Caregiving at Samaritan Bethany: Mental Health, Purpose, and Support

Rachael Maxfield is the Co-Mission Leader of Samaritan Bethany, a faith-based nonprofit in Rochester, Minnesota that offers a full range of affordable living and care options for seniors. She supervises the company as a Co-CEO and oversees the housing departments, which include independent living, assisted living, and memory care.

Q: Can you describe what Samaritan Bethany does for seniors?

A: Samaritan Bethany has been caring for seniors since 1922 and has seven sponsoring churches, which is how we’re qualified to be a part of the Pension Boards. We have a continuum of care, which usually starts when someone is looking to move into our community with independent living. That applies to anyone who is 62 or older, and we offer an apartment-style room with services they can enroll in. If somebody needs additional care, we transition into assisted living. This includes more hands-on supervision.

Memory care is available for someone who has a dementia diagnosis and may need a safe home. We have the same services for memory care that we do for assisted living, but with specialized training for staff to assist residents with memory loss. If someone needs even more medical care and oversight, we provide long-term care with 24/7 licensed nurse coverage. We also have short-term rehabilitation, which is for residents who need temporary therapy after an operation or event to heal and get back home.

Q: What do you think caregivers need to understand to serve their communities well?

A: You have to think about caregiving from an outside perspective, because you’re trying to make good decisions for the person you’re providing care for. If you are that person’s decision-maker or executor of their estate, for example, they need guidance and level-headedness to make those decisions. It’s important to ask yourself what they want. How have they gone through their life, and what is important to them? Sometimes it’s hard to separate emotions from logic, so you want to be compassionate and empathetic while still thinking through the options. Change is difficult at any stage of life, and as we age it’s important to feel like we are as independent as possible. Sometimes it looks different than how you think it should look. When I’m training someone to be a caregiver, I emphasize the importance of caring for others the way they would want their loved ones to be cared for.

Q: What mental health or emotional challenges do caregivers face? How are they supported to meet their needs for their overall wellbeing?

A: I would say the number one mental health challenge that caregivers face is burnout. They often feel like they can’t do it anymore, they’re exhausted, or feel like there’s no one helping—they feel alone. Sometimes this comes from people who have made a career out of caregiving, caring for seniors who are close in age to themselves. As an employer, it’s important to give them the support and care they need, whether it’s through our health programs, counseling, or offering them a mental health day. In our community, we have a “mindfulness room” with a massage chair and essential oils. It’s a space for relaxing during or after work.

It can be a fast-paced environment—you have families coming in asking you questions, and you always have to be engaged and alert. Sometimes there’s just so much unknown—you don’t know what Sally has in her bank account, or if she has advanced directives made up, or if she has a funeral planned. As care providers, trying to put all those pieces together can be very stressful. It includes making sure Sally has everything she needs, gets to her appointments, or has online shopping auto delivered for her because she can’t drive anymore. There’s so much a care provider needs to balance.

Q: Caregiving roles are perceived as high-stress, lower-paying, and emotionally challenging positions. What are some of the challenges you’ve seen in attracting and retaining caregivers?

A: Staffing remains a top challenge across all healthcare sectors, especially in caregiving, where individuals often step into emotionally complex and unfamiliar situations. While caregiving can involve moments of deep sadness—such as saying goodbye to a beloved resident—it also offers profound rewards, like the privilege of being present during someone’s final moments. This work, though not always easy, carries immense meaning, and for those called to it, the opportunity to provide comfort, dignity, and compassion is truly life-changing. It’s important to recognize the full spectrum of caregiving—not just the joy of helping, but the strength and grace it takes to walk with others through life’s most vulnerable times.

If caregivers don’t feel supported in the workplace, they probably won’t stay. At Samaritan Bethany, we care about the residents and staff as people. That’s why we follow the household model of care, which means caring for you as family, not just as an employee. We want to make sure that our caregivers are supported even when we can’t control the government’s pay structure. However, wages present a challenge, as caregiving is typically considered an entry-level role in the medical field. It’s hard to compete with other industries—especially here in Rochester, where various sectors of healthcare play a dominant role in employer opportunities.

Q: What benefits and practices do you use to maintain that retention?

We learn about the specific person and their needs. For scheduling, we try to be flexible with our caregivers to give them days off when they need it, finding replacements to help them cover their shifts, or encouraging them to voice their needs.

When it comes to benefits, we have a competitive plan. We try to tell people, “If you look at your benefit package, you’re paying pennies compared to other companies and you’re getting great coverage.” Maternity care is covered, for example. People sometimes don’t see benefits as the deciding factor in their job, but if you’re working full-time and you can get affordable coverage for your whole family, that’s very important—especially in healthcare. Ultimately, making our caregivers feel supported and protected is the goal.

Q: Where do you and your employees find purpose in this line of work?

A: I used to be a nursing student, but I realized I couldn’t become a nurse. It wasn’t because I couldn’t do needles or the bedside manner—it was because I cared more about making a positive change and doing what needs to be done when no one else is doing it. I had to switch my own personal gears, and now I find joy in helping the families and residents see the silver lining. When I see acceptance when someone moves in, making friends and connecting with their caregiver, that makes me feel fulfilled.

I know and enjoy the people I’m surrounded by day in and day out, and that’s where my joy comes from. I can’t speak for all our staff, but I think most would say the same. We do this for the connection and helping other people no matter what stage of life they’re in. Our staff stays because they truly care about the residents and each other.

Q: How is the Pension Boards helping to strengthen the foundation of Samaritan Bethany’s employees?

A: The biggest thing is the benefits. Without them, we’d probably be paying close to double for benefits that would likely be worse. That is the greatest service the Pension Boards can provide us—a sense of security in knowing we have an affordable benefit package. As employers, we don’t know how much it costs people for their medication or health expenses. But we do know that we provide the best options so our employees can care for themselves and their families.

The greatest thing the Pension Boards does is provide security in their benefits, and the extra stuff that comes with it—whether it’s an educational session or a resource our staff didn’t know they had. It’s important that these benefits come from a faith-based organization, and that our staff can gain this financial planning assistance. The Pension Boards also gives us access to Health Advocate, which is essentially free money for our staff if they do the work, as well as an employee assistance program that provides attorneys and family law aid. Overall, at Samaritan Bethany, we benefit greatly from the Pension Boards, which provides our staff with a wide range of valuable resources and benefits.