The Hardest No

Jimmy Alden called to tell me his wife, Rosalind, had fallen. She was recovering, and would need support at home.

My stomach dropped.

There is no family I would rather support than the Aldens (a pseudonym). Before starting this organization I spent twenty years building a company that supported people with developmental disabilities. We supported the Alden’s daughter. They were kind and enthusiastic, and they trusted us to do our best, then held us accountable to actually do it.

When I sold that company and started this one, they cheered. They read this column. They call me about it.

And I already knew what I had to tell him.

He came to the office and we sat down together. We’re growing quickly, I said. We’ve paused taking new clients, because right now we couldn’t serve them to the standard we hold. We have to build more of the organization first.

We exist to provide care for this community. That’s the whole reason. Which is exactly why we can’t let the market decide how fast we grow.

Our phone is ringing. Existing clients want more hours. The waiting list keeps growing. Every one of those calls is a person who needs care, and every one is revenue we could earn today. The obvious move is to say yes to all of it and staff it as we go. Make hay while the sun shines.

But here’s what it looks like when you do that. New caregivers come in and go nearly straight to work, because the need is right in front of you; no full orientation, no time to learn who we are or why we do this differently. So new caregivers start work carrying what they carried at every other job.

Last week a new caregiver told Roberta, “You took my hours.”

But nobody had taken anything. We have more hours than we have caregivers to work them, and overtime for anyone who wants it, Roberta had spent that morning trying to hand hours out. What the caregiver saw instead was every job that came before this one: the check smaller than the promise, hours that disappeared without explanation, being done wrong as ordinary practice. Expectation is a lens, and hers had been ground somewhere else.

It happened because we were moving too fast to sit down with her and show her something different. So she left, we were short again, and the care got thinner for everyone.

So we’ve paused. We think for two months, while we build the next layer of support, so caregivers can own more of their work. We’ve tried various sub schemes in the past; the difference now is that we have the business volume to fund this one. That’s what the “super sub” position is: a caregiver paid to be available around the clock. Some of the cost of their hours get absorbed covering for a caregiver who’s sick or on vacation, those hours paid by a client. Some will be absorbed by the organization itself: staffing orientations, interviewing new caregivers, supporting working caregivers with things like showers for clients, and relationship-building.

We’re paying for readiness while turning business away, because the alternative is a hundred clients and a staff of strangers.

Jimmy understood. In fact, he already had a backup plan, of course he did. What a marvel.

The phone is still ringing. Every call is someone in this community who needs care, and saying no to them is the hardest thing we do.

We’re saying no for a few weeks so that the yes still means excellent care.

This column ran in the Santa Fe New Mexican on August 25, 2026, under Business Different.