Changes in Skilled Nursing to Short-Term Rehabilitation - (with transcript)
Phyllis Ayman is an Eldercare Consultant, Advocate, Speaker and Speech & Language Pathologist who brings an insider's view into the nursing home industry after working in 40+skilled nursing/short-term rehabilitation facilities for over 25 years.
Phyllis is the author of “OVERDUE Quality Care for Our Elder Citizens”, published February 8, 2019 and her first book “Nursing Homes to Rehabilitation Centers… What Every Person Needs to Know” was published in December 2017.
Frank Samson: Well, welcome to Boomers Today. I'm Frank Samson. Of course, each week, we bring you important, useful information on issues facing baby boomers, their parents, and of course, other loved ones. I just want to thank everybody for joining us. We've got another great show, and we do, because the reason we have great shows is because we have great guests. We have another wonderful guest today. Her name is Phyllis Ayman.
Phyllis is an elder care consultant, advocate, speaker, and speech and language pathologist who brings an insider's view into the nursing home industry after working in 40+ skilled nursing, short-term rehabilitation facilities for over 25 years. Phyllis is also the author of Overdue: Quality Care for Our Elder Citizens, published in February of 2019, and her first book, Nursing Homes to Rehabilitation Centers: What Every Person Needs to Know, was published in December of 2017. We're thrilled to have with us Phyllis Ayman. Phyllis, thank you for joining us on Boomers Today.
Phyllis Ayman: Oh, thanks, Frank, so much for having me. I'm really thrilled to be able to have this conversation with you, and to have listeners hear this important information.
Frank: Yeah. That's what we want to do, is we want to educate people. Now, you've been in the industry for quite a while. Tell us, how did you get into this line of work? Bring us up to date.
Phyllis: Oh, sure. Thanks. You know, when I was 15 years old, I never thought I'd be a caregiver. When I was 15, my mom was caring for my grandmother. She had moved to a nursing home close to our home and my mother would visit her every day. Then there was a period of time, about two weeks, where my parents went on vacation, and my sister and I took turn caring for my grandmother.
I write this story in my book. The first time I visited her in the nursing home, I was shocked by how unkempt she looked, how disheartened. I remember leaving, and crying, and walking around the block until I could go back in and compose myself and take care of her.
I believe that experience stayed in my heart of hearts. It left an indelible impression on my heart and my mind, and in later years, when I became a speech pathologist, I believe that it was a calling for me, something I needed to pursue so that I could be the kind of caregiver for other people that my mother was for her mother.
Frank: Let’s discuss nursing a little bit more. I mean, you’ve written a book about it, so maybe you can help expand the definition of nursing for some of our listeners out there. Many people also know of assisted care facilities as ‘nursing homes,’ and in our industry we refer to them as SNFs, or skilled nursing facilities.
Frank: Why don't you tell us a little bit about that, how nursing home used to be, how they are today, and where you see the future of skilled nursing headed?
Phyllis: While I think that they’ve changed in many ways, I also think that many people’s impressions of them have remained the same, and their feeling about wanting to go to a nursing home remains the same. But they absolutely have changed. Skilled nursing facilities now have a very important component called a short-term rehab, or short-term rehabilitation. The reason for that is that people are discharged from the hospital, and they still need short-term rehabilitation, and some people can't go home, or receive it in the community, and so these facilities have these units that are dedicated to short-term rehabilitation.
Most of these facilities do have traditional long-term care units. I think these spaces have also changed in a lot of ways because of the demand for change from advocacy groups. I think what people imagine to be the hallmarks of a nursing home are people languishing in a hallway, in a wheelchair, staring into space without much to do, being bored or depressed.
I think people have accepted that as being the norm, when in reality that’s not at all what people should be receiving. They're really just continuing their life's journey, and they're still people, and they still deserve a high quality of care and a high quality of life.
Frank: Like you said, you know, people have demanded change, and I think that change has come... You know, there's changes within nursing, but a lot of people get confused, nursing and assisted living. They kind of look at the two one in the same. That's not the case.
I also know that people will often get confused between a nursing home and an assisted living facility. What you’ve been talking about, the nursing home, it’s a medical facility, right?
Phyllis: A medical model, right.
Frank: And assisted living is geared more toward people who suffer from memory loss, Alzheimer’s, dementia, etc. Assisted living is really not a medical model, correct?
Phyllis: Yes, they’re what I could called assisted living communities, and they provide a lot of different levels of care. There are people that can go into an assisted living who require help with transferring, or dressing, or bathing, or feeding. People who require more medical care or round the clock nursing care, would benefit more in a skilled nursing center.
Frank: Now I’d like to shift gears a bit and get your perspective on ageism, a nd where you’ve encountered it in your experience. If you don't mind maybe explaining to our listeners what is meant by ageism, and do you think ageism is a big issue in our society today?
Phyllis: Oh, absolutely. Ageism is a prejudice or a discrimination on the grounds of a person's age. I talk to people all the time, and I think especially now, because people are living longer.
It starts pretty young in America, too. I remember turning 35 and thinking, “Oh my god, I’m over the hill!”. I think that, in our mind, how we view older people when they get older contributes to negative thoughts about ourselves as we age.
I also think that the younger generation views the older generation as having lived beyond their purpose, their usefulness, or their ability to contribute to society, because there are so many other ways to learn and gain information. One way to combat this that I was just reading about recently are intergenerational programs, daycares, in a way, that help promote younger people’s idea that older people have a lot to contribute in terms of wisdom and the richness of their experiences.
Frank: That sounds like a great idea. Now, I wanted to shift gears for a minute and talk about your book, Nursing Homes to Rehabilitation Centers: What Every Person Needs to Know. What is something that you want everybody to know about nursing homes?
Phyllis: Well, something that has bothered me the most about working with nursing homes is what I would call the corporatization of the industry. As with any corporation, a drive for profit often supersedes what the purpose of the corporation is. I’m not saying that all nursing homes are like this, but in my experience there have been many homes that prioritize profit over the safety or health of their customers. And that’s why I’m such an advocate for giving people information about how the system works. I can help people understand how things happen, what to look for, and how to be an informed consumer when looking into nursing home.
Frank: Your dedication to providing people with the correct information is invaluable. Now, you’re based in Connecticut, correct? And how can people get ahold of you?
Phyllis: Yes, I'm in Lower Connecticut, but of course, I speak to people all over the country. My website is www voiceforeldercare.com, and my phone is 203-594-6878. People can also email me at Phyllis@voiceforeldercare.com.
Frank: As well as being an elder care consultant, you're also a speech and language pathologist. Do you incorporate any of your experience from that into your work with the elderly?
Phyllis: I used to, but I’m not doing that so much anymore, as I’m mostly concentrating on working with families, helping them advocate, and providing information for them so they understand how to advocate, work along those lines. I'm also on a radio show out of Greenwich, Connecticut, WGCH AM, and I'm on there every three or four weeks. Recently as well, I became the TV host of a show called the Golden Years: Understanding Better Living. It's on Hartford Public Access TV, but the episodes are also on YouTube. I just became a host of that show a few weeks ago.
Phyllis: So those are where my efforts are more concentrated. Occasionally I also speak on empathy, communication, cultural diversity, and caregiving. There are so many caregivers in our country who are spending an exorbitant amount of time caring for their loved ones. I believe there are over 44 million caregivers in this country, providing unpaid care to loved ones.
Frank: The term that's used quite often in our industry to describe population aging is called the silver tsunami. We’re seeing it a little bit now, but in reality it really hasn’t hit yet. I mean, it's kind of just raining outside, but in your opinion, do you think our country's ready when the silver tsunami actually hits?
Phyllis: Absolutely not. You know, I was reading a statistic earlier, that 1.4 million children ages eight to 18 provide care for an adult relative that live in their household, and 72% of those are for a parent or grandparent. I was reading something else that said that according to the US Bureau of Labor Statistics, that in 2017, caregivers provided an estimated 18.5 billion hours of unpaid care, that's valued at more than $234 billion, but the next part of it was even more interesting to me. This would be about 46% of Walmart's total revenue in 2017, and 10 times the total revenue of McDonald's in 2017. That's crazy. And it's only going to grow. I mean, by 2035, I think it is, the over 65 population is going to outnumber the 18 and under population.
Phyllis: Well, and people slightly older than millennials, that's called the sandwich generation. They have full-time job responsibilities, and they're caring for their own family, and then they're struggling with caregiving for an older parent. That’s why companies especially are paying attention to it, because they lose a lot of productivity time in the workforce, because people take days off, or they're anxious or depressed, and it's really a struggle. And it’s happening around the world too, not just here.
Frank: Oh, absolutely. It's everywhere. So Phyllis, we have about a minute left, and I want to make sure I give you time to tell people about your book. Could you give us a quick overview about it, and tell us where we can get it?
Phyllis: Oh, great. Overdue: Quality Care for Elder Citizens can be purchased on Amazon or Barnes & Noble, and it can also be purchased from my website, www.voiceforeldercare.com. People can reach me by emailing me at firstname.lastname@example.org, or by phone at 203-594-6878. You know, I'd love to speak with anybody for 20 or 30 minutes and tell them the information that I could provide and how it could be helpful to them, with no charge, because I just really want to convey this information, and of course, we could go from there, but it's so important for people to know what they're looking for, and why they need to know what they need to know.
Frank: Great. Well, time flies, so Phyllis, thank you so much for joining us on Boomers Today. Really appreciate it.
Phyllis: Oh, thanks for having me, Frank. It was great.
Frank: Great. And I want to thank everybody out there for joining us on Boomers Today. Look forward to talking to you on our next show. Just be safe out there, and talk to y'all soon.