Navigating Difficult Conversations

Transcript:

Hello, everybody! Welcome to the Story Cottage podcast. Today, we are going to be discussing navigating difficult conversations with our special guest, Kristin Cherry.

Kristin, can you tell us a little more about your professional experience in senior care, particularly in the current memory care setting that you work in?

Sure! First, thanks for having me. This is a topic that's very passionate for me as I work with memory care and resident families. My background is probably 30 years of geriatric care. I have been a director of assisted living and done regional VP work in marketing and sales, as well as operations. However, my true passion has always been memory care, so I'm very delighted to represent Story Cottage today.

Amazing! Can you tell us what Story Cottage is?

Sure! Story Cottage is a very boutique memory care setting. I find it very different from any other company I've worked for because our attention to our residents is just amazing. We really get to know our residents, and our staffing ratio is the best in Indianapolis. We're also really able to understand their diagnosis and spend the time that they need.

Wow, that's amazing! Well, we're so excited to hear more about Story Cottage and the memory care setting that you work in, and how you navigate difficult conversations in your role. I want to lean into the first question: what are some common concerns that you encounter from families when they first start discussing memory care?

Sure! I think anyone who is making this decision doesn't want to make it. This is not something that anybody wants to run in and say, "I'm here for memory care." This is a very difficult process; some people take care of their loved ones for years before they even start talking about this. The concerns that I hear often are that they've promised their mom or dad or their wife or husband never to put them in a nursing home, as they refer to it. They fear that they'll haunt them from the grave; that's just a very typical response I get. How I like to discuss that with them is they need to really see what we are doing here at Story Cottage. It does not look like what they anticipate. A big issue is that they don’t understand the healthcare of today, and of course, the other concern is understanding the diagnosis and denial of the diagnosis.

Perfect! How do you guide families through the initial conversation about moving a loved one into a memory care facility when they're ready to have that conversation?

I think it's different for every family regarding when they're ready to have even a conversation. My role first and foremost is answering the phone. A lot of people call because they recognize a need for help. I do a lot of discovery over the phone; I could be talking to a family member for several hours before we even set up a tour or discuss further what we're going to do. I feel very strongly about wanting to find them a solution no matter what goes on, so I try to discover their needs and ask them about their life story before we even move on to touring because I want to get to know who this person is prior to even a tour occurring.

That's awesome! That signifies keeping that loved one with dementia's independence. What advice would you give families to help them approach these difficult conversations with compassion and understanding—whether it's with their siblings or their loved one who has dementia? How should they approach that conversation?

What I really like to do is offer for them to meet with me somewhere neutral where I can talk with the family members who are all going through this together. My master's degree in counseling comes into play frequently throughout these conversations. I like to talk about what's going on in the family household today and whether the caregiver is completely consumed by their role. If they are, then we need to start talking about can the person be a wife again? Can they be a brother again? Can they be a child again? Those are some of the compassionate conversations that I have. I think people are very hard on themselves; they don’t think they can do this for long at home, but it's a reality—no one can sustain it forever. That's a tough conversation sometimes, but people have to realize that physically and mentally exhausting themselves to take care of another person does nothing to help that other person. So then we have to move on and start talking about some other steps of support that I can give them. I know there are a lot of mixed emotions when family members have these conversations.

Would you be able to share a story where a difficult conversation led to a positive outcome for both the resident and their family?

Yes! This is one of the best outcomes I've experienced in this profession: seeing a family return together as far as being able to have dinners together and visit their loved one at Story Cottage without having to be 100% caregivers all the time. For example, we had a husband who had three heart attacks within several years due to caregiving stress. I had a tearful conversation with him where he admitted he could no longer manage this situation; it was very difficult for him. When we finally got his wife here, he realized he could still visit her, take her out, do loving things with her—he could still be that husband—but now we were able to provide the care she needed. He is now in much better physical health; his doctor has shared with him that he likes where he is physically, mentally, and emotionally right now because we were able to care for his wife. That's a proud moment for all of us involved.

Wow! That's amazing—a great story for both the husband and wife being in such a better spot! What role does timing play in initiating these types of conversations? How do you help families determine the right moment?

This is very individual for everyone on this journey; there’s no right answer regarding timing. What I've said though is be proactive versus reactive. If we've had numerous falls or safety issues occurring—don't wait—because I've heard stories that are not good for families: someone getting out through a window or causing aggressive behaviors at home. These are things we want to look at proactively. Timing-wise, I'll directly ask family members if they're having safety concerns right now for their loved one; usually, I'll get a yes because of history with falls or crises—then I'm able to move that conversation forward. So definitely timing is very individual; sometimes I have direct conversations with families so they understand that in order for them and their loved ones to be okay, it may be time to move forward.

How can families address the stigma or fear associated with memory care during these discussions? There’s quite a bit of stigma around memory care—how can we help families address that?

I firmly believe in being proactive but also arming yourself with resources. We work with the Alzheimer's Association and have our own support group; we need families to do their own research because it's vital they feel they have control over that aspect and truly understand what choices are out there. Having worked in this field for so long, I've seen how our smaller environments—a residential setting versus institutional—really helps families with long-term arrangements because we are so different from institutions where memory care was an afterthought added on as an extra wing or heavier care option. I've seen this trend in the industry where memory care needs were not being adequately addressed. When staff understands this disease and its processes—and are educated on reality orientation versus validation—it makes all the difference.

In your role at Story Cottage, how do you help navigate families through these difficult conversations? How might they come to you if they're looking for solutions for their loved ones?

Yes! I answer questions like these all the time through various referral sources; yesterday alone I had three calls from different sources—a hospital case manager and an insurance representative—and many people reach out through word-of-mouth because we've established ourselves as great providers of memory care. Every day I'm helping families navigate these decisions; some will not make decisions until it's a crisis regardless of what we provide them—that's their choice—but we're there when it happens. I stay in touch with families for months; sometimes it can take years before they make decisions either way. I'm in contact from when they pick up the phone until they make decisions—it's a long-term relationship rather than just discharging someone from hospital rehab into another place.

Kristin, it sounds like you are an accomplished representative in the memory care field! We’re happy you joined us today and discussed navigating these difficult conversations—hopefully these comments will help some family members navigating initial memory care discussions. If people are interested in your boutique memory care concept, what’s the best way for them to reach out?

I would love to talk with anyone listening who needs assistance or resources—I know many people in this field so I can refer them as needed. If you’d like to reach me at Story Cottage, please call 317-449-5696 and extension 1—I would be glad to talk!