DR. BUFFY LLOYD-KREJCI: Infection Prevention & Disease Control - Covid and Beyond

In Episode 68,  Love Conquers Alz hosts, Susie Singer Carter and Don Priess have a fascinating conversation with  Dr. Buffy Lloyd-Krejci, one of the foremost authorities on infection prevention and control in nursing homes and long-term care facilities. Dr. Buffy (as she likes to be called) is a frequent contributor and interview source for national and trade press concerning infection prevention and control and mitigation.

 Dr Buffy is  also the  author of Broken: How the Global Pandemic uncovered a nursing home industry in need of repair and the heroic staff fighting for change. In BROKEN, Dr. Buffy Lloyd-Krejci exposes an industry in dire need of a massive policy overhaul. Her book chronicles her "boots on the ground" experience visiting 200 nursing homes across the country as the pandemic brought these deadly problems into stark relief. Through interviews with patients, healthcare workers, advocate groups, and regulatory agencies, she reveals the critical flaws in a system that was set up to fail—and her bold vision for change.

Dr. Buffy  states that  "Our elderly loved ones deserve to live out their final days with dignity and respect, not to be left alone to die in a broken system. But even before the COVID-19 pandemic, infectious diseases ran rampant in US nursing homes. Between one and three million infections resulted in 380,000 deaths among nursing home residents each year. That’s over 1,000 people per day. All because the nursing home industry has been struggling with Infection Prevention and Control practices (IPC) for decades."

Dr. Buffy's practice, IPCWell, is headquartered in the Phoenix metropolitan area and is devoted to mitigating infectious diseases and inappropriate antibiotic prescribing in all healthcare settings to reduce adverse events, infections, antibiotic resistance, re-admissions, and death. Dr. Buffy consults with health care facilities across the United States and internationally (Doctors Without Borders).

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Transcript

Don Priess: 0:03

Alzheimer's sucks, it's an equal opportunity disease that chips away at everything we hold dear. And to date, there's no cure. So until there is we continue to fight with the most powerful tool in our arsenal. Love. This is Love Conquers Alz - a real and really positive podcast that takes a deep dive into everything Alzheimer's, The Good, the Bad, and everything in between. And now, here are your hosts - Susie Singer Carter, and me, Don Priess.

Susie Singer Carter: 0:40

Hi, it's Susie Singer Carter.

Don Priess: 0:42

And I'm Don Priess. And this is love conquers all. Hello, Susan.

Susie Singer Carter: 0:46

Good morning. Good evening, whatever it is, whatever every morning, it's definitely one time because I don't sleep ever. It's like, Yeah, this is it. So it just feels like it's morning. That's okay. That's it. Yeah, I've gotten I've got me caffeine, and I'm ready to go.

Don Priess: 1:03

Yeah, busy week.

Susie Singer Carter: 1:05

It's a bit busy week, still working on No Country for Old People a lot, which is our documentary for long term care reform, which is incredibly necessary. So if you if you haven't, please head on over to the national consumer voice website, there's a dedicated page for us to donate to support this film, it's really important. We have an amazing we've aggregated so many incredible voices in this in this community of advocates, like dedicated advocates, and I'm really proud of it. And I think I think we have a really good chance of making, making some movement, at least activating it and activating a bigger movement that we need so so we can really use your help. So please, please do that. And

Don Priess: 1:57

I'll also have a tax deductible. Yeah. 100%.

Susie Singer Carter: 2:02

And I'm putting all the information in the notes for you. Yeah. And so on, on a flimsy note. Where are you going this weekend, Don? I'm asking me to do all the work. Oh, my

Don Priess: 2:16

God, I'm leaving for I'm leaving for I'm heading out to Palm Springs immediately after this. I'm going to be there for all of about 12-24 hours. That's Wow. And I'm coming back. Yeah, I have a couple of friends and from Chicago. I haven't seen them since before. COVID. That's a vacation. Okay, yeah, it's a big vacay. So

Susie Singer Carter: 2:37

they're in production life. That's a big kick. Yeah, so

Don Priess: 2:42

and then, you know, and then I gotta rush back Sunday night because I'm my other project. I'm working on my Jack Warner documentary we're shooting this week, my producers in from New York and we're going to be gallivanting around shooting editing. I am very fancy, fancy. What I do. This is my middle name. Yeah, it's not but but no, it's, it's so I'm looking forward to that, you know,

Susie Singer Carter: 3:05

You're a big producer and editor now.

Don Priess: 3:08

I really am but I can't wait. You know, once we finish that rolling right into into No Country for Old people. It's gonna be taking advantage of this 36 hour.

Susie Singer Carter: 3:20

Because you know, I will be at you with a whip No sleeping. Let's get this done.

Don Priess: 3:29

Sleeping. Sleeping for old people.

Susie Singer Carter: 3:31

For old people. Don's actually only 25 Look what happened. Exactly. His hair is now gray. Sorry, sorry. Okay, that's good, cause I haven't good. I have no we do. We do. Yes. Let's just do.

Don Priess: 3:56

Baba, baba, baba. Okay, should we should I tell them all?

Susie Singer Carter: 4:00

Yes, please do.

Don Priess: 4:01

Okay, are we ready? Okay, here we go. Dr. Buffy Lloyd-Krejci He is one of the foremost authorities on infection prevention and control in nursing homes and long term care facilities. She's the author of broken how the global pandemic uncovered a nursing home industry in need of repair and the heroic staff fighting for change. Her practice IPC well is devoted to mitigating infectious diseases and inappropriate antibiotic prescribing in all healthcare settings to reduce adverse events, infections, antibiotic resistance, readmissions and death. Dr. Buffy consults with health care facilities across the United States and internationally with Doctors Without Borders. With more than 20 years of health care and public health experience. Dr. Buffy is data driven approach is hands on and collaborative. Using her experience with more than 200 nursing homes across the US. She works tirelessly to combat the estimated one to 3 million infections leading to more than 380,000 1000 deaths every year in the nursing home industry. She's on a mission to change the way our elders are treated and given care. I could go on and on. In fact, let's do that. Let's go on and on and meet the one. The only Dr. Buffy Lloyd crece. Hello.

Susie Singer Carter: 5:17

Hello, Dr. Buffy. Thank you for being here. I love it.

Dr. Buffy Lloyd-Krejci: 5:25

I like her he is a little hard.

Don Priess: 5:29

Especially when you forget you know that to say the entire the entire

Susie Singer Carter: 5:32

name. Yes. That's okay. It was edited out. Yes. So unprofessional. How are you? I know, You've been working really hard writing a new book.

Dr. Buffy Lloyd-Krejci: 5:47

Yes, I am. So it's you know, we're talking still about broken because this broken just launched last year, April of 2022. And I didn't, I didn't really take a breath I jumped right into,

Don Priess: 6:02

I think it's upside down.

Susie Singer Carter: 6:03

It's upside down. Tired. I do that again, take

Dr. Buffy Lloyd-Krejci: 6:11

showing how broken it is.

Susie Singer Carter: 6:14

Not it to me there. It's really a good book. I had my co producer just finished reading it too. And she she's, she's A Faster Reader than me. She was like, I'm done. She was it's fair. It's very packed, impactful and packed and packed full of things. Incredible. A lot of work went into that book. Yeah, a lot of work.

Dr. Buffy Lloyd-Krejci: 6:39

Yeah, you know, I mean, I just, I was just really wanting to capture my experience during the pandemic with what I was seeing and really advocate for change. I mean, that's my whole point of doing this. And then really writing my second book, it's more geared towards the consumer, and really how to navigate this system. Because, like yourself, I mean, people, people have loved ones in long term care senior care now, or they're entering senior care. And we can't wait. I mean, we need to actively work on fixing the system. But what about today? So I'm, I'm having a lot, I'm having a lot more fun writing the second book, because it's not as traumatic. And it's really solution driven as far as finding some of these really great practices. So that's, that's been pretty cool.

Susie Singer Carter: 7:31

Well, that that actually is that, that puts a little lift in my in my, in my step because it's, I am also like, you were in broken, I am in it. I mean, I'm in the trenches right now. And it feels very heavy. The conversation is heavy. And and yeah, the system does need to change. But the thing that really like to reiterate what you said that haunts me is that right now, every day, every minute, somebody's suffering. And so the longer it stays the way it is, the more people are affected by it. And so we do need some solutions that are, you know, Band Aid solutions, as it were, because there is a huge, bigger problem. But we need to be able to address some of the things that we can at least right. So, what before we get into what those are, because I know you have some a lot of thoughts on that. Right. But but just just if you could truncate a little bit of of your experience that motivated the book broken.

Dr. Buffy Lloyd-Krejci: 8:35

Yeah, I mean, so I've worked in healthcare, really, since I was 17. So it's now now over 30 years. I just keep 20 years on there, because that doesn't make me so old. But you know, it is

Don Priess: 8:52

yeah. 30 years is over 20 years. So

Dr. Buffy Lloyd-Krejci: 8:55

there you go. Um, but I've always had a passion for, you know, helping in in health care. And both my grandparents actually died in nursing homes when I was only 19. And I navigated that system back then, you know, for me, I was really grateful that my grandparents had a safe place at first what I knew to be a safe place, and I and I still would maintain that they did have a safe place. And you know, there were a lot of things that obviously could have been different now I understand the industry more but, you know, I, I've had my family, but I've always, you know, kind of stayed and working in healthcare and in 2015, I started working on a national pilot study with CDC and Centers for Medicare, Medicaid and started work. This is really what cracked me open to the long term care industry and seeing the disproportionate number of infections that were occurring and I kind of looked around and I'm like who is working On this, you know, like, there wasn't a whole lot of action. I mean, we were doing this pilot study, but actually, after this study was done, you know, nationally, it all kind of went away. And I just was like, I'm not done. So in 2017, I launched out, I started my own company, I said, I'm going to help these nursing homes, I'm gonna really do everything I can. I had no idea what I was doing. I was very naive and had no idea what an uphill battle.

Susie Singer Carter: 10:30

I would need to be naive. But right. Yeah, that was you wouldn't do it. He wouldn't do it. I say that all the time. Because that's how I feel before you move on. I want to what kind of things were you seeing in 2015? So give us just a sense of what it looked like then. And then as you progress and tell us?

Dr. Buffy Lloyd-Krejci: 10:48

Yeah. So it was just to give everybody an understanding, infection control practices were not even really strong. At that time. I mean, we're talking seven years, seven, eight years ago, it wasn't that long ago. And because they just didn't they were really focused when I say they, I mean, like public health, and CMS focused on other priorities like falls and antipsychotic use and some other areas. So, you know, here you have this industry that has these infections, but it's almost considered just normal. You know, it's just normal for the residents to have UTIs or, or pressure ulcers, or pneumonia, or influenza or scabies, like it's just part of their world. And it didn't, there just wasn't this heightened sense of urgency to any of it. So what I working with the health care setting and working with health care professionals, the overwhelming response, which is very similar to today's we just don't have time to focus on this. We have it comes with all these. Yeah, yeah, there's just there's just, you know, in long term care, it's kind of Whack a Mole. And I talked about this in my book, you know, it's like we, you know, there's, I say that, like, you're just, you're just yeah, you're just you know, you're dealing with this, but you there's very, there's such a lack of prevention within this industry. Why? Well, it's reaction because they are so short staffed, they don't have what they need very often. And so it has to be react reactive, like they don't have in place. Now, when I say they, it's the majority of what I see, I have seen some phenomenal long term care facilities that really have changed their culture, and, and work on implementing prevention practices. And that's what I would love to spread across the country is that attitude and that and to know, it's successful, but boy to get there, there's so many layers of other things that we have to deal with. So it's not just so simple, you know, it's

Don Priess: 13:08

the truth, it can be done, it shows, because everyone thinks it's such a big problem, that it's too big, you can't do anything about it, but it can be done, we have models that show that it can be done. And so is it is it just money, it's to why it's not being done.

Dr. Buffy Lloyd-Krejci: 13:25

A lot of it is the you know, the and I haven't gone down this rabbit hole. And I quite frankly, don't want to because I know what else see, but I'm sure you guys have maybe, but there is a lot of of, you know, corrupt dealings, and I and I do mention that in my book, you know, and so it's like, for, let's say, a corporation to profit hundreds of millions of dollars, and that goes into the shareholders pockets. Right? Not sure that that should ever be happening when we're talking about our frontline staff can't even make a living wage, you know, and they're the ones caring for our loved ones. So, like, we have to look at all of that, and we have to have the accountability of where these funds are going. Because it's, you know, we can't simply say we need more funding, you know, because then on the other side, you look at it, you're like, well, we provide you more funding, where's it going? Is it going where it's supposed to go? Or is it going into people you know, the shareholders pockets like

Susie Singer Carter: 14:32

whatever weighing that is that that is it. You're right. Yeah,

Dr. Buffy Lloyd-Krejci: 14:36

the facilities that I see the the facilities that I see that are very successful, and I would say I would feel safe having my loved one here are the ones that put everything back into the facilities, right? They're not they're not the ones that are just trying to squeeze every dollar and like they are they're investing in infection prevent gym practices, they're investing in the staff, they're investing in education. So it is possible, it's just it is, are we going to make that a priority?

Don Priess: 15:10

And they can actually, you know, they can make, they can still, they could do both meaning that they don't have to. I mean, I'm saying how much anyone should make. But if let's say they just made 10s of millions instead of hundreds of millions, you know, it's fine. We know these, it's a business. And we understand that, right? Because if not, but And so everyone could still make, you know, a very nice amount of money, and there'd still be plenty leftover to actually do what they're there to do. Right? Because right now that it's just, it's, it's greed, and it's,

Susie Singer Carter: 15:42

it is greed, and it's also our step, it's a lack of regulation and a lack of oversight. Because, you know, there hasn't been attention put on it, it, you know, the infrastructure was made, and then it's like, it's implemented. And then it's like, here, now it's going to work. Well, of course, if there's billions of dollars available, you're going to get nefarious actors to, to, to want to take advantage of it. And that's just human nature that happens in every business. And that, you know, and that's just, that's just it. And so, you know, we've we've sort of, when I say we, you know, as a community, as a society, we haven't really paid attention to that. And we assume that it's been handled properly, like we, because we pay into that system. We are the we are the providers have that system. But you know, it's not, it's not and that's why you're

Dr. Buffy Lloyd-Krejci: 16:36

so what what people don't realize is that there is oversight, and if any, in the right, so there is oversight, and there, there's almost over regulation to the point where it's not effective. So the nursing home industry is actually the second most regulated industry in this country next to nuclear power. But the problem is, when things happen, the regs get bigger and bigger and bigger and bigger, which make it actually, it's almost like they just keep throwing it on top of it. So it makes it impossible to really understand what they're, it's just too convoluted. It's not, we need to like, strip it down and actually have a set, you know, the regulations that aren't 1000s and 1000s of pages long, right. So that people truly understand and the regulator's that come into the facilities, because they're under trained. I mean, that's I talk about that in my book, that's a broken system as well, they are under trained, they don't even necessarily have the expertise, they're given a certain amount of time to really evaluate are the facilities, it's more of a bullying system. It's not really like this collaborative approach. So it's like, kind of this gotcha mentality. So it's not like, it's the surveyors are doing what they can, let's say they have six hours, they're gonna pick apart every all the really easy stuff to see. Right, because that's all the time they have, right. So that whole regulatory reform needs to change as well. Yeah. And I argue that it needs to, like that needs a whole overhauling, because, like you mentioned, we've just, we've added layer and layer and layer and layer and layer over the years. And while there may be stuff that's in there from 50 years ago, that we're not doing anymore,

Susie Singer Carter: 18:35

you know, what I mean? So relevant, it's not relevant. Right. Right. Right.

Dr. Buffy Lloyd-Krejci: 18:39

So we have that really evaluate that. Yeah.

Susie Singer Carter: 18:41

And, and Dr. Buffy I think that every every layer of this system like from, from the regulators, who are the right their policy writers in the regulatory, you know, all of that each, each department is just trying to complete what they have to do without because they don't have the time to do a forensic look and say, Let's really tear this apart, you know, like cleaning out your closet, right? What don't we need anymore? What don't we were, let's throw it out. Because you're right, it's an end it becomes at the end of the day, the our frontline are bearing the brunt of it. I know that and, and so we are losing a lot of of the dedicated us and we're losing a lot of the the skilled and the vocational of you know, frontliners and we're getting people in just to fill the boxes in the spaces That's unfortunate. So that that compounds the issue, but I kind of want to circle back to what you do because I think what what you do is such a unique, you know, profession, you know, to go in and to to to identify infection because infection is is like it's it is the root of all evil for any of our Have our elder family members.

Dr. Buffy Lloyd-Krejci: 20:03

Yeah, yeah. So so we what we actually do, I have a team of three other infection preventionist myself, and which is we're just really starting to make an impact, which I'm so grateful for, because we go into the nursing homes, we work with their staff. So what we're doing is we're, you know, I can't be in that building all the time. So I, I want to educate and equip the staff that are there. So that when I leave, they know what they need to do. Now, the funding that we get typically is only for one visit. So how much good can you do with one visit, so we try to do everything we possibly can. And then we leave them with like a report with a toolkit. And, you know, we offer them a lot of free, you know, resources as well. So they can, they can keep, you know, they can get as much information as possible. But also we have, and I'm very grateful for this, and it is through CMS. So it's it's just interesting, because CMS is the regulator, they're also they fund the quality improvement organizations. And that's who we're funded through. So we've got quality side and regulatory side. But we're funded to go in and help these nursing homes. And I'm really excited because we just got funding to support 30 nursing homes in Wisconsin, Michigan, and Minnesota, to work with them for a year, like we get to work with them for one year. And we get to come on site every three months, we get to work with them monthly. And what we're trying to do is we are working to implement best practices, we're helping to shift their perspective, from this reaction to prevention, it's a lot easier to prevent than to try to mitigate and stop the outbreaks. And so it's really interesting that we have to start from the very, very, very basics, for example, I'm pulling some data that we did over the last year. And can you believe that still 50% of the buildings we go into do not have good access to alcohol based hand rub, if we cannot have a proper way to conduct hand hygiene, which is the number one way that infections are spread through our hands. Like that's where we start. Okay, fine. That's where we start, you know, and so that's, we go in and we do like an environmental scan. Basically, we're looking we're talking to the housekeeper's because if you have housekeepers, cleaning your toilets first and then go in and cleaning your tray table, you're spreading all sorts of stuff all over the entire building. So we really get down to the basics. And what's exciting is we get as we get to work with the facilities over time, then we start to work on you know, the Prevention's of the UTIs. And the, the all the wounds and you know, all the different types of potentially, you know, pneumonia, we get actually work with the designated infection preventionists, and the staff, and working to truly prevent these practices. But it's not something that, you know, if you have a culture that's been running, like, for example, I had a housekeeper one of my one of my infection preventionists was on site last week in Michigan. And she just told her the simple, simple thing, which I've been telling you is to clean the residence room first to not cross contaminate. And she goes, I have been cleaning the resident restroom first for 25 years, and nobody has told me anything different. I mean, that's just something really basic we can say with, right, so we have to start there.

Don Priess: 23:50

And when we talk, you know, we talk goats circling back to, you know, money. Isn't prevention way cheaper than reaction. Don't think that people who run these facilities realize, oh, my gosh, this way, I'd be making even more money if we just prevent all this stuff from happening, or is it that? I mean, it's, that seems like common sense

Dr. Buffy Lloyd-Krejci: 24:11

it is. But I think as humans were not the greatest at prevention, we're not the greatest at maintenance, like, you know, we know if we go and we get our oil change in our car every 3000 or 5000 Miles that's going to help protect our engines. But does everybody do that? Or we go to the dentist every six months, that's going to prevent us from having cavities, you know, so yes, prevention actually does save money. It saves harms in the long run, but we were so deep into the trenches with reaction that you've got, you've got to have you absolutely have to have dedicated leadership. And I'm talking the administrator and the director of nursing, you have to have those two roles, absolutely dedicated to turning the ship around. And, or it won't happen. I mean that I have just seen it, building after building after building, we have to have leadership buy in,

Susie Singer Carter: 25:08

you have to and it's interesting yesterday we were having a conversation with a with a lawyer who this is his vocal is he defends, you know, for elder abuse. And and it's a few it's really an exercise in futility at this time. Right. So, but, you know, I asked him, you know, and he, he's very lovely man, very, very driven by his heart, and he was talking about, you know, at the very least, it's like, he goes, it's talking about infection, it's like, it's, it's, it's not a new concept. Like, if any, he read a quote from Florence Nightingale that, you know, back in the day, and I'm gonna read it, she said, If a patient is cold, when patient is feverish, if a patient is fainted, be sick after taking food, if he has a bed sore, it's generally not the fault of the disease, but of the nursing. And, and this is, you know, back in the day, so it's, it's, it's really, in the basics of the tenant of being a caregiver provider, you know, or the front line is to is infection is number one, you know, and that's why doctor, you know, surgeons wash their hands so thoroughly and put on their gloves and the whole thing would you feel, you, you, you assume, I think as a as, as, as the consumer, you know, for lack of better you assume, like you said, you assumed your your grandparents were well, and I assume to my mom was, well, always I did I slept I thought I could sleep very well at night. But you assume that they know that. So it's really, it's kind of disheartening that they don't?

Dr. Buffy Lloyd-Krejci: 26:41

Well, I think they do. And here's the challenge. So I kind of I talked about this, I say, the problem is one of the problems, let's say, and this is why we have so many really, really important and good health care professionals leaving the industry in just absolute record numbers. And so let's say you have a nurse, and they love the elderly, and they really feel it in their heart, they're called to work in this space. And they, you know, I have an infection preventionist that works with me that worked in a nursing home for 10 years. And she couldn't take it anymore. And she had to leave and here's, here's what what happens. So you're, you're, you're saving the best nurse in your class, you're skilled, you you know what to do. And now you're given 30 patients, or, you know, the certified nursing assistants, like you cannot humanly deliver the quality of care, if you don't have the, if you have the workload that far exceeds what is humanly possible, and rad happens, that is a big problem within our long term care. The other thing is, you know, we talked about, you know, sometimes pulling profits, you know, just being so, just I've had, I've had nurses tell me, Dr. Buffy, my corporate won't buy hand sanitizer, they won't buy gloves, they won't buy gowns, they won't buy sharps containers, like they want do they want it the right thing. But so often I describe it, like they're in a straight jacket, they're trying to do what they can with a grade, what they have to work with. And so what happens is that causes moral injury to them, because they know that it's going against their own values, they know they can't deliver the quality of care that that this resident deserves that and they just can't they can't continue

Susie Singer Carter: 28:43

doing it. And this is the this is what I was actually referring to, that the administration and because that's where it has to come from. So when they don't provide that, and they don't provide Santa, you know, the, the backed antibacterial, so all that stuff, and they don't, they don't give that kind of training, then then it's on them. And, and it's really, it's really their responsibility, because that's their job, the description of their job is to administrate it. And the and that's where we're failing, because they're being told what to do above that.

Dr. Buffy Lloyd-Krejci: 29:21

Right. So, you know, the buildings that I see that how are our more successful are, you know, when when you've got kind of more of that autonomy, of that leadership, the administrator, their director of nursing, and they are they really do have the, the corporate support, are there a single, you know, just standalone facility, where it serves to where it starts to fall apart from what I've seen, is where when you have corporate leaders that are so far, so far, high above, they're so removed. They're not necessarily in it for the care like this. This is a vocation of a call. Calling and if you don't really have that, I say you don't really belong in long term care, because it is, these are, you know, such precious human beings and, and, you know, we can't just throw them away or treat them as if they're not valuable anymore because they are. And but it's it's that, you know, when I see and, you know, again, there's I get to see all of it. So for me it can be, it can be challenging, because I see the heroic staff, you know, and that's what I write about and broke. And I see the heroic staff, including administrators that are like, you know, I could go and make a lot more money somewhere else, but I'm gonna stay here because I care about this population, right on the other side, I see administrators that never leave the door of their their office, you know, and don't have any clue as to what's happening. So I see the whole gamut of it. And, you know, for me, it's like, I just want to take these best practices that I'm seeing, and really say like, this is possible, and you know, like, like, let's shift these practices over. But, you know, and a good friend of mine, Dr. Michael Wasserman, he, he does a lot of great advocacy in California. And, you know, he will tell you time and time again has to come from the leadership if we don't get to your ship buy in.

Don Priess: 31:17

And how do we get because how do you get we how do we make them understand? How do we make? I mean, it seems so simple if you could go to one facility. And despite all the regulations and the 50 year old things they do, they're still doing it, and they're doing it right. And they've got to have, you know, a bottom line that shows this works. It not only works on the human level, but it works financially. How is it so hard to get to these people and show? You know, if you do it this way? It's actually better for you? I mean, why can't Why doesn't this happen?

Dr. Buffy Lloyd-Krejci: 31:47

I think that from my observation, and like I said, for the second book, I'm I'm writing and I'm interviewing, you know, like these different best practices? Like, have you heard of the greenhouse model?

Susie Singer Carter: 31:59

Yes. Yes. So to Elon power? Who is Gary? Yes.

Dr. Buffy Lloyd-Krejci: 32:05

Very much more of that community base, like, where it's not just this big institution? You know, we have to start with asking our loved ones, when they we have to, we have to shift it from what's good for the business to what's good for the residents and our patients, you know, we have to get back to that. And the, the long term care, places that I see that really have it, right, they have that focus 100% on the residents. And as family members, and as consumers, we need to we need to kind of put on our, you know, we need to be discerning and saying like, are they like, are they putting their profits or their business over? Over the needs of the residents? Absolutely. And so we have to have a shift of that's where, you know, like, so we talked about, you know, we have, you know, more with more funding, we have to have accountability of where does that funding go and, and making sure that it does go to the specific staff or the goes to where it needs to go. But we need to so it just to me, it's like, and, you know, I hear a lot of industry leaders really rising up and even speaking out saying if you're not in this, because you care then just leave our industry because that you're you're ruining it for everybody. And, and and we need to get back to caring for our loved ones in a way that support them. And, yeah, and the community and it has to be you know, what I am hopeful. You know, last year I I've been I've seen I'm seeing a huge shift in your part of this movement is people stepping up and coming out and saying, all right, something needs to be done. And I talked to a nursing home administrator last week, I interviewed him for my book, and he left the industry after being in it 10 years. And he's actually because he just couldn't handle the corruptness anymore, you know, and he's actually going to start his own community and the way he believes that it should be done. So I think there are people that are rising up and saying, you know, we love, we love this, this group of people, I love this group of people. And and they need us we can't turn our back because it's too hard. And so I think collectively as we continue talking about it like we are today, we can really promote change. And I'm seeing that happen more and more.

Susie Singer Carter: 34:38

I agree. And I think I think it just has to be a bit we have to continue to to to promote that and to encourage that because I spoke to a nurse yesterday who I was interviewing, who who her and her husband, she got out of the corporate hospice you know, as a nurse because she couldn't take it anymore. And she's they've started their own You know, nursing home, so they could run it the way they want to, with, you know, tender loving care and, and just doing it the right way. And it's, you know, I think I think taking it back into the hands of the community is really important because we every time you fit, you don't you know, you, you assume that something's been taken care of it, it takes it off your plate, it you know, then, you know, if we're not looking, something's going on, and we've not looked for too long. That's what's happened. And so, you know, we put the fox in the henhouse to guard the henhouse. What's happened?

Dr. Buffy Lloyd-Krejci: 35:38

Yeah, and, you know, the, the pandemic, if there's a silver lining to that, and you talk about this is what your show is about is really, you know, looking at the silver lining, and it's number one, it's raised these awarenesses, I mean, our loved ones your loved one was, your mom was locked away, she, you couldn't visit her. And so there was a lot, a lot, a lot of things that happened as the result of that. And so it's really cracked the whole, I think it's really cracked things open, and which is good, it needed that. And, you know, as, as we, as we look towards the future, the aging population is growing. And, you know, we need to improve upon senior care services, so that we have the the care, not for our parent, you know, for like, my parents are entering that for ourselves. And, you know, some people say, close all the nursing homes down, you know, everybody can go home. That's not, that's not realistic. So now, you know, homecare is an option, and aging in place, is an option. And if you can do that, that's great. There's resources, I mean, I'm diving more into that. But that's not a reality for everybody. So we have to look at this, what we have in place now and build upon it and improve upon it. And, and, you know, it's going to take a lot of work, and I don't have all the answers. And you know, it does come from a lot of it comes from the top, it comes from political leadership, and people standing up and saying that they're willing to make a change, but also comes from the bottom that comes, it comes from both right, it comes from us in the field coming up, and it comes from that leadership, you know, the, the political coming, we have to have both,

Susie Singer Carter: 37:21

we have to have both, but we have to got we have to steer our political guidance, you know, because absolutely, you know, we need to help steer them. I say, we need to shame the hell out of them. But you know, that's not I mean, honestly, they, I can't tell you how many people I've interviewed now, who are been amazing advocates who have, you know, spent years writing policy of getting it right to the door and getting it passed and passed and passed, and then they get to the door of the governor and the governor goes, shuts the door. Right, you know, and they're heartbroken and it literally breaks their heart like it because no one does this for anything else. But but because they care. If you're advocating in this arena, you're not doing it for anything else. But but because you really really care. And so when you when that when those doors get shut, it's it's it's so devastating. It's so heartbreaking. And and it can be you know, you there's, you want to be so hard not to become idealistic, because you just think Is it where are all the good people? Where's the conscience? We need the conscience. We need the collective conscience.

Don Priess: 38:26

Well, you know, there's good Yeah, yeah, no, it's good to say you you said you know, just a few minutes ago, that you love these people, and the people who are trying to make change along with you and Susie and everybody are that you love these people. Guess what, these people are us these answers are kids. Yeah, these people are the people who are making these bad policies. These people are everybody because everyone's going there. So you know, if you think that you know, don't have to worry about it for you know, 30 more whatever, it's

Susie Singer Carter: 38:57

everybody Lincoln you're there my friends, blinking. You're there. It's all your friends. It's your family. It's everybody and it's we talking about and why are we trying to stay alive longer. I mean, I'm gonna you know, just to be so terrible about it. But it's like, you know, here we are. We're all health conscious. You know, we eat well, we exercise we think about longevity. It's such a goal for all of us. And yet when we get there, which is which is an honor, which is a privilege supposed to be we are devalued. We are there we are completely disregarded. There's bias. If I hear if I could hear your mom was 89 One more time I want you know, it's like I don't care about the number. We don't the number is the number this is a human being. And an every human being it's really a case of humans

Dr. Buffy Lloyd-Krejci: 39:51

to say she had 89 years of a good life so so doesn't matter.

Don Priess: 39:56

I from here on out. It doesn't matter whoever the rest days do not matter

Susie Singer Carter: 40:01

for me at least at least most, you know, she, she, at least she's an 89. At least she did that. No, we'll don't forget that she got, you know, with Alzheimer's or if you have cancer or whatever, you've been robbed of some quality of life. So you deserve to have as long of life as you want, in the best way possible. You deserve that the quality of life. Everybody deserves that. Some not so much. No kidding. But, you know, well,

Dr. Buffy Lloyd-Krejci: 40:34

you're right. And that and that's really what what I see too, and, and my heart really, that it's the quality. And for me what I see in that and you know, so that's what, what I'm doing is, is I'm going at it from the angle of, of empowering and equipping the health care workers. You know, I can't tell you how many times I've had health care workers cry with me and say, Nobody tells me Thank you. Nobody tells me I'm doing a good job. And I tell my staff, like if all we do is go in and make somebody feel loved today, then we've done our job. Like because they just don't get that. And so even as consumers, you know, you know, just going in and thanking the staff and

Susie Singer Carter: 41:20

Oh, my God, I did that all the time. Yeah, I did. I know. I used to say you're but you're just so good with my mom, you put the cream on her. Thank you so much. Did she love it? My No, my mom was very tactile, you know, I would tell them, and they go, Oh, your mom. And you know, and then you when you talk to people like that, you you, you know, you disarm them, because everyone's on their guard. And you'd be so you have to be a human, you have to be a human. Can I just tell you one of the first things that I noticed when I became you know, having to when I realized I had to be there every day last year for the last six months. And I remember I was standing out in the hallway and waiting for them to do something with my mom. And one of the women that was a resident there was in a chair and she was I could hear her, you know, she was she was bitching about something other than and then and then and then and so I was going over to the she was in the dining room talking to other residents. And I said, I heard her and she said, Yeah, three days I can't get I can't get any dental floss. I've had something caught in my tooth for three days. I said, Wait a minute, are you do you need dental floss? Oh, my God, I have something stuck in my tooth for three days. I go. I can't I can't even I can't with that. I mean, I can only imagine if I had something stuck in my tooth. what that feels like, right? I said, Hold on. Because I had just gotten one like I was at some convention where they gave away like those things. I got a free one. That was a keychain. I said it's in my purse, but it's locked. I'll go get it wet. And God had brought it to her. And she said it was as if I gave her a pot of gold. Right? And she said, Can I pay you? I said no. Just I said this is for you don't lose it. But you know, it's those little things that they use. Why? Why no dental floss. Why? Like, like, this is what you pack when you go on a trip. I mean, let's think about the basics of humanity. Dental Floss touching. We know, communication, all those things are so important. And and what we teach our kids wash your hands. If we're outside wash your hands. I mean, but

Don Priess: 43:29

they don't cost anything. Well, Democrats does. But all these things don't cost any, how many things? Do you go through that? Say, You know what, that doesn't cost anything that doesn't cost anything that doesn't? I mean, how many?

Dr. Buffy Lloyd-Krejci: 43:40

Yeah, a lot of it's even just behavioral changes. You know, I talked about, you know, the way they're cleaning a bathroom. And you know, I was a single mom for a long time. So I consider myself real scrappy. So I come in there and I don't tell them, Oh, you need these fancy robots to clean your room? No, I'm like, you know, here's how we can deal with what we've got. Right? Right. Because, you know, I know that's their number one thing they're always saying is we don't have the resources. So you'd be you know, like hand sanitizer dispensers, the vendors will get the will put them in the building for free. They do not charge them for the dispensers because you're buying their product and hand sanitizers a heck of a lot cheaper than infection of Mersa. You know, so, it's like, so I try to you know, do that as well, you know, so yeah, I mean, there's, there's, there's a lot of work to be done, but I really do. I just love talking, you know, sharing these experiences, because it's giving other people more courage to speak up. And, you know, we can't for me, it's not just about like pointing out the problems, but it's like, what are the solutions and get into the solution? And I'm really proud of the work we're doing because every day I mean, next week, I have an infection preventionist doing nine site visits and the week before we had 14 done so every single week we're doing anywhere from we're doing about 30 nursing homes every month. And I just love that because that's a group of 30 people, you know, group of 30 buildings that we can impact, and then I'm on national webinars tell him you know, so we're just really trying to impact and, and, and penetrate the industry with these with First of all, I always come from a space of love and light, and you know, just partnering with them, because I know how hard their jobs are, but I want to empower them, and I just I am not, I don't have the power to pay them more to, you know, that's where we need strong leadership to two, you know, and coming from the government to have of making some of these mandates, as well to that support the workers that are in these facilities, because let's nurture them, take care of them, so they can nurture our moms and take care of our moms. You know, like that's, that's where it comes from.

Susie Singer Carter: 45:57

It does. And I don't think that saying, you know, it takes a village could mean, it could be any more appropriate than in this arena, because it really does take a village, even as a caregiver, you have to sure see, like, what you're doing is you're sharing the perspective of the of the frontline, so that when we go in, and listen, I'm not I it took me a while. I mean, I'm a pretty friendly person anyway. And but I realized it was important that I that I, I really express how appreciative I was, when someone was really doing a good job, I wanted them to know it. And I think that we need to do, we all need to be acknowledged for what we're doing. And it motivates us, if we're being beaten down all the time, like, you know, it's it, that's not going to, that's not going to create a better situation for your loved one, it's not, you know,

Don Priess: 46:49

if it isn't for the carry, I mean, for the care staff there, if you're working in an environment, for example, you know, we know that they're completely underpaid, they need to be paid more, more and more and more. But that said, if you're working in a in a loving, wonderful environment, and it's it's a lot easier to, you know, I'm not saying they shouldn't be paid more, I'm just saying the fact that they're not paid enough, and they're working in horrendous conditions, it's not rewarding, which makes you wait, it's not rewarding, it makes it harder on everybody, it's harder on them, it's harder on the patients, or they you know, it's it's there, it's absolutely there is it's a lose lose everywhere. And you're if you have as as thinking of the administration, if you have a happy staff, it's a lot easier to say, Okay, I'm, you know, whatever, and I'm thinking from their point of view, there's bottom, this dollar bottom line, it's a lot easier to say you're getting a 50 cent raise, instead of a 75 cent raise, if they're happy. You know, it's better to they should get be getting way more, but we got to change that entire environment, you know, where we were when we when we'd walk into visit Susie's mom, and this is because, you know, she was an advocate for her, most of the staff, you know, they were, they were, they seem miserable. They seemed you know, and this was at a five star facility, this is at a great facility, quote, unquote, it just doesn't make sense in any level to have this horrible working environment.

Dr. Buffy Lloyd-Krejci: 48:18

I know. And I will tell you, it's not just about the money, you, you take anybody working in long term care, and if they have a happy environment, they will take that over a few extra bucks any day, they're not there for the money to begin with. That's, that's the thing, let, but let's respect them, and pay them a living wage, and then also create, like, an not one or the other, but an attempt both.

Susie Singer Carter: 48:45

I agree with you, I was just gonna say like, the system, yes, this is why I'm doing the documentary, it needs to change 100% Like tomorrow, but in the meantime, what you're doing is going in and make and helping create some kind of, you know, peace and, and, and a better result for everybody within this, within this system that we're that we're in, this is the situation we're in how can we, you know, what can we do now, like you said before, and that's what's so important because and that that's where as a caregiver, if you can, you know, it's important to to, to realize so everything you're saying is is if you know you do better if you know right so you in knowing you're telling us what goes on in there, so we need to be cognizant that you know, because I didn't know that this is all me learning on the trot because of course how How would I know? Yeah. How would I know you think you know you see somebody in a white coat you think that that you they have the power they don't

Don Priess: 49:47

trust you trust and you trust because they put on the uniform whether it be this whatever their way and you do you trust you think they know you think they're there to do the best for whoever's there and and

Susie Singer Carter: 50:00

your people, they're human beings too. And they're going through it days.

Don Priess: 50:05

And yeah,

Susie Singer Carter: 50:06

they're human gotta make the best environment possible. So, and they're dealing with this this system too. So nobody's loving the system, except for the people that are gaining getting money from it. Nobody likes it. Nobody, nobody is going really, this is great. Nobody is nobody. Nobody wants to see a vulnerable person went

Don Priess: 50:25

to that business. Nobody went to do like you said, they're not there for you know, they did it because they care. And then you get to the point where you hear people either dropping out or they just don't care anymore. They

Susie Singer Carter: 50:35

listen down. Can I just say something to just an addendum to that? Yes, there are bad actors. There are bad people everywhere. What what a situation like this is so and I know it is surveyed, but but not to the point that it needs to be. It's surveyed in places that it doesn't need to be, like you said, like the record keeping and all these regulations, it needs a different kind of oversight. So so in that case, it gives a lot of leeway for bad actors to, to engage in bad behavior. That's not the commute. That's not the norm, but does happen. And those are the things that get, you know, those are the things that get the notice, those are the things that get the news, you know, to say, Oh, this write this. And I'm not saying it doesn't happen. It happens a lot. But you know, sexual abuse and those kinds of things that happen in these in in facilities, yes, it happens. But it happens. I think it happens, not the majority of people that are there, those are the bad actors that happen to end up there. And they're, they're the outliers. They're not they're not the norm. But they get a lot of attention, because they slipped by because it's easy to, it's easy to. And it's you know, when there's and there's vulnerable people. It's like, unfortunately, when children get sexually abused, because they're, it's easier because they're vulnerable. Right? And you don't you know, just don't assume you don't assume, Oh, we're in a medical situation, that would never happen. It happens. But that's why there needs to be better oversight. So, but but for the most part, like what you're saying is, people are there because they want to be there because they love what they're doing their vocational caregivers, providers, their caregivers,

Dr. Buffy Lloyd-Krejci: 52:28

yeah. And they have the heart for it. But if you're not supported as a caregiver, then it's going to it'll, it'll just chop you down at the most basic fundamental level of who you are at your core. And so what are you going to do, you're going to try to go somewhere else, that's why the turnover is so high, you're going to try to go somewhere else that fulfills that, and you know, and you just keep looking, you keep looking and, you know, then eventually sometimes people just leave the industry because they're like, it's just not possible. So, you know, that's

Susie Singer Carter: 53:01

why injury, like you said, the moral injury is yes, horrible.

Dr. Buffy Lloyd-Krejci: 53:06

Right. Yeah. So you know, I mean, I think that, you know, just, we've got to invest in the workforce. I've been speaking a lot about that lately. And, you know, there is call there's calls for more funding for survey and oversight, which I am an I support regulations, we need regulations, if we don't have regulations, and things will go to the opposite extreme. We, we need more collaboration and help too. So more people like me can come on site, you know, you know, the hardest part about my job. Now, the work I do is free for the nursing homes. They don't even pay me they get it's funded through CMS. The hardest part about my job is getting in the door. Because people don't trust that when I'm there, that they're then going to get in trouble no matter what, no matter what

Susie Singer Carter: 54:03

I saw one of your videos, when I saw that in your video, that you post on

Don Priess: 54:08

it, you know why? Cuz they know that it's not right. They know what, what the practices that they're doing are not right. No,

Dr. Buffy Lloyd-Krejci: 54:16

no, it's not just that. No, it's not just that it's it's, it's just the industry. It's such a punitive, like there's so much. It's so punitive in the sense that that is that nitpicky culture of what I'm telling you to have of like, they're just there's not a supportive environment, either. Right, but they're not supportive, but the punitive

Susie Singer Carter: 54:42

the aspects of punitive nature goes to the people goes to the front line. So that's why it doesn't those peanuts, you know, the actions of punitive actions that happen don't really affect the upper tier, that's just cost of doing business. They don't really care And all they're gonna do is like, you know, the, the crap is gonna roll down the hill, and they're gonna bid you know, it's gonna be like, Hey, you guys screwed up. And they don't really it's they're so far removed from it that they have no idea. It's like running a restaurant, you know, over the telephone and just like they're not there. They don't know what goes on. They're not in the trenches, they don't understand.

Don Priess: 55:21

Yeah, but we need we need, as we said before, we need different regulations. But I think the punitive part of it isn't enough. Meaning that when when people are when these companies are really doing bad things, they're not being punished enough. They're not it's, there's no, it's like, it's it's water off there. Just said, No, I

Dr. Buffy Lloyd-Krejci: 55:41

definitely, yeah, I see what you're saying. I mean, there are definitely those situations that occur. And then so then the opposite side of that is then to show that you know, it is working, then you might give a citation to a building that, you know, like I talked in my book, one facility was cited, because the nurses didn't disinfect their pins after sharing it or something like that. So then it becomes so ridiculous, that then the whole survey process becomes ridiculous. And so it's not really effective, and what it needs to do now.

Susie Singer Carter: 56:14

It's objects, it's basically, you know, they gotta find something. So they'll find that, right. And, again, the low hanging fruit, so it's like, let's do this. And it's stupid. You know, I mean, just as, as a consumer, I mean, Don, and I would go to visit my mom. And sometimes we go there, and we'd have, they had to sign in, and you have to sign in, and you had to bring your test results, and you had temperature, and yet to put the gloves and this and everything. And then sometimes we'd walk in and there'd be nobody there, we just walk in, like five star five star facility, folks. I mean, so where's the consistency, right. So if it's happening there, it's happening everywhere. And that's the problem. And so it is too much for the frontline to handle, it's too much responsibility is too much. Because

Dr. Buffy Lloyd-Krejci: 57:04

it's their job, their job is to, to deliver quality care to the residents, you know, and they stopped, you know, they, they do not need to be dealing with all the other, you know, trauma that they do.

Susie Singer Carter: 57:19

I mean, I agree with you, you're doing such a good service you're doing what you're doing is so important, really is and it's it's it's extraordinary. And it's really basic and like, I can't believe that this program just started basically, it just seems

Dr. Buffy Lloyd-Krejci: 57:37

so and my thing is like we we have to really advocate for funding, you know, to keep doing this work, because it you know, I say like we need, we need to do more, we need to do more of this. And but we need funding, you know, and and because the nursing homes are not they don't have the funding to pay for this. And so we need, we need more support to help them as well.

Susie Singer Carter: 58:03

Where would that come from them? Where do you where would you the government? Okay.

Dr. Buffy Lloyd-Krejci: 58:09

The government? Yeah. CMS? Yeah. But, you know, they're so CMS has, you know, they have certain budget for nursing homes. I know, there's been, you know, talk about rolling that back. But that's why I'm always, you know, trying to say we need more, we need more support, you know, and that's why I always say to like, you know, if you put it into organizations that can help support to and then like, for example, the facilities that I talked about that get to work with us for for 30 facilities, I get to work with us for a year, like that's going to be major data driven, we're going to be looking at how their infections decrease, like we're, you know, we can look at how this funding is doing good, you know, we can show that we can show the improvements, you know,

Don Priess: 59:03

because if you have numbers like that, if that's I mean, it's like, you know, we're businesses, when I think when somebody first came up with maternity leave, you know, they're all though I can't that's gonna be expensive. And then finally, when you show how it actually benefits the company, and when it benefits everyone, then suddenly there's maternity leave, then there's paternity leave in those figures and showing the real life use of it that that can change things in the long run. And hopefully,

Dr. Buffy Lloyd-Krejci: 59:30

yeah, absolutely. I mean, we have to, you know, demonstrate that we're demonstrating that working collaboratively, not just in a punitive sense, is helping them and you know, can go a long ways because even like currently, the certificate the with a regular so for example, if I'm surveyed and I get a tag or I get a deficiency, I have 10 days to fix that to show the state that I'm in correction. Well, if you have something that's deep in your culture, it's You're not going to fix it in 10 days. I mean, you can show it on paper all day long. But guess what, after 10 days, everything's gone back to the same way. So, you know, that's why we are, I'm a huge advocate, we need time, we need time to get in there and work with them and change the culture and provide the education and we can't just say, oh, in 10 days, fix it, and you're good. It doesn't work that way.

Susie Singer Carter: 1:00:27

I think they're being directed though, to do that from I'm talking about not nonprofit, I'm talking about, you know, the for profit facilities there. It's basically their shot. Everyone shackled, you know, by just get it done, you know, just check off the ball. They have

Dr. Buffy Lloyd-Krejci: 1:00:42

to they have 10 days. Yeah, they have to do it. Right. They have to, but what I'm saying is, that's not sufficient.

Susie Singer Carter: 1:00:49

It's not sufficient. But you know, yeah. So in the meantime, you're right, you guys need to be in there more. And, and, you know, and and pick up the slack where they were, they can't because of because of the culture that they're in.

Dr. Buffy Lloyd-Krejci: 1:01:04

Yeah, we can say you have to show like, if you have an immediate jeopardy or you have something that is causing great harm, yes, you show that that's corrected immediately. But then, or I should say, and not but and you show that that is corrected over time and stays corrected? Not just we fix it 10 days, and we're done. We're clear, no, let's let's do it for another six months or a year and make sure that that anymore,

Susie Singer Carter: 1:01:32

right? Really, really implemented. Yeah, makes sense. So what's the say to again, your next book? Do you have a name for it yet?

Dr. Buffy Lloyd-Krejci: 1:01:42

You know, I've gone through several names. I'm thinking the bridge, and successfully navigating senior care. I like the bridge ticking right now,

Susie Singer Carter: 1:01:57

I always say that I walked to my mom over the bridge. So that's a good metaphor for me. I like it. Yeah, I like it.

Dr. Buffy Lloyd-Krejci: 1:02:05

Yeah, and, you know, I've done a lot of great interviews, I just get so excited when I hear you know, I learn what people are doing. And they're really doing some great work. And if we can highlight that, and showcase that, and give our loved ones option. So I'm also wanting to create like a workbook with it. So consumers have you know, more of they can take notes, and they can, you know, really, really have something to like, you know, something to use as they document their journey. But I dive deep into like, the five star process and is it really five star and you know, like really exploring how to find the right eye relay. the right questions to ask, well, you know, Susie, on the on CMS website, in the very first paragraph, it says, Do you know do not use this as a, you know, this, this is not what you should basically determine exactly for this,

Susie Singer Carter: 1:03:03

Isn't that sad? Isn't that sad, they have a rating system, and they have to have a caveat for it.

Don Priess: 1:03:09

Don't listen to it, don't really pay attention to it. It's

Susie Singer Carter: 1:03:12

five star ish. Terrible, terrible,

Dr. Buffy Lloyd-Krejci: 1:03:17

I think, you know, after talking to you so much, and just realizing like, we have to follow our intuition, we have to talk to people, we have to, you know, I talk a lot about our own advocacy for our loved ones. And, you know, like, how we how we, you know, really take care of our loved ones in this situation, and not just kind of get pushed over, you know, to and just just the importance of how we can support our loved ones in the situation, but, but we do need solutions now. And, and I do I am seeing them. And, you know, it's it's

Susie Singer Carter: 1:03:57

really Yes, there are,

Don Priess: 1:03:58

I agree out there they are out there providing them.

Susie Singer Carter: 1:04:02

And definitely going to going to highlight that in the documentary because I don't want people to think it's, you know, this is a exercise in futility. It's not and I listen, listen, there's very big voices that I've interviewed that said, that's not going to change. I'm here to tell you, it's not going to change and I say, You know what? Yes, it can. Yes, it can. It's gonna not gonna be easy. But there's, you know, we've made bigger

Don Priess: 1:04:28

changes, we ready change it,

Dr. Buffy Lloyd-Krejci: 1:04:29

it's already that's what I was just gonna say, right? Yes, changing right now.

Susie Singer Carter: 1:04:36

But then you have young leaders,

Dr. Buffy Lloyd-Krejci: 1:04:39

you have strong leaders who have said, Look, I still want to be in long term care, and I still want to care for this population. So I'm gonna go do it a different way over here. And that those best practices will start to will start to pick up speed, they just they will. It's just gonna take time, you know, but I say, You know what people say A Oh, it'll never change, or we should just close all nursing homes. I'm like, Well, what's that we can't, that's not our solution. Because we need people today need this level of care, not a society that has raised up our families to where we're all living in the same household and we care for. I mean, we just don't have that some communities do. But overall, that is not our culture.

Susie Singer Carter: 1:05:23

But because we also need to shift the our perception and perspective on our elders and how we view them ourselves. Because they're also, you know, societally or socially DISRE. You know, they're dismissed, they're just disregarded as, as you know. And we have been, we've grown up like that, to think that way. You know, it's like, youth is good. I'd rather get rather die before I get old and all that kind of stuff. It's like, we just don't think I mean, I saw it so much in in the homes or the facilities. When my visit my mom, I see it, I saw it, it's painful to watch. It's painful. So you know, no

Don Priess: 1:06:03

one would say close the hospitals directly. It's like, but let's close the nursing nursing facilities

Susie Singer Carter: 1:06:10

because it doesn't matter what problems. They're dying anyway. They're dying. I gotta leave you with this. Nice little like a story, this anecdote that this awesome. Michael brusca, who's the this eldercare lawyer who does it? Because he cares so much. And he says, If I can change one family and make them feel a little bit better, it's never about the money. And, and I said, How do you do it every time? Like, how do you get up and say, I know it's, I'm not going to really make a change, but did and he goes well, and maybe you know, the story people out there, but I think it was so lovely. He said, Do you know the story about the starfish? And I said no. And he said, I said tell me and he said, Well, there's a grandfather and his grandson are walking down the beach, and there's waves coming in. And every time a wave comes in, it brings in a starfish. And the grandfather would bend over, pick up the starfish and throw him back in the water. And he had kept doing that over and over there was like hundreds of them that would get washed up. And his grandson said, grapple why you keep throwing one back in. There's so many of them. What's the point? And he goes, it doesn't matter. He goes, Well, it matters to that starfish. And that's all we can do. So we have to start with one starfish at a time. Because it matters. It matters. And if we all throw one starfish back when deputy cool. I don't know, I'm just saying I think it's either we have to get back to simple thinking and really realize that these are human beings. And it does matter. Right? Because we love them. And why do we always say

Don Priess: 1:07:49

we love them? We do we love them. Because as we all know that love is powerful. Love is contagious, and love conquers all. So we want to thank our guests, Dr. Buffy Lloyd creatchi and do def F definitely pick up her book. Well, we'll have all the links in the show notes. Please like, subscribe to us. And please definitely check out the opportunity to be a part of our movement with No Country for Old people. You know, no, there's no dollar figure to small and if nothing

Susie Singer Carter: 1:08:21

else, national, national national consumer voice go to their website. And and we'll have Dr. Buffy is going to be in our documentary.

Don Priess: 1:08:31

there URL. She's going to be there. And as you can tell from this, she's going to be an important part of it. So

Susie Singer Carter: 1:08:37

very important. Thank

Don Priess: 1:08:38

you, doctor for watching and listening.

Susie Singer Carter: 1:08:41

Thank you everybody. Have a good one. Bye bye