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Business of Aging Special Coverage

House Calls

While the pandemic may have challenged the home-care industry, it certainly didn’t suppress the need for such services. In fact, demographic trends in the U.S. — where about 10,000 Baby Boomers reach age 65 every day — speak to continued, and growing, demand for care services delivered in the home. That means opportunities both for agencies who specialize in this field and job seekers looking for a rewarding role and steady work.

Michele Anstett says business was like “falling off a cliff” when COVID hit, but client volume has returned to normal.

Michele Anstett says business was like “falling off a cliff” when COVID hit, but client volume has returned to normal.

By Mark Morris

In early 2020, Michele Anstett, president and owner of Visiting Angels in West Springfield, was pleased because her business was doing well. As a provider of senior home care, she managed 80 caregivers for 50 clients.

“We were going along just fine,” she said. “And when COVID hit, it was like falling off a cliff.”

The business model for companies like Visiting Angels involves interacting with people in their homes, so when early mandates encouraged people to keep away from anyone outside their immediate ‘bubble,’ it hit the industry hard.

Even though caregivers were designated as essential workers, Anstett saw her numbers shrink to 39 caregivers who were now responsible for only 19 clients. In order for her business to survive, she continued to provide services for her clients who needed personal-care services around the clock and for those who had no family members in the area.

“Where possible, we asked family members to step in to help out,” she told BusinessWest. “At the beginning of the pandemic, there was less risk to everyone when a family member could be involved with their loved one’s care.”

Anstett also incorporated a detailed checklist of risk factors for each caregiver to review to prevent COVID-19 from spreading to them or their clients.

“I thought patients weren’t following up because of a language barrier. As it turns out, they weren’t responding because they didn’t understand the severity of the situation.”

“We talked with caregivers about the people in their circle,” Anstett said. “It was similar to contact tracing, but we did it beforehand, so people would understand what they had to consider to protect themselves, their families, and their clients.”

A Better Life Homecare in Springfield runs two home-care programs. In one, it provides personal-care services such as helping seniors with grooming, cooking, laundry, and more. The other program provides low-income patients with medical care in the home, such as skilled nursing services, occupational therapy, and physical therapy.

On the medical side of the business, licensed practical nurses (LPNs) handle many of the home visits, while certified nursing assistants (CNAs) and patient care assistants (PCAs) are the main frontline workers on the personal-care side. A Better Life also employs case workers to supervise PCAs and CNAs and to set up other resources a patient may need, such as Meals on Wheels and support groups.

When COVID hit, said Claudia Lora, community outreach director for A Better Life, she and her staff made patient communication a top priority.

Claudia Lora

Claudia Lora says communication with clients was key to navigating the pandemic.

“We implemented daily phone calls to our patients that also served as wellness check-ins,” she recalled. Because a majority of the company’s clients are Spanish speakers, A Better Life employs many bilingual staff. At the beginning of their outreach efforts, Lora became concerned when some patients didn’t seem to follow up and respond to communications.

“I thought patients weren’t following up because of a language barrier,” she said. “As it turns out, they weren’t responding because they didn’t understand the severity of the situation.”

On the other hand, she said some patients temporarily stopped their home-care service out of concern about interacting with anyone in person. The system of daily phone calls helped address patient concerns and keep them current on their treatments. In addition, patients received whimsical postcards to lift their spirits and care packages of hygiene products and food staples.

“The pandemic opened our eyes in different ways,” Lora said. “It made us aware that we needed a system of daily phone calls in both programs, which we will continue even after the pandemic is no longer a concern.”

 

Growing Need

The lessons home-care agencies learned from the pandemic — some of which, as noted, will lead to changes in how care is provided — come at a time when the need for home-based services is only increasing.

That growing need is due in part to people living longer, of course. According to government data, once a couple with average health reaches age 65, there is a 50% chance one of them will live to age 93, and a 25% chance one of them will see age 97. With the increased longevity, there is also a greater chance these seniors will need some type of assistance with daily chores or treating a malady.

Receiving care at home, with an average cost nationally of $3,800 per month, is less expensive than moving into a nursing home (approximately $7,000 per month), and nearly everyone would rather stay in their home. When seniors need assistance, Anstett said, they often rely on family members out of fear of having an outside person come into their home.

Now that concerns about COVID are easing, she reports that people are increasingly more willing to have someone come in to their home to help, but there are still some who resist. “I wish they could understand we are not there to take away their independence, but to give them more independence.”

Lora said some of her patients were reluctant to allow people to come into their homes until they considered the alternatives.

“The only other option for people receiving medical care would have been checking into a skilled-nursing facility or a nursing home,” she noted. “I knew that was the last place they wanted to go.”

She added that the extensive news coverage of high rates of COVID in nursing homes and the high case rate locally at the Holyoke Soldiers Home convinced most people that care at home was a wise choice.

Anstett and Lora both pointed out that their companies always make sure anyone providing home care wears appropriate personal protective equipment and follows the latest guidelines for preventing the spread of COVID. Anstett said she encourages her caregivers to get vaccinated, but doesn’t force the issue because she recognizes some people have health issues.

“However,” she added, “I make it clear to the unvaccinated folks that the pool of clients willing to see a caregiver who is not vaccinated is fairly small.”

While the pandemic may have slowed down business in the short term, demographic trends still remain strong for the years ahead. According to U.S. Census Bureau data, about 10,000 people reach age 65 every day. This trend is expected to continue until 2030, when all living Baby Boomers will be at least 65 years old.

 

Looking Ahead

Fifteen months after the chaotic early days of the pandemic and with many people now vaccinated, Lora said A Better Life is busier today than before the pandemic.

“In the last six months, admissions have increased by around 50%,” she noted. “That’s more than I have seen in the past three years; it’s been insane.”

She added that her company is now short-staffed because of the rapid growth it is seeing and has been offering incentives to try to bring more CNAs and PCAs on board.

Anstett said her client numbers and caregiver numbers are back to where they were before the pandemic and noted that she has not had any problem filling open positions.

“I just cut 80 paychecks, and we are anticipating even more growth,” she said, adding that her secret to hiring is treating caregivers with respect and encouraging them to grow in their careers. “I stay in touch with every one of our caregivers. They’re the reason I’m working, so I treat them with the utmost respect.”

While many professions look to push out older workers, Anstett said she appreciates more seasoned workers and looks forward to hiring them. “Caregiving is an opportunity to keep working for those who want to, and we welcome their experience.”

Pointing out that she hired another case manager last week, Lora added that, while her organization is expanding, it has not forgotten its mission.

“Even with our growth,” she said, “we see our patients as part of a family and a community, not just a number.”

Daily News

WEST SPRINGFIELD — Visiting Angels, the West Springfield-based provider of home care and other services for the elderly, is supporting the West Springfield Council on Aging in an initiative it calls Parking Lot Bingo.

As that name suggests, this is Bingo in a parking lot. Staged every Wednesday at 1 p.m., the program was created for individuals over the age of 60. Seniors receive disposable Bingo cards and pens and are able to participate from their car by listening to the numbers called on the radio. When someone gets Bingo, they honk their horn and receive a prize. The program allows people to get out of their homes to retain some of their normal daily activities while still adhering to safety protocols in light of the COVID-19 pandemic.

This week, Visiting Angels provided the prizes for the Bingo program. The Visiting Angels bags included a puzzle, nostalgic candy, and other assorted Visiting Angels goodies with information about the company’s services.

“Visiting Angels of West Springfield and West Springfield Council on Aging share a common love for helping the elder community, and we were excited to be a part of such an enjoyable event for our seniors during these difficult times,” said company president Michele Anstett.

Parking Lot Bingo is a free event that typically lasts an hour consisting of 10 games. To register, call (413) 263-3264 or do so online at https://www.townofwestspringfield.org/Home/Components/Calendar/Event/5809/556?backlist=%2Fgovernment%2Fdepartments%2Fcouncil-on-aging.

Visiting Angels offers senior in-home care, elderly care, and care for those with dementia and Alzheimer’s. It serves towns across the Pioneer Valley, including Springfield, West Springfield, Longmeadow, East Longmeadow, Wilbraham, Agawam, Ludlow, Westfield, Southwick, Chicopee, Feeding Hills, Indian Orchard, Holyoke, Southampton, and Montgomery.

Senior Planning

Some Questions and Answers About Home-care Services

By Tania Spear

What is home care?

Home-care services are delivered to clients wherever they call home. There is a wide variety of assistance available, including everything from occasional help with housekeeping, meal preparation, companionship, and errands to skilled services such as nursing, physical therapy, occupational therapy, speech therapy, and hospice care. The goal is to support clients who prefer to remain at home, but need care that cannot easily or effectively be provided by family or friends.

Who provides home care?

Home-care services can be provided by an agency or an individual. Support can be provided from one hour to up to 24 hours a day, 365 days per year. There are many reputable agencies in the area. Your physician, area Council on Aging, hospital-discharge planner, or geriatric-care manager will be able to refer you to a home-care provider most appropriate to assist you.

“The goal is to support clients who prefer to remain at home, but need care that cannot easily or effectively be provided by family or friends.”

How do I pay for home-care services?

Government and private insurance may pay for services under specific circumstances such as after a recent hospitalization when skilled nursing or therapy services are needed. Ongoing assistance with activities of daily living (bathing, dressing, feeding, etc.) and housekeeping are generally not covered by insurance and are often private pay. It would be best to contact your provider for more information.

Are there benefits to using an agency?

While you may pay more using an agency caregiver, there are some advantages. An agency will offer pre-screening of workers, liability protection, workers’ compensation, and backup care in the event a particular caregiver isn’t available. An agency handles scheduling, payroll, and taxes, resulting in less paperwork.

How do I evaluate a home-care agency?

You will want to know if the agency works with you to develop a written plan of care and/or service contract and, if so, how often it is updated. How does the agency screen and evaluate employees? Are caregivers and supervisors available 24/7/365? How does the agency resolve concerns or complaints? Can the agency provide a list of local references?

What about COVID-19?

While accepting help at home from an agency may cause some fear during the pandemic, there are some things to consider that may help make you feel more confident in your decision to refuse or accept care as well as minimize risks. First, you want to assess the need for care. For many, care is essential, and refusing assistance in not an option. If you’ve determined help is necessary, check with the agency to determine what infection-control protocols are in place and if the agency has enough personal protective equipment (PPE) available. In addition to following CDC guidelines, you may want significant details related to how the agency is protecting staff and clients.

Are there any other things I should consider before receiving home care?

If a client or family hasn’t ever had help at home in the past, it can create some distress. The loss of independence and privacy can be factors. Oftentimes, if a competent caregiver with the right skills is placed, even the most seemingly resistant client may begin to look forward to the caregiver visits. Establishing expectations based on an appropriate plan of care and a goal for each visit is important for both the client and caregiver. With the right blend of care and compassion, a bit of support can make a world of difference in allowing someone who wishes to remain home to stay safe and healthy.

Tania Spear, MSN, MBA, RN is the owner and administrator of Silver Linings Home Care, LLC. She is a registered nurse and an Elms College graduate with a master of science degree in nursing and health services management and an MBA in healthcare leadership; (413) 363-2575; [email protected]

Business of Aging

Shifting the Balance

Visiting Angels Director Michele Anstett

When Michele Anstett opened a Visiting Angels franchise with her husband in 1999, it was only the ninth branch of a home-care company that now boasts more than 500 locations in the U.S. and overseas. Home care in general had yet to proliferate; maybe a dozen agencies were offering such services in the Pioneer Valley.

The law of supply and demand meant there were more caregivers than jobs, which was great for companies, she noted.

“We had more control, and they were more willing to do what we said. Because there were fewer agencies for these caregivers to go to, they had less choice. They were easier to hire back then — you could find a well-trained one easily because there was a deeper pool, and they were more experienced. The pay was lower — like $7.50 an hour when we started. And more of them were willing to work full-time. They were more likely to take whatever you could give them.”

These days, that balance has shifted, to say the least. Home-care services, both small independents and national chains, now dot the region, and workers are in demand.

“Now, it’s not us with the control,” Anstett said. “They have the control. They can pick where they want to go. They can choose how many hours they want to work. They’re less willing to take whatever you want to give them.”

It helps, she said, that her Visiting Angels franchise, now celebrating its 21st year, is a known name with deep roots in the community.

“You don’t have someone down the hall where you can yell, ‘hey, can you help me?’ This can be a challenge for some nurses, but the nurses we have appreciate meeting with a patient exclusively, being able to develop relationships they often don’t have time for in an acute-care setting.”

“When we first started, there were only a few businesses like this. It was just emerging, and it was something that was really needed,” she told BusinessWest. “Our model was based on what people wanted. We matched the caregiver to the client. We weren’t telling people, ‘we’ll come here at this time.’ We made it all about the client. But we also matched them with a caregiver, and they could meet their caregiver and say, ‘yes, this works,’ or ‘no, this isn’t a good fit.’ There’s a lot of work in matching a personality, skill level, schedule — it’s really challenging.”

That philosophy hasn’t changed over the years, but the challenge has become more intense with increased competition for certified nursing assistants, home health aides, and personal-care assistants.

Also more challenging is the level of care many patients require, in an era when hospital stays are shorter and Americans are living longer than ever before.

“I was a home-care nurse fresh out of nursing school in the early ’90s, and compared to the patients we saw then — even compared to five years ago, really — the patients are much higher acuity, much more complex, and they really need a lot of care coordination and are on so many medications,” said Priscilla Ross, executive director of Cooley Dickinson VNA & Hospice.

“One of the biggest roles of the home-care nurse is reconciling those medications, because medication errors are one of the most common reasons for rehospitalization,” she went on — for example, people often don’t follow instructions, or aren’t aware of certain drug interactions, or are mixing pharmacy prescriptions with mail-order drugs. “Things are so much more complex than years ago, with hospitals focused on shorter stays, and there’s pressure on skilled-nursing and rehab facilities for shorter stays as well, so people are coming home with more needs.”

Michele Anstett (second from left) with some of her team at Visiting Angels, from left, Julie Dewberry, Helen Gobeil, and Natali Pilecki.

For this issue’s focus on the business of aging, BusinessWest spoke with several home-care professionals about what’s appealing about this critical work, what’s challenging, and why those challenges are only increasing as the senior population in the U.S. continues to swell.

Return to Form

The VNA has a sizable clinical staff, as many of its clients have been in and out of hospitals or acute rehab settings. But the focus isn’t on the illness itself, Ross said, but returning people to functional status in the short term. “They want to get back to making dinner, doing the laundry, taking care of grandchildren. With nursing and rehab, that process can happen much more quickly.”

She noted that the national shortage of non-medical home health aides may be more pronounced than the shortage of nurses, but it’s a struggle for organizations to recruit both. For nurses, not only is the pay scale less than in, say, a hospital setting, but some nurses don’t like the autonomy and independence that home care requires; they’d rather work in a team setting. Of course, other nurses desire the opposite, and relish the idea of focusing on one patient instead of several at a time.

“You don’t have someone down the hall where you can yell, ‘hey, can you help me?’ This can be a challenge for some nurses, but the nurses we have appreciate meeting with a patient exclusively, being able to develop relationships they often don’t have time for in an acute-care setting.”

Julie Dewberry, marketing and recruitment specialist for Visiting Angels, agreed. “They like the one on one,” she said. “They don’t have the pressure of one person with five different patients. Some come from nursing homes and say they don’t want to do that.”

Helen Gobeil, staffing supervisor for Visiting Angels, said determining who will be a good care worker is as much art as science.

“It’s a mother’s instinct — you’ve got to feel it,” she said about sitting with prospective staff. “You see they’re caring, they want to work, they really enjoy elders. They don’t call them old people; they respect them. I have to feel it.”

That ‘feel’ can be as simple as whether the interviewee makes eye contact, Anstett said. “What’s their demeanor? Are they a warm and caring person? If they’re warm, caring, and compassionate, that’s the basis, and we can move on to skill.”

That skill can be reflected in many ways — their degree, their experience, perhaps a referral. Sometimes, the agency will bring on someone whose only experience was taking care of their grandmother. “If they have good character, we’ll put them on a companion case, with a mentor, and help them get more education. We didn’t do that before. Now that the pool is lower, we’re trying to find ways to bring in more people.”

One way is to offer more training to staff. In addition, Visiting Angels has done well bringing on nursing students from area colleges, who are able to supplement their income while gaining on-the-job experience. “They’re very good workers,” she said.

The shallower pool of talent is only one growing challenge; a tougher financial climate is another. Wages are higher — Anstett said her goal is to keep what she pays workers above Massachusetts’ minimum wage as it creeps toward $15 over the next few years — as well as higher recruiting costs and expanded paid medical and family leave in the Bay State.

Finally, as noted earlier, workers increasingly eschew full-time work and often make home care one of two jobs, and they increasingly resist set shifts in favor of flexible schedules.

“We are a known name with deep roots, but it is a challenge,” she said. “We do well, though — we’re finding people of quality. Because of our experience, we understand what makes a good caregiver and who wouldn’t make a good caregiver, and how to screen them properly.”

Constant Mission

Roseann Martoccia, executive director of WestMass ElderCare, says her 45-year-old organization’s goal has long been in line with the goals of the home-care industry.

“From the beginning, our mission has been constant: to help people remain at home with the supports they need,” she said, noting that most people, as they age, want to remain in their homes, with some measure of independence.

To help them achieve that goal, WestMass ElderCare offers a broad range of supports, not just home care, aimed at helping seniors live independently. These range from nutrition services — it delivers about 1,400 hot meals daily in seven communities — to adult foster care; from housing support to personal-care management, helping people with chronic conditions or disabilities direct their own care by hiring and supervising personal-care attendants.

In the realm of home care, the goal is similar to other agencies: to help transition people from rehab settings into the home, and to maintain their function there.

“Our goal is to provide compassionate care and guidance so people can live in their homes and communities,” Martoccia said. “When we visit the home, we’re setting up a plan of care. What is your family doing? What do you need help with? What do you want help with? What’s most important?”

“Generally, people have chronic conditions, and their family may be at a distance, or they may not have a lot of family supports,” she continued. “In that case, we might be providing more services to them, helping them with many things they may not be able to accomplish on their own.”

WestMass focuses on the needs of family caregivers as well as patients, she added — people who have to work or raise families, but still want to make sure their parents or grandparents are OK.

“A lot of times, we hear caregiver stories about how what we do helps them and gives them peace of mind,” she said. “They may be checking in daily or weekly, but they know services will be coming.”

Cooley Dickinson VNA & Hospice has a different model than home-care agencies that focus on non-clinical assistance, often over the long term. Instead, it hires nurses and physical, occupational, and speech therapists, among other team members, to help clients transition from an acute or rehab setting to home life over a shorter term. Involving family caregivers in the process is often critical.

“We offer things your average person can’t provide without some training — wound care, IV therapy, or teaching about disease processes and how to manage an illness and manage medications,” Ross explained. “We’re teaching family members how to do wound care, how to provide care at home.”

The other side of the company is hospice care, which can be a longer-term engagement for people who are grappling with terminal illness and the decisions that come with it.

“What matters to you? What are your goals? How do you want your care to play out? It’s really hard to have that conversation, introducing that sense of taking away hope from people,” Ross said.

“But often, when you open those conversations, you’re relieving a burden for the patient and their family, and giving them an opportunity to actually talk about the elephant in the room — and that can lead to earlier access to care,” she went on. “Studies show that the earlier patients get on hospice, the better they do in the course of their terminal illness and the better the family does in the bereavement process.”

Giving Back

There’s a large, framed photograph at Visiting Angels of an aide with Anstett’s mother-in-law, who required home care due to Alzheimer’s disease around the time she and her husband opened the franchise; she passed away a few years ago. It’s a reminder that these services hit close to home for many people, and they’re important.

And not just for the clients, said Natalie Pilecki, the company’s administrative specialist. For workers in this field — at least the good ones — it’s more than a job.

“Spending time with the elderly is always nice,” she told BusinessWest. “The hours are good, the flexibility is always good, and they enjoy socializing with the elderly. Every day is different — it’s different every time you walk into their house.”

A good work experience starts with the employer, though, Anstett said. “I think we all have to value our workforce. We did a survey of our caregivers, about what’s most important to them. They put the highest value on how they’re treated. Pay was second, and benefits third. We listen to our caregivers, and those are the things we work on.”

She noted that one client has been with the company for 13 years, just one of many long-term connections being made.

“You develop a relationship with clients and their families. It’s about giving, and when you give, people respond. The job gives back.”

Joseph Bednar can be reached at [email protected]

Features

Feeling ‘the Magic’

Cesar Ruiz Jr. knew he was stating the obvious, but he wanted to make a point.

“This business is certainly not for the faint of heart,” he told BusinessWest, referring to the home-care industry and the fact that, by his count, there are close to 300 licensed companies in that sector within a 15-mile radius of the center of East Longmeadow, where he now operates his own venture, Golden Years.

He decided to join that very crowded field, when others might be put off by those numbers, for a number of reasons, but two in particular — a unique and highly successful model of care that Ruiz refers to simply as ‘the magic,’ and some real inspiration from three people who were very important to him — his parents and his grandmother.

As for the model, or the magic, it is a deep mix of services and programs, and three that are somewhat unique — music therapy, a ‘laughter program,’ and aromatherapy (more on all those later). As for those inspirations from his family … they were the real catalysts for Ruiz, who spent most of his career in the banking industry, to switch career gears in a profound way.

“We don’t look at ourselves as competitors — that’s a word that we don’t use here. We’re creators — we create our niche. And we do that by telling our story and emphasizing our services.”

His grandmother needed home care in Florida more than 15 years ago, and Ruiz recalls not only how poor that care was (family members generally provided the care for her), but how he resolved to create something better.

“We were asking the question — why isn’t there quality care?” he recalled. “And through that process, we began thinking that there has to be a better way.”

But the timing and other circumstances just weren’t right to launch a business.

It was after he relocated to this area — and the death of his father in late 2016 — that Ruiz found the needed inspiration to push on with providing that ‘better way’ on a commercial level and thus break into the ultra-competitive home-care industry.

As for his mother, well, she is the barometer for the hiring of all caregivers.

“My mom is the gold standard,” he explained. “Every person on our team needs to have the heart for caring that my mom has always demonstrated.”

And to say he has already made a mark in this sector would be a huge understatement.

Indeed, after starting slow — he can remember the phone in his office simply not ringing for several months while he was slowly building up relationships — he has been adding clients, and employees, at a torrid pace.

Indeed, by mid-October, when he sat down with BusinessWest, Ruiz said the company had roughly 350 clients and 374 caregivers, with both numbers expected to climb steadily in the months and years to come. That’s because Ruiz and partners Lisa and Vincent Santaniello are moving forward with plans to expand Golden Years into the Worcester and Boston markets as well as Connecticut. And after that, the plan would be expand nationally.

“We’re happy with our growth in this market, but we’re expanding to the east and to the south,” Ruiz explained, adding quickly that these are crowded markets as well when it comes to entrepreneurs looking to capitalize on an aging population, but a population that also wants to retain its independence — and thus remain in the home — as long as possible.

Cesar Ruiz, seen here with Brian Santaniello, director of Development for Golden Years, says the company is expanding its footprint to the east and the south, and will soon be looking to move into other states as well.

“The Boston area is quite saturated,” he acknowledged. “But we don’t look at ourselves as competitors — that’s a word that we don’t use here. We’re creators — we create our niche. And we do that by telling our story and emphasizing our services.”

While expanding geographically, the company is also broadening its base of services and diversifying. It recently launched Golden Years Staffing, which, as that name suggests, specializes in providing health professionals, and especially nurses, to area healthcare providers, and will soon launch Golden Years Adult Daycare.

At the moment, the company is changing the face of the center of East Longmeadow — the company has moved into the oldest commercial space in the town (once a general store of sorts) and adjacent property and has given it a dramatic facelift — while certainly shaking up the home-care industry at the same time.

For this issue, BusinessWest talked at length with Ruiz about Golden Years and where he wants to take this intriguing venture in the years to come.

At Home with the Idea

Turning the clock back to late 2016, when his father died and when he subsequently resolved to push ahead with a home-care venture, Ruiz said his research ultimately determined, as noted earlier, that this region was crowded with competition.

But when he drilled deeper into the numbers, he discovered that a large number of the players were small in size, “mom-and-pop” operations, as he called them, that were caring for perhaps a handful of clients, and some franchises “happy to have their 50 or 60 clients.” There were several larger operations, but he saw an opportunity to provide something different.

“We wanted to develop something very unique, something very large, that would have our signature stamp on it,” he explained, referring again to ‘the magic’ and its unique offerings.

“That’s what sets us apart — that’s what my mother came up with when she was caring for my grandmother,” he explained, adding that a similar approach was taken in the care of his father.

“When we were taking care of my father, we wanted laughter in the house every day,” he went on. “We wanted music in the house very day, and we wanted incense in the house every day. That’s my mom’s recipe.”

Elaborating, he offered more details on what would be the most unique of the three programs — laughter.

“That’s the most challenging for us, because we have to take people out of their comfort zones,” he explained. “The mind doesn’t make a distinction between a real laugh and a fake laugh — it still goes through that chemical change in your mind.”

The program — he doesn’t use the word ‘therapy’ in this case — involves exercises that do get people out of their comfort zones and get them laughing for real, an important ingredient in overall quality of life, he went on.

But there are several ingredients in this success formula, said Ruiz, adding that others include strong relationship-building efforts with area healthcare providers and senior-services organizations — strong sources for referrals — and a high level of quality that inspires him to eschew that word ‘competitor’ and instead use ‘creator.’

Golden Years has transformed the historic and formerly underutilized property in the center of East Longmeadow.

“We have a lot of hands in terms of the overall operations,” he explained. “We don’t just place a client with a caregiver and visit them once every quarter or once every six months; we visit them every month.

“We have supervisors that oversee that care,” he went on. “They’re responsible for the caregivers, they’re responsible for the client, and every month we have one of our staff people visiting the client to make sure they’re getting the delivery of their healthcare plan. That takes personnel, it takes time, and it takes extra expense, but we’re happy to do that because it ensures quality of service and care.”

This mindset also extends to the training of the caregivers, said Ruiz, adding that they are eventually evaluated on their ability to incorporate those three basic tenets — laughter, music, and aromatherapy — into the client’s care.

“We really want them to be engaged with our clients,” he told BusinessWest. “We encourage it, we demand it … we just don’t want to be transactional; we really want these caregivers to make a difference in overall quality of care.”

As for that relationship-building ability, Ruiz said he and his team started honing it in early 2017, just as the doors to the business opened, when the company visited as many senior centers, rehabilitation facilities, and other related facilities as possible to get its message across.

The visit that really got the ball rolling was one to Greater Springfield Senior Services, he recalled, adding that Golden Years was one of two companies invited to make a presentation to GSSS staff, including nurses, case managers, directors, and supervisors.

“We had a captive audience of about 85 people,” he recalled, adding this session took place in September 2017. “Up to that point, we had zero clients; we had just been planting seeds, planting seeds, and planting more seeds.

“After that presentation … three days later, the phone began to ring,” he went on. “And it hasn’t stopped since.”

Evidence for this can be found in the center in East Longmeadow, where the company has transformed a once-tired retail center that has seen a number of uses over the years, most recently as home to the Ski Haus. That signage is coming down, to be replaced with ‘Golden Years,’ two words that may be seen in many more places in the months and years to come.

“We plan to be multiple states — Connecticut is just the beginning of that,” he said, adding that franchising the company’s model is a distinct possibility. “We have a lot of growing still to do; we’ve only scratched the surface.”

Bottom Line

For now, the focus is on continuing with those relationship-building efforts, getting the message out, and building upon the very solid foundation that has been created over the past three years.

As noted at the very top, Ruiz knew the homecare field was already crowded when he decided to enter it. He wasn’t fazed by that reality and certainly not faint of heart.

That’s because he knew he had a good model and an even better mindset — one where he looked at every client and potential client as his own parents when it came to the level of care he wanted to provide.

That’s why he doesn’t see his surging company as a competitor — but, rather, as a creator.

George O’Brien can be reached at [email protected]

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