Reviving Caregiver Work EthicThis is my great pleasure to host Stephen Tweed,  for this week’s newsletter. Stephen is the CEO of Leading Home Care and Founder of the Home Care CEO Forum.  He recently published a book Conquering the Crisis: Proven Solutions for Caregiver Recruiting and Retention. I asked Stephen to address a concern shared by many who employ hourly workers. It is often referred cautiously as “work ethics” but really it’s about the perceived lack of appropriate work habits.

Anne-Lise: “Stephen, I keep hearing complaints from owners and CEOs in senior care about the lack of work ethic among their young caregivers. What’s your take on the situation?”

Stephen Tweed: “Several weeks ago, the topic of the millennial generation came up in a presentation. There was a lot of buzz and I shared a quick funny story.

Afterwards, a young man came up to me and said, “I think you are someone I can talk to.  I’m a millennial, and I don’t appreciate speakers who get a cheap laugh by telling jokes about millennials. I know many millennials who have a very strong work ethic.”

His candor stopped me in my tracks.  I agreed with what he was saying, and promised not to make fun of millennials again.

Our conversation caused me to step back and look at the challenge of work ethic and what we as leaders can do about it.  While there are certainly some challenges with the perceived work ethic of younger, caregivers, they don’t have a monopoly on “no-show, no call.”  There are some great caregivers who fit into the millennial generation, and who are out there doing great work making a difference in the lives of their clients.

Is this challenge specific to the senior care industry?

No, it isn’t. I interviewed Eric Chester for my new book, Conquering the Crisis. Eric understands in detail the challenges of hiring and leading younger workers. He asks a terrific question: “What do you expect from each and every employee?”

That struck me as a very precise question for leaders in home care who are hiring caregivers. Eric’s answer is: “Employers are searching for positive, enthusiastic people who show up for work on time, who are dressed and prepared properly, who go out of their way to add value and do more than what’s required of them, who are honest, who will play by the rules, and who will give cheerful, friendly service regardless of the situation.”

Does that describe your ideal home care worker? Of course.

He describes seven characteristics employers want from their people:

  1. Upbeat, optimistic, energetic, and positive
  2. Dependable, no matter what
  3. Neatly groomed, appropriately dressed, and well mannered
  4. Ambitions and dedicated (not satisfied with merely good enough)
  5. Trustworthy
  6. Coachable
  7. Determined to do anything necessary to delight every customer

Right now, you’re probably thinking of one or two of your very best caregivers who fit that description.  These are the folks we want to attract with our Culture of Attraction and Accomplishment.

So what can we do to revive the work ethic of caregivers?

Eric goes on to talk about “Sandbox Values.”  When small children are old enough to understand, and comprehend basic commands, parents and teachers begin to program their value systems. Children all around the world are taught:

  • Smile and play nice.
  • Be prompt.
  • Look your best.
  • Do your best.
  • Obey the rules.
  • Tell the truth.
  • Say please and thank you.

These Sandbox Values line up perfectly with the seven qualities employers look for. Eric says, “Instilling these seven attributes into the hearts and minds of the emerging workforce is the key to keeping our companies, and our country, stable and prosperous.”

Translating Sandbox Values into Caregiver Values

While we can all agree that the list of what employers want, and the “Sandbox Values” that Eric describes are what we want, how do we get these in our caregivers?    To better understand the very best caregivers in home care, we worked with the members of our Home Care Mastermind Groups to conduct a “Best Caregiver Study.”  Fifteen of the mastermind member companies identified their top 20% of “best caregivers” based on two criteria; client satisfaction and dependability.  One hundred eighty four “best caregivers” responded to the survey.  

Here is what we learned:

  • Average age:  46.7
  • Average years working in home care: 8.9
  • Average years working with this company: 3.6
  • Gender: 98% female
  • Would invite best friend to work here: 74.5%
  • Would be motivated by a referral bonus: 57%

We also learned how these best caregivers found their employer, what attracted them to this company, and why they stay.  The lessons from the best caregiver study gave us some interesting new clues into the mind set and work ethic of “best caregivers.”

Now, how do we translate that knowledge into building a culture in your home care company that brings a strong work ethic to the job.  Regardless of the age of the workers, there are some things you can do to find and keep high quality caregivers.  

In Conquering the Crisis, I describe in detail a seven-step system for developing a workforce of high quality caregivers:

  1. Define Your Best – identify the top 20% of your caregivers and develop a clear demographic picture of who they are, how they found you, and what makes them the best.
  2. Attract the Best – Develop a three-pronged strategy for caregiver recruiting that brings you high quality applicants from whom to select.
  3. Select the Best – While attraction is important, selection is the key. Develop clear criteria for selection and create a selection matrix of consistent behavioral interview questions.
  4. Hire and On-board the Best – That first day of new employee orientation sets the stage for everything that follows. Review and refine your on-boarding process
  5. Develop and Train the Best – Data show that investing in education and training of caregivers pays dividends in work performance, client satisfaction, and caregiver retention.
  6. Recognize and Reward the Best – The most important factor in caregiver satisfaction is feeling valued and appreciated. First is being appreciated by clients. Second is being appreciated by their immediate supervisor. Third is being valued by the owner and leaders of the company.
  7. Retain the Best – The three big factors in employee retention are, 1) feeling valued and appreciated, 2) doing meaningful work, and 3) working with a Servant Leader.  

All the data are clear.  Health Care at Home will continue to be the fastest growing segment of health care in America.  The explosion of the aging population, the desire of seniors to receive care in their own homes, and the lower cost of providing care at home means that the future of in-home care is amazing.  There will always be a need for what we do.

At the same time, there are simply not enough workers with a strong work ethic who want to do this work.  As a leader of your home care agency, you will be able to grow and prosper only if you are able to attract and retain high quality caregivers who demonstrate this strong work ethic.  

Not every leader will be able or willing to do what it takes to attract and retain the best.  You can be special. You can set your agency apart by studying and learning what motivates today’s workers, and by creating what we call “A Culture of Attraction and Accomplishment.”  

Stephen can be reached at or by calling 502-339-0653.