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Summary:
This episode of the CareLab podcast, hosted by Dr. Brandy Archie and Emilia Bourland, discusses the comprehensive preparation required when bringing a loved one home from a medical facility. The conversation highlights the importance of individualized care plans, proactive preparation, and leveraging available support systems.
Key Takeaways:
- Proactive Planning: Start preparations well before discharge to ensure a smooth transition.
- Individualized Care: Tailor the home environment and care plans to the specific needs and interests of the person returning home.
- Utilize Support Systems: Use tools like Lotsa Helping Hands to organize help and reduce social pressure when asking for assistance.
- Collaboration with Healthcare Professionals: Engage with therapists and healthcare providers early to set up the necessary home modifications and care plans.
- Holistic Approach: Address both the physical and emotional needs to prevent depression and ensure a motivating environment for recovery.
Transcript
Dr. Brandy Archie
It's CareLab Day!
Emilia Bourland, OTR, ECHM, CFPS
Yay! Welcome to Care Lab.
Dr. Brandy Archie
So excited to be here.
Emilia Bourland, OTR, ECHM, CFPS
Yes, always, always. What's up? What's going on?
Dr. Brandy Archie
Well, you know we like to start with a weird question. So I have one for you because I definitely have an answer to this question. So I'm interested in yours. Are you ready?
Emilia Bourland, OTR, ECHM, CFPS
Wait, so you definitely have an answer?
Dr. Brandy Archie
Oh, I have an answer, so you should, you gotta go first though, cause I don't wanna tip you off, okay? I believe wholeheartedly that everybody, even in healthcare, has a bodily fluid or process that they just cannot stand to hear or see or participate with. What is that for you?
Emilia Bourland, OTR, ECHM, CFPS
Okay, okay, all right, okay.
Emilia Bourland, OTR, ECHM, CFPS
Ooh, yeah, that's a really good one. Okay, so what I will say is that I used to have a really, really strong aversion to saliva and mucus. Like I remember in high school having to do this experiment in chemistry where people had to like spit in a tube or something. And I literally, I couldn't do it. I had to leave the room and they had to give me an alternative assignment. Cause I was like dry heaving in the corner.
Dr. Brandy Archie
Mm -hmm.
Dr. Brandy Archie
Whoa.
Emilia Bourland, OTR, ECHM, CFPS
Yeah, I couldn't see it at all. And honestly, once I actually released, and that was the thing that I was most worried about going into healthcare was dealing with oral care and people's spit and saliva and possibly mucus because of that aversion. And then once I actually started working, honestly, I just got over it. It doesn't bother me at all anymore. My favorite thing to do is suction a trach.
Dr. Brandy Archie
Mm -hmm. Mm -hmm.
Dr. Brandy Archie
Oh good.
Emilia Bourland, OTR, ECHM, CFPS
It's so... One of them? I mean, obviously, like, that's not, like, real OT stuff, but, you know, like, you go there and the Yonkers in, they, someone's, like, hacking a little bit, and there's some stuff coming out of the Drake, and the Yonkers there, and you're like... It's so satisfying.
Dr. Brandy Archie
It's your favorite thing to do?
Dr. Brandy Archie
It has to.
Dr. Brandy Archie
I am so glad you said that because the I answer to that question is exactly the opposite it is I I I still cannot stand mucus and spit and the thing I hate the most is having to suction somebody and thankfully I don't want to do anymore so I don't have to do this but like I mean I did it because I'm a grown -up and I can do it but just like
Emilia Bourland, OTR, ECHM, CFPS
Really?
Emilia Bourland, OTR, ECHM, CFPS
Yes, yeah, yeah.
Dr. Brandy Archie
The most ridiculous thing to me, and I feel ridiculous myself, is that we're OTs, we do everyday tasks, brushing your teeth is an everyday task that everybody needs to do. And especially at a hospital or skilled nursing level, sometimes I get overlooked and I'm always like, let's brush your teeth. But as soon as you do it, it's a lot, a lot.
Emilia Bourland, OTR, ECHM, CFPS
gets overlooked a lot, right? And it's actually so important for the rest of the like care of the body that that mouth gets cleaned. Sorry, go ahead.
Dr. Brandy Archie
Mm -hmm. And so I recognize that, but I also still hate it. And so right at the, I've gotten better, right? Because I've been doing this a long time, but at the point of spitting, I closed my eyes. Yes. And I'm like, this is ridiculous. You should be able to watch somebody do this. Um.
Emilia Bourland, OTR, ECHM, CFPS
Do you?
Dr. Brandy Archie
This is true for my kids. This is true all the time. I mean, I can spit and watch my spit go in the sink, but it's just like, I just really cannot handle, that's the one thing I can't handle. I can do poop, I can see a surgery, blood can be everywhere, puke, whatever. I'm fine with all that. But the mucus and suction and spit, I can't deal with.
Emilia Bourland, OTR, ECHM, CFPS
Yeah. Yeah.
Emilia Bourland, OTR, ECHM, CFPS
It's the viscosity. It's the viscosity of the thing, right? Like the, so I will say I actually, this is, even though suctioning mucus from a trach does not bother me. I do still, like, you know, if you have someone, they're doing oral care with someone, they rinse, they spit, they spit in a cup or they spit in a basin or something. I won't look at the basin while I'm dumping it out. I look over.
Dr. Brandy Archie
Yeah. Yeah.
Dr. Brandy Archie
See? Simple!
Emilia Bourland, OTR, ECHM, CFPS
I just like keep looking up. I just keep looking up because for some and then I turn the water on and then it's gone for some reason like that. I still don't. I don't care. I also would say, though, if there it is weird, it is weird because that's probably the least gross of it's like the least gross thing. Yeah, exactly. But I also feel like if you have to be. If there's one thing you have to like look away from and it's just someone spitting.
Dr. Brandy Archie
That's so weird.
Dr. Brandy Archie
It's the least gross thing. I don't even have to touch it, actually.
Emilia Bourland, OTR, ECHM, CFPS
or like dumping out their like rinsed mouth water, it's probably not the worst thing in terms of like impact. It has pretty much no impact on the client or safety or the plan of care or progress or anything like that, but it is weird.
Dr. Brandy Archie
I say it really, but it's weird. It's totally weird. I don't know, I can't get over it.
Emilia Bourland, OTR, ECHM, CFPS
You know what? I can't believe it was the same thing for both of us.
Dr. Brandy Archie
I know, that's so funny. Because I think it's so limited. It's just like, why? Why is this a problem for me? Like you said, it's kind of the least gross of all of the things out of your body.
Emilia Bourland, OTR, ECHM, CFPS
Yeah.
Yeah. You know, I could have never been a dentist though.
Dr. Brandy Archie
Yeah.
Emilia Bourland, OTR, ECHM, CFPS
You would have to watch people spit all day. You're like, what do you mean? Of course you couldn't have been a dentist.
Dr. Brandy Archie
I guess my top tier, I can do it as a respiratory therapist. I'm so appreciative of them. So that will be first. I'm sure dentists will be next. I haven't thought about it, I guess, but yeah.
Emilia Bourland, OTR, ECHM, CFPS
Oh well.
Emilia Bourland, OTR, ECHM, CFPS
Yeah. I feel like dentist or the dentist because that not only like you have to really get up in there, you got to look at it and like dig in it. And you know people don't brush their teeth before they get in to that chair. So like.
Dr. Brandy Archie
Yeah, you gotta be a little more.
Dr. Brandy Archie
I know.
Dr. Brandy Archie
Yeah.
Emilia Bourland, OTR, ECHM, CFPS
You can't look away during that part.
Dr. Brandy Archie
You can't, that is actually going to impact the plan of care.
Emilia Bourland, OTR, ECHM, CFPS
That could certainly impact plan of care and patient safety. So you can't, when you're in there with some instruments, you can't look away.
Dr. Brandy Archie
that.
Dr. Brandy Archie
Thank you for going down this rabbit hole with me. What are we really gonna talk about?
Emilia Bourland, OTR, ECHM, CFPS
You're welcome. Anytime. Anytime. Let's just do this all day instead of talking about something serious, shall we? No, no. We probably should actually talk about a real topic. OK. So I actually was recently asked this question by someone who both works in the care industry but is not necessarily like a, they're not necessarily a care provider. They're not a caregiving expert. They're not a health care provider. But they,
Dr. Brandy Archie
Hmm.
Dr. Brandy Archie
Okay.
Dr. Brandy Archie
Okay.
Emilia Bourland, OTR, ECHM, CFPS
provide support services. And they were wondering, and then they had recently had their own experiences as a caregiver themselves. And they were wondering, how do you successfully prepare your home when someone is about to be discharged from rehab? So someone's in rehab, or let's say they're in the hospital or they're in rehab, and they're coming home and they're not as functional as they were before.
Maybe they're still working on it, whatever it is. But their level of mobility is different than it was before. How do you actually start preparing the home for it? I thought that was a really good question to kind of dig into here with a little bit more time and where we could focus on some highlights, but also bounce ideas off of each other. So there, that's it. That's the question. How do we prepare a home?
Dr. Brandy Archie
Mm -hmm.
Emilia Bourland, OTR, ECHM, CFPS
for someone to come home from rehab or the hospital when they've had a change in their ability to get around and function.
Dr. Brandy Archie
So that's it.
That is a really great question. And I want to give specific answers, but we didn't get a specific way that their level of ability has changed. And so because of that, the very first thing I'm going to say is get somebody's eyes on the scene and like ask for help. And so you could do that in a bunch of ways. Of course, you can do a virtual assessment, ask Sammy, that's exactly what we do and why we do it. You can ask the place that they're at if they do a home assessment before they come home.
Emilia Bourland, OTR, ECHM, CFPS
Yes.
Emilia Bourland, OTR, ECHM, CFPS
Mm -hmm.
Dr. Brandy Archie
because that's ideal because they're actually working with your person and know exactly what their level of ability is. Unfortunately, most places don't do that as much anymore. And when they do, totally was.
Emilia Bourland, OTR, ECHM, CFPS
No, it used to be standard of care when I first started as an OT, standard of care, right? And then it just like went away.
Dr. Brandy Archie
Yep. And it wasn't like all of a sudden, and then it was like, oh, the worst cases were like, you have a spinal cord injury. This is a huge change. Okay, we're going to go over. And now I feel like it's pretty much none of the time. Um, but I do hear some places doing it still. So ask about it. Um, because that's good and ask to do it as soon as possible. Not like two days before they discharge. Um, that way you have a little more time. You need some time. Yeah, you need some time. Um, and okay. So.
Emilia Bourland, OTR, ECHM, CFPS
Mm -hmm.
Emilia Bourland, OTR, ECHM, CFPS
Mm -hmm.
Emilia Bourland, OTR, ECHM, CFPS
Yeah, because if you got to make changes, you need time. You got to have time.
Dr. Brandy Archie
Those are the first two options. The third way I'd say to get some help is to literally take some video of your spaces, getting in and out of the house, bathroom, bedroom. If we got a limit to it, let's just do those three and bring that to the clinicians that you're working with and let them see it. And so because they're going to instantly be like, oh.
there's a bunch of stairs to get in the house. We gotta deal with that. Oh, your bed is actually high and we've been transferring in this regular high bed. You know, they're gonna see all of the problem areas because they've been working on the problem areas with them. And then get some feedback. That's the first thing I would say.
Emilia Bourland, OTR, ECHM, CFPS
Yeah, and I think that, like that bit of advice, whether or not you think you are going to need to make any changes to your home, even if you're pretty sure that's not going to be the case at all, that last bit of advice that you gave to take videos, take pictures of the spaces that your loved one is going to have to move around and function in, take those no matter what to the rehab team, take them to the therapist because...
There's just no way for that rehab gym or, you know, mock apartment or whatever they've got there, if they even necessarily have those things. There's no way for that to be exactly like the home or the bed or the bathroom or whatever of the person that they are treating. And so it is so, it is so imperative for them to know the actual environmental like parameters of what this person is going to have to deal with.
Dr. Brandy Archie
Mm -hmm.
Emilia Bourland, OTR, ECHM, CFPS
so that they can appropriately train for and simulate that in the rehab environment and problem solve around things that maybe aren't gonna be able to be changed or that aren't gonna be able to be changed easily. Because as much as we wanna, as much as we like to think that we can always have a perfect solution to every single problem or we can make things exactly the way that they.
Dr. Brandy Archie
Mm -hmm. Mm -hmm.
Emilia Bourland, OTR, ECHM, CFPS
either were or exactly the way that they quote unquote like should be. I used air quotes for those people who might be listening to this. I also said quote unquote, so I guess that was an unnecessary explanation. But yeah, you're welcome. But we can't. We can't always make everything perfect. We can't always make everything the way we want it to be. And so we have to be able to solve those tough
Dr. Brandy Archie
Mm -hmm.
Dr. Brandy Archie
It was. Keep going. It's good. You're good.
Emilia Bourland, OTR, ECHM, CFPS
problems so people can still function as best as possible. And there's really no way to truly do that without having an understanding of the environment that the person is in. Because there are, as we often talk about in occupational therapy, we use like the PEO model, right? There are these three things that go into functioning, the person, the thing that they want to do, the occupation, and the environment. And they're all equally important. So we got to make those match up.
Dr. Brandy Archie
Mm -hmm.
Dr. Brandy Archie
Yep. Yeah. And when you're in a facility, you're missing the environment piece of it because the therapist there don't get to see what's going on at your space. So do that as early as possible. Get some qualified assistants, either a virtual assessment with us or see if they will go to the house and at the bare minimum, or maybe the first thing you should do is just video the spaces and show it to the people that are working with your family member early. Like not.
Like right away, as soon as you get there, as soon as you meet the people you're gonna really work with, show it to them. Because then they'll tailor everything around that instead of just off of words. So that's the first thing I say to get prepared. Then they're gonna give you, they're gonna see the problems and they're gonna help you come up with some solutions and then you're gonna try to implement those solutions as best you can at home. The main thing I wanna say is that,
Emilia Bourland, OTR, ECHM, CFPS
Mm -hmm. Mm -hmm.
Dr. Brandy Archie
there are very few problems that I have encountered over 16 years that can't be addressed by some piece of adaptive equipment. And so don't feel like you have to all of a sudden do a big remodeling project. You might want to do that down the road. And that's great. But this person is going to get out of the hospital in probably two to four weeks, right? At the most, they're going to stay probably in skilled nursing for four weeks.
Emilia Bourland, OTR, ECHM, CFPS
Yeah.
Dr. Brandy Archie
And so you need to have enough time to do it well. And so it's totally worth the investment to get some adaptive equipment to solve the problem, especially because you don't know if that's going to actually be the best solution in the first place. I guess what I'm saying is we can have an idea that, oh, we're going to use this tool here, put this bed rail here, it's going to help with getting out of bed. And it might, but you might find that...
Oh, after a couple weeks, we don't need this anymore. So now instead of buying a whole new bed or getting a hospital bed, you didn't even have to go through that whole process because we figured out that we wanted to do it a different way after you're actually home and living life. Does it make sense? And so, after that, we're going to help you with that.
Emilia Bourland, OTR, ECHM, CFPS
Mm -hmm.
Yeah, absolutely. I mean, I can't tell you the number of times like I'm treating someone on rehab or in the hospital and we're talking about accessing the shower, right? We're talking about bathing and they'll say, oh, no, no, no, it's going to be fine. You know, my dad or my uncle or so and so or someone is going to put in a walk -in shower. They're going to put in a curvy shower for me or something like that. I'll be like, OK, that's great. But one. Let's you don't actually need that.
Dr. Brandy Archie
Mm -hmm.
Dr. Brandy Archie
Mm -hmm. Mm -hmm. Mm -hmm.
Emilia Bourland, OTR, ECHM, CFPS
Here's a tub transfer bench. So this is $50 versus ripping out your whole bathroom. Not that I am not a proponent. Like if you're going to redo your bathroom anyway, like you said, if you're going to redo it, if you want to make it, and I'm all about a curbsless shower, you know, as long as it's got enough drainage, people never underestimate the amount of drainage you need for a roll -in shower, please. But like, I'm all about that.
Dr. Brandy Archie
Mm -hmm.
Emilia Bourland, OTR, ECHM, CFPS
But again, to your point, are you gonna be able to actually get that work completed in the time that you have before discharge? Probably not. That's actually a massive and very expensive project to do. Bathrooms are expensive, right? And two, if you don't really have to do that right then and there, is that going to be the best use of that time and funds? Or are there other areas where maybe,
Dr. Brandy Archie
Probably not.
Dr. Brandy Archie
Yeah, totally.
Emilia Bourland, OTR, ECHM, CFPS
you will have to make some significant investment in order to have something be functional or accessible that you would rather put those funds to when there's a piece of adaptive equipment that can solve that particular shower access issue or like anything else. But I think you're right. There are so much great adaptive equipment out there. It's not your job necessarily to know it is your job.
Dr. Brandy Archie
Yeah.
Emilia Bourland, OTR, ECHM, CFPS
I mean, Brandy, it is actually your job. It is my job. But it's not the listener's job to know about all those things. But there is someone there in the rehab environment whose job it is, and that's your occupational therapist. So have a conversation with them about it. And even if they don't know everything about every piece of adaptive equipment, tell them the problem. It is their job to go out and do the research and find what would be the best solution for you. Right? We're here. Use us.
Dr. Brandy Archie
It is my job. She's talking to me. Right.
Dr. Brandy Archie
Mm -hmm. Mm -hmm.
Dr. Brandy Archie
And also that's why ASCAM is here. So even if they don't know the research has been done, you just need to like type it in and find it. That's like, that's part of the problem because there's lots of stuff and people are inventing good things all the time. But if you don't know about it at the time that you need it, you like come across it a year later, like, oh, this would have been great a year ago when my mom came home after having a stroke. But now we rigged up something else, you know.
Emilia Bourland, OTR, ECHM, CFPS
Mm -hmm.
Dr. Brandy Archie
So that's really the whole point of SCME. So use that as a resource to find what's out there. Because there is something for just about everything.
Emilia Bourland, OTR, ECHM, CFPS
Um, the, the thing that I really like about Ask Sammy too, not that we're trying to make an ad for Ask Sammy right now, but like genuinely it's a, it's a great, it's a great resource because of the way it's designed. What I love about it is it's based on how an OT thinks about these things. So instead of just like you put in your problem and instead of just getting a giant list of anything related to that area of the home or that area of functioning, which is overwhelming and not helpful. Let's just be honest. That is not actually helpful.
Dr. Brandy Archie
Just, yeah.
Dr. Brandy Archie
Mm -hmm.
Emilia Bourland, OTR, ECHM, CFPS
That still just gives you a bunch of things that you have to sort through. Ask Sammy actually makes curated recommendations based on the specific problem that you are having, the way an OT thinks about it. So that's pretty remarkable, actually. Good job. Good job, Brandy. Way to go. Pat on the back.
Dr. Brandy Archie
I'm just trying out here to solve my own problems. That's all. That's all I'm doing. But because it is a lot to... It is the OT's job that's working with their family member to give you ideas and help you connect, but also they do a lot of other things. And so to stay up on all the new stuff that's coming out and it's just challenging. It takes a lot of extra time. Okay, so you're going to get some expert support advice.
Emilia Bourland, OTR, ECHM, CFPS
Pat on the back.
Dr. Brandy Archie
You're gonna start with adaptive equipment before you decide to do something else. And then the other thing I would say is get some support lined up. And so even if this is like, I don't know, a knee replacement and in 12 weeks we're gonna be back to functioning well.
If you're the person caring for somebody, that's 12 weeks is a long time. And you can't be there 24 seven helping somebody else 24 seven. It's just not possible to do. I mean, you need a break too. And also some stuff needs to be done outside the house and all these things, right? And so find a way to get your...
Dr. Brandy Archie
Are we good?
Emilia Bourland, OTR, ECHM, CFPS
Mm -hmm.
Dr. Brandy Archie
You've always been good. Okay. I was freezing and you were freezing. So I paused and I marked the clip.
Emilia Bourland, OTR, ECHM, CFPS
Okay, yeah, I know you froze, but I just kept staring at the camera. Like I knew. Like, bro, yeah.
Dr. Brandy Archie
Like a pro. Okay, I'm gonna mark this again, because I'm gonna start again.
Okay, so get some support. I feel like a lot of times, especially when there's a hospital visit, you have the people around you saying, oh, just let me know how I can help you. And that's nice, but it feels like I don't know what I need help with. I don't know what you're willing to help me do. And so should we.
Emilia Bourland, OTR, ECHM, CFPS
It also feels like more work to put together a to -do list for other people sometimes than to just do it yourself. Like, let's be honest, we've all been there. We're like, how can I help? And you're like, I don't know. It's just easier for me to do it, right?
Dr. Brandy Archie
Yes.
Dr. Brandy Archie
Yes, totally. And so there's this website called lotsahelpinghands .com.
It's like a meal train if you ever done that before where somebody you or somebody else can set it up and Put in like some things and sometimes that you might need help with maybe it's meals So you don't have to do cooking or maybe it's coming to hang out with the person for a couple hours Which then you can go do something else? And and it takes out the social pressure of me looking you in the eye to say I need somebody to help me So I don't go crazy and can you come over every week? You know, like you don't I don't want to show
stress you out, feeling like, oh, I'm not up for every week. And it just takes out the social pressure there about asking directly, because then somebody can send that link to you, and then you can think, I can list all the things that could be useful to us. And you can be like, oh, that's a thing that I can do. Oh, I love cooking. I'm going to go ahead and make a meal every couple, and let me let you choose, I should say.
Emilia Bourland, OTR, ECHM, CFPS
Mm -hmm.
Dr. Brandy Archie
how you want to help and then it's all organized already and then this reminds them and lets you know who's going to do what and it's just a great way to get some support.
Emilia Bourland, OTR, ECHM, CFPS
So what I would add to everything, all the advice you've already given, which is excellent advice, what I would add to that, that my cell phone also wanted to chime in on, I'm gonna turn that down. Sorry, everybody. I'm just gonna throw it in the other room. So what I would add to that is that it is really important as part of planning for the home environment, for that discharge process,
to also understand what areas of the home are actually gonna be important for that person to access, both in the short term and then potentially in the long term too, if the change that they are undergoing is gonna be a long term change. And the folks that you're working with are automatically gonna zero in on like bathroom, bedroom, right? Cause those are two places where people have to go. But if the kitchen is a place of importance for...
the person who is going to be coming home. We need to make sure to bring that up and let them know, okay, this person likes to cook or this person likes to do this thing in the kitchen. This is necessary. And so how are we going to navigate through this space? If there is an area of the house that they love, that they always go to, to do, to water their plants or to do X, Y, Z, it doesn't really matter what it is, but we want to think about how someone actually
Dr. Brandy Archie
Mm -hmm.
Emilia Bourland, OTR, ECHM, CFPS
lives in their home and how they move throughout the entire home in a meaningful way versus really versus just addressing those basic areas. Do we have to address those basic areas? Yeah, absolutely. But particularly when we are thinking, particularly when we're thinking about like long term changes in people's lives, at the end of the day, just being able to get up and go to the bathroom is really not enough for people. Like,
Dr. Brandy Archie
Mm -hmm.
Dr. Brandy Archie
Yeah, for a good quality of life.
Emilia Bourland, OTR, ECHM, CFPS
That does, using the toilet alone does not a good quality of life make. So, I don't know why I said that like Yoda, but I did. So, hopefully it made sense to people. So, we have to be thinking about, you know, if this person, if there's a den that this person loves to go into where they play video games or they watch movies with the family or whatever like that. And that den, it's like a sunken den or something like that. Well, we need to talk about that. We need to have a plan for that.
Dr. Brandy Archie
Right.
Emilia Bourland, OTR, ECHM, CFPS
because what we don't want, ultimately, you and that person, you're gonna decide they need to access that space. So let's plan ahead for that to be a safe and good access. Even if it's not like something that you implement, even if it's not a change or a modification that you implement it right then and there, get some ideas for how you are going to implement that change when you're ready so that you're not left in a lurch.
Dr. Brandy Archie
Mm -hmm.
Dr. Brandy Archie
Mm -hmm.
Dr. Brandy Archie
Right.
Emilia Bourland, OTR, ECHM, CFPS
three months or six months or a year down the line when so -and -so is like, hey, I really want to be able to go watch movies in there with the family, you know? And then you try and jury -rig something up yourself that may or may not be either the easiest solution, the most affordable solution, or the safest solution. So, you know, we got to think beyond just that, like, basic, can this person get to and from the bathroom, in and out of the shower, on and off the toilet, in and out of bed. That stuff's important.
Dr. Brandy Archie
Mm -hmm.
Emilia Bourland, OTR, ECHM, CFPS
but we also need to think about their greater quality of life. And these are things that can be addressed as well.
Dr. Brandy Archie
Yeah. Excuse me. I don't know what I'm supposed to do about that. Mark the clay. So what I hear what you're saying basically is use your expert support while you have it. Like even if you're not going to make those changes right away, because that can be overwhelming and you do need to get the basics first, at least know what you should be able to do and how you're going to handle it. Because we should get back to that.
Emilia Bourland, OTR, ECHM, CFPS
Bless you. I don't know. I mean, you just need to bless you.
Dr. Brandy Archie
We want to do as many things for ourselves as we can because that's what gives us motivation for living. Everybody needs a purpose. And so when a purpose is taken away, that's a quick trigger for depression. And people are not motivated to do their recovery or whatever the rehab is for this thing if you don't have purpose. So make sure that's part of the thing.
Emilia Bourland, OTR, ECHM, CFPS
Mm -hmm.
Emilia Bourland, OTR, ECHM, CFPS
Yep, it's gotta be, you know, we call them individualized plans of care, right? Because they shouldn't be the same for everyone. So ultimately like, yes, absolutely use the expertise of the clinicians that are there with you, but also communicate to them what you know about the situation that maybe they don't know and encourage the person who's actually there getting rehab. If they're able to communicate for themselves, you know, saying like, hey,
This is an important part of my life. This is something that's meaningful to me because it's gotta be about more than just the basics.
Dr. Brandy Archie
Yep, absolutely. So yeah, we went over a whole lot of things to do to prepare a house. I feel like the person asking the question was just like, what stuff should I buy and put in the house so that I'm ready? But I think what we're trying to impress is that it's more than that. And...
Emilia Bourland, OTR, ECHM, CFPS
We did.
Dr. Brandy Archie
We always want a black and white answer, right? We want a pill to solve a problem when really we should exercise or whatever the thing is, right? And so we're saying the same thing here is that dig a little deeper and do a little bit more. The earlier you start, the better you would be. And then maybe you'll spend a little less money because you get the right things and just enough that you need to make a situation as good as possible for coming home.
Emilia Bourland, OTR, ECHM, CFPS
Mm -hmm.
Dr. Brandy Archie
Another thing I'd add is like, if you know you're going in for like a planned knee replacement or hip replacement or something like that, do stuff in advance. And you can get a therapist out there before you go. And they're gonna know exactly what kind of situation you're probably being when you get out. And get yourself set up and ready before you even have to go in.
Emilia Bourland, OTR, ECHM, CFPS
I also...
Emilia Bourland, OTR, ECHM, CFPS
Yep, makes it a lot less stressful.
Dr. Brandy Archie
Absolutely.
Emilia Bourland, OTR, ECHM, CFPS
I was gonna say something and then I forgot. Oh, I know what I was gonna say. Okay, so, and I think that, I think actually this question is a good example of, like often we think that, often we think of these questions as being like relatively simple questions where maybe there is like a straightforward or pat answer. And the fact is that there's not necessarily a straightforward or pat answer because people are individuals and their homes are different.
and people have different goals and wants and needs. And so it's not really so much about understanding like, what are the three pieces of equipment that I need or what are the three things that I need to look at in my home? It's really understanding how to best utilize your resources, ask the right questions and then, and not be afraid to share your own knowledge and input into the situation because honestly like that is helpful, that is helpful too.
Dr. Brandy Archie
Yeah.
Dr. Brandy Archie
Totally is. I think that the way we have set up the medical model is to...
be top down and so we go into the hospital thinking, oh the people there in the white coats and the scrubs are gonna tell me all the things I need to do. I'm gonna passively accept that and then try to do it. But they can only offer, I'm not saying they're not smart people, they're great and experts at what they're doing, whatever that is, but they need some input from you too. And so your voice is valuable is what I'm trying to say. And so it's not looked at in a bad way for you to pipe up and say like, hey, how,
Emilia Bourland, OTR, ECHM, CFPS
Mm -hmm.
Dr. Brandy Archie
How should I deal with this and show them what's going on at home? They're gonna actually be really excited because they're gonna be like, oh great. Now I have some information to go on instead of just taking a guess at what things we should improve on based on how this person's body or mind is working. And so you're a big part of the team, is what I'm trying to say. The patient there as well as the caregiver.
Emilia Bourland, OTR, ECHM, CFPS
Yeah, yeah. I think that for me, I've always envisioned like successful health care as being a partnership between myself and the person that I'm treating and whoever else is involved in that care. Because really like every we're all team members, we all have a different piece of the puzzle. No one piece is actually more important than another piece. It's but we have to communicate, we have to communicate respectfully, and we really have to work together. It's
Dr. Brandy Archie
Uh huh.
Emilia Bourland, OTR, ECHM, CFPS
Because one person alone, no matter who that person is, no matter how smart they are, no matter how many degrees they are, they actually can't solve all the problems on their own. It's just not possible, you know?
Dr. Brandy Archie
Right? Yeah. That's why we have so many different professions. Exactly right. Yeah.
Emilia Bourland, OTR, ECHM, CFPS
Yeah, indeed. Yes. And I think also why we have better health care outcomes when, and there's lots of research on this, when the person who is receiving health care is feeling like they're listened to, like they have input, like they have trust in that relationship, we know that outcomes are better. And that I think comes from having a partnership style relationship between the provider and the patient.
Dr. Brandy Archie
Yep, absolutely. That was a great question. I'm glad we got to discuss it and care lab it.
Emilia Bourland, OTR, ECHM, CFPS
Yeah, we care labbed the heck out of that one. It really was a good question because I think it's something that's super relevant to a lot of people. And unfortunately, I think it's something that folks don't think about a lot until they are actually, they're like literally day of bringing someone home and then they're like, oh my gosh, this doesn't work or I don't know what to do or I didn't ask this question or no one told me. So it's a really great thing to think about.
beforehand and start prepping for early and often as that whole rehab process goes from beginning to end.
Dr. Brandy Archie
Absolutely.
Dr. Brandy Archie
Yeah, totally, totally important. And then if you're a healthcare professional or you're just expecting that home health is gonna come in and save the day, like they are awesome, but you're gonna get a nurse first and you're gonna, there is rules, so you gotta get them within 24 to 48 hours, but a lot can happen within that timeframe if you're feeling unprepared or something, if you don't have at least some stuff set up. And then it's gonna be another day or two after that before you get PT and OT, and then they make their recommendations and then you gotta do that.
thing. So that's still some more days. So the more you can do upfront, the even better you can use the support that is going to come into the house because you're already going to have some stuff there. You're going to have some stuff on the way and they're like, great, I'll set that up for you. We can practice using it, you know, whatever. But yeah, there's this definitely this gap between the discharge time and when you get some more support. And so planning in advance is really helpful.
Emilia Bourland, OTR, ECHM, CFPS
Yeah. I don't think, I think we, I think we care lab the heck out of that. I don't have anything else to add right now. I probably will like five minutes after we stop recording, but you know.
Dr. Brandy Archie
Yeah.
Dr. Brandy Archie
which is why we have a weekly episode. So make sure y 'all come back and listen in your podcast views next week so you can hear the rest of Amelia's thoughts that she has not thought yet.
Emilia Bourland, OTR, ECHM, CFPS
Which
Emilia Bourland, OTR, ECHM, CFPS
I don't threaten them with a good time. Don't threaten them with a good time.
Dr. Brandy Archie
And if you guys have a question that you would like us to CareLab, please let us know in the comments or send us an email, connect with us on our website. However, SmokeCircle works too, because we're happy to CareLab it with you.
Emilia Bourland, OTR, ECHM, CFPS
Yeah, for sure. Those are actually the best kind of episodes, the best kind of questions, or when we're getting real questions from y 'all. So don't be shy, and we'll see you next time on CareLab. All right, bye.
Dr. Brandy Archie
See ya.
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