Valerie VanBooven RN BSN:

This is Valerie VanBooven with the Senior Care Industry Netcast, where leaders with three or more years of experience in the senior care industry share their advice. It’s six questions in just a few minutes. So with that, let’s get started. Tell us who you are and what you do.

Rachel Botkin:

Well, thanks for having me. I’m Rachel Botkin. I’m a licensed physical therapist. I’ve been working in central Ohio for over 20 years, and I specialize in working with older adults. I started my career in an outpatient clinic at the Ohio State University, specializing in neurological rehab. I spent several years in management in the skilled nursing facility arena, and then finally found my home and passion in home health care.

Valerie VanBooven RN BSN:

Awesome. Tell us a little bit about what you do with your business, too. You just said Ohio State University. Tell us where you’re located and a little bit about what you do for folks in their home.

Rachel Botkin:

Sure. So, I’m in Columbus, Ohio. I own a company called Botkin Rehab Services. We provide physical, occupational and speech therapy services on a contract basis to skilled, certified Medicare home health agencies here in central Ohio that don’t have their own in-house therapy staff. So, we partner with those agencies to provide their therapy needs. Then I also provide Medicare Part B services, Medicaid insurance, and private pay therapy and wellness services in the home.

Valerie VanBooven RN BSN:

Wow. So, anyone can take advantage of your services pretty much, right?

Rachel Botkin:

Yes.

Valerie VanBooven RN BSN:

Awesome. That’s great. all right. So tell us, what is the best thing about serving aging adults?

Rachel Botkin:

Well, I liked this question, because I grew up as the daughter of a nursing home administrator. So, I would tag along to my dad’s buildings all the time, volunteer, call bingo, do anything that needed to be done around his buildings, and I really just fell in love with the older adult population. They all had stories and experiences to share, and I was just fascinated by that. So, to be invited into an older adult’s home, which is such an intimate and personal space, I really feel privileged to be able to provide care in that environment. So, as a home health therapist, I get to see these older adults one-on-one. I never had anybody else competing for my time, and I get to hear their stories. I get to look at their family pictures. I get to hear how they met their spouse.

            A lot of them like to cook for me and I don’t partake nowadays because I have a mask on, but sometimes we could sit and have coffee after our therapy session was over. The other really neat thing here in Columbus is we have a large immigrant population, so working with the older immigrant population has given me the opportunity to really learn about other cultures and religions from all over the world, along with the tasty food that I get offered.

Valerie VanBooven RN BSN:

Food is always good. Yeah. I know it’s a little bit more challenging right now when you go in someone’s house. We had physical therapy in the house here in the last three months of the year for my husband who had back surgery, so we are very accustomed to having a physical therapist or occupational therapist in the house. Worked well, and it’s amazing how one little movement can make you sore even though it doesn’t seem like much. This makes you feel like, “Oh my,” after back surgery. It makes you feel like, “Oh my gosh.” So, I totally understand the value of it and frankly, we probably need to continue down that road. Just having somebody come to the house, to me, and I know for a lot of seniors, it’s all about socialization. A little bit of socialization.

            They don’t have to go anywhere. Having someone come to the house is always a welcoming experience for them, usually anyway, and I know that it’s certainly one of the most helpful things is to get somebody moving and see their progress. Oh my goodness. What a rewarding thing to see how much better someone’s doing after just a few visits. So, tell us, and you may have hinted at this a little bit, but in your life and in your career, there’s probably people, organizations, could be parents, grandparents, and it sounds like maybe your dad was one of those people, who have inspired you, who have done a great job out there and led you to where you are today. Who would you like to talk about?

Rachel Botkin:

Yeah. So, my dad definitely. As a nursing home administrator, it was his idea for me to become a physical therapist and I actually landed on my career as a high school student. So, I was one of those ones that enrolled in college already knowing exactly what I wanted to do as a career, and I’ve never regretted it for a moment of these 20 years in my profession. The other group that really help make my job easier on a daily basis is our local Area Agency on Aging. We have our Central Ohio Area Agency on Aging and the case managers there are extraordinary and they help us out so much in the home. We’ve been able to get home modifications and repairs to our older adults home so that they can stay in their home and be safe. We’re able to get equipment into their homes, install stair lifts and ramps and widen doorways and put in accessible showers.

            I mean, one of the most rewarding things is going back into one of these houses after it’s been modified and that person can now take a shower and they haven’t been in the shower in maybe years because they couldn’t access it because of these barriers. So, we are lucky to have so much support financially in central Ohio with our Area Agency on Aging. They connect our older adults with a lot of Meals on Wheels programs as well, so our older adults are getting the nutrition that they need to help their recovery and rehabilitation. So, we’ve got those community resources here that make my job just run that much smoother.

Valerie VanBooven RN BSN:

That’s excellent. It sounds to me like you knowing where those resources are and you knowing how to access those resources are so important for your clients, because I’m going to guess that you’ve introduced many, many a client who all of these things out there that they had no idea can help them. So-

Rachel Botkin:

It’s true, and that’s part of my… I would love to see more communication and awareness so that our community-dwelling older adults know what they are, what benefits they have and what services there are to help them stay in their home for as long as it’s appropriate for them to be there. Luckily after 20 years in the same region, you make those connections and networking so you know who to call when somebody needs a new wheelchair and you know who to call when somebody needs a ramp put in and it does, it really helps the process move along.

Valerie VanBooven RN BSN:

I would agree with you. Being great stewards of our resources on behalf of our clients is one of the most important things that we as providers can do for them, and so that’s why we like to interview folks that have a little bit of experience under their belt, because this very reason right here, one of them is you do know what all the resources are in your local area. You’ve been there for a long time, and if someone needs something, chances are you’ve seen this before so you’re able to point them in the right direction. I think it’s important that people who watch this know that if you have to choose a service provider, you want to choose one with several years of experience who’s going to be able to hook you up with the right things, especially based on your income level and all that stuff.

Rachel Botkin:

That’s right.

Valerie VanBooven RN BSN:

So, cool. Thank you very much.

Rachel Botkin:

I always tell people there’s no harm in starting the process. The worst that happens is they come out or you do a phone interview and you find out that you’re not eligible for something and then they can direct you to the next one.

Valerie VanBooven RN BSN:

Yep. Absolutely. No harm in it at all.

Rachel Botkin:

Right.

Valerie VanBooven RN BSN:

All right. Let’s talk a little bit about online marketing. 2020. was really challenging. We are in a new year. It’s still a bit of a challenge and probably will be for a while. It’s hard to do in-person networking, and we’ve got a ways to go before we’re going to be able to, maybe this fall, I don’t know, before we’re going to be comfortable shedding the masks and just hanging out. So, online marketing has become super important. So, tell us what your experience is as a long-time business owner with online marketing. I know it can be overwhelming, but what are you doing to get the word out?

Rachel Botkin:

So, this has been my big push over the last year, especially when COVID hit and we didn’t have as many patients to see and I wanted to try to keep myself and my staff employed and making sure we’re getting people seen. I’ve had a website since 2012 and never did anything with it, didn’t know how to do anything with it. Finally got connected with a local digital marketing firm and decided that it was worth my money to outsource the marketing and increasing my online presence to somebody that actually knew how to do this instead of a clinician fiddling around. It was really eyeopening. They ran a report and my Google presence had all kinds of mistakes on it, personal information that shouldn’t have been out there. They were able to get all of that cleaned up and really teach me a lot about how to promote my brand, how to connect my Facebook page, even got me really out of my comfort zone to ask people to write me reviews. I didn’t have any Google reviews and didn’t know how the Google review process drove search engine results.

            I had homework from my marketer one week to ask two people to write me reviews, and it was the most nerve wracking thing I’ve ever done, because it seemed so self-serving and arrogant and I was so scared to ask. And the people I asked were so lovely and so happy to help and wrote the most lovely things, which I appreciated immensely. It’s gotten easier and easier over the months to ask for those reviews, as I finished up with a patient or a fee or another professional to say, “Hey, by the way, I’m trying to grow my online presence. Would you write me a review?” I’m finding that more and more older adults are online and they’re on Facebook and they’re on Google and they’re looking for that information. So, trying to make sure that we are going where they are, which is more and more online.

Valerie VanBooven RN BSN:

Yeah. I would say you’re exactly right. I know that all of us who are in a helping profession have a hard time asking for things, whether it’s help or reviews or whatever, and so you’ll find that that’s the same feeling that anybody who owns a home care agency, anybody whose owns a care home in assisted living, all of us feel like, “Ooh.” It’s not that we fear necessarily a bad review. We just hate to impose and the truth of the matter is I think a lot of folks really do understand. Not everybody will do it. There are some barriers to Google reviews, like they have to have an account and this and that. But I think overall it’s best to ask. And I also think sometimes, I tell people, “If you get an email that says, ‘Thank you so much. George feels so much better,’ or whatever, those are kind words that you don’t have to necessarily use on the… You can use them on your website.” You can say, “Hey, thank you so much. Is it okay if we use, without your name, can we use those kind words on our website?”

            So anything you can do, I agree, that is wonderful. And I’m glad you had that homework because it kind of breaks the ice a little bit and gets you through that. So, awesome. Yes. Google review, any kind of review is worth asking for. So, that’s a great lesson for everybody. It’s hard for us who are in a helping profession to do that. I totally get it. I totally get it. All right. What piece of advice would you give other senior care providers?

Rachel Botkin:

So, I think the best advice is just to listen and then to listen and then do some more listening after you’ve already listened. A lot of times, I know I do this a lot, I go into somebody’s home with a plan of what I want to work on, what I want to talk to them about, what I want to teach them that day, and sometimes I kind of steamroll through whatever it is that somebody is trying to talk to me about. But when I slow down, take a step back and really ask some deeper questions and find out what’s going on, I get so much more information and the treatment goes better, my relationship goes better, everything is just improved and the person who I’m interacting with feels validated. They feel heard.

            That establishes this relationship and alliance where they can then trust me to be serving them and that I have their best interest in mind, instead of coming in and having my own agenda for what needs to happen. My clients, the reason they’ve got me coming is because they want to either stay active or get more active, stay independent or get more independent, be able to do some functional task in their home or in the community that they used to be able to do and they can’t right now because of injury or illness. So, we try to make it as meaningful for them as possible. Instead of it being what my goal is, I want to know what would they want to work towards. So, is it getting out to their garden? Is it getting their mail from their mailbox? Is it cooking, being able to stand up long enough to cook a whole meal without having to sit down and take a break? Whatever that is, if I listen long enough, I’ll get that information.

Valerie VanBooven RN BSN:

Yeah, I’d say you’re totally right. The best therapy sometimes is talk therapy. So yeah, understanding their other fears, the challenges that they face, and some of them may have nothing to do with their physical ability, but boy, if they can get that off their chest, the moving and the exercise might come a little easier if they can get that worry off their mind or their fear or whatever the thing is. It could be a family dysfunction. It could be a, just whatever it is that’s on their mind, some other challenge has nothing to do with what you’re there for, but it’s got them to the point where they just have so much anxiety they’re having a hard time focusing. So, I’d agree. Listening.

            I think that’s also what comes with age and experience in this market is the ability to know that when you walk in the door, it may go just as planned, or it may go sideways, but if they feel better after you leave, even if they barely did three exercises, but they say to you, “Oh, I feel so much better now,” you probably did a great job that day. So, yep. Okay. Last question. When you have a win in life or business, how do you like to celebrate? That could mean anything from little things to having a great day to a wedding or a birthday or whatever.

Rachel Botkin:

So, I was thinking about this question because my work celebrations usually revolve around somebody achieving one of their goals, right? So, getting up the entire flight of stairs to the second floor of their house, or reaching that bottom shelf and pulling that pan out that then they couldn’t do it before. So, before COVID the way I would celebrate was with hugs. I am quite the hugger and I’m always hugging my patients. Whenever we would celebrate them being able to do something or meeting that goal, or especially on their last visit with me, when they’re graduating from therapy, there was always a big hug. Well, I can’t hug right now. So, we do some air high-fives and we do some elbow bumps and I do a little blow a pretend kiss nowhere near my mouth. Or even I’ll say to them, “I’m smiling really big behind my mask, and I’m giving you a really big hug,” because that’s as good as I can get, and then usually when I leave the house and I get in the car, sometimes I cry.

            If it was really quite an accomplishment, it still gets to me even after 20 years. And then a lot of times I like to just turn up the music real loud in my car because I’m in my car all day long going from house to house, and I’ll do a little shimmy dance, get some good upbeat music and celebrate that way. This question really reminded me that I need to celebrate more-

Valerie VanBooven RN BSN:

Yeah, absolutely.

Rachel Botkin:

… and take those couple minutes to stop and just recognize that like, “Oh, that deserves some celebration.”

Valerie VanBooven RN BSN:

You really do make a difference every single day. So yeah, absolutely. You know what? No one’s providing that person, that human person, the accomplishment that you just helped them with, so that’s definitely worth celebrating, personally or professionally or whatever. And I agree, our days of celebrating have changed quite a bit, so we’re not able to celebrate the way we would like to. Usually it’s, yeah, a little food, like you mentioned before, or yeah, hugs and all that, but hopefully at some point we’ll get back to a little bit of that. But I think celebrating, just taking a moment for yourself, is a great way to celebrate. A little reflection, talking to a loved one about what a great day you had or whatever. Awesome. So, thank you. Thank you very much for sharing that and I’m so glad you were on the show.

            I’m so glad you shared your wisdom, your advice, your experience, and that you are a great steward of resources because that’s what this is about, and we just want to give some good news and some happy stuff to folks out there, whether they’re professionals or consumers, and let them know what exists. So, thank you for being on the show.

Rachel Botkin:

Thank you for having me. I’m so glad that this exists.

Valerie VanBooven RN BSN:

Well, thanks.