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Join Ray Stevens, DriveChicago.com General Manager Mark Bilek and Chicago Auto Show Marketing Director Jim OBrill as they broadcast form the 2024 Chicago Drives Electric event in Oakbrook Terrace. Mark & Jim have headlines and talk to Grant Goering from cars.com to explain how they are able to make on-site appraisals and offers on vehicles for those looking to sell their current car/truck/SUV. Erik Summa from Subaru visits to highlight some of the Subaru models, including the all-electric Solterra that are available to test drive at the show. Jim has a 'quick spin' review of his trip to Texas last week to check out the new Toyota Prius Prime. See omnystudio.com/listener for privacy information.
Phil and Dave dive right into it--with Dave discussing Hiffman National, his everyday job as a broker and how his time is primarily spent with property owners or industrial landlords or tenants in the marketplace trying to buy, sell or lease a building to suit their business needs. He then tells listeners how he began in industrial real estate in 2005, how the tide turned during the economic downturn of 2008-09, and the market corrections that led to bigger opportunities. He then touches on the market before, during and post-COVID which leads into a discussion on the industrial real estate conundrum of supply chain issues that created a demand for more buildings, and then landing on how inflation and interest rates have distressed cash flow and driven construction deliveries down. The duo also talks about how industrial has become the darling of the investor world, and the regression of landlord-tenant relationships—with fewer private landlords, and how tenants are feeling the trickle-down effect of the high rents market. David explains how Hiffman is crafting ways to cut some of the costs from these deals on the tenant representative side and conversely, how landlords are holding steady since vacancies in the city are low, giving them the advantage. David delves into how tenants are realizing ways to responsibly apply their funds and efficiently utilize their space. They also touch on transportation and how this major industry is in influx, and hypothesize the blueprint of one of the world's major e-commerce companies and how they make choices on leasing space. Dave also explains what's happening with infill development and the economic programs that are available in Cook County to spur economic growth, as well as the difficulties that are created by the county's tax structure and what the future may hold for commercial and industrial property owners trying to make the best decisions for their companies. David Haigh is a vice president and industrial real estate broker whose primary focus includes landlord and tenant representation in suburban Chicago. A veteran of Operation Iraqi Freedom, 2003-2004, Dave credits his attention to detail and work ethic to his time spent in the military. His range of services he provides include acquisitions, dispositions, leasing and site search analysis. Dave and his family enjoy traveling, and he volunteers as a Big Brother within the Big Brothers Big Sisters Association of Chicago. Headquartered in Oakbrook Terrace, Illinois, Hiffman is a full-service, privately owned commercial real estate brokerage and management company. Hiffman National is the company's management platform serving markets across the nation. NAI Hiffman is the Chicago-based brokerage operation and representative for NAI Global, the world's largest managed network of real estate service providers across the world.
Episode 355: I will discuss my visit to The Oakbrook Terrace Historical Society seeing Dispensa's Castle of Toys and Kiddie Kingdom memorabilia, my memories of watching Game Show Host Peter Marshall on TV, and more.
Episode 355: I will discuss my visit to The Oakbrook Terrace Historical Society seeing Dispensa's Castle of Toys and Kiddie Kingdom memorabilia, my memories of watching Game Show Host Peter Marshall on TV, and more.
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Steve Grzanich has the business news of the day with the Wintrust Business Minute. Champaign-based First Busey bank is expanding its presence in the Chicago suburbs. First Busey is buying Merchants & Manufacturers Bank, with five locations in Joliet, Channahon and Oakbrook Terrace. Crain’s reports the purchase will increase First Busey’s deposit share in DuPage […]
During their conversation, Phil and Sarah discuss how Hiffman is not a one-size-fits-all company and the intrinsic knowledge it takes to provide what the clients want and need to satisfy their stakeholders and investors. Sarah talks about the ability to be customizable, a perk of being privately owned, and how it has positioned Hiffman as a top alternative firm to the big national players. Hiffman is responsible for spaces in office, medical and industrial real estate — with the latter experiencing a surge in the Midwest since Covid. They also discuss ESG, its history and the three pillars; E for environmental, S for social, and G for governance. Within each of the pillars, different strategies are constantly evolving and being determined in how companies are contributing to being a sustainable player in the nation, world, and ecosystem. ESG is a way for stakeholders, investors and partners to examine more than just the bottom line, and evaluate questions like: “What impact are they leaving on the environment?” and, “What impact are we leaving on society?” The pair digs into how ESG is touching real estate efforts across the globe, and how Hiffman has made huge steps in talking to their clients about how to implement ESG standards and how many institutional money is requiring ESG processes for their investments, particularly from foreign investors. Sarah talks about the growth of the company, first in the Midwest and then branching out to Philadelphia and the East Coast. Their initial growth was organic and then spread through client driven initiatives. Hiffman National delivers full range commercial real estate services nationwide and have planted their flag throughout America with offices in 27 states; however, the company is always examining what may be the best next location for expansion. Sarah Cannella joined Hiffman in 2012 and is currently responsible for the oversight of the property management platform and operational initiatives, including transitioning assets, the Hiffman U property management training program, auditing, due diligence and technology platform directives. Sarah oversees four individuals who are solely dedicated to administering and evolving the Property Management platform. Prior to her role in operations, Sarah worked with the Hiffman Management Services group on behalf of investor clients on industrial, office and retail assets throughout the Chicagoland market. Headquartered in Oakbrook Terrace, Illinois, Hiffman is a full-service, privately owned commercial real estate brokerage and management company. Hiffman National is the company's management platform serving markets across the nation. NAI Hiffman is the Chicago-based brokerage operation and representative for NAI Global, the world's largest managed network of real estate service providers across the world.
Join Ray Stevens, DriveChicago.com General Manager Mark Bilek and Chicago Auto Show Marketing Director Jim OBrill as they broadcast form the 2023 Chicago Drives Electric event in Oakbrook Terrace. Mark & Jim review the Cadillac Lyriq, talk to Bert Walters from Powering Chicago about charging solutions for EV owners, and visit with Matt Cusek, Training Manager for Weber Grills who is on site showcasing how electric vehicles can power your next tailgate party! See omnystudio.com/listener for privacy information.
In this episode, Erika Schiller sits down with Ken Chlapik, Global Market Manager for Johnson Matthey (JM), a global leader in sustainable technologies. Ken is an expert in developing solutions that utilize JM's innovative low-carbon CLEANPACETM and ADVANCED REFORMINGTM technologies. Throughout his career, Ken has played a vital role in the growth of steam methane reforming (SMR) hydrogen utilization for clean fuel in the oil refining industry. During his tenure, the capacity of SMR-based hydrogen has tripled, and the hydrogen production is projected to increase dramatically in the next two decades as the world shifts towards cleaner, more sustainable energy sources. Based in Oakbrook Terrace, IL, Ken holds a B.Sc. degree in Chemical Engineering from Northwestern University, Evanston, IL. Ken is a respected representative of JM at the Institute of Clean Air Companies – ICAC and the American Fuel and Petrochemical Manufacturers (AFPM) screening committee, which recognized Ken with the prestigious Peter G. Andrews Lifetime Service Award. He is a prolific author, having published several articles lately exploring the acceleration of decarbonization in existing refining and petrochemical facilities, providing invaluable insights on achieving “A Running Start to Net Zero." Industrial facilities are responsible for 50% of the world's CO2 emissions, equivalent to 20 gigatons. Listen along as Erika and Ken dive into the topic of industrial decarbonization, breaking down the complex terms and acronyms as they go. They also discuss JM's solutions and its partnership with ClimeCo to positively impact industrial decarbonization. Unlock the world of sustainability and join the ESG Decoded Podcast community! Make sure to subscribe to be notified of new episodes on your favorite streaming platforms, YouTube, and our social channels (linked below). Get ready for thrilling new episodes that will ignite your passion for positive change. Tune in, engage, and let's decode ESG together! Episode Resource Links Ken's LinkedIn: https://www.linkedin.com/in/kenneth-chlapik-96ab6257/ Erika's LinkedIn: https://www.linkedin.com/in/erika-schiller-2773a52/ JM's Website: https://matthey.com/ JM's Low-Carbon Solutions: https://rebrand.ly/LowCarbonSolutions JM CLEANPACE Hydrogen Solutions: https://rebrand.ly/CLEANPACE 95% CO2 Reduction in Hydrogen Plants: https://rebrand.ly/ReductionForHydrogenPlants Running Start to Net-Zero: https://rebrand.ly/StartNetZero
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Episode 232: I will discuss my memories of Radio Disc Jockey Dick Biondi And The Ebenezer Floppen Slopper's Wonderful Water Slides in Oakbrook Terrace, IL. --- Send in a voice message: https://podcasters.spotify.com/pod/show/pete-kastanes/message
Episode 232: I will discuss my memories of Radio Disc Jockey Dick Biondi And The Ebenezer Floppen Slopper's Wonderful Water Slides in Oakbrook Terrace, IL. --- Send in a voice message: https://podcasters.spotify.com/pod/show/pete-kastanes/message
In other news: Temporary migrant shelters in schools could serve communities in the long term, organizer says; Oakbrook Terrace fighting removal of red light cameras near Oakbrook Center Mall; Cause of death revealed for college football player from LaGrange.
In other news: Temporary migrant shelters in schools could serve communities in the long term, organizer says; Oakbrook Terrace fighting removal of red light cameras near Oakbrook Center Mall; Cause of death revealed for college football player from LaGrange.
Welcome to the Aphasia Access Aphasia Conversations Podcast. I'm Katie Strong, a faculty member at Central Michigan University where I lead the Strong Story Lab. I'm also a member of the Aphasia Access Podcast Working Group. Aphasia Access strives to provide members with information, inspiration, and ideas that support their aphasia care through a variety of educational materials and resources. I'm today's host for an episode that will feature Mary Ann Eller. We'll be talking about incorporating the Life Participation Approach to Aphasia (better known as LPAA) in Acute Care Settings. Let me first tell you a bit about our guest. Mary Ann Eller, MA, CCC-SLP is the Assistant Manager for Rehab Services in the Speech and Language Pathology Department at Duke Regional Hospital in Durham, NC. She has worked in the Duke University Health Care System since 1989. She specializes in evaluating and treating adults with neurogenic and swallowing disorders in acute care and inpatient acute rehab. Her current professional passions are finding functional, practical, and patient-center approaches to the care of people with aphasia, dementia and all cognitive/communication problems. In this episode you will: Receive a permission slip to do secret therapy. Hear about how the Life Participation Approach to Aphasia Core Values can be implemented into acute care. Understand how implementing the Life Participation Approach to Aphasia supports the Joint Commission standards on health literacy. Be empowered to welcome interruptions and struggles and embrace the messiness and the creativity and the joy of using LPAA in acute care. Katie Strong: Welcome Mary Ann! I'm just so excited to have this conversation with you today! And we were just in Durham, at the Aphasia Access Leadership Summit, where you showcased your beautiful city. Thanks for hosting us. Mary Ann Eller: I'm really excited to be here and very honored that you asked me to do this podcast. Katie Strong: Well, I'm excited for people to hear about your thoughts. And as we get started, I wondered if you could share a bit about your own speech language pathology journey, and about the hospital setting you work in. Mary Ann Eller: I grew up in Pittsburgh. I went to the University of Pittsburgh for my undergraduate and graduate degree and then I went to the Shock Trauma Center in Baltimore for my CFY. And that's where I fell in love with acute care, you can't get more acute than that. Then I moved to Durham, North Carolina and I have worked at Duke since 1989, which is 34 years if you're counting. And I started when I was five! It's been a great experience. I've worked mostly in acute care and acute inpatient rehab. When I was new in my career, I loved the excitement of acute care. And I think as I grew older, I fell in love with rehab because I have more personal experiences with being in the hospital and with myself and with my parents. I just saw how important effective communication was at that time in people's lives. And that's what I really want to talk about today. Katie Strong: Yeah, I'm excited for this conversation. And as we dig in a little deeper, tell me how you became interested in applying the Life Participation Approach to Aphasia (LPAA) to acute care settings. Mary Ann Eller: Yeah, this is an interesting story to me. At the University of Pittsburgh, Audrey Holland was there at the time. As people who know her and her work, she is known for being extremely functional. So, I sort of grew up professionally knowing that being functional was the way to go. That was in the late 80s, so the LPAA had not been developed yet, which was around the year 2000, I believe when the impairment-based focus of therapy was recognized as not meeting the mark. It wasn't really helping people where they were at. And so, this LPAA not being a therapy approach, but more of an idea. LPAA is a philosophy of treatment, not a specific treatment approach. So, we could still use the treatment approaches that we knew and were evidence-based, but the philosophy of what we are using them for became more widely known in 2000. So, I didn't know about LPAA until about five years ago, even though I was familiar with being functional. So, in my little isolated world, I wasn't doing CEUs on aphasia because I needed to be a generalist. I had, by that time become a manager in the department and needed to stay up to date on swallowing and dysarthria and cognition. So, I wasn't really in the world of aphasia. So, I continued to do impairment-based therapy for a long time. But I did secret therapy, which I knew is what Audrey would want me to do. And it was, I would do the things that I knew the patient and the family needed me to do but I'd feel a little bit guilty doing it because I knew it wasn't “evidence- based.” And I wasn't doing the, you know, Response Elaboration Training, or whatever it was that I had learned, but I would meet their needs. So when, about five years ago, I went to an Aphasia Access Conference and Audrey was there, and I got to see her again. And she remembered me, which was really an honor. I was validated that the things that I had been doing in just my nature were correct. They were the best thing for the patient. That was really validating. I was always, and I'm saying this for any clinician who's out there listening, to not be afraid. I was afraid that I was doing it wrong. And I had been doing it for many years, had lots of experience, but I didn't want to get around other professionals that were more recognized in the field, because what if I was doing it wrong? Or what if there was a new approach that I didn't know about? And when I got there, it really wasn't that atmosphere at all at Aphasia Access. It was very welcoming, and it was very validating. And I realized that a lot of my instincts were right. Katie Strong: I love it. So, it's almost like the LPAA shone a light on that secret therapy, and really validated you. Mary Ann Eller: It sounds so funny that “secret therapy” but it's really what it felt like. So, I got to bring it out into the open and it was a secret no more. Katie Strong: Yeah, I love it. Well, I mean, obviously, then you feel like LPAA has value. Do you think LPAA has a role in acute care? And how do the Life Participation Approach Core Values apply to this setting? Mary Ann Eller: That was a great thing that I had to work out in my brain. Absolutely, it has a role in acute care. What I was learning about LPAA, when I first started learning, was a lot of information for when the clients were further along down the line. So, they were in the community, and they were participating in their goal setting, and they were deciding, “hey, I want to go back to work.” And that's what the speech pathologist was working on. And those things were wonderful, but that's not the setting I was in. So, I started to think about how these Core Values can apply to acute care. The Core Values, I'll read some of them right here, there's five of them. The first Core Value of LPAA is that “the goal is an enhancement of life participation.” So, when you're waking up with a stroke, and aphasia, the life you have to participate in is in a hospital bed. So yes, that applies. Number two, “all those affected by aphasia are entitled to service.” You are entitled to service if you have aphasia, in addition to swallowing and dysphagia services. That's important too, but you are entitled to service if you have aphasia, you don't skip it in acute care. Number three, “both personal and environmental factors are targets of assessment and intervention.” That is a lot of what I do in acute care with LPAA, I am looking into the environment, which includes the nurses and the nursing assistants, and the family, and the call bell, and the bathroom and all of those things that are in the environment. And that is what I am targeting and that's LPAA. Number four, “success is measured by documented life enhancement changes.” It is an enhancement of a person's life, like if they can use a call bell and get to the bathroom. If you've ever been in that situation, that is the most important life-enhancing really, lately. And then number five, “emphasis is placed on availability of services as needed at all stages of life with aphasia.” That includes the beginning, so yes, it absolutely has a place in acute care. Katie Strong: I love this. I feel like it's preach, you're preaching it girl. You know, it's just, I mean, I think for many, many years, we've thought about, “oh LPAA is just something that you do after you try everything else.” I love hearing you talking about bringing it into acute care just right from the beginning, it's so important. Mary Ann Eller: If I could say one more thing, I think the weight of responsibility for setting goals is one of the things that's talked about in LPAA. You want to be partners with the person who has aphasia in goal setting. And of course, you want whatever it is that they want to work on to be the center. However, when you wake up with aphasia and you have no experience with it whatsoever, you can't expect someone with aphasia to be able to set their goals of communication at that moment. So, I think that that's the biggest difference with the approach and thinking of LPAA. In acute care, the responsibility is more so on the clinician and the family to get to know the person and what's important to him and set the goals at that stage. Slowly educating and then giving the responsibility over to them as soon as possible to set the goals. Katie Strong: Beautiful, beautiful. We talked about it earlier, the importance of being able to communicate effectively in your health care setting. And one consideration for LPAA is that JCAHO, or the Joint Commission has placed a real high value on environments that support patients and having conversations about their health care to understand their health status and engage in their own health care decisions. Could you talk about how LPAA supports the Joint Commission standards on health literacy? Mary Ann Eller: Yes. And let me just say, for people who aren't familiar with hospitals, the Joint Commission is the regulatory board that comes in once every two or three years, and they tell you whether your hospital can continue to operate or not. So, the standards are very, very important. And I'm going to read you one of the standards that they have, and I think every speech pathologist is probably going to be, as they hear the standard, is going to be like “Well, wait, that's not really happening with my people with aphasia”. And I think that's where a real opportunity lies for us. You, I think, are attaching the standards? Katie Strong: Yes, I'm going to. I'll put them in the show notes so listeners can check them out and we'll have a link to the standards there. Mary Ann Eller: Okay, so one of the standards says that patients are expected to receive information about their care so they can make an educated decision, be listened to by their providers, and the hospital is required to identify patient communication needs and provide services to meet them. And so, you think about maybe someone who speaks another language, or maybe someone who is deaf, or someone who is illiterate. And those are all most of the things I think that people think about when they read that standard. But this also includes people with dementia, and people with aphasia, because you have that diagnosis, doesn't mean that you're unable to communicate. It means that you need special supports to be able to communicate and a lot of healthcare providers are not aware that speech pathologists can offer that support. And so, I think that's where a lot of our work lies. There's a quote that I like to use in my talks, it's by George Bernard Shaw, it says, “the single biggest problem in communication is the illusion that it has taken place.” And think that there are so many boxes that are checked in acute care, like “the nurse provided education on stroke, and how to prevent further strokes.” And they check the box, and they do a great job, I'm not getting down in that. But if you have aphasia, you did not receive that communication, she communicated it to you. I communicated something to you but that doesn't mean that you received it. And people when they have a stroke, or a brain tumor, whatever it has that produced aphasia, you and their families are in a state of shock, so you're not able to absorb the information. So, I think that that is one thing we need to really be cognizant of when we are trying to change the culture of a hospital. Katie Strong: Absolutely. And I was thinking of some of the materials you sent me to take a look at in preparation for our conversation today like that Joint Commission talking about communication requiring that two-way process of expressive and receptive or receiving and understanding, you know. That information is really important, very important. Mary Ann Eller: Yeah, yeah, absolutely. Katie Strong: And I think sometimes too, we know that our clients or our patients that we are working with take more time to be able to understand what's going on with them and their health care. Mary Ann Eller: Yeah, and a lot of times what we use to make that happen isn't really that complicated. It often involves slowing down, turning off the TV, sitting down at eye level, and stopping periodically to say, “did you get that?” and “repeat that back to me.” And that's for everybody, not just people with aphasia. It seems like it should be common sense, but it's really not. People in hospitals, especially in the last three years, have been under a lot of pressure and have to do a lot of things. And so, communication can often get lost. Katie Strong: Absolutely. All this sounds great Mary Ann, but what do you think might prevent some SLPs from embracing LPAA framework in acute care settings? Mary Ann Eller: That's such a good question because I went through that for 20-30 years, I guess. I didn't embrace it because I didn't know about it. I think that one of the biggest things is being at the Aphasia Access Conferences. I loved it and I loved having the honor of presenting last time we had it, but I just thought, “gosh, I want this to get to people who don't know about it.” Because there are tons of clinicians who maybe hear about it in grad school and perhaps, they go out to their placements and the supervisors maybe don't know about it. And so, they don't put it into practice, or they don't know exactly how to integrate it into practice. I think that number one, that's the biggest thing that's going to prevent clinicians from using it is because they don't know about it. I think the other thing is that the “secret therapy” that I talked about is realizing, and if nobody's given you this permission slip, I am giving it to every clinician out there. Here is your verbal permission slip, please treat the communication elephant in the room. Whatever it is with somebody in acute care. If they are struggling to order a meal, if they are struggling to call the nurse, if they're struggling with telling you something or talking to the person beside the bed, that's what you work on. Work on what is right in front of you. You don't have to complete an entire Western Aphasia Battery. You don't have to make sure that you have them name 10 things. Those things all have a place, and I think we can fit evaluation and treatment in, but please deal with the person who's right in front of you, not the agenda that you brought into the room. So, there's your permission slip. I think people don't know how to document it and that's okay. I have a couple suggestions a little bit later when I talk about that. I think they feel it takes too much time and it really doesn't, I think you can do these things instead of the big agenda that you brought into the room. I think these people are going to be dealing with aphasia for a long time. And so, they will get to a speech pathologist who will do the more standard evidence-based treatments when they're appropriate. I'm not saying they're never appropriate, sometimes they are. But in my experience of 34 years, a person in acute care with aphasia needs a ton of education, a ton of successes, and just a lot of validation that here's your recovery process, here's what's going to happen. They are in shock, and they don't know how to deal with things, and I think we are the ones who are speaking to that. Everybody else has their silo that they're speaking about with their blood pressure and their arm and their leg and all of these things. But communication is the soul of a person and I think reassuring those sorts of things and giving them successes at that stage is really vital. So yes, that's your permission slip. Katie Strong: Yeah, yeah, received. And we're going to make lots of copies of that permission slip and mail them out to everybody. So, you touched on this a little bit, but we'd love to hear some ideas that you have about how to incorporate LPAA principles into acute care. Mary Ann Eller: Here are some practical things. Honeycomb Speech Therapy is a great service that sent out or made available some free checklists for different settings. I downloaded one of those and so that's a good place to start. So, there's, I'm looking at it now, the Functional Needs Checklists by Setting and looking through using call light, using the menu, asking medical questions, and following safety precautions. I think as a clinician, starting to think through your aphasic patients in acute care by communication need versus impairment. The other thing I'll say that's a really good way to incorporate this is whatever templates you're using in your electronic medical record. The way that we have done ours in the past has been by impairment because that's how we're trained. “How can you talk?” “How can you comprehend?” “How can you read?” “How can you write?” And in our brains we're pulling it together and we're knowing how this might affect their ability to use the call bell. But I think using a table or a checklist that automatically makes you have to pull it together and give a set of supports that will enable the person to do that or not, depending on how severe they are, is one way to make sure that that you incorporate LPAA. Katie Strong: I love that. And I love the shout out to Honeycomb and Sarah Baar. We actually had her on the podcast. It's been a couple of years, but I think it's Episode 57 if listeners want to check out a little bit more of hearing her thoughts. But I agree, helping yourself be a little more strategic about how you're going to address all of these areas. Because, as you said earlier time is I mean, time is essential everywhere but in acute care, it's really the big commodity. Mary Ann Eller: Yup. Another thing is to welcome interruptions because when you're in acute care you will be interrupted. And the nurse will come in to give meds and I think to go into a patient's room open for whatever happens. So that when the nurse comes in and gives meds, you are demonstrating some supported communication techniques. So maybe you always have a pad of paper and a pen or a whiteboard. And so, you write down the medicine, and then you ask the nurse, “what's the medicine for?” and they say, “blood pressure,” and then you write down blood pressure, you show it to the patient, and they nod. And then they have experienced what JCAHO was asking us to do, which is communicating what's happening to them. And not only has that happened, but you also are educating the nurse to see how successful that communication is when you write down a word, for example. Welcome the interruptions to show communication. I've had doctors come in and explain what's going to happen next for their discharge and I write that down or slow it down or whatever the support needed is. Same with social work. There are so many opportunities to use functional communication and LPAA in acute care. As I was thinking through this question, one of the most effective ways that I remember using it in my recent past is with a patient that had Wernicke's aphasia. And it was at the height of COVID, so everybody had masks on, including her. And she was very, very fluent, and she could not understand spoken language, I mean, lots of it. She could walk, you know, and that made all the more frustrating for her, they'd say, “you can't walk by yourself, you need to sit down.” Well, she didn't understand what they were saying. So, she might say in return, “fine, how are you?” And so, people thought that she was crazy. She was not crazy, she had Wernicke's aphasia. She did not understand spoken language. And so, when we finally got the consult after the woman was put in a Posey Bed, I was able to tease that out. I was able to educate the staff on “hey, if you do X, Y, and Z,” which included writing down what you're saying, a key word, then she can look at it, she can look at the context, and she can follow your directions. And it was the biggest difference. I mean, speech pathologists really do a great service for people with aphasia in acute care. So, those are just a couple of things that I thought of. Katie Strong: I love it. I love it. Well, you alluded to it earlier, but I'm going to invite it back into the room now. That is the elephant in the room, hello dysphagia. How does an acute care SLP balance the needs of the patient with dysphagia and also support communication issues as well? Mary Ann Eller: That is a good question, and I don't find it difficult at all to do that. And the reason I don't find it difficult is because I've embraced some messiness in my evaluations. Katie Strong: Tell me more! Mary Ann Eller: And sometimes that's hard to do, especially early in your career. Or if you are a very focused kind of Type A organized person, which a lot of speech pathologists are and that's why we're so good at our jobs. But it is a little bit messy. And what I mean by that is, you can easily do both at the same time. You can evaluate dysphagia and you can evaluate their language. You can have them following commands with your clinical swallow even though you're not saying hold up two fingers and point to the window or whatever you were taught. You can say, “hey, would you pick up that glass of water?” without pointing to it and see if they do it. You can ask them open-ended questions and closed-ended questions to see what kind of language they have. While you are writing your recommendations on the whiteboard, you can have them read it back and assess their reading in that way. There's lots of things that you can do to assess both at the same time. So, it really doesn't take that much more time, it just takes a difference in how you think about it. Katie Strong: Powerful stuff. Yeah. I love that it's not, doesn't have to be mutually exclusive, and couldn't and shouldn't be. I'm sure our listeners would be interested in exploring some of the resources that influenced your thinking about this topic of LPAA. Would you be willing to share a few? Mary Ann Eller: So, one that I read 8 or 10 years ago was by Lyn Turkstra. And I talked with her about this at a conference once and it was really interesting. It's on Inpatient Cognitive Rehab, Time for a Change. I can't remember the year that she published it. Katie Strong: I think I've got it here, it's 2013. And listeners we'll have all these resources in the show notes for you, too. But yeah, it's a 2013 publication. Mary Ann Eller: I talked with her about it at a conference once and she said that she really kind of had a hard time getting it published because it was so against the grain at the time. And basically, what it was is inpatient rehab, for those of you who don't know, is after acute care oftentimes. So, it may be within a week of having a stroke and maybe you stay for two weeks at this point. So, within the first month of having a stroke and having aphasia. So, Lyn Turkstra's thinking was, we're programmed and taught to do things in a world of rehab that used to be months long and now it's only a couple of weeks and now earlier than it used to be. So hey, why don't we focus on some other things like education and laying the foundation and making sure that there's a therapeutic alliance with speech therapy so that the person knows, you know, down the line, this is the person you're going to go to and have a good experience with that. That was the first paper that got me thinking. And then after I started going to the Aphasia Access a few years ago, I looked up an old paper of Audrey Holland's that was Early Aphasia Management and Acute Care. And that was in 2001 that she wrote that. That talks about a lot of the same things, is that we don't have to do an entire Western Aphasia Battery, but let's take care of their actual needs in acute care. I loved Roberta Elman's CAPE checklist and I felt kind of dumb when I went to Aphasia Access and I started asking people, “hey, I'm in acute care, and I'm thinking about XYZ.” And they said, “oh, well, that's what CAPE does.” And I was like, “what's CAPE?” I just didn't know. And CAPE stands for, it's a checklist of four interventions, C is connect with the person with aphasia, A is augmentative communication, P is partner training, and E is education and resources. Basically, it's if you do these four things in the very early stages, then you've got your bases covered. And it's like, Oh, that's awesome. I wish I would have thought of that. I'm just glad she did. Katie Strong: Before you move forward, I just want to say thank you for being so open about feeling uncomfortable that you didn't know things. And I guess from my aspect, I think it's also for maybe listeners who are not practitioners but are researchers putting frameworks out there. We really need to be better at getting our work out to the people who can implement it, you know? So, I mean, I think it takes both sides of things to really get it. You can have beautiful, evidence-based work but if it doesn't get into the hands of the practitioners who are using it, it just doesn't matter. So, thank you for being so open about that and I hope that, I'm thinking that it probably resonates with a lot of the listeners here too. That you know, we don't always know what we don't know. Mary Ann Eller: Yeah, yeah. Thank you for that. You know, it's funny, because even yesterday, I have a lady who has been in the rehab unit for a really long time, for a variety of reasons. But she has pretty severe aphasia, and I was looking over these notes for this conversation today and I realized as I went through the CAPE that I didn't provide her with any educational resources. It's like, wait a minute, I didn't do this. And it's just, you get caught up in the day-to-day things, even if you're invited to do a podcast about it. And sometimes it's just one of those things. Nobody's perfect. But I think if we can have some standards in front of us and go back to them, that we're going to do a great job, that the frameworks are out there. And I guess the other paper I wanted to mention was also by Roberta Elman it's, “Are we missing the forest for the trees?” and I love that. Katie Strong: It's a great title. Mary Ann Eller: Yeah. It was like, okay, we're doing all this stuff for aphasia but the person can't communicate when they get home. And I really, really liked that stark reality and I looked back on a lot of my patients, and I'm like, “ wow, I did a great job while they were in rehab.” But I wonder how they're doing at home because I didn't really work with her husband that much. And that is a failure on my part. And, you know, we do better the next time. But those are the things that really influenced how I thought about this. Katie Strong: Fantastic. Well, we'll make sure to have links to all of those articles and resources in the show notes. Mary Ann, you've been thinking about applying LPAA in your acute care work for a while now. Do you have any ideas that you could share with us that you have in the works in your own practice? Mary Ann Eller: Yeah, I have a couple. Well, one of the things that I did and it's a very specific intervention, is I developed a Picture Menu because I was doing a lot of work with dementia care and nutrition because of an initiative in our hospital with geriatric care. And dementia is a place where nutrition is often overlooked because they're usually in acute care because maybe they fell or lots of reasons. And the tray ends up getting put in front of them but because of their dementia, they don't eat it and then they start getting sicker and sicker. So, because of that, I realized, even if they could eat, they might not want the tuna fish sandwich that's in front of them, because that's the standard tray that you get if you don't order your meals. And they don't order their meals because they can't communicate. You know, it's not just dementia, it's people with aphasia. And our menus were extremely word based. They were great but they had a lot of words to them. And if you can't read it for a variety of reasons, maybe you're blind, maybe you speak a different language, maybe you're illiterate, all different reasons. Then the person comes up to your bed and takes a really great bedside order like a waitress on an iPad, but again, all words. I teamed up with some people at my hospital and we went down to the kitchen, and we took pictures of all the items on the menu, and we put it on a big giant, laminated menu that we bring to the bedside and have them point to it. So yeah, and I've trained the patient menu techs, the people who actually take the orders, to use it. So, it's a work in progress because it's an extra step but yeah, it's really useful for the people that can use it. So, that's one thing. The other thing is the idea that I had, and it is not flushed out at all. I'm just gonna like put it out there and if somebody wants to steal it and do it before I do, feel free. But in my hospital, which is Duke Regional Hospital, it's part of the Duke System, but it's a smaller community hospital made up of about 380 beds. A couple of brilliant speech pathologists teamed up, and developed a trach team. And the trach team consisted of a pulmonologist and a respiratory therapist and a PT and an OT and the main players that revolve around trachs. And through a lot of hard work, they were able to do some culture change and practice change and get these patients with trachs taken care of through weekly rounding and all sorts of focus changes. And I thought, why can't we do that for people with aphasia? Or communication, just have a communication team? And I don't know what it's going to look like yet but why can't we get the players? I mean, maybe it's just the speech pathologist. But identify in my hospital through speech pathology consults, okay, here are the most vulnerable people to not get their needs met in acute care because they have global aphasia or severe dementia and they're on our caseload. Let's put them on a special list and let's give them special attention in some way and have a communication team. And as you round on these patients, you let the rest of the hospital see you doing this. You let them see how to intervene with these people. And it catches on so that they then learn these techniques, whatever they may be. We act as advocates for these people that are particularly vulnerable. Again, I don't know how it's going to work yet, but that's an idea. Katie Strong: Yeah, I love it. And I would love to hear how it unfolds, so. Mary Ann Eller: Me too. Katie Strong: Yeah. Okay. I'd like to take it a little bit further because you're the manager of a department, right? So, talk about maybe a few tips in transitioning to an LPAA focus with a staff that isn't particularly familiar with that philosophy. Mary Ann Eller: That is a really great question, and there's not one answer. And I'd love to bring in your friend, Natalie Douglas, in implementation science to speak on this. I'll tell you what I did and then I'll tell you what a bigger department might do. I have myself and five full-time speech pathologists, We all have varying levels of familiarity with LPAA and we all have been practicing in some form or fashion. So, I did an anonymous survey, and I asked some questions like, “how comfortable are you seeing people with aphasia?”, “have you ever heard of LPAA?”, “how comfortable are you using supported communication techniques?” And I did it anonymously because everybody is not going to want anybody else to know that they're not comfortable with it. So, even if there's just one person on my team who doesn't know LPAA or who isn't comfortable, I don't know who it is, I have an idea, maybe. But I'm going to put it in front of everybody and say, “hey, there's one person on our team who's not comfortable, let's focus on this.” And so that's what I did. My team is fantastic and they are very open. And so that's what we did. We had some focus teaching on it we watched some of the Aphasia Access videos on supported communication and LPAA. And then we changed our templates to include some tables that I talked about before that have the checklists on them. I think though, and I had a conversation last night with Kim Irby who is the interim chief over at ‘Big' Duke who has like, I don't know, 40 or 50, speech pathologists. And I asked her, I said, “what have you used with bigger departments?” And she had a really good point, she's like, “you know, education alone is not enough, it's not going to produce a behavior change. People are going to think their behavior is changing and they're going to think, through doing LPAA, and they might be. But really, you have to have people be able to be in the moment with a coach and do it together.” That can be tricky. I mean, you've got people with varying levels of comfort, varying egos, varying all sorts of things. And so, she and I thought, you know, I think probably the most practical way would be to educate and then pair people up together as peers and see a person with aphasia. Try things together then come back and let's all talk about it. It's not, “hey, I'm going to go with you as your boss and make sure you're doing this right.” That would be like totally not cool. So, I don't know, again, I want Natalie to tell me how to implement this. Katie Strong: We all want Natalie to tell us what to do, for sure. But I love this idea of learning together, right? That you're not imposing “this is what you have to do.” But really, you know, because I do think that the LPAA approach takes your own style...Each person delivers it in a different way, right? And it's different with each patient that you're with because it's personalized. Mary Ann Eller: Absolutely. And you can't teach that. It's not an agenda, it's an attitude and an openness, armed with the goals that you have, and armed with the core values of LPAA. Katie Strong: Yeah, I do really love and thinking back to the Turkstra article you were talking about and just that importance of therapeutic alliance with our discipline, right? So that then later on, they think about speech pathology as a positive resource to help. Beautiful. Okay, Mary Ann, as we wrap up, do you have any final thoughts you'd like to share with our listeners? Mary Ann Eller: I want them to remember the permission slip I gave them. I didn't give it to them, Audrey Holland gave it to them in 1989. Okay. And we're carrying it forward and there is a permission slip to work on the communication elephant in the room. Whatever it is, that is your goal. I think, I guess in my mind, early aphasia intervention should be guided by the person with aphasia's need in the moment first, then the bigger picture. I go in with a really, really loose agenda and I'm open to anything. I welcome interruptions and struggles and I think that that is the messiness and the creativity and the joy of using LPAA in acute care. I've been a patient in the bed for health reasons and I've sat next to my parents in the bed. I think that once you do that you realize how not only practical but necessary it is that we change our focus on communication at this stage of recovery. Because you don't care what the doctor knows, you care that the doctor cares and can explain it to you in a way that you can make your decisions. And that's the power we have. We've all had health care workers and seen them who have been outstanding and who have been terrible. I think we obviously want to be outstanding. And it doesn't take a lot to be outstanding when you know what your job is, which is to help the person with aphasia to communicate and to be understood in whatever supported techniques that we have and that is our job. And I think that is an amazing privilege. Really, I look at it as a privilege. We are inserting ourselves into a person's worst day and we are the person that walks in there and has the power to help them do two of the most important things, eat and communicate. Katie Strong: I agree. Mary Ann Eller: So, I think that those are pretty powerful and I think that it's a real privilege to be able to do that. Katie Strong: Thank you, thank you. I feel like you've just given us some gold that we need to really admire and take out and show off. Right? That we need to let all of it shine and really take these important pieces about changing our practice in acute care. And really helping people be able to understand and have conversations about their health care so they can participate in really important conversations that impact their life. Mary Ann Eller: I hope so, I hope so. And I'm not a researcher, I have not done papers and you know, all of those kinds of things. And I used to feel a little bit intimidated by that. It's like, well, do I really have anything to say? And I realized as time goes on, it's like, yes, absolutely. And I want to really reach out to the clinicians that are listening to this. Please use your voice. Please reach out for partners. If you hear somebody at a conference or you reach out to me if you want to, if you're listening to this. Just grow your knowledge and grow your ability to this great job that we have. Katie Strong: Thanks for a real, practical and inspirational conversation. Mary Ann Eller: Well, thank you for letting me have it. Katie Strong: Thanks, Mary Ann. On behalf of Aphasia Access, we thank you for listening to this episode of Aphasia Access Conversations Podcast. For more information on Aphasia Access, and to check out our growing library of materials, go to www.aphasiaaccess.org. And if you have an idea for a future podcast topic, email us at info@aphasiaaccess.org. Thanks again for your ongoing support of Aphasia Access. Guest Contact Information Email Mary Ann at mary.eller@duke.edu Resources Aphasia Access LPAA Training Videos (LPAA 101, LPAA, Core Value, Communication Access- Fundamental Techniques) https://www.aphasiaaccess.org/videos/ Chapey, R., Duchan, J. F., Elman, R. J., Garcia, L. J., Kagan, A., Lyon, J. G., & Simmons-Mackie, N. (2000). Life Participation Approach to Aphasia: A statement of values for the future. ASHA Leader, 5(3). https://leader.pubs.asha.org/doi/10.1044/leader.FTR.05032000.4 Elman, R. J. (2014). Aphasia intervention: Are we missing the forest through the trees? 44th Clinical Aphasiology Conference, St. Simons Island, GA. http://aphasiology.pitt.edu/2529/ Elman, R. J. (2020). C.A.P.E.: A checklist of four essential and evidence-based categories for aphasia intervention. Chapter 2. In A. L. Holland & R. J. Elman (Eds.) Neurogenic communication disorders and the Life Participation Approach: The social imperative in supporting individuals and families (pp. 21-52) Plural Publishing. Holland, A. & Fridriksson, J. (2001). Aphasia management during the early phases of recovery following stroke. American Journal of Speech-Language Pathology, 10(1), 19-28.https://doi.org/10.1044/1058-0360(2001/004) The Joint Commission: Advancing Effective Communication, Cultural Competence, and Patient- and Family-Centered Care: A Roadmap for Hospitals. Oakbrook Terrace, IL: The Joint Commission, 2010. Turkstra, J. S. (2013). Inpatient cognitive rehabilitation: Is it time for a change? Journal of Head Trauma Rehabilitation, 28(4), 332-336. https://doi.org/10.1097/htr.0b013e31828b4f3f If you liked this episode – more listening… Additional Aphasia Access Conversations Podcast episodes relating to the topic of acute care and applying LPAA to different settings. Episode #57 Patient-Centered Home Programs Across the Continuum of Care for Individuals with Aphasia: A Conversation with Sarah Baar. Episode#99 Communication Partner Training for Health Care Professionals with Dr. Jytte Isaksen Episode #38 Broadening the Role of the SLP in Acute Care Assessment: A Conversation with Robyn O'Halloran Acknowledgements – A special thank you to Amanda Zalucki from the Strong Story Lab at Central Michigan University for their assistance in the transcription of this episode.
May 18th in-preson and online - LIVE A LIFE OF SIMPLICITY, BALANCE, AND ABUNDANCE! Dynamic speakers, Q A with the Audience, Game Changing Tools for Living in the Zone! with Dr. Pat Baccili and Ann Grossman Jim Fannin presents an unprecedented, inaugural, event honoring Women in the Zone to launch his new training center in Oakbrook Terrace, IL. A Global HQ to develop Champions from every aspect of life. FREE 100 live seats and unlimited live streaming! Jim has been coaching women to soar in the Life Zone , Business Zone , Sports Zone for over 50 years. Now, he raises the bar and honors a promise made to his mom on her deathbed to go global and all inclusive starting with women from every walk of life. This profoundly heartfelt event launches a life long dream to develop champions, regardless or your past disappointments, or your current challenges, starting with women as he brings his proprietary, champion development, S.C.O.R.E. Success System to the world. YES -everyone in the world. Thank you mama! https://www.eventbrite.com/e/women-in-the-zonetm-tickets-616692262157 Watch https://www.facebook.com/transformationtalkradio/live_videos/
May 18th in-preson and online - LIVE A LIFE OF SIMPLICITY, BALANCE, AND ABUNDANCE! Dynamic speakers, Q A with the Audience, Game Changing Tools for Living in the Zone! with Dr. Pat Baccili and Ann Grossman Jim Fannin presents an unprecedented, inaugural, event honoring Women in the Zone to launch his new training center in Oakbrook Terrace, IL. A Global HQ to develop Champions from every aspect of life. FREE 100 live seats and unlimited live streaming! Jim has been coaching women to soar in the Life Zone , Business Zone , Sports Zone for over 50 years. Now, he raises the bar and honors a promise made to his mom on her deathbed to go global and all inclusive starting with women from every walk of life. This profoundly heartfelt event launches a life long dream to develop champions, regardless or your past disappointments, or your current challenges, starting with women as he brings his proprietary, champion development, S.C.O.R.E. Success System to the world. YES -everyone in the world. Thank you mama! https://www.eventbrite.com/e/women-in-the-zonetm-tickets-616692262157 Watch https://www.facebook.com/transformationtalkradio/live_videos/
Good morning and happy Friday! We have a great show for you today. Our guest is Mr. Phillip Edward Van Lear, actor and director who is starring in: Between Riverside And Crazy opening tonight at The Riverfront Playhouse. Shows are Friday and Saturday running to October 8th. Get ready for a great show! Here's the news: - A clash of fashion and art; get ready for Rouse 3.0! This will take place at The Venue located in downtown Aurora (21 S. Broadway), Thursday September 22nd starting at 6 pm. This event will benefit both the Naperville and Aurora Alive Center locations. Tickets are available now, click this link to purchase and learn more: https://www.eventbrite.com/e/rouse-30-tickets-399317287757?fbclid=IwAR0taAF3_7n9t8x5fnwT2J7NqLt9X7O4HQ_sZp3Z6fTsMtti1cyjuJVZA_U - Tomorrow, September 10th is the Kid's Expo, taking place at Phillips Park! This is hosted by Illinois House District 84 and will be held from 10 am to 1 pm. This is a free and fun event open to the public and will be held rain or shine. For more information call 630-585-1308. Bring the family out for a good time, we hope to see you there! - Tuesday, September 20th from 7 to 8 pm there will be a great event titled: How Money Works for College. This will take place at 1 Trans Am Plaza Dr. Suite 500 in Oakbrook Terrace. Learn how to prepare for the FAFSA and how to pay for and plan for college. Scan the QR code on the flyer for more information! Have a fantastic day and a positive weekend! We hope you enjoyed the show. Stay tuned! We have much to show you. Subscribe to the show on YouTube at this link: https://www.youtube.com/c/GoodMorningAuroraPodcast The second largest city's first daily news podcast is here. Tune in everyday to our FB Live from 8 am to 9 am. Make sure to like and subscribe to stay updated on all things Aurora. Twitter: goodmorningaur1 Instagram: goodmorningaurorail Spotify: https://open.spotify.com/show/6dVweK5Zc4uPVQQ0Fp1vEP... Apple: https://podcasts.apple.com/.../good-morning.../id1513229463 Anchor: https://anchor.fm/goodmorningaurora #positivevibes #positiveenergy #downtownaurora #kanecountyil #bataviail #genevail #stcharlesil #saintcharlesil #elginil #northaurorail #auroraillinois #auroramedia #auroranews #goodmorningaurora #comedy #news #dailynews #subscribe #youtube #podcast #spotify #morningnews #morningshow #riverfrontplayhouse #betweenriversideandcrazy #friday --- Send in a voice message: https://anchor.fm/goodmorningaurora/message Support this podcast: https://anchor.fm/goodmorningaurora/support