The five stages of occupancy grief

There are many articles, studies and direct conversations regarding the state of the aged care industry today. One of the biggest pain points for providers is financial. Regular surveys such at the StewartBrown Benchmarking Reports highlight the significant fiscal impacts particularly as they relate to the cost of staffing, often to achieve compliance rather than impact direct resident care, and the loss of revenue when occupancy takes a hit.

We regularly work with clients across a range of projects and one such issue that commonly crops up is occupancy. Overall there is a preference to stay at home and in some areas intense competition results in significant oversupply of stock. That said, there is a market for everyone.

Throughout many of our occupancy projects we work with clients going through the well documented stages of grief.

Our take on occupancy stages of grief, with apologies to Elisabeth Kubler Ross and David Kessler, are outlined below.


“It’s just been a bad few months.” Yes it has.

“We have had a lot of deaths.” Agreed, but in residential aged care there will always be exits through death.

Denial helps to minimise the overwhelming pain of loss, in this case – bed occupancy. As clients process the reality of loss, they are trying to survive emotional pain. Denial is not only an attempt to pretend that the loss does not exist. People are also trying to absorb and understand what is happening.

Denial may last for a few months to a year or more.

Front foot it and keep a close eye on occupancy. Don’t let things slide too far before you ask for help.


“There are so many more home care packages keeping people at home.” Yes there are more home care packages however there remains a group of people who will always need to move to residential aged care. Consider also the 100,000+ people on the waiting list for a package.

It is common for people to experience anger when occupancy is declining. Organisations are adjusting to a new reality and are likely experiencing extreme discomfort. There is so much to process that anger may feel like it allows an emotional outlet.

Often the responsibility for occupancy sits with one person. The pressures are immense and often staff are wondering what is going on and how do they get out of this mees. What may have been an easier “order taking” role many (many) years ago now requires significant skill in dealing with families who are making some hard decisions.

Clarity around expectations and team accountability aids in ensuring everyone pulls together for the same outcomes.


It is common when coping with loss to feel so desperate that some are willing to do almost anything to alleviate or minimise the pain.

This is a critical moment for some providers. It is more important than ever to ensure you are in a position to be able to best support your potential residents rather than saying yes to everyone. Working collaboratively will ensure that the right residents are admitted.

It is not fair on an organisation, its staff, the resident and their family if you accept someone and you do not have the right environment or expertise to do so.

By building strong relationships with providers in your area you may be able to refer say, a resident with particular needs, and they may refer to you.

Ensure your message is clear and that you do not promise things you cannot deliver.


“Oh my goodness this is our new reality.”

During the experience of processing grief, there comes a time when providers slowly start to look at the reality of the present situation.

As panic begins to subside, the emotional fog begins to clear and the loss feels more present and unavoidable. This is a time when people are feeling very uncomfortable about how they are going and whether they will ever make a difference. Yes you can.

This is a great opportunity to closely look at what makes your home so special. Too often people are so absorbed in their own world and are doing “what we do every day” that they don’t realise how amazing they are, what a difference they make, what programs they have that others do not, what the built form means to residents – the list goes on.

Understanding your unique selling proposition helps to put your best foot forward.


Usually acceptance means we are not doing anything different. A longer bow here, however Ideal considers acceptance as part of entering the “new” way of operating.

In this case acceptance is the understanding more clearly what the customer wants, understanding what the organisation offers, developing strong relationships and clear messaging. This drives referrals and provides the organisation the opportunity to showcase its strengths.

What you can do

Close monitoring and reporting of some key metrics will highlight a decline in occupancy more quickly. This includes keeping a close eye on enquiries, tours and admissions. Weekly and year on year data will demonstrate patterns.

Critically look at the customer experience and consider how your processes may support or hinder a great welcome.

In relation to organisational / local culture, consider what you are trying to achieve. Review role descriptions, aptitude and skill set. Attention needs to be taken as to how the team are working together.