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 market share their advice. Let’s get to it. In a few sentences, tell us who you are and what you do.

Tina Baxter: http://baxterprofessionalservices.com

Okay. Well, I’m Tina Baxter. I am a nurse practitioner and legal nurse consultant. My specialty is geriatrics and my subspecialty is geropsych. In addition to having my own clinical practice working with a company in Indianapolis, I also have my business where I help attorneys on medical malpractice, product liability, and personal injury cases.

Valerie VanBooven RN BSN:

Nice, so you’re a very busy girl.

Tina Baxter:

Yes.

Valerie VanBooven RN BSN:

All the time, that’s cool. You know what, I’ve done a couple of … I would not even profess to be a legal nurse consultant by any stretch of the imagination, but a couple of times in my life, I’ve been asked to review some records for an attorney and do a deposition. It’s like, “Oh, God,” you can’t believe what you’re reading or not reading, as the case may be. It’s insane, some of the stuff that comes through. One was for a marketing case, so they were suing somebody about a name or I don’t know, whatever.

Tina Baxter:

Oh, wow.

Valerie VanBooven RN BSN:

Anyway, it’s an interesting, interesting job always. I’m sure it’s old hat for you, but for me, it was kind of exciting, a departure from the usual. I couldn’t do that now, but back then. Tell us a little bit about the neuropsych and some of that stuff that you do for seniors, tell us a little bit more.

Tina Baxter:

Well, I’m trained to be a dementia care specialist in a fall prevention specialist. A lot of times with older adults, particularly those that have chronic mental illness, we forget that as your body ages, it goes through changes. Looking at the medications and how they affect the body can be different than when they were 25. For instance, I had a lady in long-term care in the nursing home and she had been on lithium for a very long time and was managed very well on the medication. Unfortunately, her kidney function was poor and she was now in her eighties and she just was not able to metabolize the medication at all.

            I had to have a long conversation with her husband who was like, “She was so stable for years, I don’t want to change medications,” but even then we put her on the very starting doses of lithium, she would instantly become toxic and become confused. Having those conversations with the family and including the family and explaining how your body changes as you get older and there may need to be some changes in some of your medications due to the normal changes of aging. That’s one of the things that I do.

Valerie VanBooven RN BSN:

Well, and that’s so much needed. I can tell you, from my experience, my father was in a nursing home for a couple of years. Due to COVID, his wife brought him home, but when he went in, it started with the geropsych visit, as you can imagine. He started down the road of vascular dementia, he’s only 71 and we started this journey, he was probably 68, 69. He was not well-managed. He was over-medicated, as far as I can tell now, looking back. I didn’t know then, but overmedicated. But the nursing home that he was in got him all straightened out and it went from being so medicated that he couldn’t feed himself to today, he’s on the right medications, and I realize it may change again, but he’s easy to manage, or easier to manage, he knows what’s going on. He reads constantly, he reads books all the time. We bought him a Kindle Paperwhite, so he can read all the novels he wants.

            Does he still have dementia? Absolutely. He doesn’t have a good spacial distance thing going on, he needs a walker, he’ll carry on a conversation with you, but it’s not going to be super in-depth, but the difference between the day he went into that nursing home and now is amazing. 90% of it is due to how he was being medicated. It’s folks like you who can really … I mean, people can go from acting … He was almost a vegetable at that point and barely could feed himself and to he can’t live independently, but can we go over and talk to him and take him for a ride in the car, go out to lunch? Absolutely, we can. It’s amazing what the differences can be.

Tina Baxter:

I’m so sorry.

Valerie VanBooven RN BSN:

No, it’s okay.

Tina Baxter:

That is my office. I’m like, “Why are they calling me? I’m off today.” I don’t normally have my phone out. I apologize for that.

Valerie VanBooven RN BSN:

It’s okay.

Tina Baxter:

I was like, “I can’t believe they called.”

Valerie VanBooven RN BSN:

That’s all right, no [crosstalk 00:05:25].

Tina Baxter:

What I was going to say though, I’m glad that your dad is getting better, but one of the things that we find is that a lot of older adults have so many specialists that no one’s really managing the medication. They may add on a medication to treat something and it has a side effect so they add another medication on or they forget to stop one. We see a lot of polypharmacy. It’s great to work with a good pharmacist and to really look at the medications and see can we streamline them and get rid of some. I mean, I had a woman come in for consultation and she was on 55 different medications and wanted something for depression. I’m like, “Can we get rid of some of your medications?”

Valerie VanBooven RN BSN:

Wow, that’s crazy. Oh, yeah, yeah, yeah.

Tina Baxter:

Yep.

Valerie VanBooven RN BSN:

It’s amazing how fast we can get confused, over-medicated. Everyone has good intentions, all of the physicians, all the care, but you’ve got to stay organized and you have to have a real conversation. When the pharmacist asks you, “Do you have any questions?” ask a question, really do. You have to be your own advocate, but thank goodness for folks like you, who can help get people straightened out.

            What is the best thing about serving aging adults?

Tina Baxter:

I love the rich history that a lot of my older adults bring. They’ve been through so much, seen so much, and it can help you get perspective on some of the things that are happening in your own word. I know a lot of times people say, “Oh, we’ve never had it this way, it’s never been this bad,” but I’m like, “Yeah, but think about how far we’ve come as a society.” We were just talking the other day with someone and we were saying how we remember, growing up, rotary phones. These kids nowadays don’t even remember that type of thing. Or calling from my grandmother’s house to my uncle’s house and only having to use the last four digits, I didn’t even have to put the phone number in. It’s those memories, that history that they carry, that we really want to make sure that we preserve that as much as possible.

            I’m a big champion for older adults aging in place and living their best life up until the very end. If it’s keeping you at home that’s going to be best for you, we want to do that. If you have to be in a facility, let’s find the best facility, let’s work with them so you have a best quality of life as long as you live. That’s my whole goal.

Valerie VanBooven RN BSN:

Yeah, and that should be the goal for all of us, is to make sure that we provide the best care. Whether we’re actively caring for people as a professional or it’s our own parents or whatever, what can we do to make life better? Thank you for that.

            Okay, so the next question is about who’s been a mentor, or what organizations are special to you? I know something led you down this path to where you are today and there’s probably organizations or people out there who really meant a lot to you along the way. Who would you like to give a shout out to?

Tina Baxter:

Well, I would have to say my very first nursing mentors, as a professional, happened to be two nurses that I’m still connected with to this day. They retired from the hospital where I used to work, but they took me under their wing as a student nurse. They made sure I had extra opportunities to work on the floor and learn new things. They sheltered and protected me a little bit and guided me in different ways and then put me in places where I was surprised, if you think about it, someone very new to nursing, to be in. I ended up being the coordinator of a program for the hospital because she wanted me there and she wanted me to help her get this program of reducing hypertension in African-American communities through the churches, she wanted me to be a part of that. I felt really good that these two nurses really poured into me.

            Now, it’s kind of funny, we’ve come full circle, to now they’re looking at me as a mentor, as I’m now the president of the organization where they took me in, with the Black Nurses of Anderson. I’m now the president, a second time and serving again as president, and I started out as a student nurse working with them.

Valerie VanBooven RN BSN:

Wow, that is cool. That is so nice. It’s so great, as a nurse, to have people who they remember. A lot of people say, “Well, as nurses, we eat our young.” We can be tough on our young, there’s no doubt, but to have a couple of people who really believe in you and are willing to show you the ropes. I can remember, in fact, it was maybe not so much other … I did have a lot of nurses that helped guide the way, but it was the actual techs and aides that showed me the ropes as a new nurse. Now, I had been a nurse’s aide before I was a nurse, but I went straight into the burn unit, which is, if you can imagine … But when you’re 21 years old, you’re like, “Yeah, let’s do it, woohoo.” You’re ready to go.

            I can remember these amazing technicians, these wound, trauma, they were nurse’s aides, CNAs, whatever, and they had been there for years. So who did I learn from? I learned from those women who had been in that unit, taking care of those burn patients for years and years. They didn’t have RN behind their name, but did they know more than I did about maybe not the drug, but about how to do a dressing change, how to comfort a patient, how to make the doctor happy when he walked in the door and have everything the way he wanted it? Those ladies did and I will [crosstalk 00:11:27].

Tina Baxter:

Yes.

Valerie VanBooven RN BSN:

It’s always great to have those mentors. Awesome. Okay, I hear from other senior service providers that marketing online is challenging, and I know that it is. We’re in a position right now in our world where we can’t really network in person so much, but we can Zoom and we can do other things. What has been your experience with online marketing?

Tina Baxter:

I’d say, for me, it’s been a big positive. We moved to telehealth, so a lot of our seniors … Oh my God, sorry. A lot of my seniors are really learning how to navigate social media and they’re used to now Googling things, and with smartphones it’s a lot easier for them to have internet access. They’re looking for providers, they’re looking for answers online, where maybe 10, 15 years ago that would not have been the case. I’ve found that it’s been a very exciting time for me to be online and then meet wonderful people. I’ve met several people from the senior care industry and learned about what they do. A few months ago, I met someone for the very first time, I never even heard of this term, of a death doula, right?

Valerie VanBooven RN BSN:

Oh yeah, [crosstalk 00:12:52].

Tina Baxter:

I’ve heard of a birth doula, okay? I’ve never thought of a death doula and I worked in hospice for a while. I’m like, “How in the world did I never hear about this?” But it was nice to hear and meet somebody that does that and is able to support someone at end of life. It’s making those connections because we aren’t physically meeting together, people are more open to meeting online and talking and having one-on-one Zooms. For me, it’s been very positive so that I can reach out to people from all over the world. In fact, yesterday I was talking to somebody from Australia.

Valerie VanBooven RN BSN:

Yeah, that’s cool.

Tina Baxter:

And learning about how they do it down under, right, and it’s great. I think we need to do more of that. We realize how small the world really is when we do.

Valerie VanBooven RN BSN:

Yeah. Yeah, it’s true. We are able to connect with anyone, anywhere, pretty much instantly at this moment. It has been a nice awakening. I think that we can really do business anywhere we want, in most cases, not every case, but we can do business with a lot of different people and learn from a lot of different people without being in the same room. It’s been a nice change.

            All right, what piece of advice would you give to other senior care providers?

Tina Baxter:

I would say be open to change because things change every day and what worked yesterday may not work today. We certainly learned that through COVID. We initially were bringing people in and like, “Okay, we’ll just only bring in a few people at a time,” to, “Okay, we’re all going to go home, and then now we’re going to try to get everybody on a Zoom or Teams or something like that to see patients,” to, “Okay, that’s not working because not everybody has access to internet so now we have to use a cell phone and call people.” You have to be open to change and be willing to learn new skills because you never know how that new technology can impact and improve someone’s life. Just being open to new things, it’s always been wonderful.

            I wasn’t a Zoom master until COVID. I used Zoom, now I’m a Zoom master. I’ve been on so many Zooms now, it’s great. But I learn every time I’m with someone new about little tricks that I didn’t know. I just recently learned how to put a poster together on Canva. Now, that may be something simple for other people, but it’s something I’ve never done before. But I’m open to learning new skills, and that’s the important thing, is being open to new things.

Valerie VanBooven RN BSN:

Absolutely, you’re totally right about that. The world has changed a lot in the last year and it will continue to change, so that is amazing. All right, last question. When you have a win in life or business, how do you like to celebrate?

Tina Baxter:

Well, I was going to say up until today, it was probably going to be with chocolate, but I’ve been informed by my doctor that it probably shouldn’t be chocolate anymore that I celebrate with.

Valerie VanBooven RN BSN:

I understand.

Tina Baxter:

Yes. What I decided to do to celebrate me is to find something that I really enjoy doing, whether it’s reading a good book or taking a nap, but I try to reward myself with something that’s good for me and healthy instead of looking at unhealthy ways to reward myself.

Valerie VanBooven RN BSN:

I’m right there with your, sister, because you know what? I could eat a snack anytime and I’m not supposed to be doing that.

Tina Baxter:

Yes.

Valerie VanBooven RN BSN:

I get a snack with carrots instead of cookies now.

Tina Baxter:

That’s where I’ve gotten into the healthy smoothie. I’ve got these veggie smoothies, veggies and fruit in there, and then it’s really delicious and it does fill you up. Then I don’t have to worry about, okay, I really want that chocolate cake. I can have a veggie smoothie. It’s sweet enough, and I’ve learned to have a healthier relationship with food. I don’t reward myself with food anymore, food is fuel.

Valerie VanBooven RN BSN:

It is, it is. You’re right, that’s the way we should look at it. It’s the way to fuel our bodies, not to feed our needs or whatever you would call it or [crosstalk 00:17:09].

Tina Baxter:

Yes, I don’t eat my feelings, right?

Valerie VanBooven RN BSN:

Yes, don’t eat your feelings.

Tina Baxter:

But you come from a culture, and a lot of us do, where everything is celebrated and remembered with food.

Valerie VanBooven RN BSN:

Everything, everything.

Tina Baxter:

Someone dies, there’s lots of food. Someone graduates, there’s lots of food. Someone’s born, there’s even more food. Everything is surrounded by food, and so we sometimes have equated food as love. Now we have to have a new definition for that. That self-love for me is embracing a healthier lifestyle.

Valerie VanBooven RN BSN:

I agree. It has to be, if you want to live long. My goal is to live long enough to see my children into independence. If I can do that, then everything after that is icing on the cake. But I’ve got to care of me, so making sure I live long enough to get them on the road.

Tina Baxter:

Yes. As nurses, we’re very bad about that, of putting everybody else before us, but we have to learn that if you don’t take care of yourself, you’re not going to be able to take care of other people. When I teach stress management and wellness to people, that’s what I talk about. We do some mind-body work and we focus on how your emotions are affecting your physical health and how to recognize that when that stress is coming in and how to change that without pharmaceuticals.

Valerie VanBooven RN BSN:

Yeah, that’s also good too, anytime you can do it without pharmaceuticals. Thank you so much for doing this, for being on the show. You are a wise woman and I appreciate all of your advice, and what you do for people is amazing. We will make sure that your contact information is with this video, and as soon as it goes out, we’ll let you know. Thank you so much. You did great.