Lori Alford, co-founder and chief operating officer of Avanti Senior Living in Houston, and Adam Kaplan, founder and CEO of Solera Senior Living in Denver, are thinking a lot about the health and well-being of their senior team members these days. In a culture where concepts such as work-life balance, personal boundaries and a good night’s sleep can seem like an elusive fantasy, Alford and Kaplan are taking a closer look at how their executives live and operate, and they are striving to find a better way forward. And they hope more of the senior living industry is ready to join them.
Kaplan believes the topic of mental well-being and burnout is not getting nearly enough attention in senior living. Too often, he said, executives in the industry are pursuing career shifts out of the field in search of something more emotionally and physically sustainable.
“The fact that you have good people in this industry at high levels who carry a lot of industry knowledge and who are looking to get out of the industry because of the burnout and the fatigue that they’ve suffered is a big problem,” Kaplan said.
Alford suffered an aneurysm in October of 2019, leading to brain surgery. It prompted her to place a new emphasis on her health and wellness. As a result, she also became more acutely aware of her team’s health and wellness – and of the working world in general.
“It made me pause and relook at some things,” Alford said. “I would never wish a health scare on someone else, but I think that was really a catalyst for me. I’m a type-A personality, and this was a gut check. It made me think about how our society views work, and I don’t think it’s OK.”
A deep-rooted cultural problem
Alford and Kaplan are focused on mental well-being challenges in the senior living field, but they both see those challenges as being ones that exist far beyond the industry and represent a society that is consumed by work.
“It’s a major problem, and I don’t think it’s an isolated problem to senior living,” Alford said. “I think that burnout across probably almost any sector is relevant, and very, very present, and although I hate reflecting back to COVID, I think COVID just exacerbated it. But our culture is just go, go, go, go – get up early, go to bed late, just full throttle from sunup to sundown.”
Kaplan notes that health and wellness topics are receiving increased attention in recent years in the United States, such as in the marked rise of podcasts and books on the subject of longevity.
“I see a lot of momentum toward this, but I don’t see our industry doing enough right now to try to support the operational community so that we are able to retain good people,” Kaplan said. “We need to almost re-engage those people and introduce a jolt of energy to people who are suffering from prolonged burnout and fatigue. And then that can also help to attract more talent to this industry – people who are probably shying away from it because they think that the industry is just too hard.”
Kaplan would like to see the industry and individual operators focus more resources and time on mental well-being, such as by bringing in expert speakers to conferences and other events.
“I’m not seeing our industry rally around this and provide resources for people, and I think that’s a big missed opportunity,” Kaplan said. “It’s not that there’s a roadmap, like, ‘Hey, you just go take this playbook and go execute it in your company.’ But I do think that if we can come together, talk about it, and better understand what tools are out there, we can make some real progress.”
The potential gains for the industry – beyond better taking care of its team members – are substantial.
“If you can do this effectively, then you’re going to obviously have lower turnover rates and you’re going to have less call offs due to illness because if somebody’s suffering from burnout, that ultimately is going to show up in terms of their physical health,” Kaplan said. “And maybe the most impactful is the level of engagement. If we can help our team members so that they have the tools to reduce anxiety, reduce pressure and reduce stress, PTSD, burnout, fatigue, it’s going to help our team members to provide better services to our residents, and they’re going to provide better peace of mind to family members. So the flow-through effects are really beneficial.”
Finding solutions
Kaplan said there are some key efforts that employers can make to improve the current climate. In particular, he believes “the big three items” that employers should help their team members prioritize are diet, fitness and sleep.
“If you can give people the right tools and the education, then you can help them try to proactively improve their overall health and improve their overall well-being,” Kaplan said. “They will see the value of it, and they will see the return on their mental health. And hopefully they can help their teams, whether that’s the cabinet and the managers on their teams or it’s the members of their frontline.”
Kaplan said in the past couple of years he has become very engaged on the topic of mental well-being, educating himself on the topic of improving stress management skills.
“I started putting this stuff into practice, and honestly it’s very powerful and it’s very helpful,” Kaplan said. “When you are in such an operationally intensive business as we are, it’s just so important that you have the tools to better overcome the chronic stressors.”
Solera held an all-day virtual mental health summit last year for corporate team members and executive directors as part of a new emphasis on the topic. Solera also purchased Oura smart rings and subscriptions for each of the participants. The ring tracks the wearer’s sleep, along with stress and activity levels. Sleep is a particular point of emphasis for Kaplan, who noted that the summit’s speakers included a sleep expert.
Similarly, Alford gives Oura rings and subscriptions to Avant’s executive directors, fitness coordinators and department heads on their one-year anniversaries. In addition, she coaches them on how to increase their sleep scores and provides them with an array of health and wellness tips. Alford said she hopes the growing recognition of a lack of sleep as a major health risk will lead to fewer people bragging about only needing a few hours of sleep each night or staying up late to work. In fact, she has created a competition with Oura sleep scores among the team members that she gifted rings in hopes of motivating them to improve.
Boundaries are real
Alford noted that areas of the world where people are healthier than in the United States strike a better work-life balance than they do here.
“In reality, I think it’s bigger than burnout,” Alford said. “I think that our bodies are just breaking down, and I don’t think it’s just from work. It’s our lifestyle. We go from sunup to sundown, and our bodies just are not designed for that. And you pile that on with all the tech stuff and the processed foods and the alcohol and the lack of sleep, and it’s really just a domino effect that goes beyond burnout.”
Alford wonders whether employers and leaders truly respect that people should have a personal life outside of business.
“Everyone likes to say they do, but then when you start really looking at the practices of a company, no one really does,” Alford said. “We all have crossed the lines in so many ways. And it’s not our fault – it’s society.”
In senior living, the temptation to be available around the clock can easily affect an organization.
“We work in an industry that is 24 hours a day, seven days a week, and that’s necessary – it’s not a self-imposed thing. People just count on us 24/7,” Alford said. “So what that means is our teams never really get a break, especially our management teams. They’re always on. We’re always on, we always have to be available should something happen. We don’t have that ability to just shut off and not get any calls.”
Alford says companies need to take a close look at the expectations they place on their executives – not just through what they say but their actual practices and what kind of behavior is rewarded and penalized. For instance, Alford used to send emails in the evenings to team members with a note saying not to feel obligated to respond until working hours. However, one of her team members told her that it was hard not to feel as though they should respond promptly to the boss. In response, Alford shifted her practice to scheduling those evening emails to be sent in the morning.
“We have to say what are we doing to force our teams to create a divide of personal and professional because it’s not OK for those to be blended anymore,” Alford said. “We’re seeing the aftereffects of burnout. We’re seeing the aftereffects on their mental and physical health. And it comes down to, what are you as a company doing that is making that happen?”
Alford believes the youngest generation of workers has demonstrated a determination to set better boundaries than their predecessors and to say, “Hey, this is my personal time. This is not my work time. The two are not going to cross.” Alford said workers who perform well and leave the office on time – who set clear boundaries – need to be applauded by their employers.
Setting boundaries, of course, takes work because it can be simpler to be free of them.
“As an industry, we think sometimes because we are a service industry business that we have to be available to our customers all the time,” Alford said. “But I do believe that our customers have learned how to cross boundaries, and we have to reset those boundaries. And I’m unapologetic for that. I am the first person to say to my team, ‘Nope, set a boundary.’ We cannot continue to expect our people to be bending over backwards for our customers when customer expectations are becoming unrealistic. And resetting those boundaries is working for us.”
In addition to work overtaking personal time, personal problems can overflow into work and affect work performance, and leaders need to be aware of that risk and ready to help, Alford said.
“The stress from work is not the only stress that everyone carries,” Alford said. “I was a single mom, and I started a company. Work was actually a lot easier than it was for me personally because being a single mom was a lot harder. I think sometimes we lose track of that – that it’s not just work that causes burnout or unhealthiness. It’s everything, and we have to be more aware of what that all-encompassing approach looks like with our team members.
“We miss that burnout isn’t just solving for work – it’s also solving for their health and mental well-being and being proactive with it, and it’s also recognizing that their home life, their personal life plays a part as well, and how do you support them through that?”
Personal contact and direct engagement
Kaplan said when he talks to members of Solera’s corporate team or to its executive directors he is acutely aware of how well they are managing the stress of the work and how they are faring emotionally. If he determines that they are contending with chronic, prolonged stress, he will strive to find ways to help them find relief, including through encouraging – or even forcing them – to take time off, and to identify how they reached this point.
“When you are operating in this environment, you have to create boundaries,” Kaplan said. “If you just have no space between your job and your personal life, then you don’t have the ability to recover.”
For Alford, engagement is critical.
“When I see a change in behavior, I don’t have a problem saying, ‘Hey, what’s going on? Is everything okay with you?’” Alford said. “It’s important to open up those dialogues and let them know that you and your team can support them.”
In addition to providing direct support for struggling team members, it is important for senior living workers to know that they are not alone. They are joined by millions of others trying to navigate the demands of modern life and to grab a foothold so that they can feel a sense of stability, control and contentment.
“The worst thing we can do is allow people to think, ‘Oh, it’s just me. It’s my fault that I’m burned out, I’m anxious, I’m depressed, and I can’t manage my chronic stress,’” Kaplan said. “We should want them to feel like this is common and systemic and you are not alone. And by the way, not only are you not alone, but this is not OK. We don’t want to prolong this. We don’t want to sustain this. Let’s do something proactively to curb this and let’s help give you the tools you need.”