From Client to Comrade: Why Human Touch is Crucial in Home Care

From Client to Comrade: Why Human Touch is Crucial in Home Care

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Erin Cahill: Hi, Ruben, how are you?

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Dr. Ruben Hernandez Rodriguez: Hey, Erin, how are you?

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Erin Cahill: I’m good. Thank you so much for making time.

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Erin Cahill: Did they send over the list of questions?

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Erin Cahill: Yeah, okay.

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Dr. Ruben Hernandez Rodriguez: Yes.

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Erin Cahill: So that all looks good.

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Dr. Ruben Hernandez Rodriguez: Yes.

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Erin Cahill: Perfect alright, and I just wanna make sure I’m saying your name right? So it’s Ruben Hernandez.

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Dr. Ruben Hernandez Rodriguez: That doesn’t look good. Sorry, trying to get a good shot for you.

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Erin Cahill: Yeah. Oh, yeah, take your time. No rush.

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Dr. Ruben Hernandez Rodriguez: Is that good?

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Erin Cahill: Yeah, that works. That works perfectly.

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Erin Cahill: Alright. So I’ll jump right into it. And it’s Ruben Hernandez Rodriguez. Correct? Perfect. Alright. Okay. So yeah, we’ll jump right into it.

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Erin Cahill: Welcome to CareSmartz360 On Air, a Home Care Podcast. I’m Erin Cahill, Senior Sales Consultant at Caresmartz. Today, we’re diving deep into all of the details of home care. We’re talking heart, soul and a whole lot of human connection. And who better to guide us through the heartwarming journey than the one the only Ruben Hernandez Rodriguez, the Vice President of Senior Care and Clinical Services at Partners Community Health.

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Erin Cahill: In his role, Ruben provides strategic leadership for Wellbrook place LTC homes, ensuring the delivery of high quality and safe care.

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Erin Cahill: Ruben’s extensive experience encompasses strategic leadership, the implementation of safe care practices, and a strong commitment to patient-centered care. His background showcases a successful track record in areas such as patient care, strategic planning, quality, improvement, and financial management. He is also a proponent of lean principles, servant leadership, and the value of evidence-based practice.

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Erin Cahill: Today, Ruben will be sharing his insights on why a human centered approach is essential in home care, emphasizing the importance of building strong connections with clients. Welcome to the podcast, Ruben!

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Dr. Ruben Hernandez Rodriguez: Thank you so much for having me. I’m so excited to be here today.

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Erin Cahill: Oh, I’m glad. So we’ll jump right into it. How does prioritizing human touch and a comrade relationship concretely improve home care outcomes for both clients and providers?

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Dr. Ruben Hernandez Rodriguez: I’m going to start the conversation speaking from as a nurse, because that’s my background and human touch. I think sometimes we forget the incredible impact that can have in the client’s journey and in the healing process. And that’s 1 of the 1st principles that we learn in nursing at school creating that therapeutic relationship and that human touch and the benefit that that can provide to the clients.

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Dr. Ruben Hernandez Rodriguez: So speaking, from my nursing experience in the emergency department, where I practiced for 10 years at Saint Joseph in Toronto is a crazy and chaotic space, but yet that meaningful relationship with the patient enabled us to understand, really, where are they coming from? What are they needs? And then adding that emotional perspective can ensure that

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Dr. Ruben Hernandez Rodriguez: this one visit can support all the needs and prevent multiple readmissions to the hospital and multiple visits to the emergency department. And I think the same applies in the home care environment. If we develop meaningful relationships and meaningful connections with the individuals, then we are in a better position to enhance communication, reduce the anxiety and the stress, not only of the client.

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Dr. Ruben Hernandez Rodriguez: but also the caregiver. Oftentimes in the equation we put a lot of human touch on the patient itself, and we forget about the emotional struggle that the caregiver might be experiencing during this journey, so the human touch

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Dr. Ruben Hernandez Rodriguez: cannot be exclusive to the client itself, but also expanded to the caregiver because oftentimes the pressure in the health system doesn’t come from the client itself, but from the experience of the caregiver, so that human touch will increase that sense of trust from the caregiver perspective and reduce that anxiety and then improve that emotional

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Dr. Ruben Hernandez Rodriguez: support. And I’m going to give you a good example, and a few weeks back I had the privilege to visit New Brunswick and see some of the main work that they do in the province in the project nursing home with owls.

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Dr. Ruben Hernandez Rodriguez: and when I went there

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Dr. Ruben Hernandez Rodriguez: what really impressed me the most was that grassroots in the community engaging with the people where they are. They go to libraries, churches, community centers the Mall, and then the goal is to meet people where they are, and establish that meaningful

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Dr. Ruben Hernandez Rodriguez: connection from a human touch perspective, and then bring people in through that social connection, and then being able to support them in the navigation and the connection with the health system. So I think, without developing those meaningful and trusting relationships in any space of the health system. But specifically in home care. Environment is what will enable us to support people

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Dr. Ruben Hernandez Rodriguez: for aging, healthy, aging, aging in place, and aging in community.

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Erin Cahill: Absolutely. And how can home care organizations practically prioritize deeper human connections amid efficiency and cost concerns.

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Dr. Ruben Hernandez Rodriguez: Think

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Dr. Ruben Hernandez Rodriguez: the 1st approach. And I see a lot of significant work happening across Canada and here in our province in Ontario and in Toronto, and it’s about person-centered. Care sometimes comes as a buzzword or as a cliche. But truly person-centered care is when and I’m going to go back to the roots of nursing as well. Madeline Lehringer, one of the 1st

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Dr. Ruben Hernandez Rodriguez: nursing theories, developed a sunrise clinical care, and it’s like based on cultural care and cultural care and person centered. Care, I think, have a lot of

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Dr. Ruben Hernandez Rodriguez: synergies, because at the end of the day we want to put the person at the center. But oftentimes we confuse putting the person at the center

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Dr. Ruben Hernandez Rodriguez: by putting wraparound service around there and then all the service comes to the person. But person center goes beyond wrapping around the service, around the individual person centered means the person’s voice is at the center of what is being offered to them. That’s why community health. We are very proud of

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Dr. Ruben Hernandez Rodriguez: using a co-designing approach when we’re developing programs for the community and to enable home care to flourish because we listen to their voice. We take their perspective and use that to improve our communication, to improve the services that we provided, because it’s easy for us

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Dr. Ruben Hernandez Rodriguez: to partner with other care providers, and together put a suite of services together to serve the people. But

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Dr. Ruben Hernandez Rodriguez: does that always respond to the needs of the individual? Sometimes it doesn’t, because the person center is also required to involve the voice of the individual. So we need to be sure that we incorporate the voice of the individual. And I’m going to reemphasize again. It cannot be exclusive. The voice of the receiver of the service.

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Dr. Ruben Hernandez Rodriguez: the caregiver of that person has to be part of that conversation, because when we start putting their voices together and see what they need.

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Dr. Ruben Hernandez Rodriguez: then we might be able to tailor the care really to what they need. And a good example of this success from a community perspective that can

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Dr. Ruben Hernandez Rodriguez: be embedded into home and community service is the navigation project that Mississauga, Ontario health team in partnership with panic community health trio health partners and 24 other organizations in Mississauga have come together to create this platform

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Dr. Ruben Hernandez Rodriguez: where people can self, navigate the system and get connected with the service that they need. But, more importantly, we can also bring them on site and wrap around service around there. But

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Dr. Ruben Hernandez Rodriguez: the basics of this was listening to the individuals. See where their barriers were within the healthcare system in Mississauga, specifically, and sometimes what we really need to create this person center is to understand who these persons are, and evidence-based practice is a good avenue. To do this, the Institute of Better Health, our children, health partners have done a magnificent amount of work to characterize what these personas

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Dr. Ruben Hernandez Rodriguez: look like, and Dr. Kerry Kryoski and Dr. Walter have done this amazing work in Mississauga to identify what these personas look like. So now that we know what they look like, if we do.

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Dr. Ruben Hernandez Rodriguez: we also integrated the voice, we will be in a better position to truly create that person centered approach that wraps around the service. But those wraparound services come from the voice of the client and the caregiver.

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Erin Cahill: Right? And how do servant leadership and team building principles influence home care teams to build comrade relationships with clients.

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Dr. Ruben Hernandez Rodriguez: And that’s a great question, Erin, and you’re preaching to the choir with this question, because I’m a big proponent of urban leadership and transformational leadership and servant leadership is something that I practice myself. And when I was working on my doctorate studies on my Phd, it’s something that I explore a lot, because suburban leadership comes from this perspective, that

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Dr. Ruben Hernandez Rodriguez: as you grow in accountability or in rank on your leadership, it’s not that you become more powerful, but you became a bigger servant, and then the tools that you can provide your team from that perspective would truly enable this

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Dr. Ruben Hernandez Rodriguez: camaraderie work in home care or in the health system, and I go into sort of

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Dr. Ruben Hernandez Rodriguez: try to colorfully explain this for you on how I say this. I often speak with my team. There is this traditional perspective that if I am the Vice President, everybody’s working for me, and I try to change that structure of thinking within my team in telling that. No, I work for you. I’m here to put the tools

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Dr. Ruben Hernandez Rodriguez: process strategic directions that would enable you to execute your functions to the highest of your capacity. And then a serpent leader is not only paying attention what the team needs and what the community needs and what the clients and the caregiver needs, but also

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Dr. Ruben Hernandez Rodriguez: not only in terms of resources but also in development, giving them the tools in competency and development. At panic community health. We have developed our Institute of Leadership Development, where we quarterly meet with our teams and provide them with the knowledge required to be able to do their functions within the long-term care space and within the community space.

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Dr. Ruben Hernandez Rodriguez: And and this is because we, as a servant leaders, identified that our role is to serve our team and

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Dr. Ruben Hernandez Rodriguez: create capacity within our team so that they can provide the best service possible to our clients and to our residents into long-term care. And sometimes when you change that hierarchical perspective, then you can enhance the hands-on of the team, because then they see you as a

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Dr. Ruben Hernandez Rodriguez: collaborator within the team and not someone that is overseeing their work. So I don’t believe in micromanagement. I believe in giving people the opportunity to think, to use evidence-based practice to enhance care and work collaboratively. You often will hear me saying, our health system has been built for competition, not for collaboration.

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Dr. Ruben Hernandez Rodriguez: And that’s exactly what Serban leadership does is move away from the competition and move towards the collaboration, because at the end of the day every single health organization in this province and in this

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Dr. Ruben Hernandez Rodriguez: The country has only one goal, and the goal is to provide the best service to our community. And if we’re going to do that from a competition perspective the system will be not learning as a whole. So we need Serban’s leader because Serban’s leader will create that collaboration, but it will also create the opportunity for system learning.

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Dr. Ruben Hernandez Rodriguez: So if we collaborate.

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Dr. Ruben Hernandez Rodriguez: we can then share those knowledge and those discoveries that we encountered in our functions to improve the system as a whole. For example, paper performance is a great example of how we are built for competition or not for collaboration.

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Dr. Ruben Hernandez Rodriguez: An emergency department will get more funding if their scoring highlights that they have a great performance. So you will see leaders in the emergency department developing new tools and new processes to improve the performance so that they can then have funding. But

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Dr. Ruben Hernandez Rodriguez: that doesn’t stimulate them to give that knowledge to another provider, to learn from what they use to improve their system. What if we start paying per

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Dr. Ruben Hernandez Rodriguez: innovation and not performance? What if we fund people that create collaboration, opportunity to learn from each other, so the system as a whole can learn. Serpents. Leaders have a greater opportunity to create this.

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Dr. Ruben Hernandez Rodriguez: a space of collaboration, because their goal is not to become more powerful, but to be able to serve more people. And that’s where I see the opportunity to create that connectivity and that synergy of intent.

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Dr. Ruben Hernandez Rodriguez: We are all doing this work because we are passionate about it. We are passionate about creating the best health system possible. And sometimes, now I say, I’m 48 years old now, 20 years from now is when we’re going to have that big pressure or seniors. I am going to be one of those individuals. If we don’t use our servants’ perspective to create a better system today.

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Dr. Ruben Hernandez Rodriguez: We are not going to be benefiting ourselves 20 years from today, when we will be part of that large population of seniors that will be putting pressure into the system.

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Erin Cahill: Right. And how can we ensure technology doesn’t overshadow the crucial human touch in home.

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Dr. Ruben Hernandez Rodriguez: I think I used the 1st concept of that in an earlier response. But I think we need to use more co-design and the voice of the clients and the caregivers and the healthcare providers on the development of the technology.

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Dr. Ruben Hernandez Rodriguez: I’m a big proponent of technology. I have worked in organizations where technology was at the front run of moving the organization. Technology can enable us to do better data collection and use data-driven decision making to provide the best services to our communities.

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Dr. Ruben Hernandez Rodriguez: If we only use what we think will be best for the community and develop technology on

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Dr. Ruben Hernandez Rodriguez: or personal perspective, we might not be the

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Dr. Ruben Hernandez Rodriguez: developing the best tools possible to truly support the needs of the community. But when you

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Dr. Ruben Hernandez Rodriguez: use person-centered approach, you put the person at the center and you use their voice to design the future of the health system, and you use that voice to then complement the development of technology and use technology to enhance their service provision to the community. Then we will be in a better position to serve the system. Last week I have the privilege to participate at the created

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Dr. Ruben Hernandez Rodriguez: they created a disrupted laugh at G of T. And they put people together, innovators, and they used mentors to support people. And I love the perspective of having mentors and helping entrepreneurship to create better technology tools that can help healthcare providers. And the one thing that it will be amazing is if at that same table can be

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Dr. Ruben Hernandez Rodriguez: the end users. And the caregivers looking at this technology when they are almost ready for deployment say, Well, it will be better for me if I, as a caregiver, also have visibility of the data so that I can complement it with my perspective of what I see every day in the home.

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Dr. Ruben Hernandez Rodriguez: Imagine home and community service providers. We rely a lot on what the family has to say about the needs of the individuals, but imagine if they also have a voice on the technologies that we are developing to support people. I mentioned earlier about the navigation system that we have created at partners, community health in collaboration with Mississauga.

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Dr. Ruben Hernandez Rodriguez: Ontario health team, trivial health partners, and another 24 organizations. I think part of the success of the navigation system is that the voice of the individuals that will be

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Dr. Ruben Hernandez Rodriguez: the recipient of the care was incorporated into the development of this technology, and I think the same can apply, and I was at the Point click, Care Summit in Vegas a few weeks back, and I encountered a young entrepreneur individual from Brampton, Ontario, nevertheless, and I met him in Las Vegas, and he’s 25 years old, and

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Dr. Ruben Hernandez Rodriguez: he was. He’s very passionate about developing tools or technologies that can support caregivers or healthcare providers on improving the quality of care in the senior space. And what really impressed me about Ayan is his name was that he actually moved into a retirement home for a year to see firsthand the experience of the caregiver

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Dr. Ruben Hernandez Rodriguez: experiences of the residents, the experience of the care provider and then develops his technology from that experience firsthand, that is the future of technology embedded into long-term care, into home care, into any part of the health system. You need to go, observe and ensure that as you develop your tool, you are already mitigating the risk factor of being disruptive in the space

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Dr. Ruben Hernandez Rodriguez: he went there and saw what the problem was and built the technology base of the experience that he saw firsthand. If more entrepreneurial organizations and technology developers use that approach and go hands on to see what the experience is. I think technology will not be a disruptor and will be your best friend.

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Erin Cahill: Yeah, that’s amazing. And last question for you, Ruben, what are the biggest misconceptions or challenges about human connection and care that you see.

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Dr. Ruben Hernandez Rodriguez: I think some of the big conception about human connection is that people sometimes think that you have to be best friends with someone, or that you need to know them deeply to really

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Dr. Ruben Hernandez Rodriguez: made this connection. But I think a lot of people used Angelo’s phrase that people will not remember what you did with them, but they will remember how you cared for them, and I don’t remember the phrase deeply right now, but hence what she was trying to do.

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Dr. Ruben Hernandez Rodriguez: When people see your effort, when people see that you want to meet them, of where they are, is when truly the opportunity to create that connection exists.

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Dr. Ruben Hernandez Rodriguez: because I think we have spent a lot of time trying to figure out how to provide the best care possible and the challenge that we spend so much time on. That is because we don’t incorporate all the time the voice of the recipient of that care, and that is the misconception that we continue to use that paternalistic approach, that

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Dr. Ruben Hernandez Rodriguez: We are the experts, and we know what you need. But in reality human connection is about not only that physical touch, but that emotional connection of empathizing and with compassion to understand where they’re coming from.

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Dr. Ruben Hernandez Rodriguez: We have one of the most multicultural nations in the world. We need to understand that cultural experience that people come with and then use our empathy and compassion which are values of panic, community health to really understand, and home care. Providers can come with those lenses of empathy and compassion to really understand the needs of the client. That is not only the physical need of

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Dr. Ruben Hernandez Rodriguez: cure my wound. But my wound is one aspect of my need. What is the emotional distress that this wound has created for me? And if we don’t create these emotional connections, we will not be able to increase this, and are going to go back to nursing homes with our walls in New Brunswick. I think the success of that program is that they didn’t invite people to come to the healthcare center or to the long-term care home.

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Dr. Ruben Hernandez Rodriguez: They went to where the people were, they made their 1st approach to create that human connection.

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Dr. Ruben Hernandez Rodriguez: And the misconception is right there. The misconception is that we need to make the connection with the people coming to the health system? No, the emotional and the human connection has to be made before, so that that trusting relationship can exist. I spoke with one of the individuals there. His name is Patrick, and the success of his center people are now invited into their own houses.

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Dr. Ruben Hernandez Rodriguez: like

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Dr. Ruben Hernandez Rodriguez: how many people I mean, I live in a condominium, and previous to this home where I lived before I lived in a condominium for 8 years there were 200 suites. I only had 3 friends in 200 units, people that I pass in front of their house on the elevator every day. And then we have became so

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Dr. Ruben Hernandez Rodriguez: individualized into our own space that we forgot that humans started the community living as a tribe where the tribe worked together for the good of the tribe.

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Dr. Ruben Hernandez Rodriguez: Hence why servant leadership is so important. We are here for the good of the tribe, and we need to meet the tribe where they are, and then work together with the people in the foundational needs that they can express, and you can only hear what they need. If you approach people with empathy and compassion, and you foster meaningful and trusting relationships even before they have held needs.

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Dr. Ruben Hernandez Rodriguez: you

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Dr. Ruben Hernandez Rodriguez: can meet them at that emotional level and create that trusting relationship, that then they will naturally come to you when they have needs

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Dr. Ruben Hernandez Rodriguez: apanic community helped with developing this integrated senior hub. And our 1st approach was to develop or spend the day with us.

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Dr. Ruben Hernandez Rodriguez: Not a string attached you come when you want, for when you want, and for as long as you want it. And then through that interaction we’ve been able to develop a strong relationship, listen to what they need, and then use that to co-design the future of our programs. Or we need more social integration.

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Dr. Ruben Hernandez Rodriguez: social activity. We need more physical well-being.

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Dr. Ruben Hernandez Rodriguez: physical exercise. So now you create that social connection between individuals, they motivate each other, they come to exercise together. And now, what if we used that same principle into home care that home care is not just the experience of going and delivering a specific care, but creating that trusting relationship. And I think I want to finish this question with a personal experience.

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Dr. Ruben Hernandez Rodriguez: My mother was diagnosed with terminal pancreatic liver cancer. In June 2023,

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Dr. Ruben Hernandez Rodriguez: and we went to the hospital to the emergency department. We got the diagnosis. Mom was in the hospital for 3 days

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Dr. Ruben Hernandez Rodriguez: to have a full understanding of where her cancer was coming, for when you are at a metastatic stage. You want to understand where it came from, maybe not for the benefit of my mom, but for the benefit of my sister and I to know what lifestyle changes we might want to take. If this is something that hereditary might occur again, and that sort of thing. And the 1st thing that my mother said

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Dr. Ruben Hernandez Rodriguez: I do not want to come back to the hospital for anything else. Whatever it needs to happen here has to happen now, because I don’t want to come back.

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Dr. Ruben Hernandez Rodriguez: So as a son, I listened to my mom’s needs, but I also listened to my mom as a healthcare leader with a servant’s hand on it. And I was like, Okay, if all she wants is to be a home, what are the steps that I need to take to be able to fulfill this wish.

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Dr. Ruben Hernandez Rodriguez: We set the goal of care with Mom. I met her at her cultural belief of what she needed. I want to enjoy my experience at home. I don’t want a space of sadness, of pity. I want us to be able to celebrate life. Okay.

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Dr. Ruben Hernandez Rodriguez: now I know the second emotional connection that she needed. She wanted to be sure that we continue to celebrate whatever time we have left, to be able to have a meaningful time together, and then staying at home is not something that I by myself couldn’t contribute. So we connect with the amazing work of the and the home services, and then.

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Dr. Ruben Hernandez Rodriguez: Before I left the hospital, I was already connected with a case manager, and the 1st thing that she asked me was, What do you need to know about what my mom needs?” What do you need? She made that emotional connection with me. What do you need to be

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Dr. Ruben Hernandez Rodriguez: powered up to ensure that you can meet these

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Dr. Ruben Hernandez Rodriguez: wishes from your mom. And I say, oh, what I need is the days that I need to go into the office to be able to have a Psw. So that I know that the days that I cannot be at home there is someone there with her, and it will be limited. I have the benefit of being in a hybrid position, where I was working almost 70, 30%, 70% at the office and 30% at home.

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Dr. Ruben Hernandez Rodriguez: And then those 3 or 4 days that I was going into the office. I built that trust and relationship with that case manager. And then I built that same trust and relationship with the Psw. That was coming on those days, that I was going into the office to the point that she would text me at lunchtime. She had her entire meal, even when I was at the office. I have that reassurance, but I feel

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Dr. Ruben Hernandez Rodriguez: palliative. Care team have

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Dr. Ruben Hernandez Rodriguez: sort of, figured it out the wheel and figured it out that that emotional connection with people that is no physical touch is emotional connection, understanding people of what they need.

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Dr. Ruben Hernandez Rodriguez: When we left the hospital the doctor said that my mom has maybe 2 weeks to live. We have 122 days. We have an amazing summer that we enjoy. And this was possible because someone understood that we needed to make that emotional connection, to be able to fulfill her wishes, and at the end it was not costly for the system, either, because most of the care was driven by me, and only in those small interns where I needed someone to oversee

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Dr. Ruben Hernandez Rodriguez: her at home. To ensure that she was safe was the only cost to the system, because

00:28:05.290 –> 00:28:29.830
Dr. Ruben Hernandez Rodriguez: when I felt empowered, and when I trust that what was put in place will truly support me. Then I was able to relax, and I was not on discounted anxiety. We need that we need to give that power to people and home care is the space to create that same approach that palliative care have developed, to give people the tools to stay at home, and that counselor and a trusted and

00:28:29.830 –> 00:28:38.610
Dr. Ruben Hernandez Rodriguez: empowering relationship that 7 leaders can bring into the system where collaboration is at the front, and technology is an inherent

00:28:38.680 –> 00:28:50.910
Dr. Ruben Hernandez Rodriguez: enhancing of the system and an enabler and order disrupted, and that required that technology is developed in co-designing with the healthcare providers and the end users.

00:28:51.150 –> 00:28:56.030
Dr. Ruben Hernandez Rodriguez: And that’s how we’re going to be the future of the health system in Canada and in Ontario.

00:28:56.710 –> 00:29:08.529
Erin Cahill: Absolutely well. Thank you so much, Ruben, for sharing your expertise, we really appreciate it. And to our lovely audience, thank you for tuning in. Until next time, I’m Erin Cahill, signing off.