Q&A With Private Duty Consultant Candyce Slusher

Candyce Slusher has worked in the private duty sector since 2004, both in executive roles and now as a self-employed senior care consultant working with families and agencies. Prior to that she was a licensed practical nurse, working in geriatrics within various care facilities.

As a consultant, she emphasizes trust and honesty in not only the caregiver-client relationship, but also in the caregiver-management relationship. Slusher spoke with HealthLeaders about word-of-mouth referrals, client retention, and how agency owners can set the foundation for trusting relationships with clients and caregivers.

HealthLeaders: How has your nursing background helped you in the private duty sector?

Candyce Slusher: I never want to give someone the [idea] that if they're not a nurse they can't [work in the private duty sector]. It doesn't require nursing skills, but honestly, my assessment skills that I learned in nursing school have been the most valuable asset because I have the ability to walk into a situation and surmise a lot of information without having a conversation. I can gather at least 70% of what's going on just by observing within the first 20 minutes, and then be able to anticipate [client] needs.

HL: How do you ensure that your clients are getting the care they need?

Slusher: A good assessment tool is important. I have seen a lot of agencies that just use something vague, but that puts a lot of pressure onto both the caregiver and the client. One thing I always teach to agencies is the more information you can get during the assessment, the clearer the picture you can give to the caregiver. When you call a caregiver and schedule them [to] work for that client, they're walking in blind. So the more information and detail you give them, the better prepared they are. They walk into the client's home feeling confident because they have a clear idea of what needs to be done.

I teach my caregivers to be observant. "Observe and report. Your job is what's on the care plan," but if [the client needs] something else, a great caregiver can anticipate those needs. I also write my care plans for what the worst day looks like, not the best day. So if somebody has dementia or Parkinson's, every day is going to be different. I will build out a care plan that's good for six months, not just where we are now; but using my nursing skills knowing what this disease process looks like and where it could be in six months.

HL: How can agency owners actively work to build trust with their clients and caregivers?

Slusher: It's being bold enough to have the conversations that need to be had, but gentle and professional enough that people are willing to accept corrective feedback. A lot of times, trust doesn't come easy. That's just one small aspect of it, the other is when [someone calls] and asks a question, you always call them back. You don't leave them hanging; customer service is huge. Communicating things that need to be done, but mostly it's owning up to mistakes and being open and honest about how you're going to fix them, because errors happen constantly. So to tell somebody we've always got it right isn't true. It's, 'We won't always get it right, but I'll fix it; we'll step up.' We'll come to an agreement. And you have to prove that over and over again to form trust. The little things can't go by the wayside, the little things can be very important."

Building trust with the caregiver is huge. If I do an assessment and tell a caregiver [the client] can transfer on their own, but I neglected to ask the client to stand up for me, then [when the] caregiver shows up and that person can't stand, you've lost a level of trust with that caregiver and it's hard to grow back. Happy caregivers make for happy clients, which makes clients stay longer with your agency.

HL: With clients being referred to agencies primarily by word of mouth, what should agency owners keep in mind?

Slusher: Trust is the beginning. You want commitment and loyalty. So, when we talk about word of mouth, it's not, 'We used this company, and they did fine.' It's 'This is the company that my whole family uses.' We want to be the legacy agency for this client's family, not just the client.