The F-word in Elder Care


In the past 10 days, 3 women over the age of 70 have dropped the F-bomb while talking to me. Yep.

And that made me think more about one of the very struggles and frustrations I have always had while working in elder care – balancing “being real” with being “professional.” While talking last week to a colleague, she said that one of the obvious expectations while working in corporate America is that you have a personal life and a work life and the two should not mingle.

Do organizations that provide elder care focus too much on this as well? Has it gotten too corporate? The philosophy that is advocated for these days is “person-centered care.” Providing person centered care and engagement requires an intimacy, a knowing of the person you are working with. The only way to really have this knowing is by being transparent yourself. And if you are expending your energy (wasting it I might add) on trying to be your “work” self, the result is a distancing from the person you are trying to get closer to. Intimacy is the primary thing we all crave, that makes us feel valued and whole. If professionalism suggests that we leave part of our real self at home, we are missing a part of our self while interacting at work and we are not whole. We lose the opportunity to be truly authentic and connected with those around us.

In 1997 I was working in a hospital, primarily with people who had some type of neurological “injury” – at the time that was maybe 50% had a stroke which put much of the population I worked with over 65. I had an eye brow ring and punked out short blond hair. That eyebrow ring was an incredible touch point. It created conversation and intimacy that I would have had no other way to create. It made people laugh, get angry, fear for my future, ask questions, counsel me, become intrigued but most of all it was a way we really connected. One day I ran into the CEO in the hallway. He asked me to take out my ring…because it was “unprofessional.” I was so bold, I said “not until it’s in the employee handbook.” For two reasons – one, I was a bit of a rebel but the second was because I knew that that simple social rebellion and self-expression (in ’97 not every kid had a facial piercing) connected me with SO many people in an interesting way. I simply didn’t care about “professionalism,” I cared about realism and connecting with other humans as I was. The result: I was good at my job and really well-liked.

That thing which was different and edgy helped to create intimacy and connection. That “thing” wasn’t who I was but it was an outward expression of who I was and it provoked curiosity. Self-expression – physically, verbally, energetically,  makes us all interesting and unique. Respecting another does not require us to stop self-expressing… this includes while we are working with elders.

What I have in fact found is that when I am real, raw, honest, opinionated, creatively expressive – that is when people feel open and connected to me – particularly elders!! When I am focused on how I am dressed and acting “appropriately,” I miss so many opportunities – the energy I put into monitoring myself is what I could be putting into being present.

Elder care communities that are interesting and engaging are not stuffy. There is laughter, there is debate, there is expression and often messiness mixed in. It’s not about appearances, it’s about experiences. To assume that our elders … who, by the way, are about to be the rowdy, rebellious, bold, outspoken, creative, drug curious, big thinking, opinionated, fascinating crowd from the 60′s … are so easily offended and require a gentle “professional customer service” approach is almost laughable. They want to keep living and feeling and being provoked to think and create. They want interesting activity – and seriously, what is interesting about being proper and dull (that creates distance and a false sense of safety.) And I have found this all along the way even with the stoic generation of elders we have been serving!

Kindness, vibrancy, authenticity and connection are above all what I want if I have to live in an elder care community.

To go back to the F-bomb, I do use “inappropriate language” during my consulting when I sense that we need to cut through the distance and get real. I find it instantaneously wakes up the room and changes the perspective – I become real. I also tell vulnerable, uncomfortable stories when I want a group to feel that I am real and not another “professional” who is separate or above them.

I am not suggesting that you encourage your staff to start integrating bad language into their work routines. But I am suggesting that you consider what  level of “professionalism” you would want if you were in an elder care community. I can tell you that the people I know – yes half of my close friends are over 65 – are resistant to living in an elder community because they (and I) fear the lack of real true connection with others. The noise of real conversation, the freedom to do and say what we want, of being exactly who we are, when we want and the fear of going to live like we are living in a hotel with stuffy customer service everyday. I can feel the fear rising! And honestly, like now, I will welcome the good use of “inappropriate” language when it is warranted.

Every person connects in a unique way – elders and staff members. Teaching your team members how to connect in a person-centered way without sharing their drama will give them the freedom to access all of their energy, not wasting it on being professional but using it on being real.

Forget Annual Employee Reviews!


Annual employee reviews are antiquated and counter productive. They are fear based assessments of employees that create animosity and waste a ton of energy. And the truth is that most managers hate doing them and as a result are not very good at them.

Let’s start by talking about what actually is the point of a review. It is generally perceived as a way to annually inform an employee if they are living up to the managers or companies expectations, report the good, bad and ugly of their efforts, to suggest what the expectations for either their continued performance or change in performance should look like and often address a pay increase.

But in reality reviews are only helpful to everyone if they are done on a regular – yes daily or weekly – basis. You should be communicating what you expect and how things are going from moment to moment. Manager/employee relationships are relationships like all others in life and no healthy relationship waits to be reviewed annually or it becomes damaged. When you can begin to shift into an ongoing, day-to-day review process, annual employee reviews lose their fear value for both the reviewer and employee.

I call them “daily reviews” and here is why they are so effective:

  • Your employees get feedback daily from you and understand what you expect from them everyday. It builds trust and they will ask for your input in areas where they know they are coming up short.
  • It gives you an opportunity to express your intentions for business and get your team on board. When your team understands what your primary intentions are, they can make decisions based on those intentions. This frees you up because your team knows that their choices and decisions in every situation should drive the results toward those primary intentions. It empowers them to make good choices.
  • When you have annual reviews it is like a pressure cooker building steam, ready to explode – you wait and wait, building up things you will “have to tell them at their review” and your employee just keeps making the same mistakes.  This is a recipe for drama.
  • Doing it daily removes the fear from the workplace if you speak respectfully. As you see something good happening you praise your employee, right now and if you see a problem, you address it with another solution, right now. This helps people to feel safe that you appreciate their work and will be honest and solution oriented when you don’t.
  • There are no surprises. No one will be shocked if you are doing daily reviews. This helps avoid drama in the workplace.
  • You can leave work and leave behind your frustrations. When you do reviews daily, you are actively addressing that employee who drives you nuts and you more quickly help them grow or remove them from your team.  At the end of the day you know you have taken action and you can more easily leave your work at work.
  • Daily reviews shift a manager/employee relationship from one of a “boss” holding power over an employee – like an adult controlling a child – to adults talking about what needs to happen at work to progress and be successful.

If you are not comfortable doing daily reviews then this is your opportunity to review your self and ask where you need support and tools for growth. Fear and lack of effective communication tools are the primary reasons for avoiding daily reviews. Avoiding daily reviews is also a way for managers to indulge in drama by perseverating on the issues their team has. This is one of the primary reasons that I provide 1:1 sessions focused on giving managers tools for communication and engagement. Many managers never learned effective communication tools and have habits that limit our potential – being self-aware is vital to growth.

For employees who are concerned about their rate of pay, the annual employee review has come to mark an expectation that this is the time when they will either get a raise or not. When a company has no plans for annual raises, it puts a manager in the position of avoidance of annual employee reviews – “I don’t want to do reviews because I can’t give raises.” Transparent, respectful communication about how and when raises are given should be happening as you know more information. Tell them any day of the year where they stand. They work hard, be honest about when and how raises are given and stick to it. If there will be no raises this year, employees should understand that and why. They should understand what they can do to ensure a raise when it is available.

Then when you give a raise, don’t attach it to an annual review – attach it to a thank you, you are a great team member. This will diffuse the expectation that they will get a raise every year because time has passed and place the emphasis on the qualities of their contribution to the team. Maybe they get two smaller raises throughout the year to keep them motivated. If they need to make improvements to get a raise be sure you have been clear all along so they are not surprised and know exactly what you expect.

Lastly, take notes all along. Create a system that allows you to easily make note of significant conversations along the way. The notes should be short but specific, put in the employee file and dated. These notes in an employee file are either the documentation that will help you when it’s time to remove them from your team or they will be the support you need to get a great team member a raise.

Forget annual employee reviews! Honest, direct, transparent communication every single day is a what your team needs. They will respect and appreciate your insights and know where they stand and you will feel more empowered as your team is making daily improvements.


5 Tools to Stop Feeling Overwhelmed

When you feel overwhelmed it seems like the last think you want to do is stop and assess what you could do differently.  But just like every other behavior we have, overwhelm turns into an energy sucking habit if we don’t disrupt it and create a new pattern.5overwhelm

Here are 5 tools to help you Stop Feeling Overwhelmed

  1. Create lists – Oh how I love lists. They create order when my mind feels is chaotic. I use long strips of plain paper for my lists. Every morning I start the day with a list of what I know I need to do from small to potentially catastrophic. I can fill more than a page some days with bullet point items. I write creative ideas that popped into my head, people I need to contact, items I HAVE to finish and people I need to simply check in with.  After I get it out of my mind and on the paper, I prioritize. I mark what has to happen first. What works for me is to knock out a few of the smallest tasks first and that helps get my momentum going. Then at the end of the day I create another list of what I didn’t get to and what I think needs to happen tomorrow. This clears my head so when work is done, my head is freed up with more space to enjoy life outside of work.
  2. Communicate clearly what you want and expect - One of the potential problems with overwhelm is that it can trigger the stress response in the body and that screws with our ability to think straight. Taking a few deep breaths and being clear with what you can ask of others is important. Lists can help here too! What can you delegate. Then while delegating be sure to be clear about what expectations you have of someone to get the job done. If you delegate to the right person, the one who likes doing those type of tasks, they have a better likelihood of success if you are clear. Don’t dump requests on someone else without clear expectations – that will only result in their failure to complete the task the way you wanted and feed your overwhelm monster.
  3. Stop everything, walk away and breathe … for more than a few minutes – Overwhelm is addictive. Once it begins it has a tendency to build like a snowball rolling downhill. And as a result every little ridiculous thing starts to feel way more important that it most likely is. Simply stop the machine. Turn off the phone, close the computer, walk out of the building.  If you actually stop long enough you start to realize that everything is not falling apart and you can begin to think clearly about what really is most important. Breathe deeply, trigger your calming hormones and decide what 3 things that can be done that will help the others fall into place.
  4. Stop doing other people’s work – Managing too many things, ideas or people is one of the primary causes of manager overwhelm. Trying to do it all results in not doing things as well as you are capable. Doing everything doesn’t make you better at what you do, it just depletes you. At some point you need to empower those around you to do their jobs well. Mistakes will be made but mistakes and failures lead to growth if you allow it to.  Teach and counsel your team so they have the tools to succeed. Acting as if you are the “one” that should be doing a task to be sure it’s done right, is the fastest way to create a complacent team that won’t make a move without your permission. That can feel really great if you need an ego pump, otherwise it ultimately exhausts your potential for greatness. Let other people shine and it will give you the freedom to put your energy into things you love about your work.
  5. Use a schedule - Set a schedule that will allow you to say no and set boundaries. For instance only check emails during certain hours of the day, schedule time frames when you will call customers back or meet with employees to discuss ideas or issues. The brain works well when it is focused and not as well when it is constantly distracted. Everything doesn’t have to happen NOW. If you create a schedule and stick to it, unless there is an urgent issue, your team and customers begin to feel safe that they will in fact have some of your uninterrupted time. If people who depend on you for answers or leadership fear that they won’t get your time, or if they feel like they are constantly vying for it, they will panic and hound you or demand your attention whenever they see an opportunity. Give yourself and others a sense of certainty that they will get their needs met – and when it will be.

Like any habit, being in a state of overwhelm can feel like the “right” place to be and as you decrease that sensation you actually might feel like you are losing a sense of control. But it’s all part of the process of creating a new (more efficient) comfort zone.

If you find yourself saying “Oh that won’t work for me” then ask yourself what you are afraid of? Overwhelm is a state where you are burning off a bunch of energy that could be used for bigger things. Is the thought of having more energy … and potentially more success too uncomfortable?

Be uncomfortable, let go of overwhelm and think of what big ideas you can make happen with all that extra energy!


Gaining a creative edge in your management style

lizardManaging people successfully requires a constant flow of creativity. In your day, challenges are constantly arising and you are called upon to help resolve, improve or elevate a situation. The ability to keep a continuous flow of creativity is a powerful tool.

Creativity is a source of energy for you.  Once you get it flowing it generates more energy and in turn more creativity. Creativity begets creativity. Creativity exists until either you feel too uncomfortable with all that potential and block it by falling back into old habits or you stop paying attention to it.

Imagine:  a situation arises at work that is challenging and irritating. You woke up feeling inspired and you stoked your inspiration by taking a morning walk and generating some great ideas. You get to work where a staff member approaches with a challenge…the same one you heard last week. Then, in response to the tedious question, you habitually respond by trying to fix it with the same solution you’ve used before.  As a result, you feel your morning creativity draining and as the morning progresses your creativity becomes completely bogged down.

“You habitually respond” – these are the key words. Habitual behaviors – they can be oh so good and they can be oh soooo bad.

Solutions and challenges, by nature, require creativity aka the generation of new ideas. If you have habits that continue to feed and generate creativity then they are great habits to keep. If you find that your habit is to respond with the same ideas you have suggested before, even if they had not been amazingly successful, then your habits of response are starving your creativity. New, creative, inspired responses will inspire more creative ideas.

When you notice your habitual response happening, it’s time to invest in stoking your creativity so that you are better at your work and you positively affect all those people you are managing. Creating habitual behaviors that will continually feed your creative energy will help you choose to be creative more often and come up with great solutions and ideas.

5 actions to feed your creativity and break the habitual response cycle that kills your creativity:

Write about your ideas. Writing is doing for the mind. The brain is not so good at knowing the difference between imagination and reality. Capture your visions. Put them on paper. As you write, feel what you body feels like when your creative juices are flowing. Make this a daily habit for 5 – 15 minutes everyday. Fill a composition book, notepad or journal with your creative ideas. Refer back any time you need to start generating more.

Change up the creative scenery. Go to garage sales, thrift stores and art sales, art stores or any other places that might have creative objects you would like to have in your life.  Buy some, make some, borrow some cool items that make you feel alive. Then bring your creative mojo into your office and work space! Stop thinking of your office space as dead “professional” space. Creative spaces incite conversation, debate and engagement. Make your office a place you love to walk into and your employees and customers are curious about. Curiosity is the basis of passion.

Get outside during the workday. Too many people separate life from work. As if, once you enter the “work zone,” you must prepare to give out energy all day long and then only in your personal unpaid time are you allowed to regenerate it. This is absurd. You are being paid to be an amazing, inspiring, creative thinking solution master. And the key to that is increasing your levels to optimal creativity generation. Walking outdoors is one of the cheapest, quickest most effective tools to do this. So simply walk out the door when you need a boost and take a 10 minute walk about. Move your arms and quicken your pace until you feel your mind shift.

Breathe. Yes, yet again I mention this. My yoga students always tell me that I need to repeat it every class throughout the class.  I am always asking “Are you breathing?” It may seem redundant but 95% of people in my staff trainings are not breathing fully, engaging their diaphragm, yet this is another powerful way to access your creative thought processes. Increase the oxygen levels going to your brain. Allow time to sit and breathe… and so importantly to pause when looking for creative solutions. Breathe fully allowing the air to use all of your lung capacity. In and out through your nose. Keep your mouth closed….Shh, this is one of the secrets to circulating your creative energy.

Be spontaneous. “Spontaneity is the spice of life.” Change up the day’s or the week’s schedule. Your staff and seniors will love you for it. Routine can dull the creative mind. Break out of the cycle. Come in late, leave early, have a party, make no phone calls, avoid technology, stay out of your office, take a few people to lunch, pull out your drum and play it with anyone passing your office, teach the staff something new … simply spontaneously shake up the day.

Gaining a creative edge in your management style requires practicing good habits that continue to generate more creativity and allow the mind to rejuvenate.

Why Should You Invest In Personal Consulting For Your Managers?

persconsulThe first comment I hear from a director about hiring me as a personal consultant is: Well, I am the director and I should be able to train and support my department heads and other managers … right?

The reality is that once you are a director with multiple departments to oversee, the time you have available for intensive staff support decreases. If you have stellar managers that are self-motivated to assess themselves and seek out new learning opportunities, maybe you are in fact able to give them what they need. But more often than not, in order to keep your organization growing and your team working well, investing in a personal consultant can really help support your success.

The second: Who on my team would benefit from your personal consulting?

  • Directors & Administrators influence all of the other team members. The way you communicate creates the culture of your organization – every action you take and every word you speak creates the culture your team is working in. Personal consulting can help you refine how you communicate with your team to help you get the results and create the culture you want.
  • New managers that are taking on more responsibility and incurring the challenges of a new position daily are great candidates because they are creating new habits every day. Supporting them to create productive, team supporting habits is vital at this stage…especially if they are new to management.
  • Well-versed managers that are hitting roadblocks in their growth. They have created habits of interaction and communication and their team needs them to evolve and learn new skills of management and leadership.
  • Team members that are “on the fence.” Their job may be in jeopardy and you want help determining what needs to happen. The cost of turnover is expensive. Personal consulting can help this team member to grow in the areas needed to continue on with your organization or determine if they need to move on to another job better suited to them.
  • Any team member that influences others in your organization. Leaders are everywhere … they may be in the office or one of the people providing direct care. Good leaders are always looking for ways to excel. And promoting from within gives your team a vision for future investment in the success of your organization. Personal consulting sessions can help a future leader move forward.

Third: What does it look like? Personal consulting sessions are over the phone or Skype weekly or bi-weekly depending on the situation. We would focus on management and communication tools for managers or work through specific challenges that are pertinent. We would create a package of calls so we set goals and a time frame for completion or extension of the plan.

Last: Is it worth the investment? Hell Yes! One of the biggest challenges for directors is that they simply can not handle all of the staffing challenges effectively. This is most often due to the lack of time needed to actually resolve issues and train staff in a holistic sustainable way. It is generally not because they lack desire. Most managers are plugging the holes with short-term solutions simply because they can not invest as much energy and time that is needed by staff who are challenged or are in a place in their career where they are rapidly growing.

The investment in the continuing growth of managers through personal consulting is cost effective and flexibly fits into their schedule so they can integrate information at a pace that works for their growth.

How to increase staff autonomy and person-centered care

autonomyOne of the best ways to increase your team’s participation in providing person-centered care is to increase their autonomy. By definition autonomy is:

  • n. The condition or quality of being autonomous; independence.
  • n. Self-government or the right of self-government; self-determination.

Encouraging independent, creative thinking in your staff not only gives you more freedom but is a fundamental of continued motivation in the workplace. Working with a team of people who feel autonomous has multiple positive repercussions. In today’s video I talk about how to increase autonomy with the goal of increasing the ability to engage in person centered care by asking questions. Questions that start with how, what, and when are great starters.

Increase staff autonomy by asking questions:

Decrease employee stress and increase their engagement

medblogRecently I calculated that 9 out of 10 people whom I have had in staff trainings in the past year – including managers – are not breathing in a healthy way.

So what? Why should you care how your employees breath? And why do I teach healthy breathing and meditation in every training I do? Because the rhythm and quality of your employees’ breath directly affects how they think, feel and act.

The depth of your breath affects the patterns of your thoughts and in turn the choices you make, about actions you take. If your breath is shallow and rapid your mind will follow with racing thoughts, looking for potential threats. Shallow breathing triggers your sympathetic response system (your fight or flight system). For example, imagine someone approaching from behind at night. You jump, lift your shoulders up, and take a quick shallow inhale of breath. This is fear, and it triggers a fear response. The body triggers that system any time you are breathing shallowly, because it thinks you are in a stressful situation or might need to react quickly. Many people feel a contact low-grade level of stress because their breathing is continually shallow.

When you breath deeply and fully, your mind calms, and your thoughts are more clear. When you breathe deeply and engage your diaphragm (this muscle is key to healthy breathing), the body triggers its parasympathetic system, which then releases calming chemicals into your body. A common example would be when you get angry and someone suggests you “count to ten”. The idea is to breathe deeply and slowly while counting to ten, giving your body time to trigger the chemicals in the body that will calm the body and angry thoughts. You can feel the calming affects moving through your body as you slow down and deepen your breath.

If your employees are more aware of the depth of their breath, they will be more in control of their state of mind, which in turn, will affect their choices, actions, levels of attention, engagement, emotions and interactions with others. Deep breathing will help them to be more clear-minded overall.

Decrease employee stress and increase their engagement with an employee meditation practice.

I wrote my book, How to Lead Meditation Groups for Seniors, not just for groups of seniors but also so that the people who are working with seniors would have access to these tools as well. This short book will tell you how to encourage deep breathing and it includes 5 recorded lessons. Give it to an interested staff member and ask them to lead a group for the staff. Give them a resource that will affect their work and their life.



empowered caregivers, dynamic managers, increased revenue