[Applause] these are my grandparents grandma Burt
these are my grandparents grandma Burt
these are my grandparents grandma Burt papa Sam about 20 years ago they both
papa Sam about 20 years ago they both
papa Sam about 20 years ago they both ended up in a nursing home grandma Burt
ended up in a nursing home grandma Burt
ended up in a nursing home grandma Burt with severe depression Papa Sam a long
with severe depression Papa Sam a long
with severe depression Papa Sam a long painful struggle with Alzheimer’s
painful struggle with Alzheimer’s
painful struggle with Alzheimer’s disease the way that the nursing home
disease the way that the nursing home
disease the way that the nursing home dealt with their behavioral issues was
dealt with their behavioral issues was
dealt with their behavioral issues was by giving them high doses of behavior
by giving them high doses of behavior
by giving them high doses of behavior control medications now growing up my
control medications now growing up my
control medications now growing up my grandparents were always lively
grandparents were always lively
grandparents were always lively intelligent funny people but once they
intelligent funny people but once they
intelligent funny people but once they started taking these medications they
started taking these medications they
started taking these medications they almost became like zombies to me it made
almost became like zombies to me it made
almost became like zombies to me it made it not very fun to visit them and
it not very fun to visit them and
it not very fun to visit them and something I regret to this day is I
something I regret to this day is I
something I regret to this day is I totally stopped going for a long time
totally stopped going for a long time
totally stopped going for a long time this was the tendency to treat
this was the tendency to treat
this was the tendency to treat behavioral problems with large doses of
behavioral problems with large doses of
behavioral problems with large doses of medications a study was done in one out
medications a study was done in one out
medications a study was done in one out of every two people living in a nursing
of every two people living in a nursing
of every two people living in a nursing home was on one or more behavior
home was on one or more behavior
home was on one or more behavior affecting medications before you get too
affecting medications before you get too
affecting medications before you get too upset about this realize it was done for
upset about this realize it was done for
upset about this realize it was done for a reason nursing homes don’t tend to
a reason nursing homes don’t tend to
a reason nursing homes don’t tend to make a ton of money so they have to hire
make a ton of money so they have to hire
make a ton of money so they have to hire many of their care staff at close to
many of their care staff at close to
many of their care staff at close to minimum wage salaries working in a
minimum wage salaries working in a
minimum wage salaries working in a nursing home is already a pretty
nursing home is already a pretty
nursing home is already a pretty difficult sometimes rather stressful job
difficult sometimes rather stressful job
difficult sometimes rather stressful job when your grandma is able to kind of sit
when your grandma is able to kind of sit
when your grandma is able to kind of sit there zoned out well it’s easier to keep
there zoned out well it’s easier to keep
there zoned out well it’s easier to keep an eye on her and make sure her basic
an eye on her and make sure her basic
an eye on her and make sure her basic needs are being met if all of a sudden
needs are being met if all of a sudden
needs are being met if all of a sudden she were to start acting out by no
she were to start acting out by no
she were to start acting out by no yelling or crying or refusing care will
yelling or crying or refusing care will
yelling or crying or refusing care will take a much higher level of expertise to
take a much higher level of expertise to
take a much higher level of expertise to help her there are of course problems
help her there are of course problems
help her there are of course problems with giving high levels of these
with giving high levels of these
with giving high levels of these medications an obvious one is it can
medications an obvious one is it can
medications an obvious one is it can turn our loved ones into almost a shell
turn our loved ones into almost a shell
turn our loved ones into almost a shell of the people they used to be a common
of the people they used to be a common
of the people they used to be a common term used nowadays is chemical restraint
term used nowadays is chemical restraint
term used nowadays is chemical restraint because these medications can not only
because these medications can not only
because these medications can not only cause you to no longer be able to
cause you to no longer be able to
cause you to no longer be able to express behavioral problems it can be
express behavioral problems it can be
express behavioral problems it can be from expressing just about anything
from expressing just about anything
from expressing just about anything including
including
including your needs other problems are kind of
your needs other problems are kind of
your needs other problems are kind of medical in nature they increase risk of
medical in nature they increase risk of
medical in nature they increase risk of Falls which when you’re elderly can be
Falls which when you’re elderly can be
Falls which when you’re elderly can be very dangerous the increased risk of
very dangerous the increased risk of
very dangerous the increased risk of stroke they even increase risk of early
stroke they even increase risk of early
stroke they even increase risk of early mortality it’s because of these problems
mortality it’s because of these problems
mortality it’s because of these problems that a few years ago government finally
that a few years ago government finally
that a few years ago government finally put its foot down and it told nursing
put its foot down and it told nursing
put its foot down and it told nursing homes you need to start reducing these
homes you need to start reducing these
homes you need to start reducing these medications across the board and
medications across the board and
medications across the board and wherever possible eliminating them
wherever possible eliminating them
wherever possible eliminating them getting people off of really high doses
getting people off of really high doses
getting people off of really high doses of behavior meds though it can be kind
of behavior meds though it can be kind
of behavior meds though it can be kind of tricky problem is a lot of people
of tricky problem is a lot of people
of tricky problem is a lot of people started taking them because they were
started taking them because they were
started taking them because they were starting to exhibit significant issues
starting to exhibit significant issues
starting to exhibit significant issues and problems things like anxiety
and problems things like anxiety
and problems things like anxiety depression even sometimes verbal and
depression even sometimes verbal and
depression even sometimes verbal and physical aggression when you start
physical aggression when you start
physical aggression when you start taking somebody off of one of these meds
taking somebody off of one of these meds
taking somebody off of one of these meds these problems can come back sometimes
these problems can come back sometimes
these problems can come back sometimes worse than when they started so you have
worse than when they started so you have
worse than when they started so you have to do it very carefully this can be a
to do it very carefully this can be a
to do it very carefully this can be a slow and expensive process and I saw an
slow and expensive process and I saw an
slow and expensive process and I saw an opportunity here see I have a background
opportunity here see I have a background
opportunity here see I have a background in behavioral science and data science
in behavioral science and data science
in behavioral science and data science so I created a company and we started
so I created a company and we started
so I created a company and we started using modern data science techniques to
using modern data science techniques to
using modern data science techniques to help clinicians more effectively reduce
help clinicians more effectively reduce
help clinicians more effectively reduce medications we build predictive
medications we build predictive
medications we build predictive analytics so we could predict when
analytics so we could predict when
analytics so we could predict when problems were likely to occur before
problems were likely to occur before
problems were likely to occur before they started and before they escalated
they started and before they escalated
they started and before they escalated anyone who’s done data analysis before
anyone who’s done data analysis before
anyone who’s done data analysis before knows you need good data to do good
knows you need good data to do good
knows you need good data to do good analytics so I built a simple mobile app
analytics so I built a simple mobile app
analytics so I built a simple mobile app that care staff could use to know when
that care staff could use to know when
that care staff could use to know when should they look at a particular
should they look at a particular
should they look at a particular resident what things should they look
resident what things should they look
resident what things should they look for with that individual and how can
for with that individual and how can
for with that individual and how can they easily record that I have to say in
they easily record that I have to say in
they easily record that I have to say in doing this I was starting to feel good
doing this I was starting to feel good
doing this I was starting to feel good about myself I mean here I was using my
about myself I mean here I was using my
about myself I mean here I was using my experience and knowledge and I was
experience and knowledge and I was
experience and knowledge and I was building something that was going to
building something that was going to
building something that was going to help people like my grandparents now
help people like my grandparents now
help people like my grandparents now when you’re building software it’s
when you’re building software it’s
when you’re building software it’s important to talk to your customers and
important to talk to your customers and
important to talk to your customers and I knew this I’d go to potential
I knew this I’d go to potential
I knew this I’d go to potential customers and I chome what I was doing
customers and I chome what I was doing
customers and I chome what I was doing and I’d say hey isn’t this gonna help
and I’d say hey isn’t this gonna help
and I’d say hey isn’t this gonna help you and don’t you think these are the
you and don’t you think these are the
you and don’t you think these are the right features and they’d usually
right features and they’d usually
right features and they’d usually confirm it they’d be nice and say yes
confirm it they’d be nice and say yes
confirm it they’d be nice and say yes that looks like it will help and then
that looks like it will help and then
that looks like it will help and then they want to tell me stories you know
they want to tell me stories you know
they want to tell me stories you know stories about what it was like to work
stories about what it was like to work
stories about what it was like to work there and interactions with the
there and interactions with the
there and interactions with the residents I never felt like I had time
residents I never felt like I had time
residents I never felt like I had time to listen to stories I had to get back
to listen to stories I had to get back
to listen to stories I had to get back to my computer and programming and
to my computer and programming and
to my computer and programming and finish up these features that I knew
finish up these features that I knew
finish up these features that I knew they needed
they needed
they needed one day I was kind of stuck in a
one day I was kind of stuck in a
one day I was kind of stuck in a situation where I had to listen to
situation where I had to listen to
situation where I had to listen to somebody’s story and the story was
somebody’s story and the story was
somebody’s story and the story was amazing so I started asking other people
amazing so I started asking other people
amazing so I started asking other people for their stories I’m going to share
for their stories I’m going to share
for their stories I’m going to share just two of those with you here today
just two of those with you here today
just two of those with you here today the first one involved a man living in a
the first one involved a man living in a
the first one involved a man living in a nursing home who lived close to the
nursing home who lived close to the
nursing home who lived close to the elevator very nice man but sometimes
elevator very nice man but sometimes
elevator very nice man but sometimes almost randomly he would get up go to
almost randomly he would get up go to
almost randomly he would get up go to the person coming out of the elevator
the person coming out of the elevator
the person coming out of the elevator and punch them who knows why he was just
and punch them who knows why he was just
and punch them who knows why he was just doing this randomly now the normal
doing this randomly now the normal
doing this randomly now the normal response would have been to kick him out
response would have been to kick him out
response would have been to kick him out of the nursing home or give him enough
of the nursing home or give him enough
of the nursing home or give him enough meds so that he couldn’t get up and do
meds so that he couldn’t get up and do
meds so that he couldn’t get up and do this but this was a really good care
this but this was a really good care
this but this was a really good care team and so what they did is they got
team and so what they did is they got
team and so what they did is they got together to try to figure out what’s
together to try to figure out what’s
together to try to figure out what’s going on here so they the man wasn’t
going on here so they the man wasn’t
going on here so they the man wasn’t very expressive but they spoke to him
very expressive but they spoke to him
very expressive but they spoke to him they spoke to the man’s family and they
they spoke to the man’s family and they
they spoke to the man’s family and they found out in earlier life he had been a
found out in earlier life he had been a
found out in earlier life he had been a boxer which explained why he was so good
boxer which explained why he was so good
boxer which explained why he was so good at punching well another care team
at punching well another care team
at punching well another care team member realized you know the sound the
member realized you know the sound the
member realized you know the sound the elevator makes when it reaches that
elevator makes when it reaches that
elevator makes when it reaches that floor that ding sounds a bit like a
floor that ding sounds a bit like a
floor that ding sounds a bit like a boxing ring bell and so they realize
boxing ring bell and so they realize
boxing ring bell and so they realize this man was being put back in that
this man was being put back in that
this man was being put back in that situation where the appropriate response
situation where the appropriate response
situation where the appropriate response was to get up and go punch the person
was to get up and go punch the person
was to get up and go punch the person coming towards you what did they do they
coming towards you what did they do they
coming towards you what did they do they simply moved them to a part of the
simply moved them to a part of the
simply moved them to a part of the nursing home where you couldn’t hear
nursing home where you couldn’t hear
nursing home where you couldn’t hear that Bell no drugs needed next story
that Bell no drugs needed next story
that Bell no drugs needed next story involves a woman in her 80s who
involves a woman in her 80s who
involves a woman in her 80s who unfortunately had dementia and very
unfortunately had dementia and very
unfortunately had dementia and very often she was trying to leave the
often she was trying to leave the
often she was trying to leave the facility now this is dangerous for
facility now this is dangerous for
facility now this is dangerous for someone who has dementia you can’t let
someone who has dementia you can’t let
someone who has dementia you can’t let them wander off by themselves because
them wander off by themselves because
them wander off by themselves because they can easily get lost it becomes very
they can easily get lost it becomes very
they can easily get lost it becomes very scary they can even get hurt so you have
scary they can even get hurt so you have
scary they can even get hurt so you have to watch him all the time but this woman
to watch him all the time but this woman
to watch him all the time but this woman was insisting on leaving and it was
was insisting on leaving and it was
was insisting on leaving and it was really hard to keep her in the facility
really hard to keep her in the facility
really hard to keep her in the facility once again the normal response would
once again the normal response would
once again the normal response would have been medication this was another
have been medication this was another
have been medication this was another really good care team so they got
really good care team so they got
really good care team so they got together and said okay are there any
together and said okay are there any
together and said okay are there any patterns here I started watching this
patterns here I started watching this
patterns here I started watching this noticing it was occurring almost it
noticing it was occurring almost it
noticing it was occurring almost it always the same time of day 3 p.m. why
always the same time of day 3 p.m. why
always the same time of day 3 p.m. why was that why was it always at 3pm that
was that why was it always at 3pm that
was that why was it always at 3pm that she was trying to leave well it turns
she was trying to leave well it turns
she was trying to leave well it turns out this woman who
out this woman who
out this woman who in her 80s sometimes believe she was
in her 80s sometimes believe she was
in her 80s sometimes believe she was back when she was 30 years old and when
back when she was 30 years old and when
back when she was 30 years old and when she was 30 she had to go pick up her
she was 30 she had to go pick up her
she was 30 she had to go pick up her kids every day from school at what time
kids every day from school at what time
kids every day from school at what time 3pm the solution they came up with i
3pm the solution they came up with i
3pm the solution they came up with i think is ingenious all they had to do is
think is ingenious all they had to do is
think is ingenious all they had to do is go to her a 245 every day and say marry
go to her a 245 every day and say marry
go to her a 245 every day and say marry someone is going to pick up your kids
someone is going to pick up your kids
someone is going to pick up your kids for you they are perfectly safe you can
for you they are perfectly safe you can
for you they are perfectly safe you can stay here and relax and she was fine
stay here and relax and she was fine
stay here and relax and she was fine with that no longer trying to leave
with that no longer trying to leave
with that no longer trying to leave who’s by listening to these kinds of
who’s by listening to these kinds of
who’s by listening to these kinds of stories that I realized that really good
stories that I realized that really good
stories that I realized that really good caregivers were doing something that I
caregivers were doing something that I
caregivers were doing something that I had not anticipated rather than seeing
had not anticipated rather than seeing
had not anticipated rather than seeing individual symptoms that they had to
individual symptoms that they had to
individual symptoms that they had to reduce at any cost they were getting
reduce at any cost they were getting
reduce at any cost they were getting together collaborating with other people
together collaborating with other people
together collaborating with other people and really trying to understand the
and really trying to understand the
and really trying to understand the person behind the symptoms it was almost
person behind the symptoms it was almost
person behind the symptoms it was almost like they had built this group detective
like they had built this group detective
like they had built this group detective process and as soon as they could
process and as soon as they could
process and as soon as they could understand the person behind the
understand the person behind the
understand the person behind the symptoms they could reframe the problem
symptoms they could reframe the problem
symptoms they could reframe the problem and solve it in a way that was
and solve it in a way that was
and solve it in a way that was completely innovative and didn’t need
completely innovative and didn’t need
completely innovative and didn’t need medications most of the time I realized
medications most of the time I realized
medications most of the time I realized if we were going to make a big
if we were going to make a big
if we were going to make a big difference in this industry that’s what
difference in this industry that’s what
difference in this industry that’s what we needed to do so we changed our focus
we needed to do so we changed our focus
we needed to do so we changed our focus from trying to tell clinicians here are
from trying to tell clinicians here are
from trying to tell clinicians here are trends with data to enabling this
trends with data to enabling this
trends with data to enabling this process across other teams so that we
process across other teams so that we
process across other teams so that we could allow everybody involved in care
could allow everybody involved in care
could allow everybody involved in care everyone from psychiatrist a
everyone from psychiatrist a
everyone from psychiatrist a psychologist to the social workers to
psychologist to the social workers to
psychologist to the social workers to the nurses and nursing aides everyone to
the nurses and nursing aides everyone to
the nurses and nursing aides everyone to collaborate around the resident better
collaborate around the resident better
collaborate around the resident better information sharing real-time
information sharing real-time
information sharing real-time communication all about who is that
communication all about who is that
communication all about who is that person and what are their needs another
person and what are their needs another
person and what are their needs another learning that I got out of this was
learning that I got out of this was
learning that I got out of this was about myself you see it turns out I was
about myself you see it turns out I was
about myself you see it turns out I was making the classic era that new
making the classic era that new
making the classic era that new entrepreneurs make I was letting my fear
entrepreneurs make I was letting my fear
entrepreneurs make I was letting my fear of failure get in the way of being
of failure get in the way of being
of failure get in the way of being innovative myself I was going to
innovative myself I was going to
innovative myself I was going to customers and looking for confirmation
customers and looking for confirmation
customers and looking for confirmation about my assumptions about their needs
about my assumptions about their needs
about my assumptions about their needs it was a weird parallel I ended up
it was a weird parallel I ended up
it was a weird parallel I ended up realizing between caregivers who are
realizing between caregivers who are
realizing between caregivers who are overusing meds and making assumptions
overusing meds and making assumptions
overusing meds and making assumptions about their resident needs I was acting
about their resident needs I was acting
about their resident needs I was acting like that it was only when I learned
like that it was only when I learned
like that it was only when I learned about good caregivers and what they do
about good caregivers and what they do
about good caregivers and what they do opening themselves up getting rid of
opening themselves up getting rid of
opening themselves up getting rid of their assumptions to try to understand
their assumptions to try to understand
their assumptions to try to understand what the people they’re trying to help
what the people they’re trying to help
what the people they’re trying to help really need that you’re able to make
really need that you’re able to make
really need that you’re able to make this huge difference my big hope now is
this huge difference my big hope now is
this huge difference my big hope now is with our software we can make that
with our software we can make that
with our software we can make that easier for good caregivers to do exactly
easier for good caregivers to do exactly
easier for good caregivers to do exactly that be innovative with their solutions
that be innovative with their solutions
that be innovative with their solutions thank you very much
thank you very much
thank you very much [Applause]
”
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