Elyse Brummer, Executive Director of AgeUp
In long-term care, real leadership does not happen behind a desk unless your desk is on wheels and you are taking it down the hallway like a parade float. The truth is, the magic happens in the hallways, dining rooms, resident rooms, and even the staff breakrooms where the world’s most important debates, like whether happy hour should serve cheese and crackers or the good shrimp cocktail, take place. While paperwork, budgets, and meetings will always fight for a spot on your calendar, the heart of the job, creating a compassionate and effective care environment, requires you to show up in person. If we are serious about person-centered care, executive directors and senior living leaders must be visible, approachable, and willing to put in the miles on their pedometers.
Think of walking the floor as your daily state of the union address without the podium. This means being a familiar and trusted face, not a mysterious name on the letterhead. Greet people by name, ask about their families, pets, or the latest episode of their favorite TV show, and pop into a resident’s room to notice the little things, like whether their remote control is within reach. If you know the care plans of some of your most fragile residents, you will spot what is off before something small turns into a life-changing event. It is amazing what you will pick up when you are out there, like the time you learn that a resident’s favorite fitness instructor was out sick to take care of their dying parent, or morale has dipped faster than ice cream sundaes at dessert time, unaware of that the cause was an operational change that you thought would go unnoticed.
Once a week, pull up a chair at a shift change meeting because this is where the real news breaks, not in emails or monthly reports. You will hear about Mrs. Johnson’s new medication making her dizzy, the hallway light that has been out for two days, or how the lunch delivery truck backed into the rose bushes again. Your presence says, “I value your work” far more than any memo could, and you will get a first-hand read on team dynamics and catch small issues before they grow into large ones.
Evenings in memory care can be a revealing window into the rhythm of the community. Are residents all tucked in at 7 p.m. sharp as if they are boarding a cruise ship for lights out, or are there options for those who are still alert and enjoy a quiet activity, a movie, or simply sitting with a cup of tea? When you stop by at bedtime, watch what is happening. Are caregivers rushing to get everyone into bed, or are they doing room checks in the evening to meet each resident’s needs, or tucked away socializing in the med room?
And do not forget to check on the noc shift. Are they engaged with residents who cannot sleep? Do they have healthy, substantive snacks ready for the person who wakes up at 3 a.m. because their days and nights are flipped? Cookies might be comforting, but a turkey sandwich will go further in keeping them nourished. This time of day is about more than getting residents back into bed, it is about understanding their routines, respecting their preferences, and making sure nighttime feels safe, supportive, and humane. When you see bedtime care done well, you know you are in a place where dignity never sleeps.
Another great way to understand daily life is to eat with residents. Pick a dining room, sit at a table, and eat what they are eating. If it is meatloaf night, you are having meatloaf. Pay attention to the wait time, the taste, the meal presentation, and the social atmosphere. Is the environment conducive to a lovely dining experience? Is the food warm? Are staff rushing people through the meal as if they are late for a flight? Experiencing meals as residents do quickly reveals opportunities for improvement, like realizing the soup needs more seasoning or the dessert menu rotates between exactly two options.
Numbers also tell a story, so review nurse call logs to see how long residents are waiting for help, especially at night and on weekends when staffing may be leaner. Waiting too long for assistance, especially for toileting, can mean discomfort, fear, or worse, and sometimes the fix is as simple as adjusting staffing or redistributing tasks.
Leadership in long-term care is about presence, curiosity, and care. It is about knowing not just the numbers, but the names, stories, their care plans, their emotional needs, and daily realities of the people who live and work in your community. When you walk the floor, you do not just see problems, you see people, and that makes all the difference.
Elyse Brummer is the Executive Director of AgeUp and a doctoral student in gerontology. She has led long-term care communities and advocates for equity, dignity, and enabling residents to live their lives to the fullest.