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May 2, 2022

Understanding Our Nursing Home Residents

U.S. regulations require a long term care facility to be “home like,” but what can employees and professionals really do to make sure their residents feel at home.

Jennifer George M.P.T. explains that in order to make residents feel at home, employees and professionals must strive to give them as much independence as possible. To recognize their opinions and decisions and abide by them.


Jennifer has been a practicing physiotherapist for 14 years, and shares about her experiences and what she has learned in this space, as a podcaster, author, and speaker.

She served as her dad’s caregiver for many years while he was housebound and through this experience can empathize and understand the struggles of residents and their families.

Most times, going into long term care is no one’s choice and therefore its essential for residents to feel independent and at-home.

Jennifer approaches every interaction with residents with the understanding that she is in their home and in their space as opposed to them being in her space because she is the therapist.

As a physiotherapist her job is to assess patients mobility, balance, and strength and she strives to enable and empower their independence while also minimizing their fall risk. 

She advises physicians to try and tailor their sessions and treatments to the resident and their goals rather than rushing through and only thinking about the problem, not the person. 

In order for an at-home environment to be established, residents must feel trust and rapport with their physicians and caregivers. 

This rapport can only be gained if caregivers and physicians stay present with residents and remember that their role is to guide and inform, not to be authoritative and make decisions against the resident’s desires. 

Jennifer states that compassion and empathy only takes moments and even small gestures can go a long way towards making residents feel comfortable in their surroundings. 

 

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Transcript

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Oftentimes it's no one's choice, I think, to go into long term

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care. And if it is, it is just what's

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left in terms of living as independently as possible,

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right? And oftentimes it's the family's making that decision as well.

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I really empathize with the residents and the families I often

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call families myself. Like every single day I was calling family members and

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I think they were kind of shocked by that because it wasn't very common

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just to update them on their loved ones progress and things like that. But in

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terms of relating, I felt like I was in their home.

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I felt like that's kind of how I approached every interaction

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with my residents was that I was in their space as opposed to me

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or them being in my space because I was a therapist.

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Welcome to the nursing Home podcast. Your goto source

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for professional insights in the longterm care industry. Hear from

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leaders and experts as they share current and practical insights to help make

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the most of your day. I'm a long term care financial specialist.

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What that means is I help people plan for the inevitable.

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Nobody wants to think about getting old, but it's possible that someday

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we might need a little bit of care. Here's your host. Nursing home Administrator Turnpodcaster

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Schmoel, Septimash.

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Welcome to another episode of the Nursing Home

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podcast, the podcast that you've learned to come

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to and trust when it comes to real information about

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this mysterious industry, the nursing home industry.

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In today's episode, we are going to discuss some

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strategies, some ideas, a mindset for us

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to better understand the communication between the

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professionals in the nursing home space and those that they serve

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in this space. And it's service that they do in order to

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address this properly. I'm excited to have with me Jennifer

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George. Jennifer is a podcast

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host of her own, as well as an author and

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a speaker and a physiotherapist. Maybe at some point explain

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what that is. Welcome to nursing Home Podcast,

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Jennifer. Thank you so much for having me. I'm excited to be here.

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Okay, awesome. So before we jump into the

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subject matter, just don't mind taking maybe 30 seconds

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or so and just letting our it could take longer if

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you need, letting our listeners know a little bit about who you are and

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how you come to being involved in the nursing home space.

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Yeah. So my name is Jennifer. I'm a physiotherapist.

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That's what I've been trained in. Here, in Ontario, Canada. So I've been

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practicing now since about 14 years. I'd say just

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the end of 2007, I started my career in the Orthopedic space

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because that was kind of the thing to do, like a private clinic space and

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sports injuries, things like that, return to work, motor vehicle accidents.

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And I liked it. I enjoyed it. It wasn't what I was most passionate about,

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but I did enjoy it. And it served as a good foundation and then

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my clinic that I was working at was closing,

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and a former mentor of mine knew that that was happening and

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reached out to me. And she was someone who was in the OrthoSpace,

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like a strong orthopedic therapist, and actually had

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started working in long term care or nursing homes and

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suggested that I give it a try. And at first, I got

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to be honest, I was quite surprised. I didn't expect to love it

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as much. And when I started, I absolutely fell

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in love with it. So I worked in long term care for at least three

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years, and I learned a lot in that space when it came to communication

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and empowering partnerships between residents and

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provider and communicating with family members as well and staff.

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Got it. Okay, thank you for that overview.

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What did you do specifically in nursing? What was your job? So,

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working as a physio, my job was to assess patients mobility,

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essentially their balance, their strength, and enable them and empower

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them to be as independent as possible while also minimizing

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their fall risk. So I sat

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on committees around fall prevention strategies, getting rid of restraints,

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things like that, in order to promote independence. Physiotherapists and

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a physical therapist are different? No, they're actually the same.

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The only issue is geography. So in Ontario,

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Canada, we're referred to as physiotherapist. That's our title. But in the states it's

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physical therapist. So that's the

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only difference. I mean, our training is probably a bit different, but yeah,

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we're essentially okay. But that gives me a better idea of exactly what

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you did. We're going to call you a physical therapist.

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You get involved on the therapy team, on the rehab team, right.

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And you did what you do in the building.

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You had probably the usual tension between nursing

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and rehab. We just have to touch on this for briefly because

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we can many times,

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the therapy department, the rehab therapists, are the

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most trained and skilled clinicians in the building,

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but they're only with the patients for very short periods of time.

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They're like grandparents. I think that's a good way to explain it to them.

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Right? You bring the kids to the grandparents so they get to enjoy them,

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they get to deal with them on that very focused time.

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And then they go home and the parents go and they change the diapers

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and are up at night with them and intercoll lights and have

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to deal with the state and other stuff.

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But at the end of the day, grandparents can give to grandchildren,

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but sometimes parents can't get that on the spot.

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But the point is, I think that it's been hanging out

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with grandparents too much. But I think it's an apt comparison

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where the therapy can really just to

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become any type of therapist requires

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much more training and you're dealing with

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just the skilled part of the patient.

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I know they were slightly dethroned. I don't know how this works in

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Canada, but at least in that states with PDPM,

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where it pulled some of the emphasis on the reimbursement from

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rehab and shared it a little more evenly throughout the building.

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But it's still true that the rehab team sees things that

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the rest of the team doesn't see. Right? I don't know

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if the models are similar. So this was at a time back in,

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I want to say around 2013, around that time. So this was a

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while ago from my personal direct experience in

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longterm care, but the way it operated, I worked for a private

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company that was contracted out by the long term care home. So I was

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on site every day for at least 4 hours a day. So I got

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to at least be there frequently enough so that

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if issues did arise, I could follow up right away. But it was

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a learning curve because that was at the time when the restorative care model

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was being introduced into long term care, where they started to

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see the rehab potential of residents as opposed to

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just keeping them where they're at. They had potential to

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improve their transfer status, their mobility status.

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But prior to that, you're right in the sense that it was nursing

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and PSW support who were actually assessing mobility at

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that time. So when I came in and that

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model was changing and there was now this restorative care model that we

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were overseeing as therapist,

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there was a little bit of tension there. It was tough trying to

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come to a working agreement at first with all staff

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and trying to see me more as a teammate rather than a barrier or somebody

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who is trying to threaten job security in any way,

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shape or form. Right. So I just tried to make it as much as

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possible, knowing that I was there to help rather than hinder.

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But for the most part it was good. We eventually got

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through it and I believe we made a big difference and that's what mattered

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most. And that was kind of the common goal,

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right? I mean, part of it is the nursing field.

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If you're as a therapist and like you're doing a full assessment or

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you're trying to figure out you're looking for

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problems, being that you're not the one who's providing the care,

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no matter what happens, the problems are going to be with the nursing team.

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They're the ones who are actually dealing with them. So by nature, you have this

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it's a little bit of, you know, again,

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you have a surveyor that's going to come into your building to tell you how

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your nursing home is doing, even if their intent is

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genuinely and authentically for the best interests

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of the residents, which I personally used to wish that

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that was the case. And I don't believe honestly that that is the case,

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but that's a separate conversation.

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We have another episode with a former Department of

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Public Health surveyor on this podcast. We have a link to that in the show

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notes, but without going down that road again,

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by nature, you do have that type of dynamic.

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But let's refocus the conversation for a minute here's.

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What I would love to address with you right now is that some

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people call their nursing home inmates.

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Residents. Some people refer to them as patients.

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Nobody refers them as inmates. That's just a horrible thing to say. Although some

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of the residents will refer to themselves that way.

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Unfortunately, it could be for

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a variety of different reasons, but it could be the way that it was explained

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to them, or the way that they feel they're being treated, or it could be

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a myriad of other reasons. Yeah, I don't want to be there.

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They probably don't, and that's why they probably feel

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that way. But I think the biggest misconception

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that people have about nursing a home with

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folks is that it's them and it's not us.

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We think that it's those people. There's a group of people who were born

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in nursing homes with certain physical,

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psychological, emotional challenges and therefore require

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a whole team to assist them in their daily

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living. And if they're lucky, they can get some, like you mentioned

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earlier, restorative health type of program. Then there's

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them and us. We're the free outsiders who thank

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God we're healthy and independent, like you said.

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And then there's a them. I think the first thing, regardless of the name that

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you call it, I think that's nitpicking. That's not the point. The main

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point is how do we relate to those that we care for?

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How do we view them? And I'd love to hear your perspective on this.

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Oh, wow. So the other thing is, I was a caregiver to my

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dad for more than ten years, and my dad was housebound

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for many years, and he potentially should have been at longterm care level,

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but he was fortunate enough to have our family be home with

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him, especially my mom. Twenty four, seven. So much of

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what I saw there personally empathized with

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as well when I was working in long term care, because it wasn't

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my dad's choice to be housebound. Right. And oftentimes it's no

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one's choice, I think, to go into longterm care. And if it is,

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it is just what's left

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in terms of living as independently as possible,

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right? And oftentimes it's the families making that decision as well.

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So I really empathize with the residents and the families

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I often called families myself. Like every single day I was calling

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family members. And I think they were kind of shocked by that because it

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wasn't very common just to update them on their loved ones progress and

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things like that. But in terms of relating, I felt like I was

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in their home. I felt like that's kind of

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how I approached every interaction with my residents was that I was

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in their space as opposed to me or them being in my space because I

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was the therapist. So, you know,

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patients with severe dementia or residents with severe dementia,

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I had to be very creative in how I was implementing restorative

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care because it was difficult

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for them to follow sometimes. And I know lately

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we're seeing a lot of different characteristics of

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people in long term care. Traditionally, people thought it was just for geriatric

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population, right? But now we're seeing people of all ages

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who are lacking enough independence and safety to be

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on their own that they are now in long term care.

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So I can only imagine on the staff currently,

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like, how challenging that must be to try to relate to each and

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every individual and connect with them.

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But, yeah, I think that's the most the most important

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piece is that I treated it as if I were in their space,

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in their home. Okay, let's try to just make that practical

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for a minute. For others who are currently working in

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nursing home providing care on any level, we know that there are some

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of the at least United States regulations is that it's supposed to be

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a homelike environment. And that's for translation

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exactly. Or interpretation exactly what that means. Sometimes that term is

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thrown around. But moving beyond the regulations,

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I guess, to the relationship between the providers and those are receiving the

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care, I didn't do that practically walking into a place.

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This is their home. That's interesting. That's their home. There are 150 other people that

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live in this home. There's even the equal number of staffs

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that are servicing this home. There's a very limited amount

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of privacy that any particular resident has,

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even if they're in a private room, even if at the end of the day,

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some functionalities that you would find in a typical home,

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they don't have the dependence to choose to be home, to not be home.

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So, yeah, you should knock on the door before you come in.

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You should ask them, is this time okay? But maybe

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on a higher level. I'm just curious what's worked for you?

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And more importantly, how can others listen

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to our conversation and implement this in their facilities?

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So definitely, I think what you touched on there is actually very important is to

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knock on the door. I don't think we should overlook that. I think

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asking for permission is extremely important to provide

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care, because I've had a lot of residents say, no, it wasn't their

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priority, and, you know, we have to accept that.

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But ultimately, it was, like you said, establishing that home environment as

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much as possible. It was tailoring the treatment and the assessment

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according to what they wanted to focus on and

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what their goals of what their goals were. Like for some people

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I know, I'm thinking of one lady specifically. Like,

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her goal was to not be on a mechanical lift anymore.

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She didn't want to be on that list. She thought she was capable of standing

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and weight bearing and things. So we worked so diligently on that

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and had her son involved, too. So I think including the family

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is also important if they have a good relationship with

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their family members to make it feel as

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empowering as possible toward their needs and

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towards their goals. So that's really like one

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of the things I ask is, what do you want to focus on? Like,

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what matters to you right now? Like, these little things.

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And sometimes people can't say them and we

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do whatever we can to get there. Eventually we do, but sometimes it doesn't

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always happen in one interaction. And I think it's important to keep showing

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up no matter what, whether a resident is in the right space to

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participate or not, and not to take those things personally if

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they're not got it. Okay, interesting.

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So that is something that I think is a little bit

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missing, is that we as the professionals providing

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care, we have the answers. You don't have the answers.

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It's not limited to nursing homes. You go to the doctor.

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The doctor is in charge of the interaction.

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The doctor is going to tell you, what's the right level of care? I've been

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in rooms where conversations regarding very sensitive,

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emotional, spiritual, religious types of conversations were

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made. Like, how do we convince the family members and now that they've reached a

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certain level of care, a certain level of dependence, a certain

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new handicap or new setback, that it's

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time to start thinking about end of life? And really,

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I think it's a horrible thing to do, although I think, unfortunately, it's very prevalent

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because you may have your own perspectives and decisions and

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opinions and values, but you really have no right to implement

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those on the residents that you're serving. Remember,

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you're serving them. They're the master, so to speak, and you're being paid

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to provide for their needs. That's why you're there. That's something

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that I think is broader than nursing homes. It's the

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professional being a very simple

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thing. Being a cars are mechanic and say, oh, you have to do this service

17:12.175 --> 17:15.762
for $900 because in order to ensure

17:15.837 --> 17:19.072
that you're going to have this type of result, it's going to be able to

17:19.105 --> 17:22.662
drive in these types of trains or be able to drive long term driving.

17:22.737 --> 17:26.352
Just take it out for a minute so everybody can relate

17:26.382 --> 17:29.722
to Mr. Mechanic. I have a different car for long term. I just need this

17:29.755 --> 17:32.982
to drop off my kids at daycare. I just need this for local shopping.

17:33.072 --> 17:36.352
So don't tell me to do the $900 procedure, which is not valuable to

17:36.370 --> 17:39.742
me when I would like the heated seats. Even though the car is 15 years

17:39.790 --> 17:43.102
old, I spent time in this car. I want the back of the camera or

17:43.120 --> 17:46.467
whatever. And it's important to gather

17:46.527 --> 17:50.317
as much information about someone as you can, right, and have

17:50.365 --> 17:53.992
them share as much as possible. And that's why sometimes it might not happen.

17:54.115 --> 17:57.502
Like in the first and only interaction, it has to keep happening. They have

17:57.520 --> 18:01.087
to build a rapport, they have to build a trust in you. And definitely

18:01.225 --> 18:04.377
we have to as much as possible, I would suggest,

18:04.482 --> 18:07.947
to keep your personal biases out of it. Our role is to guide,

18:08.067 --> 18:12.102
our role is to inform, but our role is not to be authoritative

18:12.207 --> 18:15.622
or to make decisions for people based on what we think we

18:15.655 --> 18:17.900
would want to do. Exactly.

18:19.762 --> 18:23.227
If I could put you on the spot a little bit, what has been

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an interaction that you had with some

18:27.205 --> 18:30.877
of your residents that has been it doesn't have to be that it was you.

18:30.895 --> 18:35.292
It could be with people they were working with that clearly violated,

18:35.352 --> 18:38.977
like, everything that we're talking about. What is that you've seen? And the

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reason why I'm asking what you think about it is because just to

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bring out the point of what not to do, sometimes it's much easier to

18:46.555 --> 18:50.917
understand it that way. Oh, wow. I think just

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generally speaking, one thing doesn't stick out. But I

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think a rushed approach is and I empathize with

18:58.315 --> 19:01.677
providers, right? Like I do, because I am one and I know how busy

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we are, I know what it's like. But compassion and empathy only

19:05.875 --> 19:09.262
takes moments. It really only does. And if, again,

19:09.325 --> 19:12.562
we can just be present the person we're with in the moment.

19:12.625 --> 19:16.402
So whether we're providing care, whether we're helping them with the transfer,

19:16.570 --> 19:19.672
whatever it might be, if we could just take a deep breath and just

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think of the person in front of us at that moment, I really think

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that will slow things down enough. And it only takes a few moments to

19:27.370 --> 19:31.192
create that rapport that we need. If there's resistance there,

19:31.240 --> 19:35.077
there's a reason for that. I'm not saying it's just the provider, but there might

19:35.095 --> 19:39.082
be something else going on with the resident that you might be overlooking because

19:39.235 --> 19:42.582
you're kind of caught up in tasks,

19:42.672 --> 19:46.027
right? And that's where the systematic barriers come into play.

19:46.120 --> 19:49.672
And we have to be sensitive to that too.

19:49.780 --> 19:53.742
But yeah, that's like the thing, I think the rushed approach

19:53.802 --> 19:57.202
and just making it more about meeting a deadline and a task to

19:57.220 --> 20:01.812
go on to the next person when we can offer like, small personal touches

20:01.962 --> 20:05.152
that mean a lot. Like, I usually start an interaction with a

20:05.170 --> 20:08.737
personal touch and I try to end it with a personal touch so, you know,

20:08.800 --> 20:12.502
dimming the lights, pulling down the blind, or, you know, at the end,

20:12.670 --> 20:16.657
grabbing someone a cup of water. Like, I think those things go a long way

20:16.735 --> 20:20.600
and they only take just a few moments to

20:21.187 --> 20:24.967
develop a rapport. And you'd be surprised by how

20:25.015 --> 20:28.197
far those things go. Well, compassion,

20:28.242 --> 20:31.402
empathy only takes a few moments, less than

20:31.420 --> 20:35.407
a minute. That is so true. I'll share one personal

20:35.485 --> 20:38.422
anecdote, which I don't remember if I've shared on the podcast in the past,

20:38.455 --> 20:42.327
I probably did, but my daughter

20:42.357 --> 20:45.517
was born, she was a few weeks old,

20:45.565 --> 20:49.102
and we were in a certain hospital for a while, and part

20:49.120 --> 20:52.972
of the challenge was that they did not know exactly what was going on.

20:53.080 --> 20:57.607
And we were relatively new parents as our second child,

20:57.760 --> 21:01.467
and it's a little bit scary. She was having trouble breathing,

21:01.527 --> 21:05.982
and they didn't know exactly what it was. A little tiny baby.

21:06.147 --> 21:09.500
It was one I think it was a nurse's aide or something who

21:09.937 --> 21:13.897
probably has no idea what he did, but really, everyone was busy trying

21:13.930 --> 21:17.452
to, like you said, focus on the problem. Is it this? Is that? Did he

21:17.470 --> 21:20.842
do this test? It was like January or something.

21:20.890 --> 21:24.057
It was like, really cold outside. And this one nurses,

21:24.072 --> 21:26.952
they walked in right away. Notice, like, oh, my gosh, she doesn't have socks.

21:27.057 --> 21:30.412
Sarah Toaster probably called and he did,

21:30.475 --> 21:35.317
and he ran around until he got one. And that

21:35.365 --> 21:39.922
small gesture, like you said, it completely changed just

21:39.955 --> 21:42.650
where we are. Like, there's hope, nothing can happen.

21:44.362 --> 21:48.477
It wasn't anything too serious and ended up being as unrelatively

21:48.507 --> 21:51.922
minor. We were out a few days later, but we're just looking back,

21:51.955 --> 21:55.852
we remember that as the tipping point emotionally for

21:55.870 --> 21:59.622
us. We're like, okay, we're glad to be in a good hospital,

21:59.667 --> 22:03.397
glad that we have great clinicians here that are

22:03.430 --> 22:07.117
going to help us out. Exactly what you said that

22:07.165 --> 22:10.387
small gesture was more meaningful to us

22:10.525 --> 22:13.897
than really everything else I've done. I was just going to say you

22:13.930 --> 22:17.797
remembered it and you sharing that gave me goosebumps. Like, it's yeah.

22:17.830 --> 22:22.497
It just means so much to be recognized just as being human truthfully.

22:22.617 --> 22:26.227
Yeah. Yeah, this is really true. And like I said, you know,

22:26.245 --> 22:30.202
sometimes with the professionals in the room, we're focusing only

22:30.220 --> 22:33.232
on the problem and not on anything else.

22:33.310 --> 22:36.622
That's a very practical thing, coming into a room,

22:36.655 --> 22:40.572
whether you're a CNA, whether you're a nurse, whether you're a housekeeper,

22:40.692 --> 22:43.842
administrator, social worker, therapist,

22:43.977 --> 22:47.787
whatever you are, whether you're walking into their room, whether you're

22:47.862 --> 22:50.962
engaging with them in any interaction, just a small

22:51.025 --> 22:54.352
thing that you're a person and you're not a problem.

22:54.520 --> 22:57.952
Yeah, exactly. Person first,

22:58.045 --> 23:01.582
always. I know my dad, too, like, when he had support

23:01.660 --> 23:05.697
workers come in and staff, my dad really valued knowing

23:05.742 --> 23:09.187
about people's stories, and he really appreciated that.

23:09.325 --> 23:12.697
And those were the people that he allowed to provide care for him,

23:12.730 --> 23:16.297
were the ones that he could connect with. And so I always

23:16.330 --> 23:19.507
made it a point, too, when I worked with residents to just try to understand

23:19.585 --> 23:23.017
more of their story. I always ask them about just their lives and

23:23.215 --> 23:26.467
yeah, you'd be surprised how much they will

23:26.515 --> 23:30.412
reveal and how that changes the demeanor of things. Just talking

23:30.475 --> 23:32.825
about just talking about their life.

23:34.162 --> 23:37.402
I mean, also realizing that the 80 year

23:37.420 --> 23:41.317
old person you're providing care for right, has lived for 80 years and has probably

23:41.365 --> 23:45.877
accomplished things that none of us will ever accomplish and probably

23:46.045 --> 23:49.357
talented and has done amazing things in their life.

23:49.435 --> 23:52.662
And you're seeing them now at a certain weekend

23:52.812 --> 23:55.657
state which can be strengthened, like I said,

23:55.810 --> 23:59.547
with this positive restorative can do attitude

23:59.592 --> 24:03.622
which can change everything. I think what is comfortable to

24:03.655 --> 24:07.357
maybe giving a lot of comparisons today but a

24:07.360 --> 24:11.032
lot of times you could have a resident you can literally I

24:11.035 --> 24:14.017
don't give any specific examples, but I could think of a few that I've seen.

24:14.065 --> 24:18.072
But you could literally mess up in a very serious clinical

24:18.117 --> 24:22.557
way. You can misdiagnose something. You can let's

24:22.572 --> 24:25.897
just say you can make very serious clinical errors and

24:26.080 --> 24:29.602
they may forgive it and let it go

24:29.770 --> 24:33.327
because that's something that most people don't

24:33.357 --> 24:36.772
really fully understand the process other than the professionals are

24:36.805 --> 24:40.027
providing that higher level of care. But if you

24:40.195 --> 24:43.402
don't have the peanut butter and jelly sandwich when it was supposed to be available

24:43.495 --> 24:46.787
as an alternate on Tuesdays and today's Tuesday,

24:47.287 --> 24:51.127
then it becomes a serious problem. And the reason for

24:51.145 --> 24:54.682
that is that's not unreasonable because that is something that everybody

24:54.760 --> 24:58.152
understands, something everybody relates to. That's something that's

24:58.182 --> 25:01.732
very basic to the human condition. Whereas this other

25:01.810 --> 25:05.892
stuff we know that there's probably some inner organs

25:06.027 --> 25:09.472
in between the front and back of our body in there.

25:09.655 --> 25:13.042
And they might do different things and there might be different

25:13.090 --> 25:17.392
therapists, different disciplines that can help us do

25:17.440 --> 25:20.032
a little bit of a better job. It's with these things. But at the end

25:20.035 --> 25:23.722
of the day, the layman most people don't understand it. Even the professionals only

25:23.755 --> 25:27.172
understand their very specific limited area.

25:27.280 --> 25:31.325
Exactly. When you're providing care, like your dad's example,

25:32.137 --> 25:35.652
when someone comes in and out, look at it from the residents perspective.

25:35.757 --> 25:39.337
They're sitting in their bed. If they moved in, this is their

25:39.400 --> 25:42.742
life. There's the TV. There's the person in the other bed.

25:42.790 --> 25:46.212
There's activities. There's a once a month, highly anticipated

25:46.287 --> 25:49.867
trip outside the facility which sometimes may or may not happen

25:49.915 --> 25:53.497
with COVID fire has not happened since forever. And now you're coming

25:53.530 --> 25:57.547
in here. That's an interesting distraction, even if it's to

25:57.580 --> 26:00.822
perform a painful procedure, even if it means something that's negative.

26:00.867 --> 26:03.982
But it's something if you come in and I know that

26:04.135 --> 26:07.282
Schmoe's coming in and he's the guy who had a daughter in the hospital and

26:07.285 --> 26:10.857
he has that funny story with the socks, then, okay, now there's

26:11.022 --> 26:14.450
humans crave human interaction. And now

26:15.262 --> 26:19.032
we're having one of those interactions which is called socializing.

26:19.047 --> 26:22.492
It's life living. But if you only focus on the care and you provide

26:22.540 --> 26:25.822
the greatest care you're the best physiotherapist or

26:25.855 --> 26:29.377
physical therapist in the world. And you got them from being dependent on

26:29.395 --> 26:33.007
mechanical lift and now they can stand up on themselves and

26:33.010 --> 26:36.622
their weight bearing or whatever it is. They may not appreciate that as much as,

26:36.655 --> 26:40.327
like you said, the small touches. Yeah. The process to

26:40.345 --> 26:43.187
me is so much more than just the outcome.

26:44.062 --> 26:47.382
When I work with patients and residents,

26:47.547 --> 26:50.737
the focus is on the outcome. But what long term care,

26:50.800 --> 26:54.202
working long term care showed me was that it's actually more about the process,

26:54.295 --> 26:57.997
it's more about the journey. Because most often times

26:58.030 --> 27:01.672
they're not leaving the facility. Right. I've had a couple of people

27:01.705 --> 27:05.467
go home after long term care for a short while, but most

27:05.515 --> 27:08.752
often times this is where they're living from here on out. So how do

27:08.770 --> 27:12.697
we make those experiences enriched? How can we make them

27:12.880 --> 27:16.775
meaningful and memorable? That's kind of the

27:17.662 --> 27:21.877
mindset, I guess you can say, and the intention I go into with when

27:21.895 --> 27:25.522
I was working long term care, it really taught me a lot about the experience

27:25.630 --> 27:29.277
itself rather than just the outcomes. Because in our training we're focused on outcomes.

27:29.307 --> 27:32.352
Every health care worker, it's all about the outcomes. All about the outcomes,

27:32.382 --> 27:35.737
right. That's our paradigm. But in long term care,

27:35.800 --> 27:39.800
it really slowed me down and really made me appreciate moment to moment,

27:40.912 --> 27:45.007
amazing, unique perspective that

27:45.160 --> 27:49.857
maybe adopt and adapt to their particular environment.

27:50.022 --> 27:53.377
And I don't think that anyone purposely focuses on

27:53.395 --> 27:57.237
results as opposed to the process, but that's the measurable

27:57.387 --> 28:00.622
for what you get paid for and for your job, for what the nursing home

28:00.655 --> 28:04.377
get reimbursed for as a service provider, for the hospitals

28:04.407 --> 28:08.162
care about to send you more referrals so that you have revenue to survive.

28:08.662 --> 28:12.442
That's what everyone is focused on. PDPM, at least here in the United

28:12.490 --> 28:15.847
States, has shifted to some

28:15.880 --> 28:19.452
of the reimbursement to be more in line with the other disciplines,

28:19.482 --> 28:22.692
which does help a little bit to address this issue somewhat.

28:22.752 --> 28:26.302
But Jennifer, before we let you go, I'm just

28:26.320 --> 28:29.622
noticing the time here and we can close end of this episode.

28:29.667 --> 28:32.992
Any final thoughts you would want to leave our listeners with before

28:33.040 --> 28:36.547
we part ways for today? No, I think the main

28:36.580 --> 28:40.092
thing is that just to try to be truly present to the resident

28:40.152 --> 28:43.657
you're with at that time and the tasks are always going to be there.

28:43.735 --> 28:47.112
The next person will understand if you're running a few minutes late

28:47.187 --> 28:50.527
and just remember that it only takes a few moments to

28:50.545 --> 28:53.977
build connection. Awesome. Amazing.

28:54.070 --> 28:57.627
I would just add to that, let's not limit that to nursing

28:57.657 --> 29:01.477
homes and that you meet in the street. The person

29:01.645 --> 29:04.962
that's going a little bit too slow in front of you on the highway,

29:05.112 --> 29:08.752
probably not doing it because they hate you, they don't know who you

29:08.770 --> 29:12.682
are. Then there probably, I don't know, something going on in their life.

29:12.835 --> 29:15.817
Maybe just take a moment, take a deep breath before that happens.

29:15.940 --> 29:18.922
Thank you so much, Jennifer, for coming in the nursing home. We really appreciate your

29:18.955 --> 29:22.152
perspective, your experience, coming all the way from Canada,

29:22.332 --> 29:25.747
and we look forward to putting this out on the. Show. Thank you so much.

29:25.855 --> 29:27.875
It was fun. Thank you for having me.

29:38.737 --> 29:43.332
Now that you've enjoyed this episode of the nursing home podcast,

29:43.497 --> 29:47.167
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