The time we spend in small care programs including assisted living and adult day care allows us to come in contact with tons of home and program managers. Often the success and reputation of the program is directly tied to the program’s leadership or lack thereof. As an example in small group home environments we have encountered home managers who have not been trained in personnel leadership, care management, clinical acumen of any type or the professional nuances of regulatory compliance.
Still some owners use them in managerial capacities. Training of staff will often lag in terms of both applicability and relevance since this person may have no real connection to key areas of the long-term care community which could contribute to their own work oriented development.
Some blame relaxed licensing standards which in some cases only requires a high school education and a year of non-specific experience before one can be the administrator of a group home. Imagine such a low barrier for a person supervising care for a population that now includes peg-tube users, the physically handicapped and those with serious medical fragility.
When that low barrier rules the day as opposed to the best judgment on the part of the owner, experienced direct care staff will stop respecting this person’s involvement in the business. Morale will suffer and key tasks will not be performed properly on a consistent basis. Why? Because staff knows the person supervising them really has no clue about what constitutes the ingredients of long-term success in what should be a clinical or even semi-clinical environment. But it gets worse. This person’s insecurities associated with their lack of qualification can work to destroy what could have been a welcoming care environment.
By knowingly establishing this person in a position for which they were never qualified you make a deep cut into their personal self-worth, create a false sense of importance they may fight to hold onto and you could potentially, at least for now, destroy their confidence when they are really confronted with their inadequacies. This is where the abuse comes in.
You cannot arbitrarily arrange for attendance at a few seminars and expect this person to manage the various crucial aspects of long-term care and care management including documenting care variations and managing care conferences with families and professional care coordinators. To create in them the feeling that they can succeed could mean the owner does not accept the seriousness of their obligation regarding what the business should be prepared to accomplish.
Maybe we have given this important job to a relative or friend, hoping for the best but knowing they cannot thrive in it. This only means we have allowed sentimentality to override good judgment and that never turns out well.
Let’s avoid abusing people by not assigning tasks to those unqualified to perform them. By so doing we show respect and concern for those we serve and for those we use to serve them.
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