By Cody Montgomery, President, Nicoya Health & Lifestyle Management

I watched Susan, an old acquaintance, interact with her trainer on the gym stretch mat as they were preparing for an exercise session. After struggling with her weight and diabetes by herself, Susan had finally taken that difficult step of asking someone for help. She overcame her fear of stepping out into an uncomfortable environment and entrusting her well-being to someone else. I was pretty excited in that moment, as I knew how hard it must have been, until I moved my focus to her trainer. “Mike,” as we will call him, was not the best representation of a healthy lifestyle, often drinking sugary sodas and smoking cigarettes in between appointments. Although he sometimes spoke to Susan about living a healthy lifestyle, he didn’t heed his own advice, making it difficult for Susan to learn by example.

There seems to be a similar problem brewing within senior living staff members. We know that staff shortage and wage pressures are currently wreaking havoc among post-acute care and senior living providers, and of the significant impact of turnover on business, yet little attention has been paid to a key problem: employee well-being. The frontline staff who take care of patients are well known for their dedication and selflessness, but in a recent survey, 18 percent of nurses indicated they struggle with depression (Zavotsky, Ciccarelli, Pontieri-Lewis, Royal, & Russer, 2016).

Employees in the senior living industry have been on a health decline for many years. A recent survey of senior living providers by Willis Towers Watson for Argentum revealed an average obesity rate of 30 percent, and hypertension, tobacco use, blood glucose, and diabetes rate at around 20 percent. This is only the tip of the iceberg; when we get involved with the employees and listen to their stories, we hear the financial impact of having to pay for medications and the stress this has brought upon them and their families. This can cause more employees to seek extra or other employment in order to pay higher medical bills and medication costs, increasing turnover.

>>Sign up for our enewsletter today and get more helpful insights!<<

The good news is that many senior living providers are offering wellness programs to offset these negative effects. Yet, with a limited interest and engagement, it is hard to see any real results. So, what gives?

What if I told you that there would be a way to increase employee well-being, but it would mean a different approach; one that reframes a core cultural norm that exists at most, if not all, senior living communities? Changing a mindset that has driven an industry is difficult, but maybe the new issues around employees will turn the tide.

What mindset am I describing? It goes something like this, “residents first, always.” Changing this mindset is possibly the key to increased employee and resident well-being. If the employees can be retrained to see themselves on the same health continuum as the residents they serve, we may begin making progress towards increased well-being among senior living employees.

The power of combining employee and resident well-being can be profound. Behavioral science tells us that a person learns by observing the behavior of others and the consequences of that behavior. This is called vicarious learning, and you see it all around you throughout the day. Susie watches Johnny touch the hot stove and reel in pain. Susie now knows not to touch the hot stove without having to touch it herself!

In a similar fashion, by understanding that employees and residents are on the same well-being continuum, and combining employee and resident well-being programming, you are harnessing a powerful engagement tool. Nurse Veronica demonstrates her commitment to walk more by telling her resident Mary, showing her, sharing her progress and inviting her to join. Mary sees the benefits that Veronica is enjoying due to her commitment, which knocks down her preconceived barrier that walking was useless, and gives it a try. The specific behavior is not what is important but rather the engagement from the employee and the resident in their own well-being.

What other benefits can this lead to? Increased relationships and trust between staff and residents, improved morale, enhanced engagement in well-being, happier staff, and improved culture. Soon, a culture of well-being is born where engagement in well-being is shared among employees and staff. True culture shifts are not built by offering programs only to some, but rather to all. If leaders truly see employees and residents as the key stakeholders within the organization, then it only makes sense to offer the programming to all.

This shift will obviously be different for each senior living community, but below are a few key starting points from our manual, The Nicoya Lifestyle: Creating, Implementing and Sustaining a Culture of Well-being in Your Senior Living Community

  • Needs Analysis
    • Determine the needs and interests of both employees and residents through surveys and/or focus groups
    • Environmental audit
    • Messaging audit
  • Strategize
    • Determine budget
    • Develop communication plan
    • Launch event planning
    • Determine metrics to be measured
    • Develop incentive or reward plan
  • Program Design
    • Educational trainings
    • Launch event
    • Program (intervention)
  • Implementation
    • Launch according to plan
  • Evaluation
    • Gather feedback and results at certain intervals

Remember my story of Susan and “Mike” the trainer? No one would want to follow someone who isn’t living by the advice they give others. Susan cannot vicariously learn about how to walk the walk from him, she can only listen to his words and determine if she is willing to be brave enough to try what he is telling her to do. In the same way, I believe residents want to learn and see staff engaging in their own well-being. Then, when the invitation to join them comes, barriers have been removed. There is power in combining employee and resident well-being and maybe it is time to embrace the mindset that we are all on the same continuum.

Works Cited
Argentum/Willis Towers Watson. State of the Industry 2016. Alexandria: Argentum, 2016. Web.
Zavotsky, K.E., Ciccarelli, M., Pontieri-Lewis, V., Royal, S., & Russer, E. (2016). Nursing Morbidity and Mortality. Clinical Nurse Specialist, 30(3), 167-171. doi: 10.1097/nur.0000000000000205


About the Author

Since 2013, Nicoya Health & Lifestyle Management “has been serving the senior living community by creating innovative and customized strategies that deliver measurable health and well-being improvement for employees, residents and the communities at-large.”

For more information about Nicoya Health & Lifestyle Management, please visit their website, follow them on twitter @NicoyaLifestyle or email info@nicoyalifestyle.com. To learn more about how Love & Company works with organizations like Nicoya to promote health and wellness in senior living, please contact Tim Bracken at 410-207-0013 or Rick Hunsicker at 214-906-3801.

Share This