What’s stressing you out today? Is it because it’s not Friday yet? Is it because the Patient Driven Payment Model is lurking? Is it that your home improvement project is costing twice what you budgeted? Is it because one more national tragedy will not make a damn difference and every time you take your kids to the movies you check to see where the exit is before finding a seat?

All of these things are pushing me to the edge of the ledge. All of these things are sticking their ugly
heads into my life and this tunnel needs some light. Finding the light is not an easy task. My staff are worried about their jobs (are therapists still going to be a necessity in a non-revenue-driving role?) Census is down nearly everywhere, and subsequently billable hours are too. Where does that put people with Doctorates and Master’s degrees who worked hard and are zealous about their mission, and are now considered a lesser commodity?

The light that we see, and that we have to magnify and concentrate on, is the good that we are doing for the population we serve. Our focus used to be on the healthy aging, the catastrophic injuries, and the elective endeavors to create better function. Part of our mission has shifted over time to younger and more challenging patients. Those challenges lie in substance, mental health, and other issues that may be triggered by the above-mentioned stressors. How can caregivers bring the light to those who need it?

Therapy will always be a necessary commodity. This needs to be emphasized to our staff, our
administration, and our payers. Those payers who are scrambling to make a profit when their industry may be overhauled are showing stress too. They’re worried about collecting premiums, and making a profit, and (as we all know) often at the expense of the beneficiary. It is our job, our mission, to advocate for our patients and improve their quality of life. It is wrong to believe “he had a stroke, but PDPM won’t pay for intense therapy, so we’ll do the minimum” when rehabilitation is required.

Here are my suggestions for bringing the light to the tunnel:
• Continue to encourage the patients who come to us to participate in all of the services we can
offer. Whether it’s therapy, or music, or food, or puppy visits, we cannot forget why we are
• Continue to push your caregivers to provide the optimum care for our residents. Census is low?
It’s an opportunity to provide more one-on-one to the existing residents. They will benefit from
the attention, and we will too.
• If your staff are exploring other options because they think PDPM or dropping census will have a
negative impact, make sure they know that we in long-term care are infinitely adaptable. Every
year we have a new adaptation and we do it. Every time. We will adapt to and figure out how to
make PDPM a benefit for our patients and staff.
• Want to decrease stress? Schedule something fun for staff that doesn’t cost much and builds
cohesion in your team. Stretched canvases are cheap and so is paint. Schedule one of those
“Paint Nights” that involves staff and residents and gets everyone involved in something fun.
We need to destress ourselves, our staff and our patients, and it’s our responsibility to find a way.

The negativity that’s pervasive in our lives can be managed, and can be sublimated and deflected into constructive and positive efforts and make a difference in the lives of those we serve. How do I manage my stress? I set my right-brain free and paint. Sometimes my paintings are dark.

Sometimes they’re full of optimism. Here’s one that shows golden light and hope.

Jean Wendland Porter, PT, CCI, WCC, CKTP, CDP, TWD, is the Regional Director of Therapy Operations at Diversified Health Partners in Ohio.