Understanding Our Nursing Home Residents

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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

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for $900 because in order to ensure

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that you're going to have this type of result, it's going to be able to

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drive in these types of trains or be able to drive long term driving.

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Just take it out for a minute so everybody can relate

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to Mr. Mechanic. I have a different car for long term. I just need this

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to drop off my kids at daycare. I just need this for local shopping.

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So don't tell me to do the $900 procedure, which is not valuable to

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me when I would like the heated seats. Even though the car is 15 years

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old, I spent time in this car. I want the back of the camera or

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whatever. And it's important to gather

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as much information about someone as you can, right, and have

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them share as much as possible. And that's why sometimes it might not happen.

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Like in the first and only interaction, it has to keep happening. They have

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to build a rapport, they have to build a trust in you. And definitely

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we have to as much as possible, I would suggest,

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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

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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

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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

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be something else going on with the resident that you might be overlooking because

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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.

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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,

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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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