Hurdling the Challenges of Rising Acuity

The demographics and times are changing, and the impact on senior living is real. As Gwen Wilburn, MBA, RN-BC, senior vice president of clinical operations at The Aspenwood Company and AALNA board member, says, “By 2030, the entire baby boomer generation will be 65 or older. By 2034, older adults will outnumber children for the first time in American history. This means we’re going to be seeing more seniors with chronic conditions; and they will want a more holistic view of their care that goes beyond the disease process and medical condition.”

Behind the Numbers

Acuity is growing and changing in senior living for several reasons. The biggest is that people are delaying entrance into communities. The trend toward aging in place is stronger than ever as the desire to stay in their homes and concerns about costs of care lead more people to put off moving to a senior living community – even as their frailty increases and they need support with activities of daily living (ADLs).

As a result, staff need training on issues such as caring for residents with advanced dementia, those with brain injuries, individuals who need post-stroke care, and others. At the same time, not only are residents coming in with more comorbidities and chronic conditions, but with more complex medication regimens as well.

As this care sector faces these changes and challenges, here are 5 steps that can help communities navigate the stormy seas:

1. As acuity increases, consider what services you can offer and what equipment, tools, and training you’ll need.

It is important to look at your current residents, as well as the inquiries and referrals you’re receiving, and determine what special equipment or supplies you’ll need and what kind of staffing and staff training will be essential to care for high-acuity residents and those with special needs.

2. Attend to wellbeing as well as health.

“We need to address the emotional and spiritual aspects of care under that clinical umbrella,” said Wilburn, adding, “We need to look at what services and amenities we can offer to give residents a better life and make things easier and more convenient.”

For instance, are therapy providers on site? Is there an on-site medical clinic? Can laboratory services be provided on site instead of residents having to go out for bloodwork and other tests? “It’s almost like a concierge service. What can we do to look like a five-star hotel? We need to be thinking about opportunities to add more diverse programming,” said Wilburn. “It’s important, for example, to tap into the desire for lifelong learning and offer programming and activities. Our older adults not only want to continue to learn; they are eager to teach and share their stories and experiences with younger generations.”

3. Jump on the technology train…but thoughtfully.

There is so much technology out there and new devices, tools, software, apps, and more every day. It can be tempting to embrace all the promising new advancements, but it’s important to make measured decisions. “You have to know the technology your staff currently uses, how it works, and what they need that they don’t have,” said Wilburn, adding, “We should prioritize technology that not only improves resident care but also makes life easier for staff. When we have happy staff, we have happy residents.”

Technology that gathers relevant analytical data and makes it easier for staff to identify ways to use this information to improve care and processes is increasingly important. But this technology isn’t valuable if staff doesn’t know how to use it or it isn’t pulling analytics that they need. She added that artificial intelligence (AI) will play a role in collecting and analyzing data, among other uses.

4. Implement ongoing staff training that is instructive, empowering, and even fun.

“Especially as acuity has increased, training and engaging our staff needs to go well beyond onboarding. We need continuous training, and we have to make it interesting and fun for staff,” said Wilburn. She added, “We need to offer some specialized training. To do this, we need to know what’s happening in our communities. If we have residents with heart failure or Parkinson’s disease, we need to educate our teams so they can recognize condition changes and implement appropriate preventive measures.” Don’t forget frontline staff. “We have staff who enjoy engaging with residents, and they’re positioned to notice changes of conditions. We need to empower them with education and training and make sure they feel engaged as members of the care team.”

5. Engage the consultant pharmacist beyond regular medication reviews.

“The pharmacist can help enhance the resident experience significantly. Beyond their monthly medication reviews, they help nurses recognize and address side effects, decrease polypharmacy and associated costs, and provide training and information for staff,” said Wilburn. These practitioners have a wealth of knowledge and have access to useful technology and data that can help with issues such as falls prevention and behavioral management. “We need to tap into their knowledge and make the most of the experience and expertise,” said Wilburn.

“Changes are happening already, so we need to be prepared. In addition to growing acuity, our communities are seeing more cultural diversity, so we have to educate our staff about these cultural differences and help ensure our care and programming are inclusive of all residents,” said Wilburn. She noted that with challenges come opportunities, such as partnerships with local colleges and universities to satisfy residents’ desires for lifelong learning, nurture intergenerational connections and expose students to careers in this care sector. “I love working in this field, as do so many of my colleagues. We’ve come so far in our industry, and we’ve overcome many challenges. I am excited about the future and what we can accomplish.