Caring CEO, Jeff Salter, was interviewed by Joanne Paskins for Taking Care of Mom and Dad. Jeff shares why he founded Caring Senior service over 30 years ago. He shares how Caring's process has enabled seniors to remain healthy, happy, and at home while also empowering business owners to own their own home care businesses. Listen to the podcast below or read the text transcript below.
00:00 – Joanne
Welcome to Taking Care of Mom and Dad. Today we will be talking with Jeff from Caring Senior Service. So welcome Jeff.
00:09 – Jeff
Nice of you to have me.
00:10 – Joanne
What made you go into this field?
00:13 – Jeff
Well my career stretches 33 years. I started in home care really in a home health company. I worked as an assistant secretary for a home health company that did not provide the non-skilled services. They just did nurses and nurse aids, and I witnessed the struggles that families were going through from having a frontline viewpoint and saw that there was no easy way to coordinate having a caregiver come in to your home to care for Mom or Dad and to manage that process — what families would struggle with. They would call back and ask us for help. Our way of helping was to give them a list of names that they could self-employ, and what we found was people would call back all the time because something didn’t work out. I would be giving another name to that same family over and over, and I just felt maybe I could manage this business for these families. Really I didn’t have any intention of starting a business, I was just trying to help people out and...
01:15 – Joanne
So I think was it like 1991, 1992?
01:19 – Jeff
01:20 – Joanne
Okay, so this was a new idea the companion part of it, right?
01:24 – Jeff
Yeah, the industry didn’t exist. I mean it was only a few years prior to that that the industry of assisted living had even really been born. Prior to that, in America, families moved in their elderly people with them or they went to nursing home settings but assisted living was a fairly new concept. So, this care for someone at home, sending a caregiver out was not the norm.
01:51 – Joanne
Wow. So do you mind going through the process of what you did?
01:56 – Jeff
Yeah. So for us it was a matter... for me, I recognized early on that to coordinate the services, we had to understand the availability of our caregivers. We had to make sure we had the right type of people, and things that we now take for granted within our own company, things that we just do, and it is just part of who were are, were created in those early days. Things like, for us it was a matter of making sure that all of our caregivers get a very thorough orientation. That starts with a personal introduction. It is a great expense to our company in money and time to make sure that every time a caregiver is meeting a client for the first time WE are there to introduce them. While we’re there we give them a solid orientation to what they are experiencing in the house. Every family member keeps their towels in a different place. Every family member rearranges their cupboard in a different way. The sugar is over there. The teacups are over there, and we want to make sure, and initially I want to make sure, I can organize that so the families weren’t stressed out about how to teach a new caregiver where things were. That orientation process they were doing was a hassle and they just didn’t like it. So, it was a focus of ours to make sure that we learn the household and then we can share that with our caregivers.
In the early days, it was me going out and doing those orientations so I would make sure that each house that we were caring for someone at I knew the general layout of the household, where things were kept and how the family and how the client liked things to be done in their personal way, and then we tried to incorporate that as best as possible and that orientation process was super important in doing that. But it started out as just helping a couple of families and then it just continued to grow and helping people in a small town in west Texas, in Odessa, Texas, is where I started at. It grew throughout Texas, and then 10 years after I started my first location after having five locations, we became a franchise system and now we have locations across the U.S. in over 20 states and over 55 locations.
04:07 – Joanne
Wow. You must be so proud of your business.
04:11 – Jeff
Yeah, it’s been a cool ride and it’s really good to see the ability to handle and to help so many more families across the country.
04:21 – Joanne
Yeah. Now I like what you were talking about, your introduction process because I feel that is so crucial. Because when that is lacking, you’re already starting off on the wrong foot. What services do you provide?
04:36 – Jeff
Our services are anything that someone needs to be able to remain at home and as independent as their health allows. So, that can be the traditional services such as meal preparation, housekeeping, personal care helping them with the restroom, helping with a bath, caring for their household in any other ways, errand running, grocery shopping, but we also focus on coordination of things that need to be done at the home. You know when you’re 85 years old you’re no longer able to mow your yard but if you live at home you need to get the yard mowed. You may or may not have little Johnny who did it for you for many years who is now grown up and off to college. So you’ve got to figure out whose going to replace that. So, we help coordinate with vendors to get that work done as well but its things like if you’ve ever called a plumber and felt like I think they’re trying to sell me more than i really need. We’re kind of there for that as well. We can’t stop all that from happening but at least we have another adult in the home that can help make a decision on is it really just a simple cleaning of the p-trap or do we need to replace the sink. You know, that kind of thing that is there so for granted all the decisions that you make, and the processes you go through. We as a company try to not just think of the care needs, direct care needs, but everything that is going to be necessary for that person remaining independent as they can in their own home.
06:08 – Joanne
So to step in to that type of situation.
06:09 – Jeff
Yeah, and that’s not to say that the other things don’t come natural. Companionship that we provide, all the things that we engage with our family members and our clients, we have a lot of that that goes on as well. We’re there for maybe eight hours of the day. Our clients range from some people need us just a few hours a day, some are there all day long because they have needs. Sometimes we work 24 hours around-the-clock. So all those moments between the meal preparation, the housekeeping, the direct personal care is engagement time so we’re engaging with that individual to help stave off loneliness, help them feel like they are part of their community in whatever way that they want to engage with that, so we do a lot of that work. That sometimes gets overlooked. It’s by no means the main reason people call us but it’s an important part of what we do.
07:02 – Joanne
It’s crucial I feel to keeping a person whole. They don’t want to be isolated. They want to feel like a person and if you’re able to engage them throughout the day, I mean that’s wonderful.
07:15 – Jeff
Yeah, yeah. I mean we all need our downtime and our alone time but not many of us in our adult lives experience the loneliness that can come if you’re an elderly person and it can be really, depression can set in. Your health is harmed when you have that happening, and when you don’t have any interaction. We of course respect everyone’s desires. There are plenty of our clients that want to be left alone as much as they want and we respect that but there’s a lot that would be happy to be doing something else if they were triggered in the right way. If someone just asked them “hey would you like to go do this?” and they’re like well yeah but I haven’t done that because I didn’t have a helper to get me there. So we provide that means to give them the assistance they need to do things they previously couldn’t do.
08:03 – Joanne
Walk me through the process. I have my mom that I just suddenly found out that she has Alzheimer’s. What would the process be?
08:16 – Jeff
As a company, Caring Senior Service, we’re a little bit unique. We have a process that we follow that we find to be very helpful in working with the family member to make the right decisions. That decision might not actually be to use our service. It may be that they discover that they can cover it in some other ways. But what we do is a very thorough assessment of the situation. We come in and schedule a time to meet with the client directly and with the family member. We find that if there is family involved we want them to be involved in that assessment but we also want to make sure we involve the client regardless of their condition. Even someone with Alzheimer’s we’re still going to involve them in the process. One, out of respect, but two, because we’re going to learn things that the family member didn’t either know or didn’t see because when you’re in care with a loved one its’ much different than when you’re a third party analyzing a situation.
09:17 – Joanne
That’s a great point to bring out.
09:19 – Jeff
Yeah, so our assessment really goes through, we start off by covering what’s called the IADLs, the instrumental activities of daily living which are not the things most people focus on but that’s like how can I interact within my environment. Can I use my telephone? Can I utilize or manage my bill paying? Can I use transportation? These kinds of things. We ask really unique questions to understand what someone’s level of independence is from the IADL aspect. Then we go through and really go into some of the health history as naturally part of that understanding what conditions they are dealing with or facing, some of the past history, but then we really get into what we want to accomplish with bringing someone into the home. What are the goals, if you will. So often we’re focused on the condition and the situations that are caused by that condition and we’re not looking at things, like something as simple as maybe someone goes to church. We might ask how often would you like to go to church versus how often are you going to church. Because, if my routine is changed due to my condition then if I ask what’s your daily routine like I would miss that. But, if we ask is church something you would like to do, then we create a plan to get that back if it’s in the realm of possibility. Sometimes it’s not but sometimes it very much is. A question like what does a normal day look like for you, or is there something that you used to do that you would like to do. These are all questions that we ask during our assessment and it bring out, sometimes it brings out some tears because people tell some things about what they want to accomplish and we might know that it’s going to be difficult to get there but we can figure out a way to get close to there oftentimes and we can create environments and situations to where they can get some joy out of what they used to do. It’s a modified version but they can figure that out. But its that assessment that’s not just looking at the health condition that so many of our companies sometimes can just focus on the health condition and what that allows us to do is then create an intended plan of service that the family can decide on. So, it’s much different than what most companies do. Many companies will do an order taking process kind of like going to a restaurant, what would you like to eat and have a menu in front of you and you just pick those thing.
11:57 – Joanne
That would be specific things like...
11:58 – Jeff
That works. If you are an expert in senior care and geriatric home care then you can maybe figure out what your mom or dad needs but most of us have no experience and we don’t know what those things are so when we state what my mom or dad needs, it’s going to miss out on a lot of other things. So our assessment is a cornerstone to our services and helps us provide that service plan and it’s still a starting point because that assessment is used throughout the delivery of the service so we can tyr to plan things for that family and for that client that enriches their lives so we’re really doing what you mentioned earlier which is caring for the whole person. That is something that starts off that process, and then if the decision for the family, what would they like to do in their scenario. If our assessment says Mom’s Alzheimer’s advancement is to the point that she should not be alone anymore, she needs someone with her around-the-clock. You’ve said we’ve got nights covered because we have family that can stay there, we probably just need someone during the day. Well then we create a plan that fits those needs but we also want to have backup because the care that is there at night may not always be able to be there. So we would want to have a plan in place for what happens when that person needs some time off. How do we make sure we give them the respite that they need as well, so that’s all kind of pulled into that planning and part of that assessment process and part of that decision making that we would do. From there the families get the chance to make the decision they want. They can go with the plan that we have laid out, they can modify it some that best suits their needs and their situation, or we can really continue to evolve that plan based upon, you know the situation changed so we always have an evolving plan ongoing for our client.
13:56 – Joanne
I really like that Caring Senior Service looks at the whole person and brings the other person into the conversation because I’m sure you’ve seen many surprises in family members that certain things were brought out like “oh I didn’t realize they liked to do that”.
14:14 – Jeff
Yeah. If I can share a personal story that really hits that home well. My aunt received services prior to her passing from my company and it was an honor to be able to provide services to her but I tell this story in that I was doing the exact assessment we would do with a client that we would come across. I was doing it with my aunt and uncle at the same time, her husband. I asked my aunt a question like, her name was Aunt Connie, and I said “Aunt Connie, how well are you able to answer the telephone? She said “I can answer the phone with no problem. I can pick up the phone. I can say hello to whoever is there and it’s easily done. I said “Ok that’s good”. I will mark that one down and you can do that with no assistance. Then I said “How well are you able to make a phone call if there was an emergency?” and she said “I can make a phone call with no problem at all”, and while she was saying those words to me directly my uncle beside her looked befuddled. He said “Honey you can’t”. You’ve got rheumatoid arthritis and your hands are like this. They’re all crumpled up and you can’t push the buttons on the phone. So there is no way you could dial a number if you had to”. That is an example of where the client thinks I can do anything, no problem but the family member was able to say hey, you can’t. Now in that situation it was a husband and wife, my aunt and uncle, and she was like no I can do it and he was adamant that no you can’t and so I had to play a little bit of a middle peacemaker like oh it’s not that bad but probably something you need some help with and it might be a situation we need to be aware of. Again, that was a real simple example. It was an obvious one but it’s a type of question in a way that we ask something that is out-of-the-blue like why would someone in a home care situation ask about phone calls.
16:12 – Joanne
Yeah you wouldn’t think that.
16:13 – Jeff
But fundamentally those two things are so different and to get to those two things discovering that information would help you understand a lot of other things later on. So what about if my aunt had to open a jar up to put jelly on her bread. She wouldn’t be able to do it so there’s things that you have to account for that makes it impossible. Again, your industry is not really great at doing that. If you were a therapist or a geriatric clinician then you might ask these type of questions and that’s were we went to as a company, we want to make sure that we understood that we were asking the right things. It might seem intuitive to most of the people at Caring that are going it now but it’s just not doing very frequently. That’s not to say that Caring is a better company in that sense. It’s just that our industry needs to be better at understanding the needs of our seniors and I hope that they all do improve that process and we all have the chance to understand really what the needs are because families need to understand it as well. It’s like my uncle needed the opportunity to be able to speak up.
17:14 – Joanne
That’s true and I find a lot of times we assume things. Even in the industry unfortunately we just assume this is the way to do A to Z, this is the way we do it so I like that point that you brought out. You’re not assuming anything about the client you’re actually finding out the information that you need. What would you say the philosophy of your company is?
17:44 – Jeff
That’s a deep question. I think that for us it’s the commission statement if you will. I would probably put that as our philosophy which is on our logo and its there for a purpose – Healthy, Happy, Home. If we can do what we can to make sure our clients say as healthy as possible by using our services we believe that makes them happier and if those first two things are accomplished people will be able to remain at home as long as is physically possible and most people what that and we are helping to achieve that. We try to make it real simple. All of our team members understand what our mission is and I think our philosophy is about doing all the things that are required to make that happen.
18:27 – Joanne
I recently wrote a letter called “I Am Not a Stranger”. I feel like a lot of family members are on the fence about hiring a caregiver. So for those that are on the fence, what would you tell the family members?
18:45 – Jeff
I think it has probably been well documented but probably not understood enough. I think the number one reason why people don’t bring in help is guilt. As a daughter and son, we think that this is our responsibility and we need to take care of the situation and if we have our own lives we tell our spouses, we tell our kids, hey I’ve got to deal with this right now. We don’t always respect the timeline that we’re dealing with. It’s not a short timeline often. Sometimes it can be but sometimes it’s a very long timeline and so don’t feel guilty about this. I think that is something that people have to get past. Guilt is not something many people admit to. It’s the tough part of that conversation because I say it’s the number one reason. It is a bit of an assumption. It’s an assumption based upon talking to thousands of families throughout many years of doing this though and the fact is that I try to point out that you will do more harm in trying to help by not bringing in a third party in some way, shape or form, than you will if you just let someone help you out. You bring in that help. If its money issue, sometimes it’s a money factor. Money is better spent in care of your mom or dad than it is being saved for a rainy day later on because the rainy day is here. That’s what I try to tell people. It’s here. It’s raining really bad right now and we need to get help. But, some of the other questions that get brought up maybe are the concern about a stranger in the house, bringing in someone that’s never been there. I think that is vetting the company’s policies is real important. Ask how do they come about hiring people. What are their safety mechanisms in place? What do they do to make sure that the caregivers are screened and that they are qualified to do the work, asking those questions and being comfortable with those answers and digging deeper in those. If nothing else, your job now as a son or daughter is to be thorough in that evaluation. I think that is what people to move to is being thorough. If you are in doubt of a company move on. Go to the next company.
21:12 – Joanne
That’s a great point to bring out, yeah.
21:14 – Jeff
Until you get comfortable yo need to be comfortable with that company. It’s not just the company’s brand, it’s not just their name, it’s not just what you’ve read on the Internet, and it’s the leadership of that branch, someone you trust. Do you feel like they will look out for your best interests. Will they answer the phone at 10:30 on a Friday night? You know, that kind of thing is important. So, I think if you answer those questions then you can get off that fence. You can decide, okay, I can move forward with this and get rid of my guilt, know that I can’t do it all, I’m going to harm someone else by trying to do it, and then next is to really make sure to make a good decision in the process.
21:58 – Joanne
Anything else that you would like to share?
22:01 – Jeff
My goal as a leader in senior care is to elevate the industry and to make the choice for more families easier so I really appreciate the questions that you’ve asked about that because I think that is something that we just need more people informed and know what services are out there so they make an informed decision. That’s all we ever care about.
22:20 – Joanne
Thank you Jeff for joining us today and sharing your story.