The Power of Empathy in Long Term Care with Leslie Pedtke

How do you solve staffing retention issues? And how can you engage both staff and residents to create authentic connections? We recently sat down (virtually, of course) with Leslie Pedtke of King Management, to hear her inspiring story about how she changed the culture at her facility, solving staffing issues and creating a more empathetic relationships between care givers and residents.

Q: Tell us about your role with King Management

A: I am one of the owners at King Management, and my main role is to oversee the facility and everything that goes on within it to ensure we are meeting our goals and the residents and staff are fulfilled.

Q: What would you say is the most rewarding part of your job?

A: I really love working with elders. I started working as a nursing administrator in 1994, and worked at the same family-owned senior community for 22 years. I learned a lot in my time there. Although that can be a stressful job, it is also an incredibly rewarding job. I love working with the elders we care for and partnering with their families and the staff at our facility to give them the best possible care. That is definitely the most rewarding part of my job, the people I get to work with each day are truly incredible people.

Q: You created an inspiring program called ‘Through the looking glass’ to help staff better understand what their residents go through. Can you tell us about this program?

A: In 2004, I experienced a federal oversight survey, and for anyone who has been a part of this kind of survey, it is an extremely stressful experience. We had 27 F tags, and four of those were immediate jeopardies. It was quite a shock as earlier surveys had gone well.  We knew immediately we needed to make some changes.

It was after this time that I started to hear about culture change and really loved everything I was learning about person-centered care. We started on our journey implementing culture change, mostly focusing on environmental changes, to make the facilities look less medical and more like a home. Shortly after, I was at a conference and listening to a speaker talk about making these changes in facilities and I will always remember when she said, “It doesn’t matter how pretty you make the bathroom if I still can’t use it”…I realized at that point; I was focusing on the wrong things.

That’s when I came up with Through the Looking Glass as my own way to teach empathy and person-centered care. With this program, I had my staff move into the facility and live like dependent residents in a long-term care setting. They were given a diagnosis and they had to live the role of that diagnosis the entire time they were there. Every day I would present them with a bucket of challenges and they would have to pull out a slip of paper that presented them with a situation. Things like ‘the staff didn’t reach your call light in time and you didn’t make it to the washroom in time’, or ‘the speech therapist has decided to downgrade your diet to soft or puree foods only’, or ‘family promised they would come visit but they just called and said they aren’t coming’.

Q: What were the results of this program?

A: With this experience, our staff was required to go through everything that our residents go through on a daily basis so they could fully understand what it was like to be dependent on others for everything. From basic needs like I need a drink of water, to dealing with changes in diet, medical conditions worsening and even isolation.

The results of the program were truly transformative. Even the staff members who didn’t take part in the challenge were able to learn so much from seeing their peers participate. It really changed our entire culture. After that, we decided to take it one step further. We decided to make it mandatory for all new employees to complete the program for 24 hours before they were able to start any type of orientation or onboarding. We called it our elder shadowing program, which meant they had to shadow someone that was already living in the facility and see what it was like for them. The reason for this requirement was that after we implemented the program, we had come to such an incredible place in our culture, that we didn’t want to hire anyone who hadn’t experienced it because that could derail our progress and put us right back where we started. We wanted to make sure that everyone we hired from that point on was already buying into who we were and the values that we stood for in our facility.

Q: Have you implemented any additional programs for hiring new staff?

A: In that time, we also developed a resident hiring committee, which meant that we (the staff) did a first official interview and if the person was still being considered after that they would then go interview with some of our residents, and that committee had the final say on who we hired. So, not only had they met with our residents during the hiring process, but they would also then go live with them for at least 24 hours, which helped our staff members to develop relationships with the residents they were be caring for. This program had a powerful impact on our staff members, and helped us with staff retention since from the very beginning of their time with us, staff members had been creating these authentic connections with residents, making it difficult for them to leave abruptly. Prior to the program, like many other senior care facilities, we had a problem with staff retention. Sometimes staff would go on lunch and never come back. And we can confidently say that we don’t have that problem anymore, because our staff has already made a commitment to our facility and our residents.

Q: Tell us about your book, ‘What Living as Resident Can Teach Long-Term Care Staff: The Power of Empathy to Transform Care’

A: The book has a lot of journal entries from the staff that went through the program and details the lessons they had learned from it and how they learned how to better understand the residents. For example, there was one resident who the staff had come to know as someone who was a bit more surly and sometimes difficult to work with. A staff member participating in the program was given the same diagnosis as this resident, stroke with right sided weakness. One day I saw this staff member crying and I went over to ask her what was wrong. We had put a weight on her arm and on her leg to signify that she wasn’t able to use them anymore. She went on to say that she was now only eating pureed food and detailed everything else she was going through which was quite similar to what our other residents who have had strokes, especially the woman referenced earlier was going through. Then she turned to me and said, ‘This contest of yours, it sucks, I hate it. But do you want to know why I’m really crying? In a few days I am going to be done with it and I will get up out of this wheelchair and drive to McDonalds and get a Big Mac, but she (the resident) will never be able to do that again”.

It was at that moment that I knew that the program was working, because that’s exactly what I wanted them to feel, I wanted them to know what it was like for the residents and to be empathetic. The resident wasn’t just a mean woman, she was mad (and rightly so) about all that had happened to her in her life. And it was after that moment that I really saw a difference in both the staff and the residents. The staff had gained a deeper understanding of what the residents go through on a daily basis, and the residents appreciated it. The program allowed them to make these authentic connections with the residents and become much better listeners. I always tell the staff, when you listen to people you have to listen with your whole self to their whole self. I think the program helped people to understand life from someone else’s perspective, and allowed us to create a culture that values listening, understanding, and empathizing with one another.

What and incredible story! Thank you for sharing Leslie and thank you for everything you have done to create such a caring and understanding community for your residents and staff.