Ep:55: Caregiver Career Ladders Really Work—Here’s How

Miriam Allred (00:08):

Welcome to Vision | The Care Leaders’ Podcast. I’m Miriam Allred with Activated Insights. My guest today is Dawn Spicer, the Caregiver Development Manager at Home Instead out of Jacksonville, Illinois. Dawn, welcome to the show!

Dawn Spicer (00:22):

Hi Miriam. Thank you so much. I’m so happy to be here today.

Miriam Allred (00:25):

We were just chatting about it before the call, but caregiver shortages are almost

Miriam Allred (00:31):

Unbearable right now as you’re kind of experiencing. And I wanted to say this, we just got off a webinar about the top complaints from caregivers and 94% of providers have said they’ve turned down cases due to staffing shortages and the last couple of weeks and months. And I know you guys are kind of experiencing that there with a wait list, but the topic today is just understanding that there are career paths and career ladders for caregivers within this industry. There are the caregivers out there that are passionate about this field and want to make a career out of it. And that’s why we brought you on the show today is to talk about the journey that you’ve gone through over the last nine years, starting as a caregiver now becoming this caregiver development manager. And I just want you to tell your story. So, so let’s really just start there. You started as a caregiver when you were 18, how did that come about? What did you know about home care? You know, just kind of start from the beginning.

Dawn Spicer (01:27):

Okay. Yeah. So I’m actually a second generation caregivers. My mom actually worked for home instead and I’ve always had a passion for taking care of people and helping anyone. I kind of wear my heart on my sleeve, so that’s something that’s really important to me. And I was an ambitious person when I was younger too. I did see any school and just really love to taking care of people. So when a mom enjoyed home care so much at home instead I knew I just had to give it a try. I didn’t know much about home care, but I definitely knew that I wanted to keep people as home as much as possible and, and kind of help them be independent so they can live the rest of their lives at home.

Miriam Allred (02:05):

I love it. I didn’t know you were a second generation caregiver, probably what all agencies want to hear. They want to find caregivers that kind of know about the field, because obviously we talk a lot about how COVID has shown a light on this industry, and now there’s more kind of household knowledge about home care, but before there really wasn’t. So it’s cool to hear that you knew about it before. So, so you were 18 when you started as a caregiver sounded like you were going to CNA school. Talk to me a little bit about yeah. Where you were at when you were at that stage of life and, you know, kind of just how the first few years as a caregiver were.

Dawn Spicer (02:43):

Yeah, for sure. So actually spent three years ne caregiver. I started in a long-term care facility first as a CNA and I, of course I loved that helping seniors and you know, getting them the care that they needed. And just being able to see them laugh. And, and then home care kind of gave me a whole new perspective because they’re inside their homes and they just want to be there and be happy. Sometimes, you know, in a longterm care facility, they get separated from the people that they love. And this just kind of keeps them independent. So I spent three years as a caregiver at home instead, before I moved into the office. And that was just such a good journey for me. I had so many like laughs and tears and I got to hold a lot of people’s hands and just see them through that. So that was very important to me is to get that kind of perspective before moving into a different position.

Miriam Allred (03:37):

Yeah. So let’s kinda talk about that this career ladder, you know, it sounds like home instead kind of set you up for that, but it was because you wanted that and I’m sure there were some communication. What did some of those touch points look like early on? You know, as you’re a caregiver, was there open communication of like, Hey, I want to progress or were they, you know, keeping an eye on you? What, what did that look like? Kind of in those, in the transition?

Dawn Spicer (04:02):

I think it’s a definitely a two-way street. And we actually opened up all of our positions to our caregivers. We believe in unlimited potential. You just need a passion and we can teach the rest. And we, we believe that to this day. So I definitely, you know, anytime I had a review, we talked about goals. Like where do you see yourself in five years? What do you want to do? And our mission is, you know, the hands, the lives as others. And we can do that in any role here at home instead. So it was definitely a two-way street of, you know, yeah, this is something that I’d like to continue in and I love being here at home and, you know, home instead, what else can I do here? So

Miriam Allred (04:38):

I love hearing that you were offered reviews. I think that that’s common, but maybe not as common as it should be. How often were you being reviewed? Just for context?

Dawn Spicer (04:49):

So annually, we had definitely a lot of conversations outside of that, but each year we had an overview and I just kind of just to sit down and talk about our experience our clients that we’ve worked with goals that we’re setting personal professional and kind of where we’re at and it’s really good feedback. Right now I’m doing those reviews for our caregivers and it’s really good chance to get that feedback. Like what else can we do to help them feel satisfied in your role

Miriam Allred (05:15):

A year is, is probably great, but maybe some providers tuning in with things, you know, we have caregivers leaving after two to three to six months, obviously there’s checkpoints leading up to the year review, but I think it’s just really good practice to identify when you need to be reviewing your caregivers so that there is that open communication. And so that those goals can be discussed.

Dawn Spicer (05:39):

Now we actually have a mentorship program, so it lasts 90 days after we hire someone. So we touch point each week with them to kind of see how things are going so that they have the training that they need. After we give them the initial training, cause the initial training, it’s fantastic. It’s meant to build them up and make sure they have everything they need, but once they get going, they might hit little snag. And they’re like, why? I think I want this, but they might not feel really comfortable kind of asking for that help. So we’ve kind of set ourselves up to be right there to provide that when it’s needed.

Miriam Allred (06:11):

Yeah. I didn’t anticipate talking about mentorship programs, but if let’s, let’s talk about it for a little bit. So you mentor your caregivers for those first 90 days. Yes.

Dawn Spicer (06:22):

Yeah. So that includes like weekly touch points. And that is done by a key player assistant one of my staff that touches point with them every single week, just to see how things are going. Are they getting the hours they need? Did they feel well-prepared prepared for this situation or that situation? And then after 90 days we actually meet with them and do a review. And that’s when it goes into that annual afterwards.

Miriam Allred (06:46):

Yeah. And that obviously like, you know, the first 90 days are so important. And so there needs to be probably more communication, more touch points a 90 day review at that 90 day mark to make sure, you know, even if people have gotten to the 90 days, that’s a huge milestone for a lot of agencies, but just really kind of holding their hand, identifying their satisfaction levels in those first 90 days to see, you know, how can we set them up for success onward? So, one, one follow-up question. You said you have an assistant underneath you. That is the mentor that’s providing all the mentorship.

Dawn Spicer (07:20):

Yes. Yep. And she’s actually a part-time caregiver too. And she’s been a team lead in many homes because not just do we offer, you know, positions in the office for growth, but we also have like team lead positions for caregivers to kind of have leadership inside the homes and help mentor other caregivers. Cause that’s sometimes something that they want to is to have that like hands-on mentorship available for them.

Miriam Allred (07:44):

Let, let’s talk about those, those designated roles. It looks a little bit different and there’s a lot of different terminologies, but it sounds like, you know, you have the caregivers, then you have team leads and then you have kind of this mentorship assistant and then yourself kind of define each of those roles so that we can see, you know, even the career ladder in the first, you know, so many weeks and months and even within a year, you know what that can look like.

Dawn Spicer (08:07):

Yeah. So we have caregivers that get hired and they just start out as caregivers learning the role. They surpass that 90 days and you know, when we do those goals and they say, well, we would like to have a leadership position that is when they can go into that team lead position. And that is where they actually mentor other caregivers in the home that might need assistance and need to grow. And then my assistant actually trains that team leads to be successful and have leadership. And then I train, you know, that, you know, key player assistant to be able to lead the other. So it’s really just, you know, us communicating and, and making sure that every step there’s training provided. So that way they feel successful and it just grows from there. Our team needs can become key player assistance, which is pretty much, you know, working part time in the office to help out with duties and also, you know, keeping that compassion and passion for home care and staying inside the home and doing that hands-on caregiving as well.

Miriam Allred (09:01):

Yeah. I love hearing that and I love that the team lead role, because I think some people think, you know, there’s the caregiver and then there’s kind of office staff and there needs to be some roles in between that, that can set them up to, you know, become a scheduler, become, you know, an office employee. Let’s talk about some of the roles of the team leads. I think you kind of mentioned some that maybe they’re there early on in the caregiver’s first few visits or something, but what, what are some of the roles of those team leads?

Dawn Spicer (09:33):

Yeah, so our team leads they actually provide that contact. So they have each other’s numbers. If they ever have questions, they can reach out to them specifically, specifically, and they report to our client care coordinator. So it includes like training shifts. So when we have a new caregiver and might not even be a brand new caregiver, but a new caregiver for a client, like they haven’t had this caregiver before, no matter how seasoned they are, that team lead is there to train them specifically set up to what that client wants and what they feel comfortable with. Cause that’s the best part about training is when you have the adequate training that you need, you feel confident, but it also just goes so much smoother. It’s easier. And the client bills, you know, a lot more competence in us too, cause they feel like their needs are met.

Miriam Allred (10:18):

I love everything you’re saying maybe for context, you could share, you know, roughly how many caregivers you have and how many team leads for so many caregivers. Just kind of what like the org chart looks like underneath.

Dawn Spicer (10:30):

Yeah. So we have about 90 caregivers right now. Our goal is of course is to get over that a hundred mark again, cause we were there and I would say we probably have about 12 to 14 team leads. Not every team will need a team lead, but let’s say we have like a 24 hour client or just a client that has a lot of appointments or health conditions. And a lot of up that is when we put that team lead in place just to bridge that communication, like you said, between office staff, caregivers and that way it just all connects. Now I will say that the team lead, it connects us more. A lot of people would say, well, they feel distanced from the office cause that in between person that helps them actually communicate so much more. They feel more confident that they can take it to the team lead and to the client care coordinator or to their supervisor. Me who can help them with anything that they need.

Miriam Allred (11:19):

My mind is caught up. I’ve I’ve been looking at kind of the top complaints from caregivers over the last six months. I just was, you know, reviewing like 50,000 surveys of these complaints from these caregivers. And, and this is like the solution to so many of the complaints in that. Just a lack of communication, but it’s because the office staff have so many things to be doing on a daily basis. And if you have 90 to a hundred caregivers, you know, they can’t hold the hand or give the attention to each and every one of those caregivers. So you need all this career ladder with all of these different roles to make sure that every caregiver has a one-to-one relationship with a team lead or with a mentor so that they feel heard. And when something comes up, they have someone to turn to.

Dawn Spicer (12:06):

Yeah. It’s like they have that instant kind of person to be able to hear their concerns and report that to, and get a follow-up from both people if need be, you know, let them know that I already sent that to the office and they’re going to follow up with you. So, you know, we hear that a lot too is, you know, other people it’s, they need the satisfaction of the job and feel heard that communication and that training together is definitely a very big solution to make our caregivers and help them feel satisfied.

Miriam Allred (12:33):

Totally. So let’s, let’s shift gears a little bit and talk about some of the training takes place, you know, obviously there’s the orientation and kind of the initial training, what are some of the training opportunities that you have as people progress through this career ladder and why is the training so important for their satisfaction and for kind of their long-term career goals?

Dawn Spicer (12:55):

Yeah, for sure. So we, we actually do monthly training as well for all of our caregivers, but each position that we hire in for let’s say like a key player assistant, which would be an assistant to an office person, it has kind of a set up training program, like what they need to learn to feel successful. And it’s not just the skills. But sometimes it’s just, you know, feeling comfortable, you know, sharing and transferring calls or just helping someone else, you know, making sure that they’re comfortable with certain conversations. So we set up training plans for each of that. And then we also have training plans for our team needs to, so there’s like a training plan in place for each person. And really that just kind of us sitting around saying, okay, what do you feel like we need to do to make you more comfortable in this? And we just create something from that. Sometimes it’s a communication, like an effective communication training plan and just helping them feel satisfied. Cause that’s the biggest part of longevity is helping them, you know, feel successful and no one wants to, you know, we all fail, which is not really failing if we’re trying. But if they keep trying and they don’t have that help there, that is where you feel like you’re really failing. So we just help them with the tools that they need and they take it from there.

Miriam Allred (14:10):

It’s easy to get caught in the mindset of kind of a one size fits all training plan. But like you’re saying, it needs to be so customized to the individual caregivers know, I think you were kind of doing some sort of CNA school when you became a caregiver early on. So your knowledge was probably way further than someone that has never provided care has no idea what they’re doing. Just, it looks so different for the different, you know, employees that you hire on. And so the training has to be so customized. It

Dawn Spicer (14:43):

Does. And just really learning like, you know, what have you done before we actually have like a caregiver evaluation? So the training, you know, the initial is all the same, but from their evaluation, we can provide more training for them for specific areas. We actually have a great program with home and said, that’s empower so we can do hands-on training. And we also can morph it with online training as well.

Miriam Allred (15:06):

And what, what are you seeing there as you offer both? I had imagine you have a wide demographic of caregivers as most agencies do. And if you have 90 caregivers, I imagine they’re all different ages, backgrounds kind of demographics. So what, what’s the response like when you offer a variety of training or what, what are people gravitating towards?

Dawn Spicer (15:25):

I would say since it’s such like a variety, it’s a little bit of both and we see a lot of relief, like for some of our older caregivers that aren’t super tech savvy. They’re like, oh, you still do in person. That’s fantastic. They’re they, they feel relieved that they can still have that person there for them. And for some of our younger caregivers or just maybe very busy caregivers, maybe they’re still in their forties, but they have kids in college and another job they’re like, oh, that’s so easy, accessible. Like I can just log on and get that training whenever I need it. So we see a lot of satisfaction with both.

Miriam Allred (15:57):

I think, you know, maybe some agencies feel like, oh, we can’t offer it all. We can’t do it all it’s too much. But, but then you see the level of care is elevated. The job satisfaction is elevated when you give them options. Cause like you just mentioned. Yeah. The older caregivers may think, you know, I can’t get online and do an E an e-course or something, but then there’s really busy caregivers that are working multiple jobs, have kids. They like the online. So it’s just really good to offer a variety.

Dawn Spicer (16:27):

Yeah. And it makes our life easy too. Like integrating our empower training. Only made things easier. Cause you know, we had that big group that was just all hands on. So it actually took a little bit, you know, off our plate as well to provide that. So it was a win-win for sure.

Miriam Allred (16:42):

For sure. Tell me a little bit about your personal experience being trained. You know, you came to home care with a background of what home care was and kind of knew what it would be like, but, but what was so important about the training that you received in how it helped you want to kind of make this a career?

Dawn Spicer (17:01):

Yeah, I think it was just that it was so customized. Like when we’re going into the new hire and orientation, it’s a lot of the same basics, but they do ask the inquire, you know, what have you done before? What have you not done before? What do you feel comfortable with? That’s something that I really enjoyed is trying to customize that for everyone and make sure because success looks different for each person. You know, we might have someone that wants to go all the way up the ladder. We might have someone that just wants to stop with the team lead and that’s, that’s exactly where they want to be. So that’s the kind of training that we try to provide message training the iPad. I was definitely ambitious and hungry and I have a passion just for learning to and taking care of people. So I was just like, what can I learn? What can I do? And if you have, and that’s what you want to do, it’s definitely provided for you.

Miriam Allred (17:52):

Yeah. I love what you’re saying in that, listening to the individual needs of each caregiver, some want to progress. Some are happy being a caregiver for 10 or 20 years and that’s fine. And just meeting them where they are. I love that concept of just listening and learning and meeting them where they are and being okay with that and not pushing anything on them. I want to talk a little bit about training as it pertains to retention. You know, we started the conversation talking about the shortage and how hard it is to recruit right now, but also the flip side of that is retention keeping as many of your employees as you can. How have you seen training help you retain some of your employees?

Dawn Spicer (18:36):

So training has definitely been a key part. So a lot of times, like we were saying earlier, if it’s a new employee, they might not feel comfortable. You know, no matter where they work saying, Hey, I don’t know if I can do this. Like, I don’t know if I have the skill for this or that you most likely will see someone just quit before they say that. Which is really disheartening. So we tried to combat that with open communication. And that’s why training is such a good part is, you know, they can come to us and say, I’m not sure that I know how to do this just yet when we say, okay, well let’s, let’s start on a plan. Let’s see where you’re at and see how we can get you that. So you feel successful. No one likes to keep working on something and then continually not do well. That’s not good for anyone. And it helps them feel like, you know, good at what they’re doing, but also loving what they’re doing. And that’s super important. We have like a motto here. We have even yard signs that says, I love my job. And that passion is that first step. And that training is like that foundation after it.

Miriam Allred (19:32):

Yes. So well said, I couldn’t have said that any better in that. Yeah. They’ll, they’ll learn to love the job. The more confident they feel in their skillset. And that comes from training and just the care there’ll be able to provide better care and, you know, get along with the client and interact so much better if they’re trained and then loving their job, that satisfaction comes from really being trained. So I love what you said there. This is really everything that I wanted to cover. I am just so impressed with you and your journey and you’re representing home instead. So, well, I know it said at the beginning that you’re the first guests we’ve had from home instead, but I just think of how young you are and your journey and how inspiring it is for other providers or other office staff to hear your story and know that it’s possible for caregivers to make

Miriam Allred (20:22):

A living and to make a life in this industry. And we’ve just got to instill that from the beginning, train them, right. Set them up on these career paths and, and you’re a testiment.

Dawn Spicer (20:33):

Thank you so much for having me. I enjoyed it. And I’m so happy to be a part of Home Instead second generation caregiver. And I just, I love my job. It’s helping people love their job is making me love my job even.

Miriam Allred (20:46):

Yeah. Well, thanks for joining me, Dawn. It’s been a pleasure.

Dawn Spicer (20:49):

Thanks Miriam. Have a great day.