Corrections or additions?
This article by Kathleen McGinn Spring was prepared for the July
4, 2001 edition of U.S. 1 Newspaper. All rights reserved.
In Assisted Living, Empathy Counts
Take notice. There is a 56-hour course that leads to
top jobs in a rapidly expanding industry where the base qualification
is a high school diploma. Perfect for empathetic peacemakers with
a background in health or social services, and an aptitude for finance
too, the job is Certified Assisted Living Administrator.
Living Services, teaches the course along with her business partner,
County Community College. Cost: $1,700, not including a $500 testing
fee required by the state. Call 609-586-4800, ext. 3281.
Courlas and Barbato were in on the ground floor of assisted living,
which is a way of caring for elderly individuals whose needs range
from a little help with household chores to round-the-clock care.
In contrast to nursing homes, assisted living facilities generally
provide small apartments rather than dorm-like rooms, and put less
emphasis on nursing and more on individualized care. Courlas says
assisted living was born in the mid-1990s amid complaints against
the state’s existing care system.
"The senior population in New Jersey was not happy with the
says Courlas. Lynn Fishman, then Commissioner of Health, sent five
people, including Barbato, on a fact-finding trip to Oregon, a state
that has pioneering assisted care programs. The group observed the
Oregon system for two weeks, and then gathered information from other
states. As a result of this research, the state’s Department of Health
and Senior Services in 1996 drafted a regulation (Number 8:36) that
Courlas says is a blueprint for the broadest system of assisted living
in the country.
Prior to the adoption of this regulation, increasingly frail seniors
would move along a continuum of care. An elderly person might move
to a residential health care facility when he needed help with meal
preparation, be transferred to an assisted living home when he was
no longer able to take his medication without supervision, and end
up at a nursing home should he need round-the-clock medical care.
Now, in most cases, an elderly person in relatively good health can
set up housekeeping in an assisted living facility, and stay there
even if his health deteriorates.
At the time assisted living was being launched in New Jersey, Courlas
and Barbato, who helped write the regulation, were working at
Homes & Services, the Roszel Road-based elder care corporation.
then human resources director, started an assisted living unit for
Presbyterian, but she and her friend decided that the new type of
senior care was taking off so fast that it would be a good idea to
launch an entrepreneurial enterprise to move nimbly into the space.
The two became Certified Assisted Living Administrators through a
course offered by Excellence in Caring, a Cape May-based business.
They then came up with their own curriculum, got it approved by the
state, and started teaching their own courses, which they hold about
once a month. The classes, made up almost entirely of career changers,
who, Courlas says, "don’t want their bosses to know what they’re
doing," are held at night and on Saturdays, freeing the pair for
consulting work during the day.
There are now 150 assisted care facilities in the state. Approximately
six of them have been closed to admissions for failing to abide by
all the regulations that govern them. "For the first few years,
the state was lenient," says Courlas. "Now, six years later,
they’re closing facilities down." When a closing occurs Courlas
and Barbato are often called in to figure out what went wrong, and
to fix it. The process can take a year or more. "Nine times out
of ten," she says, "it’s the policy. That’s where all the
For example, she says, the facilities are to sit down all new
and teach them the values that, by state regulation, govern care.
These include choice, dignity, privacy, independence, and
Each employee is to understand how these abstractions translate into
care of their charges. They learn, for instance, that a patient who
needs help with bathing is to be asked what kind of assistance he
would like rather than being undressed and summarily whisked off to
a shower. This instruction is to be given once a year to all
but, Courlas says, it is not uncommon for harried administrators to
skip past it in their eagerness to get hands out on the floor.
After finding the problem that got the facility in trouble, often
as the result of a call from a concerned family member to state
Courlas and Barbato show facility administrators how to fix it —
and how to avoid such lapses in the future.
Other consulting work comes from preparing new facilities to open
by helping them comply with regulations and get the permits and
they need to operate, and from marketing facilities that are under
Courlas says the greatest satisfaction in her work comes from sitting
with a patient who is facing death serenely in a facility that has
become a home. Working in assisted living facilities is never easy,
and rarely is a 40-hour-a-week job, she says, offering this
to those who might want to take up the challenge:
from Wall Street, who took her course and made an excellent assisted
living administrator, and the card store owner, who found the
difficult, but is hanging in there. She gets a lot of nurse’s aides.
"They’ve been doing it for 15 years," she says. "They
realize they know how to do it. They’ve watched administrators screw
care background," says Courlas, "but it helps if you bring
with you some experience." What you do need, she says, is a good
head for finance. At the larger facilities, there may be a Marriott
at the helm, but even there, the administrator is responsible for
day-to-day budgeting. Along with an accounting aptitude, candidates
"have to be able to listen." A lot. Responsible for residents
and staff, and having frequent dealings with residents’ often anxious,
and sometimes guilty, families, administrators need to "listen
with two ears."
Superb people skills are essential. Administrators will be in charge
of workers who are not paid terribly well and who are doing an
difficult job. Skill as a negotiator is essential.
administrator can expect a starting salary of $55,000 to $65,000.
At a large facility, that figure goes up to about $85,000. If the
facility is fully-staffed by competent people — a situation that
is not all that common — an administrator might work just 45 hours
a week or so. Add staff vacancies or difficulties of any sort, and
the hours can soar. And don’t expect week-ends off, Courlas says.
"Families often visit on Saturdays and Sundays," she says.
Administrators often content themselves with taking a Wednesday off.
While this is not a soft job, it might be just the thing for an
nurturer who is not afraid to take on bookkeeping chores, and wants
a job where he can make a difference every single day.
To find out more about assisted living services at home from a sponsor of this page, please visit www.comfortkeepers.com/OUR-SERVICES.html
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