Episode Transcript:
Producer Voice Over: Join us as we resume with Part Two of our LIFE Conversation with world renowned dementia educator, Teepa Snow. Enjoy!
Christina Chartrand: You know, one of the things, Teepa, I say to folks is that one of the things, you are an "edutainer." And I think when we first met, you were kind of the one woman show out there, six days a week. Your schedule was insane. You were like a rock star, you know? Going from place to place.
Teepa Snow: We did tours. What do mean it was just me? You supported this tour. Senior Helpers.
Christina Chartrand: Well, those tours I did, but even before our official Senior Helpers Teepa Tour, you know, you were still doing that and you were doing it during the tours. You were going from place to place, being invited to all these different organizations, you know, and it was kind of this, you know, you were on this mission and this is what you're doing. Was anybody helping you then?
Teepa Snow: I had somebody who we, I did have a website. So I had one person who manned the website and the phone so that when I was off doing things, at least they could take in data so that when I got off that one, they could say, okay, we've gotten a request for this. We've got a request for that. I think it'll fit in your schedule. But I mean, I was still paper pencil, figure out the schedule, do my own booking, do the billing. But they did keep up with the website and respond to questions and set things up like as far as there were contracts, just really basic stuff initially. That was pretty much it.
Christina Chartrand: Yeah. Yeah. But you really, you know, and for people who haven't seen or some of our viewers who haven't seen Teepa live before, the way she presents, she's obviously full of lots of knowledge and wisdom and information that is helpful in understanding dementia. But at the same time, you're laughing along the way and/or crying along the way because you always, have such wonderful stories that you've put together that just make it so meaningful. And one of the things that I've always said that you make a very complicated disease, as well as sometimes complicated in understanding how we're gonna help that person, you bring it down to a level that is digestible for everybody.
Teepa Snow: Yeah, I try because if we can't get it to where, "Ooh, hey you, not her, you, you, the one there, you, you know who I'm talking with? You know which one? Hello? Do you know what I'm saying? Hello? Do you speak English?"
David Chandler: You.
Christina Chartrand: Mm I think so. Yes, me.
Teepa Snow: Now, David, if you don't say something soon, this is gonna go sideways. What's missing for me right now?
David Chandler: You
Christina Chartrand: Right.
Teepa Snow: Do I have the ability to appreciate that you're trying to be polite? Do you have the ability to appreciate you think I'm interacting with Christina? Here's the thing, your inability makes my dementia quote unquote so much worse. Whereas if you just go, "Teepa, me or her?" you'd be fine. So let's try it. Let's see what happens. So you, you, are you listening?
David Chandler: Who? Who? What? Me? Christina?
Teepa Snow: You, you the one there. No, the other one.
Christina Chartrand: Teepa, Christina, David.
Teepa Snow: Who are you?
Christina Chartrand: David, your hand, David.
David Chandler: David, David.
Teepa Snow: There you go. Okay, David, now don't panic. I can't actually come through the screen. I can't do anything. But now what's happening is we're all realizing in that moment how much my change in brain function impacts everybody in different ways. Whereas Christina's like, "Oh yeah, there goes Teepa!" But for David, it was like, "What is she doing?" And so this is like a brother sister combo where we got two family members and one is going, "David, answer her!" Don't yell at him, he's just stupid.
Christina Chartrand: Raise your hand, David.
Teepa Snow: "Mom, quit telling him he's stupid! That's not your fault!" It's just like, how can this go sideways in so many ways? And the answer is, well, just about every which way, but loose if you don't have the skills you need in the moment when you need them. And so having fun with recognizing, "Oh man, you're going to screw up. I don't care how skillful you are. Dementia will surprise the bejeebers out of you multiple times a day." So being able to be comfortable with discomfort is like, so essential in this job. You know, it's just like, "Huh, well, that wasn't what I was gonna happen." It's like, "Wow, I mean, the number of times it's been like, I didn't think she'd do that with that." Huh, well, I didn't.
Christina Chartrand: Yeah, It definitely, I will agree. I think from all the video trainings that we do and the practice that we do even here at Senior Helpers and just all the different things I've seen you do around the country, it is getting people outside of their comfort zone because I think it's the only way that you can just, you know-- I always say to this and people are like, "Oh, what is she crazy?" But I say when a difficult situation comes up and somebody asks me about it. Like, "What do I do if this happens?" I always say "I use my inner Teepa." I go, "Okay, what would Teepa do?" And the reason why is that you don't you think that lineal outside of the box. Everything is like, "Okay, well, let's think about this. Let's think about the situation. What time of day was it? What was happening? What did it sound like during that time?" And you allow people to go bigger outside of it versus only thinking one way to fix a problem. Yeah, I know.
Teepa Snow: How do I get her in the shower? You the most famous question of all, "How do I get her to take a shower?" It's like, let that go. I mean, we may never get her to get a shower. My real question is how can we get to the vital areas where bacteria build up? So let's look at what's working, what's not working with interactions with her. You know, and I often will say, you know, like, "Have you gotten her shoe off yet?" Well, like, mean, if she's not gonna take her shoe off, I'll guarantee she's not taking her shirt off.
So maybe start with getting the first base before you want to go all the way, you know, like a home run. But getting people to recognize how much they're asking of someone, how much they're asking of themselves, what's working for them and what's not working for them. Because I know you've heard me say not everybody's meant to do this work. I mean, there's way too many families that feel compelled, not enlightened, and they struggle and struggle until they can't anymore. But by then, there's so many negative interactions that have happened that it's super hard to bring new people in and not have that be part of the equation. And so, you know, my whole mission in life is to let's not have so much that negative to start with. Let's pause a second and go, "I think I need help." I mean, I don't know what I'm doing. And I recognize, wow, there's some brain change and I need some. I don't know what to do. And we still have so many empty spaces where people are not getting the information early to be able to be supportive in an effective way.
Christina Chartrand: I agree. You know, one of the things that we're seeing just in our industry within the home care industry is that our clients are coming sicker and sicker and more unhealthy than than they ever before with so many chronic conditions. And Teepa, I think so many times what happens to these folks is that we can tell there is some dementia, but they're never going to get diagnosed because it's the last thing on a primary care's mind when they've got congestive heart failure and COPD and diabetes and so forth, you know?
Teepa Snow: And what they're not realizing, I mean, this is crazy, but what truly they're not realizing, the reason you're having so much trouble controlling those conditions...
Wait, there's something wrong up here and those things are making it worse and it's just this cycling, this escalating cycle. And we don't have the family support in place because unfortunately there's a lot of distress around this stuff or a missing family member by then. I mean, the other person has already bailed because they've like, she won't listen, she won't let me help. I mean, she's got 15 cats and it's like, wow, well that's just a recipe for things going right.
So let's pause earlier. We still as a society are still thinking, wow, let's wait. And I would say, wow, you know what? I would love people to spend some of their resources really early on to notice, wow, what's working in our environment, what's working in the family, what's working in the health system, before we get deep in the water and we're drowning, which is our current pattern. I mean, because nobody wants to pay for X, Y, or Z. And it's like, well, you will one way or the other. I mean, I'll break this to you. We'll have multiple ER visits. We'll have multiple stays in psych. We'll have multiple hospitalizations. It's like, guys, pause. Let's put the pause button and be smarter because we're not. It's just, we keep repeating a pattern from the past. And it's like, we have new data. Let's, let's use it.
David Chandler: So Teepa, where do you see us? I love hearing your story about being, you know, 40, 50 years ago, going from the point of restraints with sheets to having the Velcro restraints to medications, to the Positive Approach to Care. Where do you see us five, 10 years down the road? Where are we heading?
Teepa Snow: I think we're going to have to start acknowledging dementia support and care is a specialty practice. I think it has to be acknowledged, not everybody is gonna be able to do this work well. And we really need experts at this. We need people who are good at this, who can help other people get better at this. We're gonna need people for whom when their dementia is really in the forefront of their routine, of their day, of their care, of their home life, of their life. We're going to need people who have some ability to do this pretty well. Because I don't think you can do this with no ability. I truly think there is skill and there's knowledge and there's awareness here. And I think we're at this break point in the system where pretending like, no, it's not a big deal. It's like we can put people in a secured space and and keep them all in there. like, that's not where most people living with dementia are, nor has it ever been. Families are doing 70 % of the care and they're drowning and they're collapsing. And they're saying, I quit, not doing it. I have to work. don't have the luxury of having a one income household. I don't have a family that's big enough that will support mom. I'm it. I mean, I am it and I'm wearing out.
Christina Chartrand: Yeah.
Teepa Snow: My husband, my daughter with Down syndrome. I mean, are, the storyboard is so much broader than it used to be with young onset, with late life onset, with I mean, the numbers of families who are being impacted and the length of time. And my concern about the new beds is, good, let's have it last longer, but go slower. It's like, okay.
What's that gonna do to the front loading of the system when we don't really have the care system in place, nor is there funding other than private and some insurances? I mean, we've got to start like writing's on the wall, guys. We better figure this out.
Christina Chartrand: You know, it's interesting, because I agree, and as we can all say, the silver tsunami hasn't hit yet. We're still, and we're thinking about, David, just popped up in my head about the GUIDE program, right, with the GUIDE. And finally, CMS is recognizing that people need help. it's with care management and providing some respite, that people, and so you're right, people are. I think it's starting to happen, but Teepa, probably not fast enough for. Yeah.
Teepa Snow: Not at all fast enough. I mean, we're going to hit the brick wall before we get there because what we saw most of the GUIDE models, they're waiting for the first hospitalization before they kick the GUIDE model in. And we believe that the GUIDE model should be kicked in long before then so that we don't do that first hospitalization. We try to revamp this system to reduce the cost because hospitals are the most dangerous and the most expensive places for people to be.You know, and we just don't have game plans that make sense yet. I mean, we really are struggling with that.
Christina Chartrand: Yeah. Yeah. So you have recently in the past couple of years, you've started a foundation. Tell us a little bit about that.
Teepa Snow: Yeah. Yeah, so we, I mean, we do work, I do work globally and nationally and internationally, but I've always lived right outside of Hillsborough, pretty much other than, when I went to, when I was young, I lived in Pennsylvania, but I've been in North Carolina, either in the Durham area or outside Hillsborough for the last 55 years, 54 years. I mean, I've been here over 50 years. So, it was about time during the pandemic. It was like, "Wow, we need to create something so people can come and see what it looks like in action." So we actually are building a community resource system that in this area does support people if they want to stay at home, if they need to go in community, if they want to come together, if they need to find what they need separately, that could be inclusive, that trains everyone at some level or another, basic awareness, basic knowledge, skill building, so that people can live with dementia in their community and get the support and the family gets what they need. And we have skilled providers who are becoming more skillful in their work so that people can have life that they like to live and find purpose still. And so we're currently, we have the program where people come here to get some of their certification training. But every week people come into our building, which is where I'm at right now. It's a great big space, but we have lots of spaces within the space to learn more about what is this thing we call brain change and how do we support one another with brain change. And so we're doing this work locally so people can come internationally, take a look and figure out what to take back to where they live. Yeah, so it's a lot of fun. We're having a good time. We're learning lots and we're growing lots. So we're working with a group in Pinehurst that's working with their entire community to do this, including their hospital system. So that's kind of exciting.
Christina Chartrand: That's awesome— That's great! I mean, I think I, I mean, that's where, you know, I feel there's so many different organizations that are out there, obviously so many different senior care communities and it, you know, and I know many of them have adapted or tried to adopt your philosophy in caring for people with dementia. I mean, clearly our company Senior Helpers and their other home care companies as well, you know, who just see it, see how important it is and need curriculum, training. And I heard you say, you know, that there, needs to be like are you thinking like a designation like a national designation?
Teepa Snow: We truly believe that at some point we have got to acknowledge this actually requires a skill set and people shouldn't be able to say I have a dementia care unit simply by saying I have a dementia care unit having a secured door and having watched a video. I, you you don't, wouldn't want you doing surgery or even driving my motor vehicle if only thing you've ever done is watch a video about driving. I mean, I hate to say this, but I don't think you should get behind the wheel with just watching a video.
Christina Chartrand: So is there a bigger voice around this? Not, I mean, from obviously PAC, Positive Approach to Care, are there other organizations that are kind of working together and in the same feeling the same way?
Teepa Snow: There are, mean, even the World Health Organization is saying, we need to address this as a major health and wellness issue, a life issue. We have CMS actually going, don't know what we should do, but we've got to do something. We have hospice and palliative care groups saying, "We've got to get, yikes, I don't know if we know for sure how to do this thing other than you know, what the Medicare guidelines," and it's like, yeah, well, there's more to life than that. So we do have some national groups that are starting to go, you know, I think we've got to come up with something that isn't just fee based. You know, like if I give you money, then you can be identified as an X, but that there has to be skill demonstration and you can't just watch a video and you're ready to provide support and care to somebody who's in crisis, which people usually are by the time we're talking about moving into a care community. mean, things aren't working well somewhere. So they've had failure. There's been issues. And having somebody walk into that situation, not having any training and going, yeah, go ahead and go help her. You're going to be getting her up the hall and come into activities. And it's like, she said, no. It's like, okay, we'll go back. And it's like, okay. She still said no. It's like, wait a minute. "I said I'm not coming, damn it! Don't touch me!" And it's like, now we're going to fill out the incident report. It's like, okay, well, where did we fall down? Well, somewhere between we watched the video and I asked you to take on something that was beyond your skillset without the right coaching. We early on did coaching videos because we knew, I mean, there's more to this than exposure. Yeah.
Christina Chartrand: Right. It needs to be more than that. You're right. It was fun. Yeah, and it's part of our criteria at Senior Helpers. I mean, you have to do hands-on training. There's a group of caregivers that are in their pool of caregivers that are working for an individual franchise office that have to do hands -on. I get it. And you wouldn't send a teacher out without student teaching. A therapist, they wouldn't learn just from a video without practicing, right? So, it's...
Teepa Snow: No. You know, you need somebody who knows what they're doing, watching you doing what you're doing and helping you do it better. It's not, you know, it's not like we're trying to keep you from doing something. It's just, we want you to develop the skill you need so that the person you're supporting is getting what they need and the family is getting what they need. And I mean, that's.
Christina Chartrand: Exactly. It would be interesting, like even I think about CNAs, because I think about the biggest pool of helpers out there is that like adding that extra designation, you know, like they do for GNAs, know, like to have something around dementia care. Wouldn't that be cool?
Teepa Snow: Yep. Yep. You got it. It would be super cool and people are starting to think that way. I mean, but it's still like, but you know what that means? Do know what that means? Then the people who don't have it, what are we gonna do? Because you know, there's a lot of them out there taking care of people and it's like, yeah. And we can't just grandfather them in. We've got to make it available and then we've got to start accountability. We've got to have a window in which people do have to start developing their skillsets. And that's so scary, but you know what? We probably should have done it a long time ago.
David Chandler: So Teepa, we're just about out of time. Do you have any parting thoughts or maybe some encouragement for families that may be going through this time of caring for a loved one?
Teepa Snow: One of my, one of my really strong beliefs is when I ask you, "Tell me what you still like about the person you're supporting and caring for," and there's a long pause and the person says, "Well, I love them and I promised." I would say, "Yeah, I know that, but that's not what I asked." I think it's super important in that moment to say, "Sounds like this is getting really hard. And I suspect you could do with some more support, because when you can't find what you like about someone that you're spending a lot of time with, it's super risky to your own wellbeing, to theirs, and to the relationship." And dementia can really break a lot of things. And it's about time we quit letting it break relationships simply by not getting the support and help we need. And acknowledging, "Boy, this is really hard. Let's look around and see what we can do differently," because there's a lot we can do if we're willing to take the step back and realize what I'm doing isn't working. And I really do love the person, but I need to like them too.
David Chandler: Yeah, that's an amazing way to end. So thank you so much.
Teepa Snow: You're welcome. Thank you guys for the opportunity and thanks for spending some time talking about this stuff that's really important. Yeah.
Christina Chartrand: It was great. It was awesome with a great experience. Thank you again, Teepa we, again, from the, from your Senior Helpers family, we, we just, you are a treasure to us and we really appreciate it.
Teepa Snow: Thank you. Take care of everybody. including ourselves!
David Chandler: Thank you, Teepa. All right, and for our listeners, we look forward to you joining us again on our next episode of LIFE Conversations.
