Empathy by Immersion: Through the Eyes of Residents, Part One

By Jim Nelson | December 5, 2024

With Netflix’s Man on the Inside series currently shining a spotlight on the senior living industry via Ted Danson’s exploits as a private eye embedded in a fictional assisted living community, we turn our attention to a real-life embedding.

It was nearly a decade ago that Leslie Pedtke, who was then an administrator at a long-term care community, inspired more than a dozen of her staff members to immerse themselves in the community by actually living with and as residents for as many days as they could take it.

Pedtke is now a national speaker in the long-term care sector, assisting senior living companies focus on culture change, workforce development, and teaching empathy through her Dignity Quotient company.

She is also the author of What Living as a Resident Can Teach Long-Term Care Staff — The Power of Empathy to Transform Care, which chronicles the profound experience that changed her and the staff at Aviston Countryside Manor in 2015/2016. At that time, the 97-bed, intermediate-to-high level skilled nursing community in Illinois was family-owned and operated; beginning in college, Pedtke worked there as an administrator for 22 years.

This experience may have taken place many years ago, but the lessons learned by Pedtke and her staff are universal and timeless, so we wanted to amplify the details here for a new generation of caregivers to learn.

Impacted by the passing of a longtime resident, Pedtke began to question whether they, as stewards of their residents, were doing enough to respect and show dignity to the people in their care. Gathering some of her leadership staff, Pedtke proposed inviting staff to move into the nursing home, to live with whatever diagnosis they drew at random. The idea was to really push the staff to experience what residents experience, so every day there were additional random challenges, and whoever stayed in the longest, through their diagnosis and daily challenges, would win a cash prize.

Going through everything a resident goes through — even filling out an admission packet with their families and having their clothes marked — some staff members lasted as many as 12 days. The contest was filmed, and highlights are available online.

Senior Living News chatted with Leslie Pedtke at length about her perception-changing experience at Aviston, and we present that conversation in two parts. Here is part one.

SENIOR LIVING NEWS: The story of what you and your staff experienced is transfixing and inspiring.

LESLIE PEDTKE: It’s been a long time since that experience with my staff, and I love that I’m still able to tell that story, that people have not tired of it. When I hear so many people talk about the challenges that they’re having in their long-term care communities, my first thought is those staff members need to move into that community. It would change their perspective so much just to see things from a different lens. Your outlook, the way you would approach care, all of that stuff changes when you’re able to see things from a different lens, but a lot of times, we don’t want to see things from a different lens because it makes our jobs, in a way, a little bit harder. We become a lot more vulnerable whenever we see things from a different lens.

SLN: It’s the difference between sympathizing and empathizing. I think about the one young lady, Nikki, who came to the realization that the residents can’t get up and change their situation at the end of a contest like she was able to. It took a lot of guts for those staff members to move in like that. Were you their boss or were you all teammates?

LP: I was their boss.

SLN: And was there any sense of compulsion that they had to do this or was it entirely volunteer?

LP: It was entirely volunteer. If nobody wanted to do it, that was fine. If everyone wanted to do it, we would have figured that out as well. When I say it was entirely volunteer, people got paid for what they normally would have worked. So, say someone stayed there for a week and they were going to be on the schedule to work as a CNA three eight-hour shifts that week, we paid them for the three shifts that they would have worked, but the rest of the time that they were there, was strictly volunteer. And I think that’s really important for people to hear. I had a single mom that moved in and had to make arrangements for somebody to watch her young son just so she could learn to be a better CNA. I find that amazing and I feel like the luckiest administrator ever to have staff that was willing to do that.

SLN: And the flip side of that, of course, is that if a staff member who volunteered to move in was also scheduled to work three of the days, Aviston had to pay for a second person to cover those shifts. So, you not only had to get volunteers to participate in this, but you also had to get your supervisor to sign off on it.

LP: Yes, and this was my approach to that: We spend a lot of money in servicing our staff — you might have an all-staff in-service maybe twice a month or once a month, and you’re paying them to be there. Maybe I’m having an all-staff in-service to reduce the amount of falls that are happening in my community. I have 50 people come in and does anything really change? No. Maybe one person walked away with something. But doing this [contest] impacted the entire community. It was an immersive, deeply felt change that stuck because they felt it. That’s what really made the change. A lot of those things that we did are still happening at that nursing home.

SLN: Taking you back to the impetus for this competition, you were sitting with a resident named Lila as she was about to pass. You were thinking about whether you and your team had done enough for her, had shown her dignity. This led you to create an ultimate experience of empathy in the form of an employee contest. What was your expectation in terms of how it would go over?

LP: The majority of my leadership team was really excited about it, so that gave me a lot of hope that people were going to want to do this. We called it “Through the Looking Glass,” we came up with the rules, and I put a note in the breakroom: “If you’re interested in participating come to this all-staff meeting.” So, I’m hoping that maybe a dozen people would show up and show interest. That all-staff meeting was packed. People were really curious to hear about what this would look like and if they could do it. That first time I did it I had three people, I think, that were interested right away: a housekeeper and two CNAs. I found that interesting that a housekeeper would be motivated to want to move in and live like a resident, and she said, “My parents were in a nursing home, and I always wondered what it was like for them to have to be dependent on people.”

The only guy that moved in said, “As a CNA, I don’t feel like I have the opportunity to really get to know who all of my residents are, so I want to move in here, I want to be their peer, and I want to actually get to know them. I want to become friends with these people and get to know them on that level rather than just always being their caregiver.” That was really cool.

We no longer called ourselves caregivers after this experience; we really felt that we were care partners because we had developed that much better relationship with people.

[In part two of this two-part interview, we’ll dive into the results of the contest, we’ll learn Pedtke’s biggest takeaway from it, and we’ll learn how Aviston’s resident hiring committee reduced staff turnover.]