Have you considered a nursing home concierge? Want to "wow" residents and families? Take a tip from the hotel industry. (Feature Article).

Trend watchers indicate that future residents of nursing homes will want more individualized activities as opposed to the earlier models of primarily group activities. Forecasters also warn that the baby boomers will demand increased special services." So reports Mary E. Miller, a therapeutic recreation consultant at Mary E. Miller & Associates in Cincinnati, Ohio.

The traditional menu of services provided at nursing homes does cover a lot, including housekeeping, laundry, dining, nursing, security and activities, but could prove to be inadequate as more sophisticated residents enter facilities. If so, a demand for more services means a demand for more labor hours. Who should perform that labor? We can look to the hotel industry for an answer: a designated "concierge."

The concierge is, as you know, the staffer who takes care of the details of completing everyday tasks for hotel guests and makes arrangements for special activities. He has nothing to do, of course, with activities of daily living, or ADLs (see Table).

An effective concierge has good verbal and written communication skills and is proficient at operating a computer and office equipment, performing research, managing conflicts, organizing events and maintaining good follow-through. A concierge needs the flexibility to handle last-minute requests. It helps, too, if the concierge is active in the community and knowledgeable about local events. A long-term care concierge would also require something extra: enjoyment in working with older adults.

In a nursing home, the concierge would need to have a good working relationship with the facility's activities and social services departments. All would work together with the administrator in designing the concierge's list of services without overlapping of responsibilities.

It is true that today's activity professionals and social workers already handle some of the requests that might be performed by a concierge. They would be hard-pressed, though, to meet any significantly increased demand for special services and individualized activities. Perhaps the main differentiation is this: The objective of a concierge is to provide personalized, even luxury, services; the concierge provides amenities unnecessary to life and health, but comforting and pleasurable. Activities staff provides more generalized and regulation-required services. Social services concentrates on meeting needs relating to a resident's physical, social and emotional well-being.

Assuming that you have someone in mind who might serve very well in this role, you are probably wondering how much it will cost. Compensation varies depending on each regional market's cost of living and competitive salaries, but in the Midwest a concierge might start at between $16,500 and 22,000 a year. As experience increases, the salary of a facility's concierge should be comparable to the salary of a local hotel concierge, since the job requirements are essentially the same.

The concierge's services could be billed as an initial fiat fee for each request with a charge for the time involved to fulfill the request. Expenses, such as gas to perform errands and vendor charges (tickets, taxi, etc.), would be billed to the resident, or a monthly bill could be sent to the person who is financially responsible for the resident. This person would sign a contract agreeing to pay for concierge services for the resident up to a maximum amount of money, perhaps based on a monthly retainer or minimum monthly fee.

Offering a concierge service would clearly be a marketing tool. It would be the "perfect gift" for friends and family members to give residents to show their support in a thoughtful way, not to mention relieving them of some of this responsibility.

Long-term care today boils down to increasing competition for residents. Put simply, the nursing homes that offer the most desirable services to service-demanding customers will remain viable.

Table. Services That a Long-Term Care Concierge Might Provide.

* Arranging for outside church visits and funeral attendance

* Arranging for repairs of TVs, VCRs, DVD players, CD players, computers and printers

* Arranging for dry cleaning 

* Sending and delivering faxes and e-mails

* Arranging for the auction or sale of property and personal goods, only after the family's approval; scheduling donations of property to charities with family's approval

* Arranging for special entertainment: a horse-drawn carriage ride, a clown visit, a balloon ride or a singing telegram 

* Ordering birdseed for the season; keeping bird feeder cleaned and filled

* Arranging for gift basket, floral, balloon and cookie bouquet delivery

* Arranging for medically approved alcohol and/or tobacco delivery

* Performing plant care: watering, trimming, repotting and replacing

* Arranging travel plans, including setting up appointments and scheduling transportation for visits to physicians, dentists, ophthalmologists, rehabilitation, etc.

* Facilitating visits to groceries, department stores and pharmacies, scheduling a facility van when needed

* Providing drop-off and pick-up of film and photos

* Arranging for tailoring and alteration services

* Providing pick-up and drop-off of VCR/DVD rentals

Cassandra S. Clancy, ADC, MTS, works in the activities department of Whetstone Gardens and Care Center, a 200-bed nursing home with an adjoining 60 assisted Living apartments, based in Columbus, Ohio. She is certified as an activity director (ADC) by the National Certification Council for Activity Professionals. For more information, e-mail cclancy@ columbus.rr.com or fax [phone].