Can Person-Centered Care Help Address Staff Turnover

Here’s a question for these times. In a long-term care system where staff turnover is high, could shifting to a person-centered care model result in better staff retention even as it improves care? 

Staffing woes continue to plague long-term care. A number of surveys indicate that a majority of long-term care and retirement community staff plan to leave their jobs within just a few years, and a growing number of nurses are leaving the field entirely. According to federal data, the average nursing home will turn over more than half its staff (53.3%) within a year.¹  

Although being underpaid is often cited as the catalyst for staff turnover, it isn’t just the low pay driving them away. The work is physically demanding, and long-term care workers report that their job satisfaction and sense of well-being are low. In fact, those two factors are cited more often than low pay as reasons to leave.  

The pandemic certainly didn’t help, but in fact rates of staff burnout have been rising for years.  

Meanwhile, quality of care may be compromised by lack of continuity, and providers are constantly challenged to maintain high quality ratings, for which staffing excellence is a huge determinant. 

The pessimist might say this is just the way it is, and until our long-term care system is overhauled, there’s not much we can do but continue scrambling to narrow the gap between staffing supply and demand.  

The optimist would say, let’s try closing another gap. Let’s close the gap between seeing clients as data points and seeing them as people, as individuals who have unique likes, dislikes, and routines. Let’s close the gap between problem-centered care and person-centered care, which sees possibility in every client and every care encounter. 

Long-term care staff want to deliver person-centered care. In one recent nursing home study, both families and caregivers agreed on the need to focus on person-centered care, including finding ways for new staff to quickly learn residents’ preferences so care teams could consistently provide the type of care they wanted to deliver.²

Person-centered care says, if this is what you want, let’s find a way. If this manner of engaging authentically and being sympathetically present existed throughout your organization on behalf of clients, imagine what it could do for the organization itself.

At CareScout we see person-centered care as foundational to a long-term care system. In a person-centered care climate, it is critical to engage in actions that let the caregiver learn the values of their client or patient as well as the caregiver. This shared understanding can improve care while often reducing excess costs.  

Person-centered care isn’t just a shift in how care is delivered, however. It’s also a shift in attitudes about how we engage with care seekers. As we state in our white paper, "Person-Centered Care: Redefining Quality for the New Age of Aging" person-centered care is based on who the person is versus what they present. Our full definition:

Person-centered care looks beyond safety, to also integrate a person's values, preferences, and goals into the care they receive. It creates a partnership between caregiver and care recipient that encompasses the physical, mental, spiritual, and social elements of a person's health. 

Person-centered care takes the view that if staff have the opportunity to meet clients where they are, both client and staff will do better. Certainly, analyzing healthcare data plays an important role in knowing your clients well and addressing their needs through more personalized prevention and intervention. Person-centered care goes deeper.  

It surfaces other client data that can touch on the values of the care seeker as well as understanding how the care seeker became the person they are. Commonly this lifts the spirits of clients and caregivers alike: 

• A woman with mobility issues who proudly points out that her grandfather built the house she lives in. It means a lot to her that she can age in place there.  

• A man who prefers to shower at night. He appreciates that his caregivers have altered their shifts so an aide can be with him to make sure it happens safely.  

• A woman who now has dementia but can recall her grandmother’s special recipe for latkes word for word. Her caregiver prepares latkes on her birthday. 

Knowing clients deeply and honoring their uniqueness, as in these examples, may take more staff time. However, the dividends extend beyond excellent care delivery to also provide improved job satisfaction for long-term care staff.

At CareScout, job satisfaction is an important piece of our evaluation when a provider joins the CareScout Quality Network. We survey staff, asking them to rate the extent to which their workplace fosters a person-centered care climate. Questions on the survey may include these examples:

“My peers and co-workers...” 

• Respect the values and choices of our clients regarding how, when, and where they want to be cared for. 

• Ensure that care plans reflect our clients’ choices, values, and beliefs. 

• Respect the different cultures of our clients and engage with them in ways that are appropriate to their background.

“My employer...” 

• Values my training, experience, and the unique capabilities I bring to the job. 

• Helps me to understand the importance of my work. 

• Equips me with what I need to deliver care based on our clients’ choices and values.

These are all signs of a caregiving culture that encourages staff to be more person-centered in their profession. It’s not a stretch to propose that anyone who rates these types of questions highly feels positive—and hopeful—about the care they give and the organization they work for. 

Person-centered care is integral to supporting an aging experience that is dignified, connected, and fulfilling. It can support a caregiving experience that feels more dignified, connected, and fulfilling as well.  

In a long-term care system where too many staff leave, the satisfying experience of working in a person-centered care climate can give them many reasons to stay. Better staff retention could very well be the result.