Laundry and housekeeping always have played an important role in an industry that places ever-increasing demands for cleanliness and service against a backdrop of mounting occupational hazards.

They are the unsung heroes in so many senior living communities, for much of the scrubbing, gathering, folding and fetching go unnoticed and unrewarded. But their work literally can make or break a business. Do their jobs well, and inspection surveys are a breeze and resident satisfaction scores soar. Do them poorly and it could send potential new business out the door or, worse, lead to closed doors.

“Housekeeping is the most unrecognized department in senior living, even though they are the frontline for facilities in infection prevention and control,” said Brandi Whiteley, LVN, E-Mist Innovations director of clinical services. “As Darrel Hicks, author of ‘Infection Control for Dummies,’ writes, ‘One conscientious housekeeper, given the right tools, chemicals, equipment and proper amount of time to do his or her job, will prevent more infections than a room full of doctors can cure.”

As the Nurses Learning Network notes in its Administrator’s Guide to Housekeeping, “Although most people do not inspect a facility with white gloves and a magnifying glass, almost all will be very observant of the perceived attention, or inattention, given to the cleanliness of floors, toilets and sinks within that restroom.

“If an administrator greeted a prospective resident and his or her family with hair in disarray, shirt or blouse untucked, and a disgusting body odor, that [person] may very well reconsider his or her application submission. Why would an unclean restroom be any different?”

Two game changers

Two powerful trends are shaping laundry and housekeeping in senior living. And it could be argued one led to the other.

Several years ago, architects and designers began toying with living spaces that more resembled homes than nursing facilities. It was seen as one way of promoting more independent living.

Today, movements such as the Eden Alternative and the Green House Project, have come to define this emerging interest in non-institutional senior living. All but a handful of states now host Green House and Eden Alternative communities for seniors.

Although both have unique characteristics, the concept is similar: clusters of personal care homes or apartments where active seniors live communally, sharing resources such as kitchens and laundries.

Craig Coogan, president of Lift and Transfer Specialists, has installed track systems in these types of communities, including Mount San Antonio Gardens in Pomona, CA, a continuing care retirement campus that includes Green House living.

It was at that project where Coogan was first exposed to the shahbaz, which the Green House project defines as a someone “who provides a wide range of assistance, including personal care, activities, meal planning, preparation and service, laundry care and light housekeeping duties.”

“It’s a really great concept where you hire out individual caregivers,” Coogan told McKnight’s Senior Living. “The idea is that individual, patient-centered care is much better than being often left alone, wondering when someone is going to show up and give you a hand.” Coogan said he anticipates he’ll “be seeing more and more of these places being built.” In another community where he installed systems, Coogan saw as many as 12 shahbazims working various shifts. 

A new approach

It’s no secret that housekeepers and laundry staff have jobs with unpleasant elements. Most spend hours on their feet, twisting and bending and getting exposed to unpleasant, even dangerous things. The lines of their responsibilities are often blurred, and sometimes melded. And given ongoing studies that seem to amplify dire staffing shortage forecasts these days, they along with their caregiving peers, will be expected to wear more hats in the future.

So it may be surprising to some that housekeepers are among a group of long-term care workers who actually seem to love where they work, and what they do. (In assisted living, housekeepers’ salaries are in the low $20,000 range, according to the Bureau of Labor Statistics.)

A recent National Center for Assisted Living study reported by Leading Age found that maintenance staff and managers join housekeepers as the happiest bunch on senior living payrolls today and are most likely to not leave their posts in assisted living communities. (Nursing and dietary staffs, meanwhile, are on the other end of that spectrum and claim the highest attrition rates in assisted living, the NCAL study found.)

What’s not surprising is how housekeepers’ satisfaction dove-tails nicely into the Shahbaz concept of non-nursing staff who have multiple jobs, assuming roles that more resemble that of a personal assistant than a laundry worker or housekeeper. Many feel we are in the dawn of the universal worker.

The Green House Project asserts that shahbazims are changing the face of long-term care. “Through deep knowing, strong relationships and an organizational structure that keeps much decision-making power in the home, the shahbazim are able to create a meaningful life for and with the elders who call the Green House their home,” the organization noted in a recent blog.

In or out?

Housekeeping and laundry folks are a hearty bunch, and for good reason. Aside from the occupational pitfalls lurking around every corner, innumerable opportunities exist for infection.

Such concerns have prompted some facilities to outsource their laundry, according to John Scherberger, president of the Healthcare Laundry Accreditation Council board.

“One of the biggest challenges is cost,” he notes. “A lot of facilities tend to think it’s cheaper to have an on-premise laundry than it is to use an accredited healthcare commercial laundry doing their textiles.”

David Potack, vice president of Unitex, said that too many facility laundries fail to “have clear separation of soiled and clean linen,” mostly because of manpower issues.

“Unitex and many other healthcare laundries have embraced and implemented voluntary compliance programs to ensure the cleanliness and safety of products provided to customers,” he added.

Dan Goldman, OPL national sales manager for Laundrylux, strongly encouraged operators to have HLAC inspect and accredit their equipment.

Vendors have responded with many high-tech solutions, including armor-like personal protective gear and high-efficiency cleaning chemicals and equipment. Still, government regulators are incessantly tweaking the rules and recently have become hyper-vigilant because of emerging and highly virulent strains of bacteria. It can send many managers into a tizzy, said Jim McLain, general manager of the Eldercare Interiors Division for Construction Specialties.

“I can imagine Monday morning all-staff meetings taking place in many facilities across the U.S.,” McLain said. “And I can imagine the director taking a roll call and asking each department head if their state survey were to happen this week, would they be ready?”

Laundries and housekeeping staffs always should be vigilant when it comes to maintaining proper water temperatures and using the right kind of detergents and cleaning chemicals, said Mike Weber, principal scientist, products research with Procter & Gamble Professional. Weber advised staffs to use multitasking cleaning disinfectants. He also strongly advised against relying on bleach as a cleaning agent.

Washing machine manufacturers constantly are tweaking technology to deliver more powerful machines. But operators are looking for other things as well.

“Senior residents and staff in non-skilled settings like assisted living are looking for machines that are also durable and easy to use,” said Bob Bruce, national accounts sales manager for UniMac.

What most administrators seek more than anything are efficient and effective machines.

“With multiple residents in a facility, getting personal clothing as well as additional linen through the laundry operation is key,” Bruce added. “It’s also critical to be able to prove that the wash load hit a specific temperature to ensure the bacteria has been diminished.”

Steve Hietpas, new business development manager for Maytag Commercial Laundry and American Dryer, believes outfitting your facility with the appropriate mix of energy- and water-efficient commercial laundry equipment “is a wise investment. Efficient laundry equipment can increase staff efficiencies significantly and can help decrease operational costs, such as labor and utilities,” he added.

A few more tips

Here are some housekeeping and laundry pieces of advice P&G Professional has provided in recent blogs: • Create cleaning protocols and checklists and educate staff on them.

  • Read labels on all disinfectant products carefully.
  • Avoid cross-contamination from supplies such as scouring pads, brushes, mops and scrapers.
  • Implement procedures to properly clean and sanitize tools regularly, and thoroughly clean and disinfect high-touch areas to avoid the spread of germs.
  • Providing clean and fresh-smelling linens, towels and garments significantly raises the comfort level for patients, residents and visitors. When the company polled more than 500 LTC professionals, 85% said residents who are surrounded by familiar sensory experiences feel more comfortable and at home in their living environment.
  • Extend linen life with near-neutral pH detergents. (Richard Case, director of institutional product management for Betco Corp., advised facilities to keep their linen rewash rates low.) Another way to extend linen life is to keep inventory levels up to par levels as much as possible.