Just a Memo
We all know how much easier it is to find fault and complain rather than to look for the positive side of things. In a long career of working in geriatrics, I have worked with people in rehabilitation who were learning to be more independent after a stroke, an amputation, joint replacement, spinal cord injury…you name it. It amazes me how hard they worked and even though they were in pain, or anxious or wondering if they could return to their home instead of nursing home placement…they always, always could be heard sympathizing with the person next to them. I heard a burn patient who was horribly disfigured, with fingers burned away, blind, and unable to move without help…I heard him express sympathy for the quadriplegic next to him. I have heard quadriplegic patients express concern and worry for a senior citizen trying to learn to speak after a stroke. I have heard stroke patients grieve for the spinal cord injured patient who would never walk again, or father children, or dress himself. They were expressing gratitude for their blessings and each one of them said, “I am so lucky to not have his problems.”
In all areas of life, including assisted living, we can always look for reasons to complain and find fault, and reinforce our own negative beliefs about ourselves, other people, and the world in general. For example, if you basically think people are no good, and out to get you, that is what you will always think, believe and see.
In assisted living, I have noticed that for some people complaining sometimes seems to be a favorite pastime. If it isn’t the food, it might be the temperature. If it isn’t the temperature, it might be the staff. It might be the staff, or the napkins, or the laundry. We always try to respond to legitimate issues or complaints, and fix the problem. My point is only to say that automatic negative assumptions can be refuted, or they can be spread like a virus, infecting other residents and affecting community morale.
The experts say that if an individual consciously identifies “Five Gratitudes” every single day, negative moods and depression can be thwarted. In other words, you can actually choose your mental outlook and mood. Our resident Harry Painter is a good example. He looks for positives, and lo and behold, he finds them. He chooses to find the half full glass and not the half empty.
I want to recognize some other positives that happen here every day. I can’t list them all, but here are a few:
Arlene Abbot’s daughter brings joy to our downstairs residents. She brings her friends, her crafts, fancy lotions and bath gel, decorations and tons and tons and tons of love. She sees each resident’s most loveable qualities, and is a team member with our staff.
Jimmy Tiller has brought plants from his yard for our courtyard.
Julia Humphries bought the cutest Betty Boop PJ’s for a memory care resident, using her own money.
Devita Freeman found $300.00 in a resident room and returned it, so the family could take it for safekeeping.
Cece made special desserts and dishes for the Halloween party.
Tim Sexton helps out with any caregiver who is getting overwhelmed or behind. He has bought special treats and gifts to residents, taken them out for rides, and as you know, he is the one who takes the ROMEOS out to lunch. He responds as quickly as he can to resident requests and goes the extra mile.
Laura O’Connell has brought her baby goats and her rabbits to visit.
Melissa and CeCe took a roadside breakdown on the way back from shopping in Georgia and made it into an adventure. As you may have heard, on the return trip from Hamricks, the wheelchair lift jammed and it was impossible to drive the bus. Melissa called me, I went on the Internet and found a mechanic in Oglethorpe, Georgia, and within a half hour they were on their way back. The great part of this is that they broke down near a winery, went in to get cheese and crackers, and snacked till the repairs were done. Then, to reward themselves, they stopped for milkshakes. I waited here and worried that I would get blasted with gripes, but our girls are troopers. Everyone arrived in good spirits, no complaints, just chattering about their adventure. They took it all in stride, and they bragged on Melissa and CeCe. Eloise Smith was tired, but laughing her great laugh. Nancy Gossage was pooped but in such great spirits. Connie Obodzinski was relieved to get here, but triumphant with her purchases. Charlotte Shultz was ready for bedtime, but glad to get home with her loot. It just goes to show, you do have control over your response to any situation. If we could just hear ourselves whining and accusing, and instead take a minute to give thanks, we could rejoice and savor every day.
I want to wish everyone a lovely Thanksgiving, and to express my thanks to everyone here at River Oaks Place. I am in love with this place, the residents, and all of our staff and caregivers. Even on the most challenging of days, it is an honor, a gift, and a joy to be here. I am thankful every day for the lessons, the blessings, and the fulfillment of being a part of it.
Barbara
We are competing this week in a Memphis Barbeque Network (MBN) event in Gainesville, Georgia in the professional category. This is a first for our team on many fronts. First of all, the MBN requires on-site judging with 3 visits per category. Therefore, because we are entered in 3 categories (Whole Hog, Shoulder, Ribs), we will have to make 9 presentations during the course of about 4 hours on Saturday morning.
This was supposed to be a warm up event because we have decided to compete at The Big Pig Jig in Vienna, Georgia in the fall. The Pig Jig is a super bowl of sorts with many teams from all over the country coming in to compete. Originally, we decided to just enter the Shoulder and Ribs category, figuring we were not skilled or capable of producing a Whole Hog worthy of competition.
We recently catered an open house at Brantleys Assisted Living, our Milledgeville community, and we prepared a whole hog. We had a great time, learned a ton and produced a decent product. Todd and I, sometime in the middle of the night or early morning hours, questioned why we shouldn’t compete with the pig in Gainesville. After all, we have always been “all in” guys. We have never ever backed away from anything. Why should this be any different.
We used the theme for our Las Vegas meeting with our Executive Directors of “Think Big Things” and, as good examples, decided to practice what we preach. We also planned to participate in the event figuring even if we finished last that we would gain experience and we were cool with that. Well, we don’t roll that way either. We compete to win no matter what we do and if we don’t finish in the money you can count on some discouraged folks when the day is done.
As if all that isn’t enough pressure, when I informed the event promoter that we wanted to enter the whole hog category he asked if we would consider taking the site right next to reigning world BBQ champion, Melissa Cookson and Yazoo Delta Q. I told him absolutely we would take the spot. We are fans of hers and, if you had to take a butt whipping, you might as well have the world champ as your neighbor.
So, no pressure, right? Absolutely, we think we can compete and we think we can win and as long as we continue to Think Big Things, we will always be champions and so will you.
Wish us luck – we need it.
We do what we do…
Most everyday at Senior Solutions Management Group we focus on multiple facets of senior care. We talk about assisted living, Alzheimer’s care, dementia, dementia care, the Alzheimer’s Association, medication, medication management, senior costs, senior care issues in Tennessee, and senior care issues in Georgia. After all, this is what we do.
Over the last several weeks Todd and I both have had to deal with the two most dreaded words in the English language – Breast Cancer. The evil beast has come to be in both of our lives with close family members and dear friends. My point is not that Breast Cancer is the only devastating news that one can receive at any time. We realize any life or death issue, whatever the cause or diagnosis; can be devastating to family and friends.
The point I want to make is for the families, the sons, daughters, brothers, sisters, grand children, nieces and nephews of those we care for in our communities: the SSMG network of communities now employees over 200 associates in Georgia and Tennessee. That number will continue to grow in 2011 as new communities join our ranks. Many times you as a family member may have no idea what those that care for your loved one may be battling in their life, while taking care of the ones you cherish. To be honest Todd and I don’t often the trials and tribulations that many of our employees are dealing with.
When there are cases that we are made aware of, many times we find that the employee affected finds the connection and human element involved in caring for a resident is good medicine in dealing with their condition. I recall a situation just last year where we had a female employee stricken with Breast Cancer that asked if we could adjust her job duties a bit, even if it required a cut in pay, so she could keep her job and maintain resident contact while suffering through chemo therapy treatment. We gladly accommodated her request.
While I can only speak and express my own feelings since I am the blogger and honestly say that when bad news comes, like it did today, I find myself both saddened and angry at the same time, I guess that is why they call it emotions.
So for those of you that call me boss or respectfully address me as Mister (which I hate) please know that we honor you for taking care of our residents, even when your road is torn up and falling apart, when devastation is wrecking havoc at your home or in your family; may peace and well being come to you.
Senior Solutions held our 2011 executive director's retreat in Las Vegas. What a great time to "recharge the batteries" and focus on Thinking about Big Things!!! We had a great time and were able to bring our leaders together and share great ideas with each other. The "Think Big Things" montage video highlights the success stories of each of our communities. What a great group of people to have on your team!!
It was recently announced that Ventas is attempting to acquire the assets of Atria Senior Living for $3.1B or $230,000 per unit. The deal is comprised of a large stock offering, assumption of debt and a small amount of cash. I am not a “bigger is better” advocate and I don’t say that as sour grapes. The cap rate on the deal is between 6% and 6.5%, so say the experts.
Bottom line: someone has to pay and that will be none other than the residents of these affected Atria Communities. Back when Todd Barker and I first started Senior Solutions Management Group in 2004, cap rates were super low and per unit prices were at unprecedented rates. We would run numbers that in some cases dictated we would have to raise rates by 30% to 50% just to make the debt payment.
As I mentioned in my last blog there are many communities, especially independent living communities, now owned by the bank. Anyone remember a company called Sun West? It is mighty tough to please your residents, their families and loved ones, some asset manager that has never run a long term care community, let alone the investors and Wall Street.
We have always set very realistic expectations with our owners to try and achieve a balance between good care and customer service and a competitive return on investment. It’s not easy and we are certainly by no means perfect. Sometimes we get it right and sometimes we don’t but we have never ever compromised care for profit. This economy doesn’t make the job any easier.
The level of acuity we see today at admission is getting higher by the day. The residents are between 85 and 90 or older. They need care, some more than others, but as a company I would estimate more than 50% of our residents need more than moderate care. Their money can only go so far and to have to cover a moderate profit to the board room makes for an interesting business model.
I will be interested to see how this all plays out. I like the fact that I can talk with the boss or the property owner and get a fair and honest answer. Sometimes they don’t always tell you what you want to hear but at least they know your name and appreciate your business. Choice is a great privilege. Be sure you make the right one.
On September 20, 2010 The National Bureau of Economic Research announced that the recession had ended in June of 2009. Many would look at this as positive information. But, if you happen to be a part of housing for seniors, you would beg to differ.
Let me tell you what has happened since June 2009. Independent Living for seniors has been decimated. If you had the good fortune of providing Independent Living before the downturn in 2007, you are most likely counting your misfortunes. We certainly are among those spewing cash like the Deep Water Horizon Well in the Gulf. There is no “top kill” for an economy where a house can’t be sold. And, even it can, it’s perhaps at 50% of its value of just a few short years ago.
Senior financial vehicles such as pension funds and, the favorite product of senior citizens, the certificate of deposit have either lost so much value or pay so little interest that they are no longer viable to sustain living expenses.
For the operator that may choose to attempt to provide benefits for their employees, he is facing 30% or greater increases in premiums; completely the opposite of what was sold. Nearly every resident inquiry has some financial issue or barrier to deal with before the potential resident can think of moving in.
Assisted Living has now become a life style decision not a need-based decision. Families are now taking mom or dad or both out of a community because they need their Social Security income to live on. Foreclosures are rampant and no one seems to care. The care of mom and dad has become secondary to simple survival.
We have employees who have lost their homes and become homeless; lost their kids to state custody because they can’t take care of them; lived without basic utilities because they were cut off due to non payment. Local oversight agencies have been cut back so much they no longer will investigate an allegation of abuse simply stating “there is nothing we can do”.
Unemployment continues to hover around 10%. On a recent visit to Nashville, it was reported that home closings are down 19% from last year, when the recession supposedly ended.
In reality, this announcement could be the worst news we could receive. This recession is not over, far from it. The bigger question is: will our senior citizens be able to live out their lives with the peace of mind that they will have enough money to the end? In the end, the sad story here is this could have been prevented or at the least minimized by simply following sound basic financial principals.
From our position and perspective, these are troubling times. How it will play out, we can only wait and find out.
At the start of 2010, we began to look for a new way to market our communities. We strived to find something that was different, something that would make for good discussion, something that would be memorable.
During one of our partner meetings, Todd asked me “What would you like to accomplish this year?” Without much hesitation I simply said, “I would like to compete on the professional BBQ circuit.” Within several minutes we had located a pit and come up with a plan to get more information.
The pit was ordered, which took about 5 weeks to build, and during that time we decided there was no better practice than to cook for our communities. We consulted our graphic designer who knew our company and business well and he came up with our team name of The BBQ Doctor. During April and May we cooked for open houses, health fairs and family gatherings at many of our communities. It was obvious that we had hit on a common connection to BBQ. Many of our residents and family members had stories to tell about family reunions, church barbeques, raising hogs, good bacon, sausage, ribs, hams and, of course, butts.
We cooked ribs, Boston butts, chickens and brats. People just raved about the pork and many times I could scarcely get my foot in the door before someone would ask if I brought the pit. When are we going to have ribs again? When are we going to cook again? If we had the time, we could easily schedule an event a week.
Now that we have had some time and have competed in several events, I can tell that our BBQ is so much better today than what we cooked just a few months ago. We have not scored “in the money” yet but we have been in the Top 10 or Top 5 of every contest in which we've competed. We have our logo mounted nicely on either side of the pit and people frequently ask us where our restaurant is. We tell them they can only get our BBQ at a Senior Solutions community.
We have the inside story of The BBQ Doctor on our website and we have had more feedback from that section then we ever expected. That pig is mighty powerful. It can make for great conversations, fond memories and satisfy a big hunger. You can see our products, pit and contest results by entering The BBQ Doctor in the “search” section of FaceBook.
Here are some brain teasers for you. What is the best prescription for depressive mood? What can a person do to keep their brain nimble? How does being outdoors boost your outlook?
First of all, depression is a mood that can come and go, but it also can become a medical issue if it persists. It feeds upon itself if not addressed, and can lead to isolation, insomnia, lack of interest and low energy and concentration. It is a secretive disorder because it can be unrecognized and left untreated. A chat with the doctor can help address and treat depression and help “reset” the brain’s chemical balance. Why let your quality of life decline when there is so much to savor?
Brain exercises such as games, socializing, current events, puzzles and learning something new all contribute to vitality and preservation of memory. These type activities as well as regular exercise keep wits sharp and increase a sense of purpose, all of which contribute to self esteem and engagement. These are crucial ingredients for longer, happier lives.
Outdoor activities can help with preserving bone mass by adding vitamin D to the body. Being outside also increases positive thoughts and feelings such as gratitude, pleasure, and connection. Increased exposure to light can help banish depressive symptoms and boost mood.
All of these comments are aimed to provide food for thought and increase the life satisfaction of our residents. Our goal is to help the whole person to thrive and remain content, as independent as possible, and mentally and physically healthy. We love seeing you make friends, laugh, and flourish.
Back when I first entered senior housing in 1997, the assisted living boom was in full swing.
I can remember the biggest challenge at the time didn’t seem to be if we could care for a resident as much as if we could just get them to move in! Back then, the sales and marketing process was crucial and the operation was relatively easy. Our residents were in their mid to late 70’s; had good cognitive abilities; and were, by today’s standards, relatively healthy. Family members were cooperative, visited frequently, attended events at the community and would usually take Mom or Dad out to lunch or dinner on occasion or take them home for a few days of vacation or a holiday.
A length of stay of 36 months or longer was the industry standard.
My how things have changed!
Late last fall we held our annual Executive Director’s Meeting near our home base in Alpharetta, Georgia. We worked for months in preparation of the meeting and considered several formats for the gathering. We looked into using a guest speaker, perhaps a motivational figure.
We considered hiring a consultant to give us some advice on the best way to plan. When we formed the company we basically had two simple principals: 1) we would never buy something for more than it was sensibly worth, and 2) we wanted to keep as much corporate burden off the communities as possible; meaning, we would keep it simple with as little paperwork and distraction as possible so that our Directors could run the communities. As an example, our purpose statement for the company is simply “we take care of old people”.
That’s it. That’s all we do. And, we adapted the motto from Tony Dungy’s book Quiet Strength, “we do what we do, no excuses, no explanations”.
Operations today boil down to three components: The Financial – can they pay? The Clinical – can we take care of them? The Social – can they thrive? It is still amazing to me that as an industry, we still do not in any official manner financially qualify our prospects but our accounts receivable remains consistently current. The clinical aspects for us are fairly straight-forward; we simply manage by the regulations as published in the states in which we operate. We rarely, if ever, push the limits of regulation even if we believe the regulations to be questionable or petty.
It is just not worth the hassle, time and energy to deal with bureaucrats, surveyors, and state agencies that really aren’t concerned about the resident’s well being.
Our biggest challenge as an operator today is the Social component- can they thrive? I would estimate that on a monthly basis 70% of the questions and issues that our Directors challenge us with are social in nature. Our average resident today is 89 years old, white and female. At least half of our families have some form of dysfunction, meaning that responsible sons or daughters are divorced, have remarried, and live more than 50 miles from Mom and/or Dad. They visit infrequently, are reluctant to spend money on their parents and, don’t want to be bothered or involved. This scenario runs across the continuum of Independent Living, Assisted Living and Memory Care. In many cases, the families seem to seek out our direction and counseling on what they should do, yet very often fail to heed the advice. Today, our Directors must be skilled at managing emotions, be quick to develop generic answers for why residents question the behavior of a son or daughter and, be professional at managing the 30 day notice. We call this “family dynamics” and it is as much a part of our daily management as bingo, the bible and prune juice.
Today’s operator faces tougher challenges than ever before and they are social in nature which makes each situation unique and different. In many cases we spend as much time, if not more, managing the family as we do the resident. We have to be very meticulous in our documentation and our Directors have to have good communication skills and relentless patience. Frankly, I don’t see this scenario getting any better in the near future. But, in the meantime, we strive to provide the best care we possibly can to the resident and their families. We do what we do, no excuses, no explanations.
Chris Sides is co-founder of Senior Solutions Management Group, LLC. Chris and his partner, Todd Barker, formed SSMG in 2004. The company manages various continuums of senior living in
Tennessee, Georgia
and Alabama and is based in Suwanee, GA.
www.ssmgrp.com
This is the final part of a nine part series on finding the right senior living community. This article was written by Jim Moore of Moore Diversified Services (http://www.m-d-s.com/) and published on the Assisted Living Federation of America website (http://www.alfa.com/).
9. Carefully Consider What the Future May Hold
As we all age, all of us will experience increasing levels of frailty and other health complications. You need to understand how the community will justify and charge for the costs of increased services that may be needed. Also, consider the community's policies if it were to determine it could no longer care for you or your loved one. It may seem like an uncomfortable dialog, but knowing the answers to these questions can provide long-term comfort for you and your family.
Senior Solutions Management Group is one of the leading senior housing operators in the country providing the following services to older adults: independent-style living, assisted living, continuum of care retirement communities. We hope you have enjoyed this series and welcome your questions about our facilities and how we might assist in the search for a senior living community.