Care Consultants for The Aging

An Interview with Michaela Williams, President; and Melissa Smith, Vice President of Care Consultants for The Aging, A 2014 BBB Integrity Award Winner
By Dana Kimzey and TJ Burns, Creighton University MBA students

As an admirable business leader in the patient care industry, Michaela Williams has helped develop her family’s business with moral courage and integrity. As president of Care Consultants for the Aging and winner of the 2014 BBB Integrity Award, she and vice president, Melissa Smith describe the ethical side of managing their successful business. 

Can you give us a little background, where were you raised, education, career trajectory?

Michaela: “I was born and raised in Omaha and graduated from NW Missouri State.  My Mom, Virginia Williams, is the founder of Care Consultants.  I literally grew up with the business in the room next to me when I was 14.  I have a unique perspective on home care and how it got started.  The company was started because of my grandmother who had combative dementia behaviors and was asked to leave quite a few different situations.  My mom and friend were talking about what options were out there and they had to do something fast since she was unable to take care of herself.  Mom and Roseanne got together and decided to start this company.  I’ve been involved for 16.5 years full time.  I went to school as a child and family studies major with a minor in gerontology.  I came back after college and started working here and went from scheduling coordinator to president.  I’ve been in every desk.” 

Melissa: “I’m from Omaha and went to school at UNO; my degree is in environmental studies with a life sciences concentration.  Unlike Michaela, I had no idea where I was going and that I would end up at Care Consultant.  I started working here part time during college and got to know Michaela, Virginia, and Roseanne who started the company.  I worked for 1.5 years part time, and loved it all.  I graduated then went off for a couple years and did wild life surveys in California and Oregon.  Came back every once in a while when they would have a need in the office.  When Michaela became president 10 years ago, she took me out to dinner and asked me if I wanted to come back.  It’s a company that I love and I know the reasons it was started and it was for good reasons, so I decided to come back.”

What do you like most about your work? Least?

Melissa:  I love people, people as a whole and this is a people serving industry so for me it fits and allows me to give people options.  I enjoy that our service helps people and helps them to remain independent.  The most difficult thing is running a business while helping with people and the need to take care of the business side such as asking them to pay their bills.

Michaela:  Definitely the clients are the best part. It is fun to go out and meet people and hear their stories.  Hardest part for me is a lot of the people we’re working with are going through a very emotional part of their lives because they’re either losing their independence, sick, or dying.

Can you define ethics and tell us what ethics means to you?

Melissa:  Basically, actions and behaviors that are morally and socially acceptable.  How you live your life defines who you are, what you want to portray, and how you want to interact with people.

Michaela: Making decisions that benefit the greater good whether that be our clients or employees rather than making decisions that just benefit myself.  I was drawn here because I saw people that could make decisions that benefit people and have the ability to make decisions that they feel are best for everyone around them.

Do you think there is a difference between “ethics” in general (personal) and “ethics in business”?

Melissa:  The biggest difference is that business ethics has a greater effect on a larger amount of people whether that be the employee, care givers, clients, or community at large.  With personal ethics your decisions affect just you and those immediately around you.  They’re definitely intertwined in a lot of ways but the main difference is whom you’re reaching. 

Is there a formal ethics program at your firm?

Michaela: Yes, but it is not called an ethics program.  We have a policy book where we outline different things for when you’re interacting with a caregiver or a client and different procedures to follow.  Being a small company, we have meetings all the time that just come about and it’s situational where we will brainstorm together on different topics or scenarios.  We are both involved in a lot of the day to day details of what is going on in everyone’s desk.

Who started the policy book and what prompted the start?

Michaela: “All three offices desired more direction on different things We have a board of directors with members from our Lincoln, Des Moines, and Omaha offices and it was truly a collaborative effort between all of them.  We would take different parts and email back and forth to each other; it is something we look at every year.  Things constantly change and evolve so we are always looking at it and fine-tuning what we have in place.”

What were some challenges along the way? Was it hard to get started?

Melissa: “It was not hard to get started. People involved in making the policy book have been heavily involved in the day to day experiences with clients and caregivers so this gave them a good idea of what needed be addressed in the policy book.” 

Were the employees receptive/hesitant?

Melissa: “Employees appreciated it; there are so many different situations that arise, there is no normal day to day of what questions you will get.  Situations are always going to come up, but they like having a little bit of direction on how to approach these different situations.”

Can you talk about the ethical culture at your organization? What is tolerated and what is not?

Melissa: “Illegal activity is not tolerated. In this field, there is no set of direct guidelines we can give people of how to act.  We ask our staff to look at each situation and make decisions like they would make for their own loved ones or family.  Would they want this for their parents?  It gets said a lot from our employees that ‘I would send this person to take care of my family member’.” 

How is ethics infused in your organization? What is an example of policies? An example of practice?

Michaela: The background checks and he screening process of finding the caregivers.  We have a list of questions and things we cannot judge the care givers on (age, race, etc.) outlined in questions to ask during the screening process.  In general, the biggest problem with home care is a shortage of CNAS and caregivers.  Part of us wants to just get caregivers in but you have to stop and realize even though we need to get more caregivers in, this is not someone I would feel comfortable sending to my own family.” 

Have you always done business in Omaha? If not, where else have you done business?

Melissa:  “I travel the most these days!! In an ideal situation, everything runs smoothly but as an owner you have to own what happens in all three locations (Des Moines, Lincoln, and Omaha).  When you feel like you need to be there, you need to be there.  It’s important to have that support and know what is going on in all the offices.” 

Do you notice any ethical or cultural differences in the three offices?

Melissa:  I do not see the ethical part as much.  I see the difference in the cities and how they interact. 

Michaela: “When someone new is being trained in another office, we have enough of a presence there where they can see how we would act ethically in different situations.  I feel like they get a good idea of how we feel they should handle something.” 

Melissa:  “We are a small company, but we are more involved than most owners.  Our employees have direct access to us and we’re in there doing the grunt work every day.” 

I would assume that your employees appreciate seeing you guys doing the “grunt work”? 

Melissa: Oh yea, absolutely!  Not only do the employees appreciate it but our clients do as well.  For the most part, we know what’s going on.  We have 125 clients in Omaha but we know who they are, their preferences, and what is going on with them.

The Ethical Omaha Project of the Business Ethics Alliance has identified the Omaha business core values to be the following:  Accountability, Community Responsibility, Financial Vitality, Integrity and Moral Courage. Can you elaborate how these fit in your organization and what do they mean to you?

Michaela: They all fit, it is part of running a business. 

Accountability

Michaela: “You have to stand behind what you offer and explain to potential clients and care givers how we work because our model is different and it’s working with independent contractors.  At the end of the day everyone needs to be aware of that and what it means.  Before we sign up with anyone, we are going through that process.  We sound like a broken record half of the time, but it is something that is very important to us.  They need to be aware of what they’re signing up for and how we work.  This is most difficult when you find a client in an emergency situation where they just want to sign up quickly to receive a caregiver within a few hours.  They’re not always thinking about what you’re telling them, they have so much on their minds.”

Community Responsibility/Integrity

Michaela: “We provide an elder care resource handbook that outlines different options for the aging if our services are not a good fit for a prospective client.” 

Financial Vitality

Melissa:  “I do believe in the long, in terms of the money aspect, we have a reputation in Omaha for being someone you can call to get your questions answered.  Having that reputation in the long run will help us get future clients.  Maybe we’re not the answer for them now, but in a year when they need someone, they will call us."

A lot of times when emergency situations arise, people may not be prepared…have you ever had to turn down a client for this reason?

Michaela: “Yes, if our services don’t make sense for their situation, we are not going to take it on.  We produce an “Elderly Care Resource Handbook” that lists other options for the aging.  If we are not the right fit, with our understanding of the industry, we are able to guide them in the right direction to find something that makes more sense for their situation.”

Describe an ethical situation in business you have faced that was relatively easy to handle?

Michaela: “We get this call at least once a day if not more, where a client doesn’t want a caregiver. As you age you lose so much: your independence, finances, and physical ability.  Going through that journey to explain and make them feel important allowing them realize that it is okay to accept a caregiver is very important.  When we sign up a client, there is no set amount of time on the contract.  We always try to express right off that if you are not happy with a caregiver, you can cancel allowing them to feel less obligated and more inclined to give it a shot. 

Describe an ethical situation in business you have faced that was relatively hard to handle?

Michaela: “When caregivers call in sick, for an emergency, it is always hard because we have to call new people and assess the options. Since every family is different, we just need to explain that we are doing as much as possible to make sure their loved one is cared for. Sometimes we have very little notice when a caregiver is absent and we just have to do what we can to find a replacement. If a terrible situation should occur (though in 24 years nothing too terrible has ever happened), we listen to both sides, stop, breathe and work with both sides to find a solution.” 

Melissa:  “Our clients are usually older and our caregivers are very diverse.  We do run into issues with race a lot.  We have a lot of situations where the client does not want an African American caregiver.  We do not discriminate on those but it’s hard when it is something that the client is saying.  We tell the clients it is something we cannot guarantee.  If it is a situation where the client is going to be horrible to the caregiver, we will do our best to get someone else in there.  Most of the time the client is uncomfortable at first and that is due to them being unfamiliar.  With time the clients usually grow to love their caregivers.

Why did you call the previous two situations ethical? Why not just say, “It’s just business?”

“Well, it’s really both. It reminds us for the need for communication for everyone involved.”

How does it feel talking with us about ethical quandaries you faced?

Michaela: “For us, ethical conversations come up on an hourly basis. It is something we talk about a lot. As far as it being easy or uncomfortable, many times we just reevaluate things in the office. We want to make sure everyone is on the same page and comfortable. Many situations that arise have already happened in the past so we look at what has been done and see how we can improve, then apply it on a day to day basis.”

Are there unethical behaviors that give other companies and/or business people a competitive advantage?

Michaela: “What we decided was that especially in this industry, if your business is not doing what it says it is doing, then it develops that reputation and the public will find out. We must be realistic with our promises and not over promise (claim to provide more than we are able to). There are different types of care that some families need, and there are times when we are not able to provide the care that a loved one may need. In that case, it is best to be honest about what we can provide. It has happened many times where a client will come to us after being over promised and unhappy at another company.”

Did you have you had any ethical mentors?

Michaela: “Three people immediately came to mind when thinking about this question: Virginia Williams, Roseanne Opperman, and Jeff Oslek. They were the previous owners and they had such a unique blend of personalities, strengths, and weaknesses. They were all so involved and caring; they really helped teach the younger generation in the company.”

Melissa:  “Seeing Virginia and Jeff and working for a company like this was incredible!  They were so positive and involved in the day to day and didn’t stop working at five.  They truly cared about the people they were working with and seeing that was truly inspiring.” 

How do your upbringing and family values play into your ethical development? Do you see a connection between your upbringing and how you handle ethical situations?

Michaela: “Basically, my family taught me 24/7 about the business growing up. My grandmother inspired the business from when she had combative dementia behaviors, and I learned so much from her needs. It is important to educate people on their different options for insurance, affordability, and practicality. I feel like I am definitely utilizing my family values in this business when handling ethical situations. I think of every person as in my grandmother’s situation, and it important to treat all patients in a way that lets them know we care. I use my story a lot to educate people on different options and show them how they can be their own advocate and empower them to make their own decision.”

As you move up in the organization, how have ethics played a role in decision making?

Michaela: “In all situations, we consider the impact of our decisions and who will be affected. In time, the decisions have become heavier with more responsibility. It is important to decide how each decision will affect everyone impacted.”

Melissa: “I have become more comfortable making those decisions.  When I was younger, it was a lot more difficult to make those decisions.”

Now having won the BBB Integrity award, how does it feel?

Michaela: “I’m kind of geeking out about it!  We are so excited about this! We filled out applications 5 times, so to win it is very encouraging. It’s also amazing because all of the hard work by the caregivers is recognized. They work hard and people realize it. It’s inspiring to the employees because they have something to be so proud of.  We fell like we’re winning it for my Mom, Roseanne, and Jeff. ”

What are the biggest ethical challenges that you think face the younger business professionals today?

Michaela: “Social media is changing how we communicate as a whole.  Probably one of the hardest things, especially in this industry, is that the younger caregivers are taking care of the older population. With social media and cell phones, it is important that the caregivers take care of the patients, as well as respect their elders. When they are caring for the patients, they need to turn off their cell phones and give their full attention to the patients.  It is important to keep verbal communication and personal skills tuned.”