Patty Kikos interviews Yasmine Loupis, who works as a rehabilitation case manager and has a wealth of knowledge and passion about healing and recovery. Yasmine shares many helpful tips for how carers can best support themselves, and their loved ones on this journey, which often begins as a sudden and unexpected event which can be both shocking and traumatic. GUEST: Yasmine Loupis - Social Work Spotlight Podcast SOCIAL MEDIA: Follow Patty on Instagram Follow The Benevolent Society on Instagram Follow Carer Gateway on Facebook Follow The Benevolent Society on Facebook CREDITS: Host – Patty Kikos Producers – Patty Kikos and John Hresc Sound Engineer – John Hresc GET IN TOUCH: Carer Gateway is proud to offer emotional and practical services and support for carers with the aim of making your life easier. You can call us on 1800 422 737 to find out more about peer support groups, counselling, coaching, online skills courses, tailored support packages, emergency respite, other government supports, as well as tips and information, or visit our online home at www.carergateway.gov.au Got some questions or thoughts for Patty or the team? Email us at cgconnections@benevolent.org.au and put ‘Attention Patty’ in the subject line. ACKNOWLEDGEMENTS: The Benevolent Society acknowledges the Traditional Owners of the Land we have recorded this podcast on, the Gadigal people of the Eora Nation. We pay our respects to their Elders past and present and extend that respect to all Aboriginal and Torres Strait Islander cultures.
Patty Kikos interviews Yasmine Loupis, who works as a rehabilitation case manager and has a wealth of knowledge and passion about healing and recovery. Yasmine shares many helpful tips for how carers can best support themselves, and their loved ones on this journey, which often begins as a sudden and unexpected event which can be both shocking and traumatic.
GUEST:
Yasmine Loupis - Social Work Spotlight Podcast
SOCIAL MEDIA:
Follow Patty on Instagram
Follow The Benevolent Society on Instagram
Follow Carer Gateway on Facebook
Follow The Benevolent Society on Facebook
CREDITS:
Host – Patty Kikos
Producers – Patty Kikos and John Hresc
Sound Engineer – John Hresc
GET IN TOUCH:
Carer Gateway is proud to offer emotional and practical services and support for carers with the aim of making your life easier.
You can call us on 1800 422 737 to find out more about peer support groups, counselling, coaching, online skills courses, tailored support packages, emergency respite, other government supports, as well as tips and information, or visit our online home at www.carergateway.gov.au
Got some questions or thoughts for Patty or the team? Email us at cgconnections@benevolent.org.au and put ‘Attention Patty’ in the subject line.
ACKNOWLEDGEMENTS:
The Benevolent Society acknowledges the Traditional Owners of the Land we have recorded this podcast on, the Gadigal people of the Eora Nation. We pay our respects to their Elders past and present and extend that respect to all Aboriginal and Torres Strait Islander cultures.
Yasmine:
I think generally the longest period that someone will spend in rehab will be when they're first injured or unwell, because a lot of this time needs to be spent figuring out exactly what's gone wrong. Trying to stop the progression of a disease if possible, so to stop it affecting the body more than it already has, and then the process of “where to from here?” So I see it as kind of like a snow globe is being shaken. And we need to wait and see where the pieces have landed before we can formulate a new plan.
Patty:
I love that analogy.
Yasmine:
So, there are times when it might be appropriate for rehab to start really early in someone's hospital admission and research does tell us that the earlier someone can start moving and increasing their independence with daily activities like feeding, showering, dressing and talking. The better their outcomes are likely to be.
Patty:
Is it true that sometimes when you have a hip replacement, you're encouraged to get up and move and walk straight away?
Yasmine:
Straight away
Patty:
So, it’s not a rumour...
Yasmine:
I'm here to dispel myths.
{both giggle}
Often, you'll be put in a type of traction that actually just keeps your legs cycling. It's almost like you're in a recliner cycle, so the key is to just keep things moving. Keep your joints lubricated even often the rehab will start in the main area of the hospital. It might just not be called that.
--
Billy
From the Carer Gateway at the Benevolent Society, we welcome you to, Carer Conversations with your host Patty Kikos.
The Carer Gateway is the Australian Government national care hub and provides reliable services, support and advice especially for carers.
This podcast is where we share interviews with guests that have specialized knowledge to help support carers to look after their emotional, mental and physical well-being.
We are recording on Aboriginal country, on lands which were never ceded. We acknowledge the traditional custodians and cultural knowledge holders of these lands and waters. We pay our respects to Aboriginal elders, past and present.
Always was, always will be.
---
Patty:
My lovely carers, how are you? There are so many topics that I want to share with you, and rehab has been on my hit list for some time.
Because it's such a huge topic, I'm going to save the episode for drug and alcohol rehabilitation for another time, because today I'd like to focus on physical rehabilitation. This is the process that an injured person goes through to restore their physical functioning, and it can be a long process that starts while a person is still in hospital, maybe after an injury or surgery, or even a long illness, and it continues through a skilled nursing facility, in home therapy, outpatient therapy and even other settings.
Now, during physical rehabilitation, a person may work with a variety of rehab professionals, including physiotherapists, occupational therapists, speech pathologists, nurses, psychologists, dieticians, as well as social workers and various medical specialists. For example, if you broke your wrist and it was immobilised in a cast for months, you might need to have physical rehabilitation to regain your strength and range of motion. This rehab will help you with tasks in your daily life, like preparing meals, bathing yourself, working, caring for children and lots more.
Now a person who has had a stroke may need physical rehabilitation to improve their balance, regain strength and motion on one side of their body, as well as relearn how to feed themselves or even to drive. They would likely work with the physiotherapist and occupational therapist, or even a speech pathologist to reach their goal.
Today's guest is Yasmin McKee-Wright, a social worker that specialises in rehab. After getting her qualifications over 20 years ago, she works as a rehabilitation case manager and has a wealth of knowledge and passion about healing and recovery. Her current role is for a company called iCare, who introduced the Workers Care Program to improve the way treatment and care services are delivered to people who are severely injured at work.
Severe injuries can include:
Now, Yasmin, thank you for being here today.
Yasmine:
Today, thank you so much for having me Patty. I'm excited to be here.
Patty:
Me too. Now, before we get into your specialty, which is a wealth of information, can you tell us a little bit about what your life was like when you were growing up?
Yasmine:
Absolutely so it's a little bit of an unusual story, I guess. I was born in Papua New Guinea. My parents were both working there at the time, so my older brother and I were born there but I mostly grew up in Sydney. So first we moved to Marrickville, into a lovely little house there and then at the time in the 80s, Marrickville was not a great place. It wasn't as safe as it is now. Now it's quite gentrified with lots of young families, but my parents wanted something a little bit safer and somewhere where we could spread out a bit. So, we moved down to Sutherland Shire where we had heaps of space and heaps of activities, heaps of things that we. Could do
Patty:
Which part of the Shire?
Yasmine:
In Como.
Patty:
Ohh, that's a beautiful place.
Yasmine:
It's a beautiful little suburb. We've got bush out the back and water out the front, so it was just divine to grow up in. But I also had the luxury of having family in Sydney and having family overseas so I could kind of bounce in between and go on exotic holidays. I just really had incredibly supportive family in general, and my parents were wonderful. So yeah, I had a wonderful childhood.
Patty:
What sort of places did you travel to?
Yasmine:
Travel to mostly the US, so we had half of my family are over there in different places, so road trips were a lot of fun and then had the luxury of just going on family holidays and. I guess also Japan, when I was 13, I went as a delegate for the Red Cross, which is a whole other story. But that was kind of, I guess, a real eye opener for me and what probably more than anything shifted my focus on supporting people as a career.
Patty:
What kind of things kept you active when you were younger?
Yasmine:
I was always active. I did a lot of gymnastics and tennis at a very high level, but I also, wherever I could, did lots of school sports. I loved fishing and also sort of the more cerebral, creative things. I loved art. I loved chess. I was the only girl in my school chess team. So just anything that I could do to keep me busy and active and thinking, and moving was really my jam.
Patty:
Wow, I was going to say is there anything about your life back then that you wish you still had now? But I know for a categorical fact that you are still very busy right now.
Yasmine:
I am. I am and I love it, but I think I'm also better at allowing myself to have downtime. I wasn't very good at that as a kid. I think if anything, what I miss from my childhood is just the grown up stuff. You know, I I found out many years later in life that there were times when my parents struggled financially. Really, especially with all the activities that my brother and I needed to be ferried to, but they never let us know we were very protected, never wanted for anything. So just that adult, you know, responsibility stuff.
Patty:
Yeah, and there seems to be a philosophy within you about giving back and being of service.
Yasmine:
I think I am very fortunate to have had the supportive upbringing and even access opportunity to education and the freedom to do what I wanted to do, as opposed to something that was going to generate the most amount of money. As you know, social workers don't get into it for the money. So I had that luxury and that real support behind me to do something. That I had a passion for.
Patty:
And why the interest in social work?
Yasmine:
I guess so, as you said, I finished studying social work around 20 years ago now. I actually completed the combined Arts and Social Work degrees at Sydney Uni, which would have given me a chance to veer off into Psychology studies if I found that I was particularly passionate about that, and that I'd rather focus on being a psychologist and not a social worker.
But as I spent more time with subjects like Anthropology and Sociology and Gender Studies, I was compelled to continue into the Social Work degree. I also have an older cousin who studied Social Work and she was just finishing Uni as I was considering what I wanted to do, so it helped to have someone who could tell me a little bit about what to expect.
Patty:
Did that influence you?
Yasmine:
Absolutely it did. It was that or just opening the UAC guide and pointing at something at that point. But as I spent more time with those subjects, and then came the 2 placements that we have to complete to I guess graduate from baby Social Workers to real professionals.
Patty:
To qualified ones.
Yasmine:
That's it. As these really solidified my desire to support other people. And I had 2 incredible placements. The 1st was at Wollongong Hospital. I was with the social worker who was positioned in the Neurology Unit and Outpatient Hemodialysis. Just the generosity of the other social workers, even within that tiny department, to take me under their wing and show me the other areas of the hospital was incredible. And I came out of that thinking. I really want to work in a hospital setting.
Fast forward to maybe 6 months after that, and I had my 2nd placement, which was at Canterbury City Community Centre in Lakemba, and it was a little community project that I was tasked with, which was to do research with an existing older men's group to look at, potentially setting up a group that could support people who were, I guess missing the camaraderie of the workplace. They were all over 65 and they wanted a social outlet, somewhere where they could feel as though they wanted to do something every week and come and just be present.
Patty:
What completely different placements, so oppositional.
Yasmine:
Yes they were completely different, and I had the opportunity to work with amazing stakeholders like Council and even got to attend the local boys' school, and I set up Campsie Men Shed, which is still running today, so that was my little baby - Campsie Men Shed as a 2nd placement.
Patty:
I love how flippant you are about it when you mention this.
Yasmine:
Haha – yep just casual. 😊
Patty:
Yeah, I use the same tone when I say, “hang on a second. I've got tie my shoelace”.
{both giggle}
Yasmine:
I came out of the 1st place thinking I'd love to work in a hospital and then I finished my 2nd placement and thought, “no community development is where it's at for me”. So my first job out of Uni was at a settlement at a migrant resource centre, in Sydney's eastern suburbs where I was responsible for settlement support and complex refugee case management. I absolutely adored that work. And I guess after 4 years in that role just felt like I needed a new challenge in the long term rehab.
Patty:
What a gem to land in, right after you finished uni. Usually, you need a lot of years of qualification and to have earned your stripes to inherit that type of responsibility, don't you?
Yasmine:
I think they just took a chance. I think I interviewed well. They could see that I had an interest and a passion. Yes, I have a multicultural background as well, but I don't present as multicultural. I look very Caucasian, but I think having that history, having that context and having that interest and curiosity about people from other cultures definitely helped.
Patty:
And the fact that you set up Campsie Men's Shed, don't you think?
Yasmine:
Absolutely. But yeah, I landed in that role when the organisation was in a lot of a period of change. They just lost their core funding and they had just transitioned a lot of their programs to Aged Care services, and all of a sudden, I was the only person in that one Settlement Service. But it was a great opportunity to step back and go, “What can I do with this funding? What is out there? What is the need in the Community?”, and I was able to build that program up, to when I left, we had 2.5 full-time equivalent workers, so we had a little team, and we had a bit more of a reputation in the area.
Patty:
That's actually really impressive and I know you landed into rehab after that, but a quick little segue before you share about that, what is your multicultural background?
Yasmine:
So I am half Greek, a quarter Polish and quarter Czech. So, my mum was born in the U.S. but she grew up in Germany. And my dad moved from Greece when he was five, so both of my parents were born overseas.
Patty:
So you’re first generation Australian?
Yasmine:
That's it.
Patty:
And then along came an opportunity to work at Saint Vincent's Hospital?
Yasmine:
Yes I was very fortunate to secure a position in the rehab unit. I was considered fairly green in the area, but the team took a chance on me. So I I found my way into a new passion and that passion was supporting people with all sorts of physical conditions. Caused by sudden illness or injury, as well as helping their family members navigate through the maze of recovery, and that was what I was really passionate about.
Patty:
So you worked with carers early on in your career, didn't you?
Yasmine:
I did and continue to.
Patty:
And what did you become particularly interested in?
Yasmine:
In I loved orthopedic work, so injuries to bones, muscles, structures that hold us up as well as neurological problems like strokes and spinal cord injuries.
Patty:
Which is kind of the almost the whole gamut of rehabilitation. In my introduction, I spoke a little bit about what rehab is and gave examples of either breaking your wrist or having a stroke, but physical rehabilitation is a separate medical specialty, isn't it?
Yasmine:
That's right. Yeah. So many rehab physicians are also pain physicians. But they're also really great at supporting people holistically. They can look at all areas of someone's physical well being. And at St Vincent's Hospital, it was quite a unique place to be positioned because there were quite interesting specialties of medicine that we covered.
We'd have cases that would land in rehab that included degenerative or progressive illnesses like motor neuron disease, or multiple sclerosis, or chronic pain conditions. People requiring methadone treatment, people undergoing HIV treatment as well as people after organ transplant. We had a lot of heart transplants and lung transplants at Vinnies.
So, these were people who had been in hospital for a long period of time, or they had waited for a long period of time for their transplant. And in that time had become quite deconditioned. So they'd become very weak.
Patty:
And the immune system would have been compromised?
Yasmine:
So compromised!
And then they were put on a lot of medication to try to suppress their immune system once they'd had the transplant so that their body didn't reject the new organ. We also had some incredible things like a totally artificial heart. Which a lot of people have never heard about, but it's effectively a little contraption that takes the role of the heart and it's completely.
Patty:
I think I saw it on an episode of Grey's Anatomy, but never in real life. So it exists?
Yasmine:
There you go. I've never seen Grey's Anatomy but it must be accurate.
Patty:
Well, and being a hospital that's situated in the inner city like that, you get a whole host of a myriad of people that can potentially come in and be an inpatient.
Yasmine:
That’s right. So, we had a full spectrum and we had people who were so incredibly disadvantaged financially and socially, compared to those who had an incredible number of resources. So, for me it was a great lesson in realising that injury or illness can affect everyone, everywhere.
So, through that 9 years that I spent at St Vincent's Hospital, I became very interested, as I said in neuro rehab and it included a lot of nerve problems, a lot of paralysis, muscle weakness, coordination, but it also affected people's cognition; so their thinking, their confusion, their ability to do things independently. And it could have been from something that might be a genetic disorder that they've lived with their whole lives, or it could have been from a sudden injury. So, it was very diverse and really interesting work.
Patty:
It's interesting cause when you were younger, you were a gymnast. So, you were very much in your body and you could contort your body into all sorts of very impressive pretzel like shapes, but you also have the academic inquisitiveness of wanting to know how it's actually structured and how nerves actually function.
Yasmine:
Yeah. Yeah, that's right. I guess what we find sometimes is people who haven't needed to come in contact with the health system. We say that they have poor health literacy, I guess to put a term to it, but that just basically means they haven't had to know all of this stuff.
Patty:
To not have a lived experience and then to be thrust upon this kind of condition for yourself or your loved one is a real rite of passage.
Yasmine:
It's a whole new world which you hope no one ever has to go through, but, we also, as helping professions, need to understand that this is completely new to people and sometimes they really just do need the time and the space to understand what's going on.
Patty:
Why rehab, but not another area of social work?
Yasmine:
I wish I had a better answer for this, but I think I just landed in an area of healthcare that was perfect for me. I liked the fact that rehab isn't as fast paced as other areas of the hospital, and we call the main area of the hospital the acute side of health.
When someone has first come into hospital, everyone's rushing to either stop the problem from becoming worse or trying to diagnose a problem, and often working to move someone along as quickly as possible to free up valuable space.
So, when someone has been accepted into rehab, usually their most immediate health problems have stabilised and we can then focus on their recovery. So, there’s still pressure on beds and a need to move quickly. And some of that is just someone's wanting to get out of hospital, which I completely understand as well, but we generally have more time, which means we get to know each person and the supportive structures around them so much better. And I love making those meaningful connections with people.
Patty:
Because you wouldn't just get to know the person, you'd also get to know their family and their respective carers, wouldn't you?
Yasmine:
Yes! And sometimes, depending on the certain illness or injury that someone is facing, you might almost exclusively be working with the caregiver of that person. They might not be able to communicate at all.
Patty:
Of course.
Yasmine:
And they need that person to be a representative for them.
Patty:
Yeah, I see. So what's the main difference between short term rehab stints and longer ones, and what are some tips that can help prepare carers to cope with either one?
Yasmine:
I think generally the longest period that someone will spend in rehab will be when they're first injured or unwell, because a lot of this time needs to be spent figuring out exactly what's gone wrong. Trying to stop the progression of a disease if possible, so to stop it affecting the body more than it already has, and then the process of “where to from here?” So I see it as kind of like a snow globe is being shaken. And we need to wait and see where the pieces have landed before we can formulate a new plan.
Patty:
I love that analogy.
Yasmine:
So, there are times when it might be appropriate for rehab to start really early in someone's hospital admission and research does tell us that the earlier someone can start moving and increasing their independence with daily activities like feeding, showering, dressing and talking. The better their outcomes are likely to be.
Patty:
Is it true that sometimes when you have a hip replacement, you're encouraged to get up and move and walk straight away?
Yasmine:
Straight away
Patty:
So, it’s not a rumour...
Yasmine:
I'm here to dispel myths.
{both giggle}
Often, you'll be put in a type of traction that actually just keeps your legs cycling. It's almost like you're in a recliner cycle, so the key is to just keep things moving. Keep your joints lubricated even often the rehab will start in the main area of the hospital. It might just not be called that.
So, let's say a physio comes up to you at bedside and does an assessment. As part of that assessment, we'll be looking at what the rehab plan is for this person. They might be looking at activities and things that you can do and the things that you can't. They're focusing their exercises on trying to improve your mobility as much as possible and to see what the next steps might be.
Patty:
In terms of the rehabilitation plan, who puts that together? Would it be a combination of say the physio or the OT or I guess I've got 2 parts to my question; who puts it together and then who is in charge of implementing it?
Yasmine:
The thing I love about rehab is that it is an all or nothing approach, so it's a well oiled machine. The COGS are turning constantly. There are so many people involved which can make it a little bit challenging for caregivers and we can go into that a bit later, but effectively you will be having a little bit of everything unless your only problem is your speech and your swallowing, and you can walk fine and you can do everything else independently, but oftentimes people will get an assessment from everyone who's in the rehab unit and they will figure it out, “Is there a role for me here?” “Is there something I can be doing to support you?”
So there will be goals from everyone and depending on the situation you might have just one person who is leading the rehab, or you might have a little bit of everything. So again, it's up to whether that person feels as though they can handle it, even from an energy level. Even just communicating with everyone on the team. Or do they want just one person as their contact person.
Patty:
I love that it's not one size fits all well, it can't be, can it.
Yasmine:
That’s right it can’t be. A person's journey through rehab is, I say, like a fingerprint, so no 2 experiences are going to be identical. You may go through rehab once and the second time it's going to be completely different.
Patty:
That's really interesting and there are also outpatient services or day rehab programs, aren't there?
Yasmine:
Yep, so often if you've been in an inpatient rehab setting, you'll be invited to come to an outpatient setting, which is really great from a continuity perspective. So, it gives the hospital teams an opportunity to follow that person up. And just monitor how they're progressing. They can always be rereferred for more inpatient therapy if they're not doing as well as they expected.
Patty:
So the outpatient is that you've already gone home, but you go back to the hospital for continued treatment?
Yasmine:
Yeah. So, you can either be allocated to the hospital setting again, or you can have home rehab therapy. Who actually comes into the home? Sometimes there are treatments that are either outpatient or community that just aren't necessary or appropriate as an inpatient. So you might have a completely different type of therapy as an outpatient, in the home. It's about finding what is the right time for the right type of therapy.
Patty:
And what would be an example of that?
Yasmine:
So, let's say someone has had a stroke that's affected their swallowing, and they've had a tube inserted and they've basically got a lot of things happening with their throat, and it's really hard for them to actually communicate effectively.
They might not get to a point where those tubes, and a lot of those feeding apparatus can be removed until they've left the hospital. And it's that time that they start that intensive speech therapy because all of a sudden, they can start using those muscles a bit more.
Patty:
OK, that makes sense. And what's the best thing that a carer can do?
Yasmine:
I really think it's just to show that they're keen to work with the team, ask lots of questions. For most people, this is unchartered territory. You never want to be in this situation and also it can affect carers just as much as it affects the people who are ill or injured. So, we tend to view the carer as part of the rehab team. So the more you can be involved the better it is.
Patty:
That is amazing. I'm so glad that you said that. And I'm so glad that you're very encouraging of carers to ask questions because I think that people don't want to come across as being silly or stupid or uneducated. But when you're in a state of shock because you've almost lost your loved one, you're already beyond capacity. You've far breached that capacity, so a lot of the time because you are in that state of shock, whatever has been said to you hasn't necessarily been retained, has it? So, you actually do need that repetition.
Yasmine:
Yeah, that's right. And look, the person that you're talking to can always tell you “I've heard this before, I don't need to hear it again”, but we will probably just assume that it is helpful to hear it again. Yeah. So I would recommend asking the social worker and rehab, “Are there other resources for carers that might be beneficial for you if you don't live close to the hospital”? There might be benefit for you being physically close to attend meetings or therapy sessions.
Maybe there's hospital accommodation available, or you might be eligible for income payments through Centrelink as you transition to a caregiving role, you may want to get connected with other carers who have gone through something similar. See your rehab team and definitely your social worker as a one stop shop for all of those practical concerns.
Patty:
This is the setting usually, where social workers will refer carers to Carer Gateway, which is great. We love getting referrals like that cause it's when people go “Wow we really need support and we don't know how to organise it. Things that haven't been approved yet, but we really need domestic assistance or personal care. And ohh yeah, I do need counselling. That's great. Thanks for offering.”
Yasmine:
And so often we get to the stage where we're planning a discharge meeting, so we invite the family and all the people in the hospital team get to get together and they talk about the person's progress and they say, “OK, So what do we need to do to get this person home”? Unless those conversations are happening at every point in the hospital admission, it's going to be a complete shock. The person's not ready for it. Yes, they're going to be bamboozled. What is going on? What is expected of me, so I think. The more during that hospital admission, you can have those conversations, the better it's going to be for everyone.
Patty:
That's right. And they say that hope is always the last emotion to die. But I also think that denial can also be a river in Egypt, expectations versus outcomes. How do we navigate that fine line between hope, acceptance and even denial?
Yasmine:
Yeah, I again think the best thing you can do as a carer is to ask lots of questions.
I think the most important thing to acknowledge is that often following severe injury, 100% recovery may not be possible. Our bodies are incredible, but occasionally they're pushed beyond the limits of what they can return from.
Patty:
So we have a new baseline that we inherit, don’t we?
Yasmine:
That's right. So. Our bodies can't heal from that point, and there might be a degree of organic or natural recovery. But you shouldn't be expected to just get over it or get on with it. You're allowed to grieve, and that in itself is a deeply personal experience. So, we grieve many things. And in many ways, there will be grief around loss of independence and physical ability. Grief for financial stability, grief for the roles we held in our family and community, as well as loss of friendships and activity groups.
And then there's this thing called anticipatory grief, which is mourning a loss that has not yet occurred but could be inevitable. So often we mourn these things in silence. Because it's so hard to explain to someone how we're. Feeling, or even to identify that grief is the emotion that we're feeling.
Patty:
And I'm so glad that you brought it up. Our first episode after our introduction to Carer Conversations, actually talks about the ‘Journey of Grief, and you've summed it up quite beautifully just there.
Yasmine:
Hmm yeah, we refer to, I guess in rehab we refer to this part of recovery as “finding out what that new normal might be”. And rather than acceptance, it can be a sense of acknowledging that things are different and seeing the possibilities in this.
Patty:
And adjusting accordingly. And that takes time, doesn't it?
Yasmine:
And it might never happen, and that's OK. So, for instance, what would you do if you couldn't work again? This could be an opportunity to find a sense of meaning and contribution in other ways.
Some of the people I support in my work now are unable to return to their formerly very physically demanding jobs. Yeah, you might be able to volunteer for a couple of hours a week and still feel a great sense of pride and fulfilment.
Patty:
Yeah, I've worked with people who have had strokes and are unable to work, to businesses that they've started themselves. And it's a big journey of having to get to re know yourself. Yeah, and revalue yourself.
Yasmine:
That's right, yeah.
Patty:
Yeah, and I often see within interdisciplinary teams, we don't always agree. I know many social workers who have had to rally for their clients. When a doctor has said, “Yep, this patient's ready to go” and the nurse will say, “Yep, their bloods are checking out” and the social worker will say, “Hang on a second. You don't have the context. You don't know that their family hasn't quite arrived from Melbourne or Interstate, so they're not gonna go home to safety. We can't discharge them now”. So it is a very collaborative process, isn't it? And everybody has to agree in order for the patient to be discharged in most cases.
Yasmine:
And one of the great things is that there is a lot that goes on behind the scenes that helps the team to arrive at that cohesive point. So we have our regular meetings that might be, let's say there's once a week we go in depth into a situation. First time someone arrives on the ward. They've had all their assessments, they've met everybody. And we can tell the team this is what's happened and sometimes in other settings I've been part of the social work kind of gets looked. You look over at the social worker when someone's ready to leave hospital, whereas in the rehab unit at least where I worked, everyone goes around the room and unless everyone's had their chance to talk, you're not going to move on. So it is really focused on making sure that we understand who this person is. And what's important to them.
Patty:
What are the best ways that carers can navigate rehab for their loved ones?
Yasmine:
Knowledge. Knowledge is power, so the more you can know about the illness or the injury that the person you support is facing, the more you'll be able to talk the talk so people will use words that are unfamiliar without realising that they're doing it actually.
Patty:
That jargon can be very jarring, can't it?
Yasmine:
And it's almost never intentional, right? So, they're just so used to using jargon in a healthcare setting. It to the point where it becomes a mental shortcut for them. So really, if you don't understand something, please ask. You'll never be seen as difficult or time consuming. In fact, we as healthcare people, will worry if you don't get involved, we'll think that something's wrong. We'll think that you're not engaged in the process.
Patty:
And we’ll be worried that you won't be able to care for your loved one once they get discharged.
Yasmine:
Yes! So, it's really important that you are participating in those decisions that will affect the person that you care for.
Patty:
Especially with milestones and time frames, as well, right?
Yasmine:
Exactly. So show the people that you're wanting to learn. Basically you're giving them the green light. You're giving them the go ahead to get you involved, ask about you know, what is someone making progress? These things might be really subtle, but if you know what you're looking for, it's so very satisfying when you can see that improvement or see that something's changing, which.
Patty:
You also encourage carers to bring a support person. If this makes them feel more comfortable, or if they find the whole admin process overwhelming, which it can be.
Yasmine:
Yes, especially to a family meeting or a planning meeting. Bring someone that you know and trust, it doesn't have to be someone that knows anything about the healthcare setting, and it could be just someone that you feel comfortable with who can help you as an advocate.
Prepare questions for the team once you're thrown into a meeting and you've got everyone there and it's all very intimidating, you might forget what you came in to talk about, so feel free to write things down during the meeting. Ask for information to be repeated. Or even print it out for you, including translations in other languages if you don't understand what's happening.
Patty:
Yeah. I mean, one of the most important things to keep in mind is as a carer, is knowing when to push and when to hold back. Do you have any thoughts about that?
Yasmine:
Yeah, look, unless there's any risk to keeping someone moving so they're not going to do any damage or become unwell from this process, it's really best to encourage the person with an injury or illness just to keep moving. So, it's the old “move it or lose it” saying and really for all of us, being physically active and working towards a goal helps. Someone's motivation in other areas of their life, not just their general social and physical wellbeing, so really carers need to wear many hats. Sometimes they're cheerleaders. Other times they're personal trainers.
Patty:
Sometimes they're drivers, sometimes they're snack dispensers, yes.
Yasmine:
They could be counsellors, advocates.
It's a lot, yes.
Patty:
What are some useful communication skills, like the language of rehab? Like you've said before, that might be helpful for carers to know.
Yasmine:
I think just know, as I said, the different therapy types. And their roles.
Ask lots of questions and don't be afraid to ask for it to be presented to you in a way that you can understand. I think also ask “what is likely?” given the hospital team probably know if this particular injury has happened.
“This is the likely progression or this is how it's going to affect someone's independence and this is what the long term treatment might be”. Or “this is what medications they might need? And is that permanent or is that short term? What is that test for? Why are you doing that exercise? What is it targeting? Why is it being looked?”
Patty:
Yeah. And what are the different stages of recovery and what's the best process for navigating health systems? So I guess that's two questions.
Yasmine:
Recovery is not linear, so our experience tells us that there's often a predictable way. As I was saying that an illness or an injury would progress, or if a particular body part is affected, that this might make certain tasks more difficult, but we can never ever predict how someone will react to challenging news and being faced with significant challenges. And changes in their lives.
Patty:
And whether it's impacted a previous trauma that they've had in their lives that we're not aware of.
Yasmine:
That's right. Some people might be super internally motivated and be determined to prove the statistics wrong and we love that but other people might find it difficult to muster up the energy or the motivation to do something that we might think they're physically capable of doing, and that's OK.
All we can do is provide people with as much information as possible. Try to meet them where they're at. And as I said, start those conversations early even. With your loved one while you're still healthy and capable of making informed decisions. For instance, working in neuro. It really made me aware of the need to have these discussions and to plan early to the point where my husband and I have prepared ‘Enduring Power of Attorney’ and ‘Enduring Guardianship Orders’ and an Advanced Care Directive.
Patty:
Already?! And you're not even elderly! Wow.
Yasmine:
It's just so helpful in situations where a person's family may not share your wishes or your perspectives, or you have a very firm preference for where you want to live. If you can't remain at home, what support you might receive.
So often what I would see is that people would land in rehab and they would (because of their injury), develop an incapacity to understand the information that was presented to them and make an informed decision about what they wanted to happen and all of a sudden it's left up to, “so who else is going to make this decision?” And that's where the arguments come in if it's not in writing.
Patty:
You're the first person that has said or actually you're the first person I've interviewed that has suggested that this might be a good thing to do before you become elderly. I mean, obviously I know about ‘Enduring Guardianship’ and ‘Power of Attorney’ because I have elderly parents But I've never considered doing that with my family.
Yasmine:
Do it!
Patty:
OK. She's going to keep me accountable!
Yasmine:
It really helps to have friends who are solicitors then they can sign the paperwork for you. But you know what? Just do it because things happen like that. You just don't know. No one expects it, right?
And it's similar to even on your driver's licence, having your will for what happens to your organs, a lot of people don't realise that just having it on your licence doesn't mean that that's what's going to happen. It comes down to the person who's physically there at the hospita to represent you to have the final word.
Patty:
I might have been today years old when. I found that out as well.
Yasmine:
Yeah, one of the many things that I was involved with at the hospital was the on-call register for when horrible things happened overnight and they needed a social worker and we were part of what was called the ‘Postmortem Coordinator Role’, where we would have to have conversations with caregivers, such as “this person's life support needs to be turned off. Do you consent to X organs being donated?” And they're like, “I don't know, is it on the licence?” You need to know what do they want. You are the representative, for those sorts of situations.
Patty:
That is not for the faint of heart to do.
Yasmine:
Again, you hope never to do this, but you just realise how sensitive we are and how vulnerable we are, and it doesn't hurt. You're not going to make it happen by talking about it.
Patty:
Certainly not. And I think it you've made a good point about acknowledging that healthcare workers, especially social workers and anyone that goes into those situations, are people too. And we have good and bad days like you have said. Yeah. Yeah.
Yasmine:
But we encourage you, just like we do, to bring your authentic self, so engaging with healthcare settings. They want to see you for who you are because oftentimes the things that you might think are weak. Processes we might perceive as strengths and could actually contribute to someone's recovery. So, you might again need to be told the same thing multiple times or in different ways because you're not ready to take on that feedback. But we are there, we genuinely care. We want to help.
Patty:
So this is the last question that I want to ask you before. I do a ‘rapid fire wrap up’ which you know is my favourite. Do you have any success stories or personal achievements from rehab work that you can share with us?
Yasmine:
I do have a few that I'm very proud of. So while I was working in the rehab unit at St Vincents, I published a literature review on family conferences in stroke rehab, which then prompted me to enrol in a masters degree by research at Sydney Uni, and my research explored the information and support needs of carers of people who had suffered a stroke, and I trialed a new resource that I'd created so my university supervisor was the lovely Rosalie Pocket who was an incredible mentor.
She was recently awarded member of the Order of Australia, and I explored the introduction of a rehabilitation ‘mid term report card’ is what I called it, in communication and education for families of stroke survivors.
So, the study provided an opportunity to gain some insights into the caregiver experience and clearly showed that caregivers of stroke survivors need to be supported to engage effectively with the rehab teams, and last I heard. There are quite a few other hospital teams that have picked up the report card as a resource and tailored it to their own settings in order to help more and more carers prepare for what's to come.
Patty:
My goodness I got here today without without actually staining my shirt and I feel very accomplished. You you founded the Campsie Men’s Shed and you created the mid term report card, OK.
I also know that because you've got so much free time, you have a side hustle. Another thing that you founded that you don't necessarily get financially compensated for, and it's an amazing resource for all social workers. And you know, I promote this. Can you please tell us all about this?
Yasmine:
Of course I can, so I have my own podcast which I started 3years ago, which just seems like yesterday. And it's called ‘Social Work Spotlight’. So grab it wherever you would like to. It's an opportunity for me to connect with social workers who are doing incredible things in diverse areas.
What got them into it, why they stayed, what is unique about it, and just gives an opportunity for people either wanting to know more about social work or might be considering studying social work, just genuinely interested in what we do and why we do it and where it can land us.
And I've had the great privilege of interviewing the wonderful Patty Kikos as well. So, look out for that.
And we're up to 80 something episodes now. So yeah, it's. It's a fun. https://podcasters.spotify.com/pod/show/socialworkspotlight
Patty:
Yasmin, it's amazing. I'm so in awe of the energy that you bring to the world, to your life, to your patients, to your clients, to all of our interactions as well. Right now it’s rapid fire wrap up time. I know you want this.
Yasmine:
Oh no.
Patty:
OK, on a scale? Of 1 to 10, how good are you when it comes to keeping secrets?
Yasmine:
Is 10 the best?
Patty:
Yep
Yasmine:
Yeah, I think I'd be a solid 9. I've never been one to gossip. Who has time or energy? Really. If someone trusts me with their sensitive information, they'll be fairly certain it's safe with me.
Patty:
9 is good. You're a bit of a vault. That's good. I think as social workers, we're often privy to a lot of private information about people that a lot of people in their own family of origin don't necessarily know.
Yasmine:
And it's a big responsibility, isn't it?
Patty:
Yes! What is the weirdest thing you've ever eaten?
Yasmine:
A tarantula in Cambodia Ohh I was there to give a talk to some nurses and doctors in Phnom Penh around Trauma Recovery and Rehab. And after the training, I went out with my colleagues from the rehab unit and got to try some of the local foods.
Patty:
Of course you did!
Gun to your head. You have to choose one. Would you rather sing karaoke in public or do stand up comedy?
Yasmine:
Yeah, both terrify me.
Patty:
Gun to your head.
Yasmine:
But I feel like people would laugh even if I sang karaoke. So at least with the comedy. I would be doing something right if people were laughing right? So I think I think comedy, you know, you've done. A good job If people are laughing.
Patty:
100%! Do you watch shows one episode at a time, or do you binge watch the whole season?
Yasmine:
I'm a Binger, some real, some fantasy. I'm watching ‘Shrinking’ at the moment, which is from the creator of ‘Scrubs’ and ‘Ted Lasso’. It's about a psychologist who crosses boundaries with his clients to process his own grief, but it's really touching and hilarious at the same time, and I'm resisting the urge to watch each episode as it comes out because I just want to watch it all at once.
Patty:
Yeah. So, I'm in a similar conundrum at the moment with ‘Mayor of Kingstown’. I wanted to wait until a couple of episodes accumulated so I could binge watch it and unfortunately. I just I. I have no.
Yasmine:
No will?
Patty:
None whatsoever. Yeah, it's a punish. Yasmine, you have just been absolutely amazing. You are so inspiring. Thank you so much for joining me today.
Yasmine:
Thank you, Patty. It's been wonderful.
Patty:
It's been wonderful for you to shed so much light on rehabilitation. Thank you. So so much.
Yasmine:
I'm just grateful I get to talk about something that I love. So thanks.
Patty:
Ah and you did! and folks, if this is an episode that you did find inspiring, subscribing and living us a 5 star review will make all the difference to us.
And of course, if you've got any suggestions about upcoming episodes or anything you want to share your opinion on, you can always email us at CGConnections@benevolent.org.au and attention ‘Patty’ in the subject line.
That's it for today. I want you to take very good care of yourselves until we are in your listening ears again. Be well. Bye for now.
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Billy:
If you are caring for a relative or a friend who has a disability, a mental health condition, a life limiting health or medical condition.
Or they are frail because they're getting older. Please contact us at Carer Gateway on 1800 422 737, or look us up on www.carergateway.gov.au
And if you are a carer, you're allowed to take time to look after yourself. You are just as important as the person you take care of.