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Staff member conversing with community residents

Elder abuse can take many forms in community settings. In one case, a resident was being bullied by her neighbor. She was reluctant to speak out and became depressed, and her family eventually moved her to a different community. Another resident was treated roughly by a caregiver at a community that was understaffed. In another case, an executive director of an assisted living community discovered a resident’s son was misappropriating funds from the resident’s bank account, draining money needed to pay for care.

These situations illustrate why the safety of residents and a focus on combating elder abuse is a top industry priority. Senior living providers universally recognize the importance of keeping residents safe and happy. Not only are they responsible for an often frailer than average population, but satisfied residents are more likely to thrive.

But what are the best practices to ensure resident safety? How can education and engagement be used to promote resident safety?

Luckily, experts have put forth a host of best practices and new tools to help educate managers, workers, family members, and residents. In fact, resident safety emerged as a major initiative this year at Argentum, which released a resident safety toolkit through its Senior Living IQ initiative.

The basic ingredients of a successful resident safety program include the careful screening of job applicants, rigorous job training, adequate staffing to prevent burnout, outreach to families and professionals, leadership that models company values and empathetic behavior, and a quick response to any incidents that may occur.

“One unfortunate incident in one community can impact the entire industry,” said Maria Nadelstumph, vice president of organizational development and program excellence at Brandywine Living. “Operators need to be mindful of how and who they are hiring. And what quality measures they have in place.”

Hire the right people

Resident safety really begins during the hiring process. Finding the right staffers—those unlikely to engage in mistreatment and speak up if they see it happening—is the first defense against later problems.

The industry, however, faces a highly competitive job market. Executive directors don’t have the luxury of a deep pool of applicants. That doesn’t mean the hiring process should be less rigorous. Instead, managers need to step up their screening practices.

“It’s hard to find workers,” said Sue Coppola, chief clinical officer at Sunrise Senior Living. “But we cannot fall into the trap that anybody is better than nobody.”

At Sunrise, the pre-hiring process includes background checks, drug screening, and a reference check. Other providers conduct similar checks.

Sunrise uses behavioral-based interviewing techniques, asking about past behavior as a way to gauge future behavior.  In order to improve employee retention and reduce turnover, Sunrise has partnered with Arena, a Baltimore-based firm that specializes in predictive analytics.

Questions are embedded in the online application that help predict whether the applicant will stay in the senior living industry and at Sunrise. The questions are based on real-time data collected from thousands of applications.

In-person interviews are key, according to James Olney, senior vice president and senior human resources consultant at Associated Benefits & Risk Consulting (ABRC), a risk consulting and insurance brokerage agency. A misstep is to focus too much on whether the applicant can perform the required job tasks, such as the physical work of assisting residents.

“Managers should be exploring the critical personality attributes in workers that are necessary to perform their jobs honestly, capably, and with the proper amount of motivation,” said Olney. Employees with the right mindset and the desire to do well are less likely to cause problems, he added. “If you get someone there only for a paycheck, the risk goes up exponentially.”

The right interview questions can help identify the people with the right attitude. “Someone with no experience and the right drive is better than someone with 15 years of experience and no drive,” said Olney.

Craft interview questions to determine the applicant’s integrity. Instead of asking what it was like to work at a previous organization, which usually elicits only a general response, pose questions about hypothetical and real life situations. These questions follow two patterns: ‘What would you do if…?’ and ‘What is an example of a time where…?’

For example, Olney suggests asking: ‘Tell me about a time when you discovered that a coworker had not followed proper protocols. Did you address this with the individual? Did you bring it to the attention of your manager? Did you do something to try and correct it yourself?’

People don’t usually want to get coworkers in trouble, so applicants who say they did nothing are probably not likely to make the best decisions when put under pressure. “Everyone faces a crossroads in their careers of making the right choice or the wrong choice,” said Olney. “Someone with the right mindset and the desire to do well is  less likely to commit acts of abuse.”

Train employees

Staff training and education helps to prevent abuse, neglect, and misappropriation. Onboarding and ongoing instruction on resident safety is crucial.

“We want to make sure the staff is aware of the various types of abuse and what to look for,” said Beth Sampath, senior director of quality resident services at Benchmark.

At Benchmark, a general orientation program covers the warning signs of all types of abuse, including financial exploitation and physical abuse. The training is also offered annually to all employees including managers. “Everybody’s priority is resident safety,” said Sampath.

At Brandywine Living, new employees undergo onboarding training that covers all aspects of senior living operations, safety, compliance, resident rights, memory care, hospitality, and quality resident care.

Abuse training is covered by a review of The Brandywine Code of Conduct and a program called TRUST (Treating Residents with Understanding, Sincerity, and Tenderness). New hires sign a written acknowledgement that they understand the rules and the disciplinary process.

“We have a zero-tolerance policy for abuse,” said Nadelstumph.

The rules address the use of social media, which has become an area of concern for community operators. Employees are not allowed to post information or pictures of residents on social media.

Ongoing education is also conducted. Brandywine’s compliance training program—E3 (Empower, Engage, and Educate)—consists of monthly sessions that cover fire safety, resident safety, elder abuse, and other topics. “The goal is to ensure team members are aware of their active role in compliance and their role in protecting the rights of our residents,” said Nadelstumph. She oversees the Brandywine Center of Excellence that develops and conducts programs on leadership, training, innovation, and quality.

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