile, residents whose lives were changed through engagement.

These examples are the heartbeat of service and re-ignite pride in the work.

Elder care isn’t just work—it’s a calling. Purpose doesn't have to be shouted from a podium; it’s present in the whispered good morning, in the patience offered, and in the legacies honored. Let this be a reminder: your role matters profoundly, and rediscovering its meaning isn’t a luxury—it’s a lifeline.

Less Burnout, More Bonfires: Your Fall Refuel Plan

By Jessica Kritzeck, RN, LALD

Let’s be honest, summer wasn’t exactly slow. Between surprise surveys, last-minute staff call-outs, and covering three roles in one day, it’s no wonder you might be feeling a little… crispy around the edges.

But guess what? Fall is just around the corner. And while pumpkin-scented everything won’t solve staffing woes, it is the perfect time to refuel before year-end chaos rolls in We’re not talking grand vacations or three-hour morning routines (who has time for that?!). We’re talking mini habits and micro-moments that make a big difference in how you feel—and how you lead.

5 Quick Ways to Refuel Before Fall

1. The 5-Minute Close-Out

Before you leave the building (or log off), spend 5 minutes writing down:

• What went well today?

• What’s the one thing I must tackle tomorrow?

Why it works: It clears your brain and helps you start the next day with focus—less mental clutter, more control.

2. 10-Minute Driveway Rule

• Once a week, take 10 minutes in your car before you walk in the door at home (or back into “real life” if you’re remote). No calls. No podcasts. Just deep breaths and maybe some silence.

Why it works: It gives your brain time to switch gears. You can’t lead at work and at home without space to reset.

3. Replace “I Don’t Have Time” With “It’s Not a Priority”

Try saying it out loud:

• “I didn’t make checking in with my team a priority this week.”

• “I didn’t prioritize eating lunch today.”

Why it works: This mindset shift can feel uncomfortable—but it’s a powerful way to reclaim your choices and spark change without guilt.

4. Pick a “Bonfire Buddy”

• Who’s one colleague you can vent to, laugh with, or bounce ideas off of—without needing to over-explain? Make a point to check in weekly.

Why it works: Community combats burnout. And let’s be real, some days you just need someone who gets it.

5. One Tiny Joy a Day

• A favorite coffee mug.

• A new playlist.

• The 3-minute video of goats in pajamas. (Don’t judge.)

• Put one tiny joy on your daily checklist.

Why it works: Joy isn’t a luxury—it’s fuel. The smallest sparks keep the fire burning when your tank is low.

Fall Doesn’t Have to Mean Fizzling Out

In healthcare, especially in Assisted Living and SNF settings, you’re constantly giving. But you can’t pour from an empty pitcher—or light a fire with wet matches. This season, try picking just one of the ideas above and make it part of your week. Better yet—share it with your team. Sometimes the best way to beat burnout… is to prevent it in the first place.

Why Trauma-Informed Care Matters: A Compassionate Approach to Better Care

Imagine walking into a place that is supposed to be your safe haven, yet something as simple as a sound, a touch, or even a routine procedure triggers deep-seated distress. For many residents in skilled nursing facilities and assisted living communities, this is a daily reality. By adopting trauma-informed care, we can transform caregiving environments into spaces of healing, safety, and trust.

In 2016, the Centers for Medicare and Medicaid Services (CMS) revised their conditions of participation for nursing homes. As part of their regulatory updates, CMS emphasized the importance of trauma-informed care, stating, “Trauma survivors, including veterans, survivors of large-scale natural and human-caused disasters, Holocaust survivors, and survivors of abuse, are among those who may be residents of long-term care facilities. For these individuals, the utilization of trauma-informed approaches is an essential part of person-centered care.” (CMS, 2016)

This means that skilled nursing facilities (SNFs) and assisted living communities (ALFs) must integrate trauma-informed practices into daily operations, ensuring that care is compassionate, sensitive, and avoids re-traumatization. Since many individuals carry experiences of trauma, whether known or unknown to caregivers, a trauma-informed approach is essential in fostering a supportive environment.

What is Trauma-Informed Care?

A trauma-informed care approach recognizes that trauma can have lasting impacts on an individual’s health and behavior. The goal is to create environments that promote healing and prevent further harm by understanding and addressing the effects of trauma. A trauma-informed system:

• Realizes the widespread impact of trauma and understands potential paths for recovery.

• Recognizes signs and symptoms of trauma in residents, families, staff, and others involved.

• Responds by integrating trauma knowledge into policies, procedures, and practices.

• Seeks to actively resist re-traumatization.

Six Key Principles of Trauma-Informed Care

1. Safety – Creating a physically and emotionally safe environment.

2. Trustworthiness & Transparency – Building trust through clear communication.

3. Peer Support – Encouraging a support network among residents and staff.

4. Collaboration & Mutuality – Promoting shared decision-making.

5. Empowerment, Voice, & Choice – Valuing individual preferences and autonomy.

6. Culture, Historical, and Gender Issues – Recognizing the influence of identity and experiences.

Addressing Challenging Behaviors

Residents who have experienced trauma may exhibit behaviors that are difficult to manage. Here are some steps to better understand and respond to these behaviors:

• Identify the purpose of the behavior.

• Anticipate situations that might lead to maladaptive responses.

• Recognize early warning signs and intervene promptly.

• Assess how staff responses may contribute to the resident's behavior.

The 6 W’s of behavior can help caregivers assess and respond effectively:

1. What is happening?

2. Who is involved?

3. Where does the behavior occur?

4. When does the behavior occur (time of day, after certain events)?

5. Why is this behavior happening?

6. What needs to be done?

Common Triggers for Behavioral Distress

• Pain or medication changes

• Unmet basic or social needs

• Boredom or overstimulation

• Desire for personal choice and control

• Misinterpretation of situations or reality

• De-escalation Strategies for Trauma-Informed Care

When responding to residents in distress, consider these trauma-informed de-escalation strategies:

• Show empathy and validate feelings.

• Ensure the resident feels safe, respected, and in control.

• Stay calm, breathe, and lower your voice.

• Use non-threatening language and neutral body language.

• Respect personal space and avoid confrontational postures.

• Listen actively to the resident’s words and emotions.

• Provide options to resolve the issue and move forward.

• Redirect attention to a less stimulating or private space when necessary.

• Offer clear next steps and set compassionate boundaries.

• Recognize that silence can be okay; allow residents time to process.

• Avoid taking negative reactions personally.

CMS Guidelines and Regulatory Requirements

CMS has incorporated trauma-informed care into its regulatory framework for nursing homes. The Phase 3 Requirements of Participation (RoP), effective as of October 24, 2022, include specific guidance on trauma-informed care. Facilities are required to ensure that residents who are trauma survivors receive culturally competent, trauma-informed care in accordance with professional standards, accounting for residents’ experiences and preferences to eliminate or mitigate triggers that may cause re-traumatization (CMS, 2022).

Additionally, CMS has identified several F-Tags related to trauma-informed care proficiency, including:

• F699: Trauma-Informed Care

• F656: Developing and Implementing Comprehensive Care Plans

• F726: Competent Nursing Staff

• F742: Treatment and Services for Mental and Psychosocial Concerns (AHCA/NCAL)

These tags guide surveyors in assessing compliance with trauma-informed care requirements and ensure facilities prioritize residents' emotional and psychological well-being.

A Commitment to Trauma-Informed Care

By integrating trauma-informed care principles into daily practice, skilled nursing and assisted living communities can foster a supportive and healing environment. This approach not only improves resident well-being but also enhances staff satisfaction and overall quality of care.

Implementing trauma-informed strategies ensures that every resident receives care that acknowledges their past experiences and supports their path to healing. Let’s continue to create spaces where residents feel safe, empowered, and comfortable.

Enhancing Staff Engagement, Education, and Satisfaction in Assisted Living and Skilled Nursing Facilities

By: Sharon Stiegler, RN IP RAC-CT ALA, Regional Director for Advanced Health Institute 

The heart of every assisted living and skilled nursing facility is its staff. Engaged, educated, and satisfied healthcare workers create a positive environment for residents and improve overall care quality. With workforce shortages and burnout on the rise, facilities must adopt innovative strategies to enhance staff well-being and professional growth. Here’s how: 

1. Prioritize Continuing Education and Professional Development 

Investing in staff education boosts confidence and job satisfaction while improving patient outcomes. According to a 2023 study published in The Journal of Nursing Administration, organizations that offer structured learning opportunities see a 15% increase in staff retention rates (Smith & Turner, 2023). 

Actionable Steps: 

• Provide tuition reimbursement or scholarships for certifications in geriatric nursing and infection prevention. 

• Host in-service training and workshops with interactive case studies. 

• Implement mentorship programs where seasoned nurses support new hires. 

2. Foster a Culture of Recognition and Appreciation 

Employees who feel valued are more likely to stay engaged. A Gallup survey found that organizations with strong recognition programs experience a 21% increase in productivity (Gallup Workplace Report, 2022). 

Ways to Recognize Staff: 

• Implement “Employee of the Month” programs with meaningful rewards. 

• Celebrate small and large achievements, from resident success stories to work anniversaries. 

• Encourage peer-to-peer recognition through internal newsletters or meetings. 

3. Enhance Work-Life Balance and Mental Health Support 

Burnout and stress are major contributors to high turnover in healthcare settings. A report from the American Nurses Association emphasized that facilities prioritizing mental health support saw a 30% decrease in staff absenteeism (ANA, 2023). 

Strategies to Promote Work-Life Balance: 

• Offer flexible scheduling options to accommodate personal needs. 

• Provide access to counseling and employee wellness programs. 

• Encourage breaks and time-off policies to prevent exhaustion. 

4. Strengthen Team Communication and Collaboration 

When staff members feel heard and empowered, they are more engaged. Studies show that facilities with open communication channels experience 25% higher job satisfaction rates (Healthcare Leadership Review, 2022). 

Communication Enhancements: 

• Hold regular staff meetings with an open forum for feedback. 

• Utilize digital platforms for real-time collaboration. 

• Encourage leadership to have an open-door policy. 

5. Leverage Technology to Reduce Workload 

Technology can streamline tasks and reduce administrative burden, allowing staff to focus on patient care. Implementing electronic health records (EHRs) and AI-assisted scheduling has been shown to improve efficiency by 40% in long-term care facilities (Journal of Health Informatics, 2023). 

Technology Implementation Ideas: 

• Adopt automated medication management systems. 

• Utilize mobile apps for instant staff communication. 

• Invest in AI-driven tools for efficient documentation. 

Final Thoughts: Building a Thriving Workforce 

By prioritizing staff engagement, education, and well-being, assisted living and skilled nursing facilities can cultivate a committed, motivated workforce. As healthcare continues to evolve, investing in staff development and satisfaction is not just beneficial—it’s essential. 

“When healthcare professionals feel supported, valued, and equipped, they deliver the best care possible.” (National Institute for Healthcare Excellence, 2023) 

Let’s work together to create workplaces that nurture both our caregivers and the residents they serve. 

Nurse Leadership and Conflict Resolution: A Mindfulness and Yoga Perspective

By: Evangelina "Jazzy" Palacios, BSN, RN 

As a nurse leader who integrates yoga and mindfulness into daily practice, I have witnessed firsthand the transformative impact these disciplines have on managing workplace conflicts. The high-pressure environment of healthcare often gives rise to interpersonal tensions, communication breakdowns, and ethical dilemmas. By embracing mindfulness and yoga, nurse leaders can navigate these challenges with clarity, compassion, and resilience. 

The Role of Mindfulness in Conflict Resolution 

Mindfulness, the practice of being fully present and engaged in the current moment without judgment, enhances self-awareness and emotional regulation. Research indicates that mindfulness is significantly associated with integrative conflict resolution styles among nurse managers. This approach fosters collaborative problem-solving and mutual understanding, essential components in resolving disputes effectively.

Implementing Mindfulness Strategies 

• Mindful Breathing: In moments of tension, focusing on the breath can ground emotions and reduce reactive responses.

• Present-Moment Awareness: Encouraging team members to engage fully in discussions promotes active listening and reduces misunderstandings.

• Non-Judgmental Observation: Approaching conflicts without preconceived notions allows for unbiased assessment and fair solutions. 

Integrating Yoga into Leadership Practices 

Yoga, with its emphasis on physical postures, breath control, and meditation, complements mindfulness by promoting physical and mental well-being. Regular yoga practice has been shown to reduce stress and burnout among healthcare professionals, thereby enhancing their capacity to manage conflicts.

Yoga Practices to Enhance Leadership 

• Asanas (Physical Postures): Incorporating poses that release tension can prepare the body and mind for calm and focused interactions.

• Pranayama (Breath Control): Techniques such as deep diaphragmatic breathing can alleviate anxiety, fostering a composed demeanor during conflicts.

• Meditation: Regular meditation enhances self-awareness and patience, key attributes in effective leadership and conflict resolution. 

Cultivating a Mindful and Cohesive Team Environment 

As nurse leaders, modeling mindfulness and yoga practices can inspire team members to adopt similar approaches, leading to a more harmonious workplace. Educational programs focusing on authentic leadership and mindfulness have demonstrated positive effects on managerial competencies, further supporting the integration of these practices in leadership development.

Strategies for Team Implementation 

• Mindfulness Workshops: Organizing sessions that teach mindfulness techniques can equip staff with tools to handle stress and interpersonal challenges. 

• Group Yoga Sessions: Facilitating regular yoga classes fosters team bonding and collective well-being. 

• Open Communication Channels: Encouraging transparent and empathetic communication nurtures trust and reduces the potential for conflicts. 

Integrating mindfulness and yoga into nurse leadership practices offers a holistic approach to conflict resolution. By fostering self-awareness, emotional regulation, and a culture of open communication, nurse leaders can effectively navigate workplace conflicts, leading to improved team dynamics and enhanced patient care. 

References 

1. Assi, M. D., Eshah, N. F., & Rayan, A. (2022). The Relationship Between Mindfulness and Conflict Resolution Styles Among Nurse Managers: A Cross-Sectional Study. SAGE Open Nursing. https://pubmed.ncbi.nlm.nih.gov/36467312/ 

1. Al-Ghabeesh, S. H., Abu-Snieneh, H., Abu-Snieneh, A., & Abu-Snieneh, A. (2023). Effect of Authentic Leadership and Mindfulness Educational Program on Nurse Managers' Managerial Competencies. BMC Nursing, 22, Article 63. https://bmcnurs.biomedcentral.com/articles/10.1186/s12912-024-01976-z 

1. Alexander, G. K., Rollins, K., Walker, D., Wong, L., & Pennings, J. (2015). Mindfulness-Based Yoga as an Intervention to Manage Stress and Burnout in Nurses: A Systematic Review. Holistic Nursing Practice, 29(5), 231-241. https://journals.sagepub.com/doi/full/10.1177/0898010120921587 

Empathy in Action: The Heart of Healthcare

By: Taylor Brown, RN, Client and Operations Specialist for Advanced Health Institute 

In the fast-paced world of healthcare, it’s easy to get caught up in the technical aspects of our work—medications, diagnoses, care plans, and administrative duties. But at the heart of our profession is something that transcends all these critical elements: empathy. It’s the foundation upon which we build trust with our patients, families, and teams.

As healthcare professionals, we are often the first people patients turn to during their most vulnerable moments. Whether it’s delivering difficult news, guiding them through recovery, or supporting families, our role extends far beyond clinical care. Empathy is the bridge that connects our technical knowledge with the human element of our profession, allowing us to provide care that truly heals—physically and emotionally.

Why Empathy Matters

Studies show that when healthcare providers practice empathy, patient outcomes improve significantly. Patients who feel heard and understood are more likely to follow through with treatment plans, communicate openly, and experience better overall satisfaction with their care. But empathy isn’t just beneficial for patients; it’s also a crucial element of a supportive, collaborative team culture. When we lead with compassion, we create an environment where colleagues feel valued and understood, which can reduce burnout and enhance team performance.

Practical Ways to Cultivate Empathy

• Active Listening: It sounds simple, but truly listening to our patients and colleagues can make all the difference. Give them your full attention—set aside distractions and focus on understanding their needs, fears, and concerns.

• Mindfulness in Care: Slow down, even for just a few moments, to connect with the person in front of you. A smile, a kind word, or taking a few extra minutes to explain something can go a long way in making patients feel supported.

• Self-Care: Empathy starts with caring for yourself. In a profession where we constantly give to others, it’s important to replenish our emotional reserves. Take time for your mental and physical well-being, so you can offer your best self to those in your care.

A Healthcare Culture of Compassion

We strive to integrate empathy into every aspect of our work. From leadership to front-line care, we believe that compassionate communication fosters trust, resilience, and healing. As we look ahead to the future of healthcare, let’s remember that it’s the human connection that often makes the greatest impact. No matter how advanced our technology or treatments become, the power of empathy will always be at the core of exceptional care.

Work-Life Balance for Healthcare Professionals: A Vital Necessity

Healthcare professionals often face long hours, emotional strain, and physical exhaustion, making work-life balance difficult to achieve. This balance is essential for maintaining their well-being and ensuring high-quality resident care.

The Impact of Imbalance

Work-life imbalance is common in healthcare, leading to higher rates of burnout. The demanding nature of the profession can cause physical and mental fatigue, lower job satisfaction, and even affect resident outcomes.

Strategies for Achieving Balance

1. Set Clear Boundaries: Establish boundaries between work and personal life. When at home, it’s important to disconnect from work-related stress.

2. Practice Self-Care: Self-care is crucial. Healthcare workers should prioritize exercise, sleep, and mental well-being through activities like meditation or hobbies.

3. Time Management: Efficiently managing time with tools like to-do lists or apps can prevent feeling overwhelmed. Scheduling regular breaks is also important.

4. Seek Support Systems: Surrounding oneself with a support network of friends, family, or colleagues helps manage stress and creates a positive environment.

5. Leverage Flexibility: Whenever possible, advocate for flexible scheduling options like telemedicine or part-time work to better manage personal and professional life.

The Role of Employers

Healthcare employers should provide adequate resources, time off, and manageable workloads to support their staff’s well-being, improving both job satisfaction and resident care.

Work-life balance is essential for healthcare professionals, enhancing both personal well-being and resident care. By setting boundaries, practicing self-care, and seeking support, professionals can maintain a healthier, sustainable career.

The Importance of Vaccinations: Protecting Our Health and Our Communities

Vaccinations are one of the most critical tools we have in modern healthcare. From eradicating smallpox to drastically reducing cases of polio, vaccines have been instrumental in saving lives and preventing the spread of deadly diseases. Yet, despite their proven success, the importance of vaccinations remains a topic of public discussion. In this blog, we’ll revisit the vital role vaccines play in both individual and community health.

Why Vaccines Matter

At their core, vaccines train the immune system to recognize and fight off harmful pathogens without causing illness. This protective immunity is crucial for preventing the onset of severe diseases such as measles, influenza, hepatitis, and now COVID-19. Vaccines significantly reduce the chances of contracting these infections and can lessen the severity of symptoms if a person does get sick.

For healthcare professionals, ensuring that patients understand the safety and necessity of vaccines is paramount. Vaccinations help keep preventable diseases at bay, which in turn reduces the strain on our healthcare system, lowers healthcare costs, and protects vulnerable populations such as the elderly, newborns, and those with compromised immune systems.

Herd Immunity: A Community Effort

When a significant portion of the population is vaccinated, it creates what is known as "herd immunity." This form of protection helps to prevent the spread of disease within a community, especially safeguarding individuals who cannot receive certain vaccines due to medical reasons. Herd immunity can effectively stop the chain of transmission, reducing outbreaks and limiting the spread of infectious diseases.

Without widespread vaccination, highly contagious diseases can return quickly, as seen with the resurgence of measles in certain parts of the world. It’s crucial to remember that diseases eradicated in some countries may still exist in others, and international travel can reintroduce them if immunity levels drop.

Looking to the Future

Vaccines are not only essential for controlling diseases we’ve already encountered but also for addressing new and emerging health threats. Research into new vaccines continues to evolve, offering hope for protecting future generations from diseases that currently have no cure or prevention.

As we move forward in the fight against infectious diseases, let’s continue to advocate for vaccinations. They are not just an individual choice; they are a collective responsibility that saves lives, protects communities, and ensures a healthier future for all.

Press: Transforming Long-Term Care with Technology (Eldercare Review Article)

AHI’s very own Christopher Blomquist contributed an excellent article for Eldercare Review. Christopher is AHI’s Regional Director for Skilled Nursing Services & VP of Clinical AI Strategy at DOVAXIS.

“AI systems have the potential to serve as personal assistants to streamline the process of gathering and organizing essential health information. This technology could empower individuals to make informed decisions quickly by providing instant access to all relevant data they need to provide safe and effective care.”

Read More: Transforming Long-Term Care with Technology (eldercarereview.com)

Addressing Violence Towards Healthcare Workers in Assisted Living Settings

by Heidi LaMeyer, RN, LALD, Regional Director at AHI

Violence against healthcare workers has been on the rise, particularly in assisted living settings where staff often work alone or with minimal support. This trend has severe implications for both the physical and mental well-being of healthcare professionals and the quality of care they provide. This post explores recent data on this issue, strategies for coping, and methods for ensuring safety and self-defense.

Current Trends and Statistics

Recent reports indicate a significant increase in workplace violence experienced by healthcare workers. The National Nurses United (NNU) survey found that 81.6% of nurses experienced at least one type of workplace violence in the past year, with nearly half reporting an increase in such incidents. Factors contributing to this rise include patient frustration, mental health issues, and the aftermath of the COVID-19 pandemic​ (National Nurses United)​​ (AAMC)​.

Strategies for Coping and Safety

Training and Education: Providing regular training on de-escalation techniques and self-defense can equip staff to handle violent situations effectively. Programs like the Behavioral Escalation Support Team (BEST) at UC Davis Medical Center have shown success in calming aggressive patients through trained mental health care providers​ (AAMC)​.

Safety Protocols: Implementing strict safety protocols, such as flagging systems for aggressive patients and controlling access to certain areas, can help protect staff. For example, Boston Medical Center uses electronic records to flag patients with a history of aggression, allowing staff to take preventive measures​ (AAMC)​.

Support Systems: Ensuring that there is always a mechanism for staff to call for help, such as panic buttons or quick-response security teams, can enhance safety. The Occupational Safety and Health Administration (OSHA) emphasizes the importance of management leadership and employee participation in hazard identification and control​ (CDC Blogs)​.

Environmental Design: Modifying the physical environment to minimize risk, such as securing furniture that could be used as weapons and ensuring clear escape routes, can reduce the likelihood of harm during violent episodes​ (World Health Organization (WHO))​.

Self-Defense and Mental Health Support

Self-Defense Training: Offering self-defense courses tailored to healthcare settings can empower workers to protect themselves without escalating the situation.

Mental Health Resources: Providing access to counseling and mental health support for workers who experience violence can mitigate long-term psychological impacts. Organizations should prioritize the mental well-being of their staff, recognizing that violence can lead to burnout and decreased job satisfaction​ (World Health Organization (WHO))​.

Legislative Support: Advocating for stronger legal protections and support for healthcare workers is crucial. The proposed Safety from Violence for Healthcare Employees Act aims to increase penalties for assaults on healthcare workers, providing a safer working environment​ (AAMC)​.

Conclusion

Violence in healthcare settings, particularly in assisted living facilities, is a pressing issue that requires a multifaceted approach. By implementing comprehensive training, strict safety protocols, robust support systems, and advocating for legislative changes, we can create a safer environment for healthcare workers. It is essential to prioritize the physical and mental well-being of these professionals to ensure they can continue to provide high-quality care.

For more detailed information, you can refer to the original reports and articles from the National Nurses United, CDC, and other sources mentioned in this post.

New Requirements for Facility Assessment in Long-Term Care Facilities: What Leaders Need to Know

The Centers for Medicare & Medicaid Services (CMS) have implemented new regulations under §483.71, Facility Assessment, as part of the final rule on Minimum Staffing Standards for Long-Term Care (LTC) Facilities and Medicaid Institutional Payment Transparency Reporting. These changes, effective August 8, 2024, bring significant updates that long-term care leaders must understand and integrate into their operational strategies.

Key Changes in Facility Assessment Requirements

Comprehensive Evaluation of Resident Population.

The new regulations mandate a thorough evaluation of the resident population, including:

• Resident Count and Capacity: Detailed accounting of the number of residents and the facility’s capacity.

• Care Needs: Assessment of the types of diseases, conditions, physical and cognitive limitations, and overall acuity. This evaluation must be evidence-based and data-driven.

• Staff Competencies: Determining the skills and competencies required to meet the care needs of the resident population.

• Physical Environment and Equipment: Identifying necessary physical space, equipment, and other resources.

• Cultural and Religious Considerations: Including activities and food services tailored to the diverse needs of residents.

Annual and As-Needed Updates

Facilities must conduct and document these assessments at least annually and whenever there is a significant change in the resident population or other circumstances that could affect the assessment. This ensures that the assessment remains current and reflective of the actual needs and resources required.

Active Involvement and Input

To ensure a complete and accurate assessment, the facility must involve key personnel in the assessment process:

• Leadership and Management: Including members of the governing body, medical director, administrator, and director of nursing.

• Direct Care Staff: Such as RNs, LPNs/LVNs, and nursing assistants.

• Resident and Family Input: Soliciting feedback from residents and their families to inform the assessment.

Utilizing the Facility Assessment

The facility assessment should directly inform various operational aspects:

• Staffing Decisions: Ensuring sufficient staffing levels and appropriate competencies to meet residents’ needs.

• Resource Allocation: Identifying and planning for necessary physical, technological, and service resources.

• Contingency Planning: Preparing for events that could impact resident care without activating the emergency plan, such as staffing shortages.

Compliance and Survey Procedures

Surveyors will continue to assess compliance with staffing requirements. Even if a facility meets the assessment requirements, it may still be cited for noncompliance if resident needs are unmet due to insufficient staffing. Therefore, it is crucial that the facility assessment accurately reflects and addresses staffing and resource needs.

Preparing for the New Requirements

As leaders in long-term care, it is imperative to take the following steps to ensure compliance with the new facility assessment requirements:

1. Review and Update Policies: Ensure all facility policies align with the new regulations.

2. Conduct Thorough Assessments: Implement a detailed and data-driven approach to evaluating resident needs and resources.

3. Engage Key Stakeholders: Involve leadership, staff, residents, and families in the assessment process.

4. Regularly Update Assessments: Maintain an ongoing process for updating the facility assessment as required.

5. Train Staff: Educate staff on the new requirements and their role in the assessment process.

By proactively adapting to these changes, long-term care facilities can ensure they provide high-quality care that meets the needs of their residents while maintaining compliance with CMS regulations.

Resources for Further Information

For more detailed information, visit the CMS website and review the updated State Operations Manual (SOM), Appendix PP.

By staying informed and prepared, long-term care leaders can navigate these regulatory changes effectively, ensuring continued excellence in resident care.

Key Focus Areas for a Nursing Home Administrator

Running a nursing home requires balancing multiple priorities to ensure the well-being of residents, the satisfaction of staff, and the efficiency of operations.

Resident Care and Quality of Life

The primary responsibility of a nursing home administrator is to ensure that residents receive quality care that enhances their well-being. This involves:

• Personalized Care Plans: Developing individualized care plans that cater to the specific needs of each resident.

• Health and Safety: Implementing health and safety protocols to prevent infections and ensure a safe environment.

• Engagement and Activities: Providing a variety of activities and social opportunities to keep residents engaged and active.

Staff Management and Development

Well-trained and motivated staff are essential for delivering high-quality care. Administrators should prioritize:

• Recruitment and Retention: Attracting and retaining skilled nursing staff and support personnel.

• Training and Development: Offering ongoing training to keep staff up to date on best practices and regulatory requirements.

• Work Environment: Creating a positive and supportive work environment to reduce turnover and improve job satisfaction.

Regulatory Compliance

Nursing homes must adhere to strict regulations and standards. Administrators must ensure compliance with all local, state, and federal requirements by:

• Staying Informed: Keeping up to date with changes in laws and regulations that affect nursing home operations.

• Documentation and Reporting: Maintaining accurate records and submitting required reports to regulatory authorities.

• Inspection Readiness: Preparing for and managing inspections and audits to ensure the facility meets all regulatory requirements.

Financial Management

Effective financial management is crucial for the sustainability of a nursing home. Administrators should focus on:

• Budgeting: Developing and managing budgets to ensure financial stability and the ability to invest in quality improvements.

• Cost Control: Implementing cost-control measures without compromising the quality of care.

• Revenue Management: Ensuring accurate billing and maximizing revenue through efficient management of insurance claims and payments.

Community and Family Relations

Building strong relationships with residents' families and the local community is essential for the reputation and success of a nursing home. Administrators should:

• Communication: Maintain open and transparent communication with residents’ families about care plans, changes, and any concerns.

• Family Involvement: Encourage family involvement in residents' lives and care plans.

• Community Outreach: Engage with the local community through events, partnerships, and volunteer programs.

A successful nursing home administrator must balance the needs of residents, staff, regulatory requirements, and financial realities. By focusing on these key areas, administrators can create a supportive, safe, and high-quality environment for all residents.

Trauma-Informed Leadership for Dietary Staff

by Mistin M Warkenthien, CDM, CFPP, CFPM 

In the dynamic world of long-term care facilities, dietary staff are essential in promoting the health and well-being of residents. However, these teams often grapple with challenges like managerial turnover and insufficient guidance, sometimes leaving them to manage on their own. Such circumstances can lead to what we might call 'managerial trauma,' affecting staff morale and eroding the effectiveness of team management.

As consultants, we've encountered numerous dietary crews facing these very issues. Our experiences have reinforced the value of trauma-informed leadership—a strategy that pivots from punitive oversight to fostering a culture of support and understanding. Grounded in principles like safety, trustworthiness, choice, collaboration, and empowerment, this leadership style acknowledges and mitigates the impact of stress and trauma on staff.

The Role of Supportive Leadership

Emphasizing supportive leadership in the kitchen is crucial. This approach is not merely about being agreeable; it's about genuinely understanding the challenges staff face and addressing them with empathy and respect. Such leadership has consistently proven effective, enhancing job satisfaction, reducing turnover, and ensuring the delivery of high-quality meals to residents. It demonstrates that understanding and respecting staff is fundamental to maintaining a high-functioning care home.

Implementing Kind Leadership: Our Approach

Through our consulting work, we've applied several key strategies to promote kind leadership:

• Engage in Open Communication: Encouraging leaders to regularly engage with their team, fostering a culture where staff feel comfortable sharing their experiences and challenges.

• Provide Training and Support: Identifying areas where the team needs additional support and offering targeted training and guidance to address these gaps.

• Recognize and Appreciate Efforts: Showing appreciation for the hard work and dedication of the staff, making them feel valued and motivated.

• Foster a Positive Work Environment: Creating an enjoyable and positive workplace that encourages team cohesion and individual satisfaction.

• Establish Clear and Fair Expectations: Setting understandable, transparent expectations and policies, while also being mindful of the team's past experiences with autonomous operation due to leadership voids.

Witnessing Transformation Across Environments

Our approach, grounded in trauma-informed leadership practices, has yielded positive outcomes in practically every environment we've encountered. By addressing and healing from managerial trauma, teams become more cohesive, the quality of service improves, and the overall atmosphere of facilities becomes more positive. This transformation underscores the effectiveness of balancing kindness with accountability and high standards.

Embracing Change with AHI's Support

At AHI, we deeply value the principles of trauma-informed leadership and understand the transformative impact it can have on long-term care facilities, especially within the dietary department. Our firsthand experiences across various environments have shown us the effectiveness of this approach in healing managerial trauma and fostering a positive, productive workplace culture.

We're committed to supporting facilities in embracing this change, offering a range of services tailored to the unique needs of each environment.

Our Services Include:

• Interim Leadership: Providing experienced leaders who can step in temporarily to stabilize and guide your team through transitions, implementing trauma-informed practices along the way.

• Support Leadership: Offering ongoing leadership support to help your existing managers adopt and refine trauma-informed leadership skills, ensuring they can effectively lead and nurture their teams.

• Culture Change: Assisting in the transformation of your workplace culture to one that is rooted in the principles of trauma-informed care, fostering an environment of safety, trust, and empowerment.

• Remote Morale Support: Offering remote support to boost team morale, address challenges, and provide guidance on maintaining a positive and supportive work environment.

At AHI, we walk the walk. Our approach is not just about providing interim solutions; it's about instilling lasting changes that enhance the well-being and satisfaction of staff, which in turn, improves the quality of care for residents. We've witnessed the positive impact of thoughtful leadership on staff morale and performance, and we're here to help you achieve these outcomes in your facility.

Let's Partner for Positive Change

If you're ready to transform your dietary department—or any area of your long-term care facility—into a more supportive, effective, and compassionate workplace, AHI is here to help. Together, we can create environments where staff thrive, residents receive the best possible care, and the entire community benefits.

Contact us today to learn how we can support your journey towards implementing trauma-informed leadership and fostering a culture of care that reflects the values and excellence of your facility.

Nebulizer use in the Long-Term Care Setting

To use a nebulizer or not to use a nebulizer, that is the question! 

The recent past- 

During Covid, Long Term Care (LTC) clinical staff often switched residents from a nebulizer treatment to a metered-dose inhaler with a dedicated spacer. The rationale being that we would be reducing infectious respiratory aerosols. Now we are past the Covid Pandemic yet many of our residents remain on inhalers when they might be better served with a nebulizer treatment.  

Why the switch- 

The recommendation for the switch came from various sources but one source could be found on the MN Dept of Health website which has since been retired. The recommendations from the website included considerations to minimize transmission risk from nebulizers. This included the suggestion of utilizing a metered-dose inhaler with a dedicated spacer to reduce residents and staff exposure to infection. The document also included identification of Aerosol Generating Procedures or AGPs and considerations to minimize transmission risks.  

So where are we now- 

In a nutshell, residents with Asthma and COPD are less likely to tolerate inhalers. In fact, an inhaler often triggers coughing which can increase the risk for exposure to respiratory infections. It is imperative that we assess each resident individually and provide the best treatment possible. During the peak of Covid facilities often resorted understandably to removing almost all the nebulizer treatments which was not the intention of CDC or the Mn Dept of Health.  

What do we do now- 

If SARS or Covid infection is not suspected in a resident presenting for care (based on symptom and exposure history) the health care professional should follow Standard Precautions (and Transmission-Based Precautions if required based on the suspected diagnosis).  

For a resident with suspected or confirmed COVID staff should wear all PPE as indicated per the CDC guidance. And as always we close the door while administering the treatment not only for privacy but also for containment.  

Facilities should determine if they have any Aerosol Generating Procedures and have a policy that guides the staff when performing these procedures. An example would be open suctioning of airways, CPR and manual ventilation and CPAP/BIPAP. Guiding staff on what PPE should be utilized is key.  A reference tool for this can be found at cdc.gov Respiratory Virus Toolkit. 

In summary- 

Please consider reviewing the residents within your care that are at risk, such as those with Asthma and COPD and assure that an individualized assessment is updated. It is important that if the resident would benefit from a nebulizer treatment regime that they be allowed to have a nebulizer treatment. If there is a concern with a SARS or Covid infection, we will utilize Transmission Based Precautions which is what we are already doing.  We are back to a new normal. I hope this clears up some of the confusion and removes the barriers to providing nebulizer treatments for those in need. 

Lynn Fossen RN, VP | Advanced Health Institute 

From Bland to Grand: The Purée Revolution

by Mistin M Warkenthien, CDM, CFPP, CFPM 

Food is more than just fuel for our bodies; it's a source of joy, comfort, and connection. In long-term care environments, where individuals may rely on puréed diets for extended periods, the quality and flavor of these meals take on an even greater significance. Serving flavorful, carefully prepared puréed dishes can profoundly impact residents' quality of life, offering not just nutritional sustenance but also emotional and psychological benefits. I remember in high school, being silly with friends, when I decided to try baby food. How many of you have ventured into the baby food aisle as adults, curious about the taste? Let me tell you, it's like eating flavored water, with the faintest hint of what it's supposed to be—and it's awful! This experience made me wonder, why are we serving such bland fare to our elders or anyone in need of a puréed diet? Puréed food can and should be as delicate, flavorful, and gourmet as any other type of cuisine. After all, TMD stands for texture modified diet, not taste modified diet. We must not overlook the potential of puréed foods to be rich and satisfying, just like any other meal.

The Importance of Flavorful Purée Food:

Eating is one of life's greatest pleasures and a fundamental experience that should bring joy to everyone, including those on a purée diet. Ensuring that purée food is both flavorful and nutritious is not just about meeting dietary needs; it's about respecting the dignity of every diner. The joy of eating well extends beyond the palate, touching on mental and emotional well-being. Here are the key benefits of making puréed food flavorful:

• Dignity: High-quality meals respect the dignity of all diners, regardless of their dietary restrictions.

• Enjoyment: Flavorful food enhances the enjoyment of eating, making meals something to look forward to.

• Well-being: A tasty meal can brighten the day and positively impact mental and emotional health.

• Comfort: Good food offers comfort, reminding individuals of the joy of eating and the pleasures it can bring.

• Sense of Normalcy: Flavorful dishes help maintain a sense of normalcy and inclusion in social settings.

• Connection: Meals prepared with care can express love and foster a deeper sense of connection between the diner and the caregiver.

• Better Nutrition: When food is appetizing, individuals are more likely to consume the necessary nutrients for their health.

Basic Principles of Making Tasty Purée Food:

Creating tasty purée food that delights everyone involves a careful balance of flavors to ensure that the puréed version mirrors the dish being served to the rest of the diners. It's essential that a puréed lasagna, for instance, retains the rich, layered flavors that make the original so beloved. This means adding the same herbs and spices used in the traditional recipe and being mindful not to dilute these flavors with excessive liquid. The goal is to maintain the integrity of the dish's taste, ensuring that each purée offers a true reflection of its namesake. A key strategy in achieving this is to use complementary liquids judiciously. Adding compatible liquids — such as using milk or butter in potatoes, chicken broth for chicken dishes, or beef broth for beef-based meals — enhances the natural flavors without overwhelming them. This approach helps in keeping the essence of the original dish intact, making the purée as enjoyable as its solid counterpart. Moreover, thickening liquids to a pudding thick (IDDSI 4) level before blending gives them a cohesive consistency, making the food easier for the blender to process to the desired texture. By carefully managing the consistency, we ensure that the purée is appealing and safe for those on a TMD. Attention to seasoning is paramount, as it brings out the depth and complexity of flavors in puréed foods. Just like in traditional cooking, the right amount of seasoning can elevate a dish from good to great. It's vital to taste and adjust the seasoning, accordingly, striving for a balance that resonates with the original dish's flavor profile.

Puréed Taco Plate:

Transform the vibrant flavors of tacos into a smooth, delightful purée with this innovative recipe. By carefully combining seasoned ground meat, beans, and vegetables, we create a puréed version that encapsulates the essence of a taco night in a format suitable for all dietary needs.

Ingredients:

·  1 lb ground beef or turkey

·  1 can (15 oz) black beans, rinsed and drained

·  1 cup of your favorite salsa

·  2 teaspoons taco seasoning

·  Water or broth as needed

·  Powdered or Gel Thickener

 Instructions:

1.  Prepare a thickened liquid of your choice with the thickener according to directions on the container. We suggest beef broth or tomato juice.

2.  Cook the meat until it is browned. Drain all excess grease and liquid.

3.  Add taco seasoning, salsa, and beans and stir. Let simmer until heated through.

4.  Add all ingredients to a blender blend to a smooth consistency.

5.  Prepare puréed avocado, sour cream, and tomato as toppings.

6.  Plate the purée in a circle to mimic a taco shell, and add the toppings using a pastry bottle for precision.

Tips for Attractive Presentation:

A notable study by Rush University found that individuals on a puréed diet consumed 500 more calories when their food was shaped into simple geometric forms, compared to when it was presented without any distinct shape. This underscores the importance of presentation in encouraging better dietary intake and ensuring that puréed meals are both nourishing and enjoyable.

• Color Contrast: Bright and vibrant purées can significantly enhance the visual appeal of a dish. Utilizing color contrast not only makes the plate more attractive but also stimulates the diner's appetite and interest in the meal.

• Creative Plating: Inspired by the findings from Rush University, shaping puréed food into simple geometric shapes can be both an art and a science. Tools like pastry bags, molds, or squeeze bottles allow for precision and creativity in plating, making meals visually engaging and more likely to be consumed in larger quantities.

• Serving Ware: The choice of dishware plays a crucial role in presentation. Selecting plates that contrast with the purée's color can frame the meal beautifully, enhancing its overall appeal.

Our journey through the world of puréed food reaffirms that texture-modified diets do not have to compromise on taste, nutrition, or visual appeal. From the simple act of enhancing flavors with thoughtful seasoning and the careful selection of liquids, to the artful presentation of dishes that appeal to the senses, we've explored how puréed food can be both a culinary delight and a nutritious necessity.

The Puréed Taco Plate, along with the insights on presentation and serving, illustrates that with a bit of creativity and care, meals can transcend their texture, offering joy and satisfaction to all who partake. The study from Rush University underscores this, showing that the appearance of food significantly impacts consumption and enjoyment, even in its puréed form.

As we conclude, remember that preparing puréed food is an opportunity to express love and care through culinary creativity. Whether you're cooking for someone on a texture-modified diet or simply exploring the vast landscape of culinary textures, the principles of flavor, nutrition, and presentation remain the same. Embrace the challenge, experiment with new recipes, and celebrate the joy of eating in all its forms.

Together, let's continue to break the boundaries of traditional purée perceptions, proving that every dish, regardless of its texture, can be a gourmet experience worth savoring.

Contact Us to learn more about how AHI’s Certified Dietary Manager Consultant Support can help your facility!

Elevating Safety Standards in U.S. Skilled Nursing and Assisted Living Facilities

By Sharon Stiegler, RN RAC-CT ALA IP, Advanced Health Institute Regional Director  

In the ever-evolving landscape of healthcare, the safety and well-being of residents in skilled nursing and assisted living facilities across the United States remains a top priority. The Centers for Medicare & Medicaid Services (CMS) has set forth regulations aimed at enhancing life safety, emergency preparedness, and infection control measures. These steps are designed not only to protect those who call these facilities home but also the dedicated staff who support them daily. 

Recent audits by the US Department of Health and Human Services Office of the Inspector General, including unannounced comprehensive checks at selected facilities, have highlighted a common theme: there's room for improvement in adhering to these critical safety standards. Findings showed notable deficiencies in areas such as fire safety, emergency response plans, and infection prevention, signaling a need for facilities nationwide to bolster their safety protocols. 

The essence of these findings is not to critique but to motivate positive change. The challenges identified—ranging from oversight gaps to the need for more consistent staff training—underscore the importance of collective efforts in raising the bar for safety and preparedness. 

To address these gaps, a collaborative approach is recommended. Facilities are encouraged to take proactive steps towards rectifying identified issues, enhancing staff training programs, and engaging in more frequent and thorough safety audits. This is not just about meeting regulatory requirements but about fostering a culture of continuous improvement and readiness. 

The call to action extends beyond individual facilities; it is a nationwide push towards excellence in care and safety. By embracing standardized training, prioritizing regular audits, and committing to swift corrective actions, the collective goal of safeguarding the health and safety of residents and staff becomes more achievable. 

This journey towards enhanced safety and preparedness in skilled nursing and assisted living facilities is a shared responsibility. Together, through diligence and a commitment to excellence, we can ensure that our facilities are not only compliant with regulations but are also sanctuaries of safety and care for all residents and staff. 

Let this be a reminder of the critical role that safety plays in the quality of care provided. It is an opportunity to reflect, reassess, and recommit to making our facilities the best and safest they can be. Let us unite in this endeavor for the betterment of our communities and the nation. 

Heartfelt Leadership: Empowering Healthcare Teams to Thrive

In the fast-paced world of elderly care, the role of leadership extends far beyond the logistical coordination of care and resources. It encompasses a deep responsibility for nurturing the well-being of healthcare teams, especially those working in high-pressure environments such as skilled nursing and assisted living facilities.

In February, when heart health and themes of love take center stage, it is an opportune moment to reflect on the concept of heartfelt leadership—an approach that emphasizes compassion, support, and connection to empower healthcare teams to thrive.

The Importance of Leadership in Elderly Care

Leadership in healthcare, particularly in elderly care, can make or break the quality of care delivered. Nurses, social workers, and caregivers are on the front lines, facing emotionally and physically demanding situations daily. Without strong and compassionate leadership, the strain of caregiving can lead to burnout, disengagement, and high turnover.

In contrast, leaders who prioritize empathy, active listening, and team well-being create a ripple effect of positivity that not only enhances staff satisfaction but also directly impacts the quality of care residents receive. Heartfelt leadership is about leading with empathy and putting people—both residents and staff—at the center of decision-making. It's a style that encourages open communication, emotional intelligence, and genuine concern for the mental and emotional health of healthcare professionals.

When leaders take the time to understand and support their teams, they foster a culture where staff feel valued, motivated, and equipped to provide the highest standard of care.

Leading with Empathy

Empathy is at the core of heartfelt leadership.

For administrators and nurse managers, demonstrating empathy starts with understanding the unique challenges that staff members face in caring for elderly residents. Whether it’s managing complex medical conditions, providing end-of-life care, or simply handling the daily stressors that come with caregiving, leaders must acknowledge these experiences and respond with compassion.

One of the most effective ways to lead with empathy is through active listening. Healthcare professionals often feel unheard or overlooked, particularly when they are dealing with difficult situations. By taking the time to listen to their concerns, leaders show that they care not just about the work being done, but also about the emotional and mental health of their team. Regular check-ins, both formal and informal, can provide valuable opportunities to hear feedback, identify challenges, and offer support.

Creating a Culture of Support

In any healthcare setting, creating a supportive environment is essential for team well-being. Heartfelt leadership involves building a culture where collaboration, mutual respect, and teamwork are emphasized. When leaders foster a supportive work environment, healthcare professionals feel more connected to one another and to the mission of providing quality care for residents.

One way to create this culture is through peer recognition programs, where team members are encouraged to acknowledge and celebrate each other’s successes. Recognition can come in the form of monthly awards, shout-outs during team meetings, or even a simple thank-you note. These small acts of appreciation go a long way in boosting morale and reinforcing the idea that every team member’s contribution is valued.

Another aspect of a supportive work culture is ensuring that staff have access to the resources they need to succeed. This could involve professional development opportunities, such as training on new care techniques, or providing mental health resources to help staff manage stress and avoid burnout. By investing in their team’s growth and well-being, leaders show that they are committed to their success.

Empowering Through Appreciation

A key component of heartfelt leadership is showing appreciation for the hard work and dedication of healthcare professionals. Acknowledging their contributions not only boosts morale but also strengthens their sense of purpose and belonging. Staff who feel appreciated are more likely to stay engaged, be proactive in their roles, and go above and beyond for the residents they care for.

Simple gestures of appreciation—like personalized thank-you notes, public recognition in staff meetings, or even organizing events such as team lunches—can create a lasting impact.

During February, in particular, leaders can incorporate the theme of love and care into these gestures, perhaps by organizing a Valentine’s Day appreciation event for the team. Small tokens of gratitude, like heart-shaped cards or a personalized message, can remind staff that they are valued and respected.

Leading by Example

Finally, heartfelt leadership requires leaders to model the behaviors they wish to see in their teams. This includes maintaining a positive attitude, demonstrating resilience in the face of challenges, and showing respect and kindness to all team members. Leaders who lead by example create a culture where staff feel encouraged to follow suit, resulting in a more harmonious and supportive work environment. Moreover, leaders who prioritize self-care set an important precedent for their teams.

In healthcare, where burnout is common, it is crucial for leaders to practice what they preach when it comes to work-life balance. By taking time to rest, recharge, and focus on their well-being, leaders send a powerful message that self-care is not only acceptable but necessary.

In elderly care, where the stakes are high and the work is emotionally demanding, heartfelt leadership can make a world of difference. By leading with empathy, creating a culture of support, showing appreciation, and modeling positive behavior, administrators and nurse managers can empower their healthcare teams to thrive.

In February, a time when we focus on love and heart health, it’s a fitting reminder that leadership is about more than just managing tasks—it’s about caring for the hearts and minds of those who care for others.

When healthcare professionals feel supported and valued, they are better equipped to provide the compassionate, high-quality care that residents deserve.

Empathetic Care in the Clinical Setting

By Kyle Svee, COO & VP of Strategy

Consistent demonstration of empathy towards residents is among the strongest predictors associated with positive resident outcomes, including resident satisfaction and health-related outcomes. Showing empathy is a critical method of providing individualized care that takes a plethora of unique resident needs into consideration, therefore improving the overall quality of care. There are three primary branches of affective resident empathy: cognitive, behavioral and affective. Cognitive empathy shows interpersonal sensitivity and shows effective verbal and nonverbal communication which allows a staff member to get to know a resident on a deeper level and helps to foster comfort and demonstrates kindness. Behavioral empathy involves staff members demonstrating sensitivity and resident advocacy to help to alleviate pain and improve overall health. Affective empathy is shown by staff members recognizing residents as individual people and not as generalized “customers of the facility.” Nonverbal communication can be related to body positioning, eye contact, and active listening between residents and caregivers. Verbal communication can be added by mirroring resident communication, recognizing resident feelings or moods, and by asking questions to clarify resident wants and needs. Ultimately, demonstrating empathy and effective communication skills empowers healthcare staff to positively impact resident satisfaction. 

Healthcare staff can demonstrate empathetic resident care while listening to residents, providing verbal and nonverbal communication, as well as delivering a high level of individualized advocacy and good quality resident care. Maintaining resident empathy may lead to a syndrome called “compassion fatigue”, which is a type of physical, emotional, and psychological exhaustion that caregivers and healthcare staff often experience while delivering individualized empathetic resident care. Compassion fatigue may result in the caregiver and healthcare staff experiencing withdrawal, irritability, disillusionment, and moodiness. Healthcare staff exhibit a high level of compassion every day while on the job and this can contribute to “burn out.” Prevention of “compassion fatigue” and “burn out” can be alleviated by staff and caregivers providing self-care; developing hobbies, speaking to supportive people who understand their struggles, getting plenty of sleep, reading, exercising, and conducting healthy lifestyle choices. Traumatic events, minus any private health information, may be discussed with a trusted friend, co-worker, or professionals and this can greatly reduce pent up stress and frustrations. 

For some healthcare staff empathy does not always come naturally; however, empathy can be developed like any other skill. Two ways to improve caregiver empathy while on the job include practicing mindfulness or meditation and finding a strong caregiver support system among your co-workers. Mindfulness is demonstrated by making sure that you are aware of what you are doing, where you are, and what you are feeling. This helps lead the person to acceptance. Healthcare facilities can help to alleviate burn out and compassion fatigue by developing a positive workplace environment, consisting of supportive coworkers, and ensuring that staff members take appropriate breaks to recharge and reinvigorate. Demonstration of empathy has tremendous benefits for positive resident care experience and rewarding feelings of accomplishment and caregiving for healthcare workers. For these reasons it is imperative that efforts and methods to maintain consistent expression of empathy towards residents are standardized.

Best Practice Narcotic Control in Assisted Living Settings

By Heidi LaMeyer, RN, LALD - Regional Director of Assisted Living - MN  

Assisted living facilities provide care for elderly or disabled individuals who may require assistance with activities of daily living. One of the most critical aspects of care in these facilities is narcotic control. Narcotics are prescription medications that have a high potential for abuse and addiction and can cause serious harm if misused or mishandled. In this blog post, we will discuss best practice approaches to narcotic control in assisted living settings, including strategies to prevent diversion of these medications. 

Shift to Shift Counts 

One of the best practice approaches to narcotic control in assisted living settings is shift-to-shift counts. At the beginning and end of each shift, staff members should conduct counts of narcotics to ensure accuracy and accountability. Any discrepancies should be immediately reported and investigated. This approach ensures that the facility is aware of the total number of narcotics in their possession at any given time and can help prevent diversion by ensuring that all medications are accounted for. 

Double Signatures and Witness on Administration 

Another best practice approach to narcotic control is double signatures and witness on administration. Whenever possible, narcotics should be administered by two authorized staff members who sign off on the medication administration. This approach ensures that there is a second person to verify that the medication is being given to the correct resident and in the correct dosage. It also helps to prevent diversion by ensuring that the medication is not being misused or diverted by a single staff member. In addition, having a witness present during administration can help to further reduce the risk of diversion. 

Bound Narcotic Logbooks 

Bound narcotic logbooks are another best practice approach to narcotic control in assisted living settings. Staff members should keep a record of all narcotics dispensed, including the resident's name, medication name, dose, and date and time of administration. These logs should be signed by both staff members and witnessed, if possible, to confirm the medication administration. This approach provides a clear record of all medication dispensing and ensures that the facility can track and monitor the use of narcotics. 

Double Lock Storage 

Narcotics should be stored in a secure location accessible only to authorized staff members. One of the best practice approaches to narcotic control in assisted living settings is to use double lock storage. This means that the storage area should have two locks to ensure additional security. Access should be granted only by key or code. 

In conclusion, narcotic control in assisted living settings is essential for the safety and well-being of residents. Best practice approaches to narcotic control include shift to shift counts, double signatures and witness on administration whenever possible, bound narcotic logbooks, and double lock storage. These strategies can help to prevent diversion of narcotics and ensure that residents receive the care they need. It is important to train staff members on these best practice approaches and ensure that they are following them consistently to minimize the risk of diversion.