LeadingAge Magazine · March-April 2019 • Volume 09 • Number 02

Wading Through Discomfort to Create Better Outcomes

March 14, 2019 | by Kate West and Jordan Morrow

Fellows of the 2018 Larry Minnix Leadership Academy used a study circle process, not only to examine pressing problems facing older adults, but to learn to think more creatively and in greater depth. Here is what they learned.

Editor’s note: The Larry Minnix Leadership Academy includes a “study circle” in its curriculum. Academy fellows use the study circle to examine a timely issue relevant to nonprofit aging services providers. These discussions are meant to provide a vehicle for ongoing, structured dialogue, deliberation and broadening of perspective, without the pressure to come up with silver bullet solutions.

Staffing crises; increasing regulation; lack of end-of-life planning; a huge generation of aging Americans; people aging in place with dementia; poor perceptions of aging services: These are all large hurdles that the aging services field faces in the coming years, and every one of us is searching for solutions. But do we truly understand them?

Unfortunately, there are no easy answers. In an era of immediate gratification, it is rare that we take the time to deeply dive into an issue before trying to solve it. While we often jump to answers or solutions, there is much value in sitting with an issue and exploring it without trying to fix it. In an increasingly complex world, we must pause to contemplate and reflect. There must be a better way to grapple with these complex issues.

Fellows of the 2018 Larry Minnix Leadership Academy were tasked with exploring issues in aging services that they found troubling and wanted to make forward progress on. The fellows examined gaps between what older Americans need and what is available to them. The group used the study circle model as a tool to navigate these gaps. Each of the 6 teams of 7-8 fellows identified a gap that was particularly important to its members, and which often affected them in their own roles. The gaps explored included:

  • Lack of advanced care planning: Tackling the hard truth that many individuals are not prepared for end-of-life decision making, and that all too often that burden falls to loved ones.
  • Workforce issues: Addressing the demand for workers, which is constantly growing along with size demographic in need of these services.
  • Technology and dementia: Technology has been injected into nearly every aspect of our culture and society, excluding those with cognitive impairment … until now.
  • Perception of aging services: Ageism is real, and the general perception of our demographic is negatively skewed; it’s time for that to change.
  • Family communication with people living with dementia: The overwhelming difficulties people face when communicating with those living with dementia is a sad reality that is best addressed by starting with family.

“[The study circle process] opened my eyes to more issues that we have. But it also affirmed that we all have the same problems,” says fellow Kim Schilling, vice president of health services at Friendship Haven, Fort Dodge, IA.

A study circle is a tool that can be used to deepen thinking, knowledge, and understanding of any issue. While our natural inclination is to look at a problem and immediately try to find a solution, the study circle asks us to reflect and explore the matter at hand. By plunging into facts, history and various facets of an issue, we can truly comprehend the complex systems at play in our field.

In an era of immediate gratification, it is rare that we take the time to deeply dive into an issue before trying to solve it. While we often jump to answers or solutions, there is much value in sitting with an issue and exploring it without trying to fix it.

“[At first I was] a bit overwhelmed when we began discussing … how many gaps we could identify. But what struck me is how interconnected the gaps are,” says fellow Aaron Tripp, vice president, reimbursement and financing policy at LeadingAge.

Think of the study circle as a research paper with no thesis statement. We do not approach the study circle with a hypothesis to prove, but a question to explore.

“The [study circle process was] an eye opener to me. Many of the issues talked about were not new. However, it was a specific question posed along with the perspective of the problem from each team that made me think of these common gaps in a new way,” says Elizabeth Martin, an executive director at Acts Retirement-Life Communities.

Each team spent approximately 6 months selecting and exploring its gap. These months were spent researching, discussing, asking questions, and reflecting, enabling fellows to immerse themselves in the topics at hand. At times, it felt almost impossible to discuss these gaps without proposing solutions.

As leaders, we often impose pressure on ourselves to find the answer or to fix the problem. Early in the process, there is a sense of uneasiness in not identifying solutions, but rather asking even more questions. The study circle practice asks us to sit with the discomfort and truly look at the nature of the issue we’re exploring. If we do not see a problem in all its complexity, how can we begin to move forward?

“I remember being pretty overwhelmed by the [process], feeling frustrated and even downhearted,” says Laura Edwards, director of strategic initiatives at Clark-Lindsey Village, Urbana, IL. There really is so much work to be done in our field. … Will we ever get there? But, being in that environment, surrounded by change-makers, I felt like I could see a glimmer of light.”

The fellows ended the study circle process by presenting information on their gaps in an engaging way to start a conversation and build momentum around the issue they explored. Some groups performed skits, while others presented visual exercises, created videos, and more. Each fellow left the presentations feeling inspired, rather than defeated, by the gaps presented.

What did the fellows have to say after these presentations?

  • Alyse Meyer, vice president of advocacy at LeadingAge Texas: “I’m learning to let go of achieving ‘the end’ and focusing on what I can do today.”
  • Ken Sandberg, vice president of health services at Whitney Center, Hamden, CT: “The gaps have fueled my passion for learning ways to educate and influence those I touch.”
  • Erin Kolb, chief operating officer at Poydras Home, New Orleans, LA: “The [presentations] made me realize just how many gaps there are in our field and how each one of us can play a small or large role in how they are addressed.”
  • Jordan Morrow, executive director at Greenwood Village South Senior Living Community, Greenwood, IN: “I learned that perspectives are diverse and sometimes divergent, but when guided by the study circle process, those conflicting perspectives can become a catalyst for a far better solution than any one person could have imagined.”

Putting a Study Circle to Work

The study circle tool can be used across a variety of settings in the continuum of aging services. All you need is a team of people who are passionate, possess a sense of curiosity, and desire to serve an aging population. From departmental issues to societal concerns, the study circle allows individuals to set aside preconceived notions, and instead approach problems from a blank slate.

Bringing your team together to look at a situation without preconceptions can create innovation, deeper understanding, and camaraderie.

The process begins with establishment of the circle: What is the core team that will be looking at this issue? Making sincere personal connections with the members of the circle creates a safe place to explore all sides of the issue or question being explored.

From there, the members of the circle can begin sharing assumptions, knowledge, and understood history related to the issue. After compiling all the preconceptions brought to the table, the team can then begin to divide out for tasks. This may mean researching a particular aspect of the issue, talking to outside experts and stakeholders, exploring other examples of similar situations, and endless other opportunities. Really, the boundaries of what is possible with the study circle are determined by the most restrictive thinker in the group. It is imperative to think big.

“[You need] the ability to not only listen, but to hear,” says Tadd Weese, director of facilities management at Saint Simeon’s Episcopal Home, Tulsa, OK. “My experience with this is that reception depends completely upon the degree to which a person is ready to receive. Being self-aware [about] your readiness to hear and understand is extremely powerful.”

It is important to compile information without an end destination in mind. The purpose of the circle is to explore the issue in its entirety without solving it.

Through active listening, curious questioning, open-ended questions, and transformative dialogue, the circle can bring clarity to a seemingly overwhelming issue. While the circle does not provide a solution, it lays the groundwork for next steps so that you can begin to make progress toward addressing the topic or gap.

Really, the boundaries of what is possible with the study circle are determined by the most restrictive thinker in the group. It is imperative to think big.

“My leadership journey changed, from thinking I needed to forge a new path for my team through a dense jungle of obstacles to understanding that soaring at 30,000 feet gives you a vantage point that helps you see obstacles far ahead,” says Morrow.

For the fellows of the 2018 Larry Minnix Leadership Academy, the next steps became clear after the study circle presentations. The process reignited a passion for easing the gaps in aging services. Many fellows reported that they completed their advanced directives after an eye-opening presentation on the lack of advanced care planning in the field. Individuals who worked in an affordable housing setting found themselves much more engaged with supporting individuals in the skilled nursing setting, and that support was reciprocated entirely. These presentations on unanswered questions have been catalysts for the fellows in many ways.

In summary, according to Morrow, “These conversation starters confirmed and solidified my calling and purpose in life, which is a feeling that no words can describe and [on which] no value can be placed. The study circle process is jolting regarding the level of awareness it creates surrounding the issue at hand. I can’t possibly imagine a better way to discover and understand the intricacies of posed problems and gaps within our [field].”

Kate West is director of community development for Eaton Senior Communities, Lakewood, CO; Jordan Morrow is executive director at Greenwood Village South Senior Living Community, Greenwood, IN.