Full Transcript:

Valerie VanBooven RN BSN:

This is Valerie VanBooven with The Senior Care Industry Netcast, where leaders with three or more years in the senior care industry share their advice in just a few minutes. So let’s get to it. In a few sentences, tell us who you are and what you do.

Tina Ketchie:

I am so happy to be here. My name is Tina Ketchie-Stearns, https://www.itsabouthowyoulive.com/

I’ve worked in the hospice industry for 13 years, and the last two and a half to three years, I’ve been in the assisted living memory care, senior living industry. I educate medical professionals about hospice, how to have difficult conversations. They really don’t love those conversations, that’s not why they went to medical school. And so they really struggle with it. And we get boomers coming along and there’s 10,000 of us turning 65 every day. So my goal is to help these people in the next 20, 30 years not hate their jobs because they’re having so many of those end-of-life conversations simply because of our aging population. So, that’s the bulk of what I do.

Valerie VanBooven RN BSN:

So let me see if I got this straight because I love this. So you teach medical students and nurses or just doctors?

Tina Ketchie-Stearns

Medical professionals, whether they’re students or practicing physicians, nurse practitioners, physician’s assistants, nurses, anybody that is working with patients and families that have a potentially life limiting illness.

Valerie VanBooven RN BSN:

Oh, my goodness. And it is such a hard conversation to have. And all of our hospice people are angels. We’ve had some really nice, very good medical directors of hospices on here. And it does take a special person and a special kind of way to talk to folks during these difficult times.

Tina Ketchie-Stearns

Yeah. I think they have a real calling for it. Now, I’m not clinical. I don’t want anybody to get any misconceptions. I educate because there are just so many basics about hospice, what it is, what it’s not, when it’s time to call for a consult, people just don’t know. Whether it’s the general population, the caregiver and their loved one, or the medical professionals. They just don’t really know. So it’s wonderful once they get it and they’ve had the training, then it’s like, “Whew.”

Valerie VanBooven RN BSN:

They know it’s time to refer on. They know it’s time to talk to the hospice specialists in their life.

Tina Ketchie-Stearns

Yeah, and they’re not as afraid of it once they understand what it is and what it isn’t.

Valerie VanBooven RN BSN:

Yeah. And understanding how to talk about it, I think, is probably half the battle. The words to use and what’s okay to say, and how to say it is okay. And it’s okay to be emotional about it with your patient, whose been your patient for all these years or whatever.

Tina Ketchie-Stearns

Right.

Valerie VanBooven RN BSN:

I’m sure there’s a million things I don’t know about it.

Tina Ketchie-Stearns

That’s exactly right.

Valerie VanBooven RN BSN:

As a nurse, I didn’t work in the… I mean, worked in critical care. So lots of death and happiness and sadness, but having not experienced hospice as a nurse, I can imagine. I understand completely how this is a very difficult conversation to have for anybody. That’s amazing. So thank you for being an educator and helping all of us in the medical profession, be better stewards of our resources and understand how to talk to folks who are in this difficult place.

Tina Ketchie-Stearns

Yeah. I mean, I love it. They really need their medical providers to be there, to love and support them when they need it the most. And if the medical professional is just really tripping over their tongue or just uncomfortable with the whole topic, it can make it difficult. So what I like to say is I like to turn the most dreaded conversation of the day into one of their most rewarding, meaningful conversations, they’ll have all day.

Valerie VanBooven RN BSN:

How nice is that? That is so nice. What a great way to approach this. Oh, yes. We need a thousand more of you all over the place.

Tina Ketchie-Stearns

We do. We sure do. That’s right.

Valerie VanBooven RN BSN:

All right. Well, what is the best thing? Now I usually ask what is the best thing about serving seniors and their families, but I’m going to ask you, what’s the best thing about serving these medical professionals and the families that come along with it?

Tina Ketchie-Stearns

I just think the look of relief on their face once they’ve gone through the training and they understand that they don’t have to feel like a failure. If they couldn’t cure the illness, they can do it in a way that the patient and family feel loved and supported. They don’t feel like they dropped them like a rock. It’s just the national hospice ribbon is on my wall. It says, “It’s about how you live.” And every hospice medical director will tell you, we’re not helping people die. We’re helping people live until they die. And that’s a very perfect tagline for the national hospice ribbon, where most people think, “Well, that makes no sense. It’s about how you live. Hospice is about death and dying.” No, it’s really about making the most and making memories and really embracing those last chapters of your loved one’s life so that you can… I like to say, I look at a good death and a bad death as a bad death is when there are regrets, and a good death is when there are not regrets.

Tina Ketchie-Stearns

And there are ways to have conversations with your loved one. Let’s say you’re the family members. Ways to have conversations with their loved one that can really bring them closer together than they’ve ever been before when they get comfortable with talking about what are your wishes? What do you want? What don’t you want? And then when the medical professionals understand how to have these conversations, I’ll give you one great example. Instead of saying, “There’s nothing more we can do.” What I’d like them to say is something like, “I’d like to introduce an additional plan of care to help with this transition.”

Tina Ketchie-Stearns

The care doesn’t stop. It’s more care laid on top of all the other care you’ve been getting. Now we’re going to lay on some additional care to help with this transition.

Valerie VanBooven RN BSN:

Very nice, very nice. And it is about how you live, because if you think about it, if you die suddenly in a car accident or have a heart attack and die, you were living your life until that moment it was over. So in the case of having a critical, terminal illness or a long-term terminal illness, you just kind of know a little bit more about when that time might come. You don’t know exactly, but you know it’s coming. So it’s about how you live up until that moment that it’s over. I mean, it kind of makes sense to me that you want to be as comfortable and feel as loved and as embraced as you possibly can until that moment.

Tina Ketchie-Stearns

And a lot of people have different views about how they want to live out the last chapters and months of their lives. Some people want lots of family and friends around, some people want to travel, some people just want to rock on the front porch. But it’s important that once family members understand and accept the very sad reality that this person likely has six months or less estimated in their life, that’s what makes you eligible for hospice. Really two things. Estimated prognosis of six months or less to end of life, and no longer seeking curative treatment. So those two things together make you eligible for hospice. And when I said six months, I didn’t say six days, I didn’t say six weeks. Months. So the number one thing families say is they wish they’d called sooner. So if we only have a week or two to work with the patient and family, that’s not a lot of time to make a lot of memories, but if we get months, then we can make some things happen.

Tina Ketchie-Stearns

My mother, a month and a half before she died, said she wanted to go to the beach, drink tequila sunrise on the beach at sunset. We were able to do that because she was in hospice for four months. So there was time to make that memory and we got photos. And it’s just, really, one of the most cherished memories I have with my mother is one of her last wishes. And she had hospice care long enough that we could make that happen.

Valerie VanBooven RN BSN:

Awesome. Yeah. That’s right. So don’t wait until it’s really late in the game. Start a little sooner than later because hospice benefits can be extended. Let’s say you didn’t pass away in six months. I mean, you can still continue with hospice with doctor’s orders. And obviously the things are reassessed a little bit and all that.

Tina Ketchie-Stearns

That’s really pretty common because if hospice is doing its job, they’re managing your pain and symptoms. That’s their specialty. It’s pain and symptom management. So if they’re doing their job, you probably will. Or many, many times they will live past that six months, which is great. So then we’re at the six months, they’re still with us. And so the doctor then has to determine, do I still feel like we’re in a six month window to end of life? And if they do then hospice just rolls forward. On the flip side of that, sometimes people perk up so much, the doctor can say, “I can’t really say it’s six months or less.” So they’re discharged and they go live their life. And when they need hospice down the road, they’ll be there.

Valerie VanBooven RN BSN:

Yeah. My dad is a perfect example of that. He has dementia and there was a point in time where we thought, just because of his symptomology, this is it, he’s on hospice. And hospice was amazing. And it, long story short, transitioned to over to a nursing home where he had 24 hour care and they were able to do things that the family wasn’t able to do. So manage his medications better, wean him off some things that were giving him symptoms that more making him look like he was at the end of his life. And so once they weaned him off a few things, then he perked up and it went from a few months to… And he was off of hospice. And now, although he still has dementia and he needs to live with 24 hour care, he’s not that sick. I mean, he’s… Yeah. So it can go either way. I totally see that. But we were very prepared and very pleased that hospice was so supportive and willing to do anything that they could to help him manage whatever symptoms he was having and help his wife and all those things.

Tina Ketchie-Stearns

Yeah. That’s great. Happens a lot. It does.

Valerie VanBooven RN BSN:

Okay. So obviously I told you I talk a lot, so there we… You see how that works. Okay. So I’m going to switch gears for just a second and talk about online marketing. It’s hard for us to do things in person right now, especially. But generally speaking, what has been your experience with online marketing? I’m sure that you do a lot of your stuff is online. Especially now.

Tina Ketchie-Stearns

Well, in fact, this whole Zoom situation, I do a weekly video blog. I try to keep it to less than five minutes, hopefully more closer to three minutes, on topics ranging from advanced care planning, hospice and palliative care, senior living, caregiving, and grief. And so I just kind of mix those topics up week by week by week. But every single Tuesday, I post a video blog, and that’s been the best online marketing that I’ve been able to come up with. It’s kind of like a video newsletter, if you will. But I also put it on social media and LinkedIn, Twitter, that kind of thing. And that to me has been the best way for me to connect with the most people. But again, keeping it short and consumable. If it’s a weekly thing, they don’t want to listen to 20 minutes every week. So I found that to be really, really helpful and successful.

Valerie VanBooven RN BSN:

I understand. And you’re right. And yeah, we try to keep these fairly short. Now I always say nine minutes, but we’re going to stop saying nine minutes. We probably keep it 15 minutes and under. Makes a good podcast length and video. It’s watchable. So yeah, I totally get it. I think small bites are what people need and I believe you’re… That’s a great way to get the word out to people and to continue to be in front of them.

Tina Ketchie-Stearns

Yeah, absolutely.

Valerie VanBooven RN BSN:

All right. I would imagine in your career and in your life, there have been other organizations, you just mentioned one earlier, or other people who have really done a great job or meant a lot to you. Who would you like to give a shout out to?

Tina Ketchie-Stearns

Oh, my goodness. So we have a lot of veterans. Of course, the World War II veterans are far and few between anymore, but there is a woman named Deborah Grassman who has cared for 10,000 dying veterans. She is pretty much the guru of caring for veterans at the end of their life. So I would love for your listeners to Google her. Deborah Grassman. Her company now is called Soul Injury. So she has broadened her reach to not only veterans, but really anybody that’s had some sort of soul injury, like an example might be a child that was terribly bullied, and they carry that on into their adult life. But she’s fabulous. And then there’s a wonderful doctor. He’s retired now, but his name is Dr. Edward Shaw, and he’s in Winston Salem where I am. He coauthored a book called… Hold on now. Cause I had two books in my head. Many people have heard the book, The Five Love Languages by Dr. Chapman. So Dr. Chapman and Dr. Shaw together wrote a book called Keeping Love Alive as Memories Fade: The Five Love Languages and the Alzheimer’s Journey.

Tina Ketchie-Stearns

Dr. Shaw was using the love languages in his counseling of Alzheimer’s patients and their families. And then these two men got together and with another gal wrote this book that is amazing. So Keeping Love Alive as Memories Fade: The Five Love Languages and the Alzheimer’s Journey. It was really about Dr. Shaw’s wife, Rebecca, who passed away after nine years with Alzheimer’s. So it’s a fabulous book. He’s a wonderful fellow, speaker, everything. I mean, there are many, many people. I mean, I can’t even begin to name all the people that have been wonderful influences, but Deborah Grassman and Dr. Edward Shaw are at the top.

Valerie VanBooven RN BSN:

All right. Thank you. Thank you for… And what I always tell people is we ask you for a shout out for organizations or people, or whoever means a lot to you because we can learn from that. And we will definitely make sure we Google those people. And I always highlight them when we post our videos, so people will be able to see those names and learn more about those folks. And the books that they’ve written will help so many professionals and consumers. So, all right. What piece of advice would you give to senior care providers, or healthcare providers of any kind, who are especially dealing with end of life issues?

Tina Ketchie-Stearns

Well, the first thing I want to say is with this COVID situation, it amazes me how many families think because they can’t do a face to face visit with their loved one, just may not even go by and go to the window or… Oh, my goodness. That’s so not true. The seniors really need to know that you love them. You miss them. You’re still there for them. So please, if your loved one is in a senior living community, or even if they’re just isolation in their own home, go to the window, do the window visits. There’s this great product called Eversound that a lot of communities have that is headphones that the family member would have on and the resident would have on. And there’s a little transmitter thing. Anyway, the sound quality is such that you forget there’s glass in between you. So it’s really wonderful.

Tina Ketchie-Stearns

So please, just because of COVID, just because touching and face-to-face visit is not possible, please go by. Even if you like take a little gift, chocolates, or fruit, or whatever, and you have a picture of the family on there, just anything to make sure those seniors know you’re thinking about them. That is extremely important. The other thing for caregivers is caregivers are really bad at taking care of themselves. And I have this medicine woman gal, White Star Woman, who I’ve worked with for 10 years now. And the year 2010 was a year of true generosity. And what that means is yes, it’s important to give. We all know it’s important to give, but it’s equally important to receive. So my point is is if you’ve ever offered to do something for someone and they said, no, I’m good. It’s okay. It hurts your heart just a little bit.

Tina Ketchie-Stearns

Cause they said, no. Well, White Star Woman would say they’re being stingy because they’re not letting you serve them. So when a caregiver is approached by a hospice or a neighbor who wants to bring them dinner or whatever, that caregiver needs to learn to say yes. If somebody is offering help and assistance in any way, learn to say, “Yes, thank you. That would be great.” Because if you say no, you’re being stingy and you are robbing them of the joy of serving you, plus you probably need the help. You probably really…

Valerie VanBooven RN BSN:

You probably do.

Tina Ketchie-Stearns

Exactly so true generosity. It’s important to give, but it’s equally important to receive. So let those people that are trying to help you help you.

Valerie VanBooven RN BSN:

Nice. Very nice. Yes. Let folks help you. That is so hard.

Tina Ketchie-Stearns

I know, but you’ll get better at it. The more you practice saying yes, you’ll get better at it.

Valerie VanBooven RN BSN:

Yeah. It is. And you know what? If you think about it from your own perspective, I wouldn’t offer to help somebody if I didn’t mean it, truly mean that I will absolutely help you. I would never offer if I didn’t think I could follow through with that. So whoever’s offering you help, they’re saying that because they really do mean they will help you. They’re not just throwing it out there. They really want to help. So let them do it. All right. Good advice. All right. Last question, supposed to be my fun one. When you have a win in life, or it can be anything. A win is knowing that today you helped a family, or knowing today you helped a healthcare professional turn that light bulb on and feel better about those conversations, or there’s a graduation, or a new baby in the family, or a wedding. When you have a win in life, how do you like to celebrate?

Tina Ketchie-Stearns

This was the easiest question you gave me. So I’m a front porch freak. I have a house with a front porch on it. And so I’m in my porch swing with a cocktail, listening to Louis Armstrong singing “It’s a Wonderful World”. That is my perfect way to celebrate anything.

Valerie VanBooven RN BSN:

Very nice. Yes. And we have had… I think that sounds wonderful. We have a nice front porch, too, and I need to spend a little more time on it. But we have had some great responses all over the map, but I always love it when somebody throws in a little cocktail. We’ve had vodka martini, we’ve had our hospice doctor that we love so much pull out a bottle of tequila.

Tina Ketchie-Stearns

I saw that. I saw that video. In fact, my preferred cocktail for, I don’t know, two, three years now was vodka cranberry club soda. But now I’m doing tequila on the rocks with a splash of club soda. So I’m with them on the tequila.

Valerie VanBooven RN BSN:

Yeah. He’s just a little shot of that makes his day. I was like, “Well, that is perfect coming from you.”

Tina Ketchie-Stearns

I can’t do shots. But that’s kind of my jam right now.

Valerie VanBooven RN BSN:

That sounds good, though.

Tina Ketchie-Stearns

Yeah.

Valerie VanBooven RN BSN:

Thank you so much. You did an amazing job. Thank you for all of your wisdom and insight. And I hope lots and lots of health care professionals see this and go to your website. We’ll make sure all of that’s available to them so that they can get more education and learn how to have these hard conversations. They don’t have to be that hard, I don’t think.

Tina Ketchie-Stearns

I really would love that. They need it so badly. And again, my greatest joy and it’s… I’m batting a thousand. It happens every single time. The way they come into it, and at the end of the training, and it’s only an hour. It’s just the look on their face is just lighter and they’re smiling and they just feel relief because they get it. They get it. That would be wonderful.

Valerie VanBooven RN BSN:

Well, thank you so much for being on the show. We appreciate it and keep us updated on things with you and how things are going. And let’s do this again.

Tina Ketchie-Stearns

I would love it. Thank you so much. I really appreciate it, Valerie.