Gary Tetz


That’s about all I can think to say here at the start of 2019 in long-term care. Sometimes a new year begins gently, like a lazy Sunday morning with coffee, poached eggs and some mellow jazz. This time, we’re jumping out a smoking 6th floor window into a net held by distracted firefighters.

Driving to work yesterday, doing a placid 35 as required by law, a guy in a Ford F-250 roared up behind, paused a nanosecond on my tail and then sped past doing about 60. At first, I was annoyed, but soon I realized only one explanation was possible for that sort of impatience and aggression. He was clearly thinking about PDPM, (the Patient-Driven Panic Model), and desperately trying to get to the office to plot his survival.  

Naturally, despite his best efforts, we ended up waiting side by side at the next light. He clutched the steering wheel like it was the last hand-hold on El Capitan, staring straight ahead, oblivious and angry. Concerned by the pulsing artery in his neck and wishing to help avert his impending stroke, I felt a strong urge to roll down the window, get his attention and say, “Buddy, slow down. Nothing is that important. Wherever you’re going, it’s not worth it.”

Looking back, it doesn’t take an injection of truth serum on a psychiatric couch to figure out why I noticed him — because on a lot of days, he’s me. Unless I’m intentionally wary, I can far too easily get just as anxious and impatient, blowing right by the people who most need my support and help, on a quest that may seem significant at the time, but is ultimately rather trivial.

In conversations while wandering the halls of an assisted living community last week, I picked up a sense of palpable melancholy. For several of the residents I know best, 2018 brought a series of losses and health setbacks that have left them exhausted and resigned, and their expectations for the future are modest. “This has been such a hard year,” said one resident, probably speaking for many. “We just hope the new one is somehow better.”

Thinking about them while we sit on the cusp of so much professional uncertainty, maybe that guy in the pick-up truck can teach us something. PDPM may be rightfully frightening, but it’s not a heart in a cooler, and it’s certainly not the looming crisis of life or death many of our seniors face every day. Whenever we get preoccupied and white-knuckled over all the changes ahead, it can help to slow down and ponder what’s truly vital — being champions for the people we serve.

Obviously, we can’t provide care if we don’t survive, so a high level of strategic expertise and focus is essential. But if conquering the regulatory and payment challenges becomes our sole motivation and obsession, then wherever we’re going, it’s not worth it.

Things I Think is written by Gary Tetz, a national Silver Medalist and regional Gold and Silver Medal winner in the Association of Business Press Editors (ASBPE) awards program. He’s been amusing, inspiring, informing and sometimes befuddling long-term care readers worldwide since the end of a previous century. He is a multimedia consultant for Consonus Healthcare Services in Portland, OR.