What 28 Years in Home Care Taught Me About Strengths, Synergy, and Caring for the Caregiver
Long before I became a home care agency owner, I worked as a Certified Nursing Technician (CNT) on the floor of a nursing home. I remember what it felt like to be treated as hired help rather than as a professional whose skills, judgment, and contributions mattered.
When I founded WholeCare in 1997, I knew two things: I had a calling to care for older adults, and I wanted to provide exceptional, holistic care that honored the whole person.
I also knew that the people providing that care deserved to be treated as professionals.
For decades, our industry has used the term sitters to describe caregivers. It was a term I refused to use at WholeCare, and frankly, it remains a pet peeve of mine today.
Professional caregivers do far more than sit with someone. They observe, anticipate needs, build relationships, solve problems, provide emotional support, and help people maintain their dignity and independence. Yes, also companionship, and there are those times where they make sure someone remains safe. And still, sitters implies it’s all they do, it just doesn’t serve them or us as professionals.
I believe that when we treat caregivers as professionals, invest in their development, and hold them to meaningful standards, they will rise to those expectations.
That belief became the foundation of our culture.
Over the next 28 years, I learned something even more important: If we want to provide extraordinary care to our clients, we must first create an organization that genuinely cares for the people delivering the care.
Caregivers Are Our Number One Customer
Throughout my years at WholeCare, I often said that our caregivers were our number one customer. That may sound unusual in an industry built around serving clients and their families.
But consider this: Who spends the most time with your clients? Who notices the subtle changes in their well-being? Who represents your agency in someone’s home, often without another employee present?
Your caregivers.
When caregivers feel valued, supported, respected, and equipped to succeed, they are better positioned to provide the quality of care your clients deserve.
This doesn’t mean that caregivers are more important than clients. It means that caring for caregivers is essential to caring for clients.
At WholeCare, we invested in professional education, but we also offered personal development and life skills. We listened to caregivers, asked for their perspectives, and included their voices when making decisions that affected their work.
We wanted them to know they mattered, not simply because of the shifts they filled, but because of who they were and what they contributed.
That philosophy guided our leadership decisions and helped shape the culture we became known for.
Your Core Values Must Be More Than Words on a Wall
At WholeCare, we established three core values:
- Meeting People Where They Are.
- Have a Selfless Heart.
- Commit to the Journey.
These weren’t simply statements about how we wanted caregivers to treat clients. They were expectations for how we treated one another.
Meeting People Where They Are meant recognizing that everyone comes with different experiences, strengths, communication styles, and needs.
Have a Selfless Heart meant approaching our work with genuine care and a willingness to contribute to something larger than ourselves.
Commit to the Journey meant understanding that growth, learning, and excellence are ongoing commitments.
We also had a defined mission, purpose, and vision. Together, these provided direction for the organization and helped us make decisions as we grew.
I learned that culture isn’t what we say we believe. Culture is what people actually experience when they work with us.
It’s reflected in how we communicate, how we respond when someone struggles, how we resolve disagreements, and whether our daily decisions align with our stated values.
For agency administrators, that means the work of building culture cannot be delegated to an employee handbook.
It must be demonstrated through leadership, across the entire organization.
Discovering Strengths Changed How I Saw Myself and Everyone Else
One of the most transformative experiences in my leadership journey was discovering my own strengths through CliftonStrengths, formerly StrengthsFinder.
My number one strength is Activator.
I am naturally energized by ideas, possibilities, and getting things moving. I see opportunities and want to take action.
For years, however, I had been criticized for starting things I didn’t always finish. I had internalized the idea that something was wrong with how I operated. Learning about my strengths changed that perspective.
I began to understand that initiating action was a genuine contribution. What I needed wasn’t necessarily to become someone entirely different. I needed to recognize my strengths and surround myself with people whose abilities complemented mine.
That realization changed how I approached leadership.
I introduced StrengthsFinder throughout WholeCare, inviting employees to discover their own strengths. We brought in coaches to help us better understand how those strengths influenced the way we worked.
I also used DISC to understand different communication styles.
These tools helped me recognize something I had intuitively practiced for years while meeting with clients and families: people need to be approached in ways they can understand and receive information, not how I understand it.
Not everyone processes information the same way. Not everyone solves problems the same way. And not everyone contributes in the same way.
Different doesn’t mean deficient.
When leaders understand this, they can begin building teams around complementary strengths rather than expecting everyone to think and work alike.
But strengths-based leadership also requires difficult decisions.
I once had an employee who learned nearly every role in our business and aspired to become general manager. I saw tremendous value in her abilities, particularly in marketing, but the general management role required capabilities that weren’t her natural strengths however this is what she wanted to be.
I moved her into marketing, believing it was a better fit. She ultimately left the organization.
That experience taught me that recognizing someone’s strengths doesn’t guarantee agreement about where they belong. We must balance individual aspirations with the needs of the organization.
Caring about people doesn’t mean avoiding difficult leadership decisions.
From Hierarchy to Synergy: Creating a Culture of Shared Contribution
It wasn’t until after I stepped away from WholeCare that I fully recognized the kind of culture we had created.
I came to describe it as a synarchal culture — my way of expressing an organization built around shared contribution rather than rigid hierarchy.
We certainly had defined roles, responsibilities, and decision-making authority.
But we didn’t operate under the belief that someone’s value was determined by their position on an organizational chart.
Everyone mattered.
Caregivers could influence decisions. Our schedulers, care coordinators, and managers collaborated to develop solutions for clients. We asked employees what they thought because the people closest to a problem often had valuable insight into how to solve it.
We also gave team members meaningful decision-making authority.
At times, I allowed employees to make final hiring decisions, including hiring caregivers and, on one occasion, an office manager.
That office manager turned out to be a poor hire.
The team had to recognize and take responsibility for its decision, and I ultimately made the decision to terminate his employment.
It wasn’t a pleasant experience, but it reinforced an important lesson: Empowerment and accountability must go together.
Shared leadership doesn’t mean everyone makes every decision. It means people have a voice, understand their authority, and accept responsibility for the outcomes within their control.
Our goal was to create a self-managing team.
One of the ways we supported that was through clear communication processes. Everyone understood who needed information, what they needed to know, and how their work affected the next person in the process.
Accountability wasn’t simply about completing your own tasks.
It was about making sure your teammates had what they needed to do their jobs well.
In home care, where one missed communication can affect a client directly, and an entire day of service, that kind of mutual responsibility is essential.
Resilience Is Built Before the Crisis
If you want to know whether your agency has a resilient culture, pay attention to what happens when things don’t go according to plan.
For WholeCare, few periods tested our organization more than the extraordinary disruptions surrounding the COVID-19 pandemic.
Our community experienced a bomb, a tornado, historic power outages, and then we were shut down for the pandemic. At one point, a client who depended on oxygen contacted us because he had approximately one hour of oxygen remaining.
I reached out to my Entrepreneurs’ Organization network, and we secured a generator within an hour.
During the pandemic, when essential supplies were not available, we found creative solutions, including making hand sanitizer using alcohol supplied by a local distillery.
Our team was focused on protecting caregivers and clients, communicating, solving problems, and making sure people continued receiving care.
Those moments required flexibility, resourcefulness, and a willingness to step beyond traditional job descriptions.
But here’s what I learned: We didn’t suddenly become a collaborative team because a crisis occurred.
We had spent years building relationships, trust, and shared sense of responsibility that allowed us to respond together.
Resilience isn’t created in the middle of a crisis. It’s revealed there.
Agency leaders cannot anticipate every challenge. But we can build organizations where people feel trusted to act, know how to communicate, and understand that caring for one another is everyone’s responsibility.
Systems and Accountability Support a Caring Culture
Over the years, I explored leadership and business operating frameworks, including The Five Dysfunctions of a Team, Traction, and Scaling Up.
Each helped me understand different aspects of building an effective organization. One of my most important realizations was recognizing myself as a visionary.
I was good at seeing possibilities, initiating ideas, building relationships, and moving the business forward.
What I needed was an integrator, someone who could translate vision into consistent execution and oversee the day-to-day operations.
Although I developed strong team members and systems, I never fully established that complementary leadership role.
If I were building another agency today, I would prioritize finding that person much earlier.
I would also make better use of technology and performance metrics from the beginning.
When I started WholeCare, we didn’t have access to the operational technology available to agencies today. Much of what we tracked required manual processes.
Today, administrators can gain far greater visibility into caregiver reliability, scheduling performance, callouts, completed shifts, and other indicators that affect both client experience and financial performance.
That visibility matters.
A caring culture should never be confused with an absence of standards.
Caregivers deserve to know what’s expected of them, receive feedback about their performance, and be recognized when they contribute to the agency’s success.
Likewise, managers need information that helps them identify problems early, support employees, and make informed decisions.
Care and accountability aren’t competing priorities. They strengthen one another.
The Leadership Lesson I Would Share With Every Administrator
After nearly three decades of building and leading a home care agency, I believe one of the most important capabilities an administrator can develop is the ability to create a culture where caregivers genuinely feel cared for.
That begins with leadership.
It requires self-awareness, an understanding of our own strengths and limitations, and a willingness to develop the people around us.
My continued work in personal development, including facilitating the Clarity Catalyst program, has reinforced my belief that effective leadership begins with self-awareness and self-care. When we invest in our own growth, we become better equipped to support and develop the people who depend on us. We cannot consistently create environments of trust, compassion, and resilience if we are operating from a place of constant depletion.
Self-leadership comes first.
Then we can better support the people who depend on us.
For administrators looking to strengthen their agency culture, I would begin with a few questions:
- Do our caregivers feel respected as professionals?
- Do we recognize their individual strengths and invest in their development?
- Do employees have opportunities to contribute ideas and influence decisions?
- Does everyone understand their responsibilities and how their work affects others?
- Are we measuring performance and recognizing the behaviors that support reliable, quality care?
- Are we demonstrating the same care for our employees that we expect them to provide to clients?
The answers will tell you more about your culture than any mission statement hanging on the wall.
Bringing the Philosophy Forward With CareCrown
When I founded CareCrown, I brought these lessons with me.
I spent decades learning that recognition, professional development, shared responsibility, and accountability were essential to building a strong caregiving workforce.
I also understood how difficult it could be for agency leaders to consistently recognize contributions and measure the everyday behaviors that influence performance.
CareCrown grew from that experience.
Our Caregiver Performance Management System helps agencies recognize and reinforce the behaviors that support reliable care including arriving on time, reducing callouts, completing scheduled shifts, and accepting additional shifts when available.
It’s one way to connect the human side of leadership with the operational realities of running a home care business.
Technology cannot create a caring culture on its own.
But it can give leaders better information and more consistent ways to recognize the people who make their organizations successful.
And that brings me back to where my journey began.
I believed that professional caregivers deserved to be treated as professionals.
I still do.
If we want caregivers to deliver extraordinary care, we must first recognize their value, develop their potential, and create an environment where they can succeed.
Because when we care for the caregiver, we strengthen the entire organization.