Caitlin Whyte (Host): Welcome back to in their words, the podcast brought to you by the UPMC Pinnacle Foundation and UPMC in Central Pennsylvania. I'm your host, Caitlin Whyte. And today, we have an inspiring and heartwarming episode in store for you. But first, we'd like to express our deepest gratitude to all of you for subscribing to our podcast on your preferred platforms. Your support and enthusiasm have been incredible.

In today's episode, we're honored to introduce you to two extraordinary individuals, Heather and Karen, who have been making a remarkable impact in their community. They are not just nurses, they are community paramedicine nurses, providing crucial healthcare services and support where it's needed most.

As we delve into their stories, we'll gain a deeper understanding of the challenges they face, the lives they've touched and the incredible commitment they bring to their work every day. 

Heather Andres: I'm Heather Andres, and I've been doing this for about 10 years now.

Karen Cointot: I am Karen Cointot, and I have been doing this probably about 10 years, yes, maybe 9.

Heather Andres: I started out on the ambulance back in 1989.

Karen Cointot: I've been doing it the same. In 1991, I started as an EMT and then, in 1997, became a paramedic and have been doing that ever since.

Heather Andres: I was tired of the ups and downs and the long hours of the ambulance. It's physically straining as we get older, that's a lot of work. So, I was offered to see if I was interested in this. And I tried it out and I loved it, so here I am.

Karen Cointot: Kind of the same thing. As I was getting a little bit older, I had a child and the long hours were too much for her. The 24-hour shifts and the long weekends. So, I was looking for a change, but I've also enjoyed educating patients with their medical conditions. And when this opportunity presented itself, I was right on board and excited to change.

And that's what I've always thought of, was when I would go out for the same person over and over again, whether it be an asthmatic or a diabetic or a congestive heart failure, it was, "What are you doing? What are you not doing? Have the doctors told you to do this? You should be doing this." And I've always taken the education part of it in the back of the ambulance. And I've had plenty of partners tell me that I try and teach too much to my patients. But that was the point, was to not have them wake us up at 2:00 in the morning, because they're in dire need because they're not breathing well and they're not taking their medications like they're supposed to.

Heather Andres: I mean, education is power. Our job here is to empower them to know about their diseases and to know what they need to do to stay healthy and to empower them to realize their health is in their hands.

Host: Karen and Heather, with their unique experiences and insights, will shed light on how the relationships they have built have not only transformed the lives of their patients, but have also profoundly impacted their own paths, both personally and professionally. Through their words, e'lll gain a deeper appreciation for the incredible difference that community paramedicine can make one life at a time.

Heather Andres: The first one that comes to mind is we'll call him Mr. T. He is a brain trauma patient when he was 16 years old. He is now 52, and he is a 16-year-old living in a 52-year-old body, but the system doesn't recognize him like that. And they put him in a home where he rents a room and expected him to survive. He was going back in the hospital regularly, every couple times a month with seizures because he didn't remember how and when to take his medicine, and he was supposed to take it twice a day, breakthrough seizures constantly. They referred to my program to help us help him.

This has been a long journey over the past year. He had an aide that really wasn't helping him, which is why he kept going back in the hospital. His aide refused to help him do his laundry, which he was supposed to do, so he always had dirty clothes. He didn't help him with his meds well enough to keep him from having the seizures. This aide ended up getting arrested. So, we got him a new aide and that service also was not what he truly needed.

So finally, as of October of last year, we got him somebody who is a counselor, housing counselor, residential counselor is what she calls herself, and she has been amazing. She's helped him with his funds to get a microwave and a mini fridge for his room so his food is not taken and stolen from the other people in the house, showing him how to prepare it because he didn't even know how to make a cup of coffee for himself. I've showed him multiple times, but he doesn't remember. His short term memory is not there.

So, she had an emergency and was gone for four days, and he ended up back in the hospital, because he wasn't taking his medicine because she wasn't there to remind him. He just has no clue how to do it on his own. So, we are working as a team to try and keep him going, like I said, trying to find resources. He does have a caseworker at CMU, but the whole plan was set up in January and nothing's been done. Not a single thing has changed. So, we did get him AE through the foundation, an alarming pill box. So when the alarm goes off and a light flashes, he knows he's supposed to open that door and take his pills, and it's only once a day. And according to his aide, it's working wonderfully. So if she has another emergency, he can at least get his medicine in. So, he's my biggest challenge right now.

Karen Cointot: But this is the typical. He doesn't meet the requirements because of his age. He's not old enough.

Heather Andres: And he's not young enough.

Karen Cointot: And he's not young enough. And when there's new family, or family doesn't understand how to take care of it and wants no part of it because it's taxing on them, it's a lost system.

Heather Andres: His only family is his mother, and she lives in Philly. And he moved away from Philly to get away from all the problems he had in Philly.

Karen Cointot: But something simple of a 65, 70-dollar alarming pill box that somebody, luckily he does have an aide, that can fill it for him so that it reminds him to take his meds, we try and help out with. It's finding the resources and other ways to think for the patient and the families to get them to be able to take their own health in their own hands.

Heather Andres: He's excited to see me and thankful when I come. I have dropped back to only once a month trying to keep him on track, because he's got the aid now.

Host: Heather and Karen, in the truest sense, bridge gaps by reaching out and connecting. Community paramedicine is not confined within the walls of a hospital or a clinic. It extends beyond into the neighborhoods and homes of those who need care. And in this endeavor, Heather and Karen have proven to be exceptional ambassadors.

Karen Cointot: Yes. I'd like to think that our job is one of many hats.

Heather Andres: Yes.

Karen Cointot: It's not just the ideal was simple education, finding the resources they need, sending them on their way, reduce hospital admissions, reduce doctors appointments for them.

Heather Andres: Bridging those gaps.

Karen Cointot: Yeah, bridging a gap. And unfortunately, it's become how to help them meal plan, how to do social work, or how to help with filing paperwork. I mean, it's just simple. People are thrown paperwork and said, "Well, here, fill this out." Well, when they can't read or write and no one recognizes it and the patient's embarrassed to say something, no one does anything. And then, four months later, you can get another referral. They're back in and they're constantly in the problem and it's, well, the problem is is no one realizes there's mental health issues that we have to address. There is some intellectual disabilities.

Now, I have a similar situation. My gentleman is 43 years old, acts like a 14-year-old, had great family support. But typical 14-year-old, mom and him were oil and vinegar. Mom nagged, that's what he would say, and mom just wasn't the comfort, that's how most 14-year-old boys are, they want their father. Well, father unfortunately turned sick, father ended up passing away. And in the meantime, the parents were trying to get him to live on his own so that in the event that anything happened to them, he would be okay. I've taken time just to take him grocery shopping, because that was one thing that was missed. He didn't know how to use his debit card to get groceries. He would drive, but he would only drive to minimal places where he's been to before in short distances, not on highways, so he knew what he was doing. When Dad passed, it became more of a mental health issue for him. It was no longer me trying to educate him with the importance of taking his diabetes, his medications and controlling that and how he needed to eat properly. It became a mental health, how do we help him, so that we can get him to not have this depression. And, again, he's 14 years old in mentality, but he's a 43-year-old, so he's not old enough for mental health. He's not old enough for resources. But to put him in a situation to live back home with mom, you can't do that.

I did go to his father's funeral. I still stay in close contact with him and his mother. They have become part of our family. I think most of our patients do become part of our family in one way, shape or form. We do take it to heart when they get lost in the system or lost in the street. We cry when they cry. We have our joys when they have their joys. And we do what we can to help our patients. And that's what makes us stand out different from just a paramedic on an ambulance. We're not there just to take you at your time of need. We're there to know that you are part of us and we are part of you. We do what we have to to help all of our patients.

Heather Andres: Mr. T needed a jacket, he didn't have a winter jacket. He didn't have anybody to buy it for him, nor did he have the money to buy it. So, we brought him a jacket, I brought him a hat, gloves, scarf, just simple stuff that he needs to survive. The biggest lesson I've learned doing this job is that if their social needs are not being met, they could care less about their medical needs. We focus on the medical needs initially. And then, we see and figure out that their social needs are lacking, and that's why their medical needs are lacking.

Karen Cointot: It's rewarding in its own too when, I don't like to call them my patient, but when my person, I go to their house and they say, "Thank God you're here. I wanted to talk to you first because I've had this problem going on." They feel that we have opened that door and they feel that they can be honest with us and that we are not judging them. We're kind of trying to assist them in any way, shape or form. So, we do help build that rapport with them and they feel comfortable with that.

I probably have a tendency to do a little bit more than I should for the job, as they put it. But yes, my patients have become my family and my family has accepted that my patients are part of my family. So just this past Sunday, I went to go see somebody on my own time who needed some assistance. Again, a 93-year-old woman who can't do much for herself. But unfortunately, her family was out of town. And I said, "Don't worry about it. After church, I will come over and I will take care of her well." She had asked, "How does your husband and your child feel about that when you keep coming over here on your time?" And I explained to them that my husband and my daughter understand that I do these things. My daughter has been part of taking care of my patients.

That one gentleman that is 43 with the mental intellectual disabilities, to make him not feel that he was, as he quoted, he would always say that he was stupid. I didn't like that. So to help him when we went grocery shopping, we did it on my own time on a weekend. I took my daughter with me and asked him if it was okay first and I said that we needed to teach my daughter how to use her debit card and how to realize how to spend money that she had. So, I was kind of telling him that we were teaching her finances and shopping healthy and better. But in the meantime, I asked her to come with me to help him so that he didn't feel that it was geared towards him. So, they both met in the middle and get along great. He's become part of the family just like my daughter. It's no big deal.

Heather Andres: Yeah. I had one of my other patients, Mr. C, took care of him for about two years. Before he became my patient, he was in the hospital every 15 to 21 days. So, they reached out to us and said, "Can you help with IV diuretics? He's constantly in failure." And we started that with him. And being in his home, I could see what he was eating. He thought he was eating really well, and I would point out, "This really is not a good choice and this is why."

And after several months of revamping his diet and listening, and he realized that he was in control of how he was going to feel, if he was going to have a good week or a bad week, depending on what he decided to eat. He loved pickles. He's a pickle man. I said, "Mr. C, you cannot have pickles this week. You're on the edge." And his nurse would call and say, "Mr. C's up three pounds. Can you go check on him?" And I would. And if he needed me on the weekends, my family knew how much he meant to me and they're like, "Okay, go see him. Go ahead. It's all right," because I just felt a connection with him and he truly just wanted the help and he wanted to get well. So, we do what we can for all of our patients because we just want to see them succeed. They're all special to us.

Host: One of the most significant impacts of Heather and Karen's work in community paramedicine is when they witnessed their patients achieving stability without the need for constant hospital visits. This is a testament to the effectiveness of their care and the positive change they bring to the lives of those they serve.

Karen Cointot: I have a patient who's just like that. She was in at least every three, four weeks. And it was getting to the point where if you can make it that four-week period and stay out of the hospital for one month, let's see what's going on. And giving them goals, and when they succeeded with that goal, I remember the one patient, I brought her a gluten-free cookie and made her so excited. And I said, "Happy one month out of the hospital," and she made it that one month. And it's been a year now and she has never returned back. It's been going well, but she knows what she can and can't do. She knows her limits and she just needed some of that reassurance and just felt like somebody else cared for her.

Heather Andres: I would bring Mr. C an edible arrangement. Those fruit arrangements, when he would hit mile markers for me. So, just those little things.

Host: You might think that with all the incredible work Heather and Karen do, they must be part of a large bustling team, right? Well, you'd be wrong.

Karen Cointot: I know basically on a month for my region, I could easily have about 75 people that I need to speak to. Whether they're all home visits, phone visits, or just one phone call. But usually, it's about 75 in a month for York. That's one area. That's not what they have to do in Harrisburg.

Heather Andres: We probably do almost double that, because it's me and another full timer and we have three hospitals. Karen has one and Hanover has one.

Karen Cointot: Hanover has one. Angela usually does the stats. And I thought we were doing about 700 encounters in a month and that's spaced out between the three regions, the central UPMC hospitals, and just us eight providers.

Heather Andres: That keep us pretty busy.

Karen Cointot: Yes. Yes. Now when we say a team of eight too, I mean, that's not really-- because there's you and me, Leanne's a part timer, Amanda's a part timer. Jane Anne, Roy and Patrick.

Heather Andres: So, that's five full timers.

Karen Cointot: Five full timers. Two part timers.

Heather Andres: That's why we started the program, was to help the hospital not lose money by these people being re-admitted. We're trying to save the hospital money by keeping these people out of the hospital by educating them and helping them have a health plan that they understand and will follow so that they don't end up back in the hospital.

Host: You might think their work ends when they go home. But for Karen, she has been hounded by one particular patient experience in a beautiful way.

Karen Cointot: When I first started, there was a gentleman that I was following at basically the same thing every 7 to 10 days trying to keep him out of the hospital, reduce some of his doctor's appointments because his doctors did have the time back then that if he needed to be seen instead of going to the hospital, they could see him. But it was getting too much that they didn't have any more appointments, so he was referred to the program. In the meantime, he did have in-home physical therapy and occupational therapy. He had a little Bichon who was afraid of everybody but him until I entered the house. And it got to the point where he would tell the dog in the morning that I was coming and she would sit in the window and wait for me. I used to get yelled at from him because if I pulled into the driveway and opened my computer to check him in and out type thing or answer a phone call, the dog would be in the house barking obsessively because I didn't come in the house. And he always said, "She was afraid of everybody but you." And jokingly, I would say that, "Yes, of my hour appointment, 30 minutes was playing with her and 30 minutes was taking care of him, and then it was a quick hello and goodbye to the wife," she wasn't really involved. But it was a joke between the three of us and he was very respective and receptive of our services and what I was doing.

And he kept saying, "If he ever passed, I needed to promise that I would take the dog and I always said, "Yes." But then when he did finally pass, his wife had called me and said two weeks later, "Are you going to come and take the dog?" And my response to her was, "Were you serious?" I said, "It's your husband's dog and you're still alive." And she said the dog hated everybody and was afraid of everybody. The dog would hide in the dog room and not be involved unless he was around. So, I ended up taking the dog home and she's known as the dog who has been willed to me. And every holiday, I still send a card to the mother or to the wife and let her know that I still have the dog and the dog is doing well. And to this day, you would never know that this dog was afraid of anybody. She will come running around, give hugs and kisses. And he trained her so well, she would be a perfect therapy type dog because she does love to be around people. I just think the walkers kind of scared her in time and she just needed to come out of her shell. But yes, I have been willed the dog and she's been with me for a good five, six years now. And my husband always tells me, "No, mom says that this is why you didn't become a vet because you take all the animals home." And I said, "Well, I take all the lost patients and I help them and take them into my life and now I'm taking their belongings with me." She is a good dog. She is not afraid of anybody or anything and she is really good. So, when I look at her, I do remember him and I will never forget him or her. They've become part of our lives. Our patients become part of our lives.

Host: If you're still not entirely sure what community paramedicine is all about, you're in for an enlightening experience. In the next segment, we're going to take a closer look and delve deeper into the world of community paramedicine.

Heather Andres: Well, congestive heart failure patients are a big one that we do, and COPD and new diabetics because they need a lot of teaching, and high readmits, those are our four basic categories. And then, we get everything else around the sun. But those are our four main that we focus on. Any babies that come out of the hospital that they're concerned of social situation or they have come back to the hospital for failure to thrive, then they ask us to weigh them weekly to make sure that they're eating properly and they're gaining weight. And if not, we catch it quicker than, you know, a three-month follow-up from the doctor.

So, we also have neonatal abstinence babies that we work with too. Weighing them and making sure that mom's understanding their symptoms and why, and just education a lot with that. Just making sure they have what they need and hooking them up with resources if they don't have them. But normally, when they leave the hospital, they have the most of what they need. They just need a little extra support at home for a little bit.

Host: When asked what they wanted their colleagues and community to know, Heather and Karen had powerful words to share.

Karen Cointot: We do so much. And I've always told everybody that if they ever had a question if somebody needed of our services, to just reach out to any of us and ask, and we will tell you if it's something that we think we can do or we can't do. I mean, the big thing that comes to mind is wound care. We don't do wound care, that is a nursing skill. So, while we may be a small but mighty team, we do utilize anybody in our grasp within the UPMC region to help us figure out what we can do to help everybody.

So, we don't turn anybody away. We help whoever. We will ask. And if we can go out and see them once, it might be something totally different that we were not expecting to see, that they need additional help and resources with, that we need to try and figure out how to fix them.

Heather Andres: And some people we see once. We see them, they have everything they need, they understand, they have their medications in order, they have their doctor's appointment scheduled. And it was just, "Okay, great. Thanks." Sometimes the case managers will let them know that, "Hey, I'm going to refer you to the community paramedicine, they're going to call you, and this is what they do.

Karen Cointot: Yeah. If we got a referral from the case manager, I would call them and let them know that I was asked to follow up after your discharge. You were referred during your hospital stay. The case manager may have spoken to you, but it was mentioned and I'm just touching base. And then, we explain what we can and can't do, and some people are very, "Okay, fine. Let me see what you can offer, and we'll do one visit and you're done." And others say, "No, thank you. I'm not interested, but thank you."

Yes, the biggest thing I would have to say is to remind them that we are not there to substitute their doctors. We're not there to take away from their doctor's appointments. So no, we try and get you what you need to make you better. I'd love staying in touch with everybody after the fact, but it doesn't mean that they need to see me every week, every two weeks. We do have to remind them that we're not home healthcare, because we're not. So, it's hard because they want us there as much as they can get us there. But more staff would be great. We could help more people. But right now, this is where we're at. And sometimes we can't say that we can't do any more visits with these people. I have quite a few in the past and I have some now that they do just need somebody to talk to them once a month, just to help them keep their anxiety at bay or make them feel that they are not-- Yes, that they're not follow up in three months. And it's not the doctor's position to be able to see them on a monthly basis, but sometimes we have those that we do need to just follow up with monthly just to make sure that they're still doing okay and staying on track so that their mental health stays with them and they continue doing what we ask to do.

Host: For Heather and Karen, being there for their patients means everything. It's a calling that they hold close to their hearts, even when it presents them with daunting challenges. Their unwavering commitment to the wellbeing of those they serve is nothing short of extraordinary.

Heather Andres: I've had one that was constantly, if not calling 911, calling the police or calling the doctor's office constantly. And it was just because prior to her having a dementia diagnosis. She was just very anxious about everything, fearful of everything. Afraid to be alone, afraid to die. And it was to the point where I just said, "Here, call me. Whenever you have a question, you call me. And it didn't matter whether she called me five o'clock in the evening and I was at home with my daughter and my husband, "Oh, that's your phone mom. Guess who that is." "Yes, it is. It's her and that's fine." And she needed some reassurance that she was okay and that she can continue to go to bed at night. And she woke up in the morning, I had to get an alarming pill box for her. We bought them. I bought about four of them so far of my own to give out to patients just so that it would make life simpler. But yes, she wasn't calling the doctor's office 30 to 40 times a day, wasn't calling 911 to talk to an officer, or to talk to somebody on the ambulance and go to the emergency room. So, it got to the point where I did lose count one day after 56 phone calls in one day, because she was that confused and that worried about everything. And again, the resources were not available to her.

Host: Amidst the challenges and demands of their work, there are also moments when Heather and Karen finds solace and peace within their own families and in well-deserved relaxation. These moments of respite are crucial to recharging and continuing their mission with renewed energy and enthusiasm.

Karen Cointot: I know the job is Monday through Friday, no holidays, no weekends. And if I am in the middle of eating dinner with my family, I will take that time. That's my family time. But unfortunately, like. especially now, the weekends are getting nicer. My husband goes away every other weekend. My daughter goes away every other weekend to her father's house. So, this weekend I would be alone by myself. So if somebody needs something, I'm there. I'll help them out.

Heather Andres: I have two very active boys in lacrosse. And so, my 24/7 is picking kids up, taking them to practice, taking them to games, going to games on the weekends. So, I have learned to turn my work phone on vibrate, keep it in my bag. If I have a minute and I feel like checking it, I do. If I don't, I don't. Because if I do check it and I know someone's called, then I stress about it and have to deal with it. And if I don't have time, that's not fair to me. So, that's myself.

Karen Cointot: I completely understand because I have learned that too. I don't have an office like the girls in Harrisburg or the guys over in Hanover, which is fine by me. I don't mind working from my spare bedroom. I love it. I just have learned that yes, after hours, the phone goes on silent. Because if I do feel the need that if I hear it ringing, even before I go to bed, I have to make sure that I can look to make sure that it was okay.

Heather Andres: Ever since Mr. T went missing, I am just anxious about why did I not answer that phone? Oh my gosh. So, my heart is like torn,

Karen Cointot: I give myself the grace, but at the same time, like I have such a connection for all of my people that, God forbid, if something was terribly wrong, say somebody did pass or somebody got into a car accident, and they felt the need that they needed to call me, I want them to know that they can call me and that I will answer them as soon as I am available although it's not a 24-hour, seven days a week job. We do take our vacations. We do go away and don't take our work with us. But for the most part, we are very empathetic people and we do try our best.

Heather Andres: I love this job. I have never loved a job this much in my life.

Karen Cointot: Exactly. I have no desire to leave this position.

Host: You may be asking yourselves, why did Heather and Karen choose to embark on this challenging yet profoundly rewarding journey?

Karen Cointot: For me, there was no caregiving in my family. It was just the way that my parents raised us. They were very caring for everybody. And I remember that as one of the family friends was failing their health in the way of cancer. My mother and father stepped up to do everything that they could to help. And they were kind of like an aunt and uncle to me. That's how close we were raised. And I just remember seeing my mom do so much for them. And then, a few years later, my grandmother was failing cancer. My mom quit her job to move in with my grandmother up in New York to help take care of my grandmother. It wasn't even her mother, it was her mother-in-law. And that's just the type of people my parents were.

So it was one of those, when I saw that, I knew I'd like to help. And I used those two excuses as to why I wanted to get into helping somebody. I wanted to do the best I could to help anywhere I can. In fact, one of my first one, the one that was like an aunt and uncle, they had a friend, another family friend who made a hand-stitched little frame for me. And it said Karen, and it said the meaning of it, of being devoted to the care of others. To this day, that's hanging in any office that I ever have. It's in my office, in my house right next to my work computer. And that's the truth. That's the way we were raised. You got to help anybody out you possibly can. I still hold doors for people. It doesn't matter who you are. And it's the way we were.

Heather Andres: My parents were always helping everybody, all the time. And my mom helped my grandmother through her last few years of her life with dementia. Just living in a loving, caring family.

Karen Cointot: Some people, unfortunately, don't have that capability that they can count on their family to take care of them. And some family members can't do that emotionally. It's too hard for them. I know most of our parents would probably say that they don't want us to take care of them. My father said it before he passed. He didn't want anybody to take care of him and it wasn't a thought. It was, "No, this is who I am. This is who you raised and this is what I do." And I do what I have to do for my parents, no different than I would for anybody else. They're all the same.

Heather Andres: And that's all part of gaining their trust.

Karen Cointot: Yes.

Heather Andres: Sometimes it takes several visits for you to show them that you really do care about them and their health, physically and mentally. And then, they finally open up to you. I had a gentleman, Mr. B, his defense mechanism was telling everybody that he was a deaf mute. And he would talk very difficultly, like you could not understand him, and tell me he couldn't hear. And he had a catheter, and he kept having to have it changed once a month, and he needed rides to get there and whatnot.

So, after two or three visits, he finally opened up. He spoke clearly, not completely clearly, and he was able to show me that he can function. But that was his defense, is he couldn't, that's what he would do. And he'd lash out, and he was mean, and I just killed him with kindness, and showed him I really just wanted to help him. And he finally let me. So, it's gaining that trust, showing them that you really care. Because a lot of people just give up because they don't feel like anybody cares. That's a big part of what we do too.

Mr. C, he was very grateful for my help and helping him turn himself around, and his daughter was very grateful. When he got sick at the very end she called me and said I don't know what to do with this so I came in the hospital and we prayed because he was a pastor. And we prayed and she messaged me that next morning after he passed and said, "Your buddy's gone." That obviously was devastating for me, but I formed a bond with the family, went to his funeral and everything. And these people just become part of us because of, I guess, our personalities. I don't know. It's just what we do.

Karen Cointot: I can think of a few people just recently that I've had that didn't understand that their medical conditions were that bad. And we have to put on that hat of talking to them about their life expectancy and getting them to realize that maybe palliative or hospice, because they've probably heard it before and then they get upset. They don't want to talk about it. They don't want to hear it. But we give them the time that they need to talk to them, ask them questions, let them ask us questions, answer all the questions. And then, we give them time to think about it and go back in another week or so and talk even further so we have to arrange that for them.

Heather Andres: Our visits could be anywhere from 20 minutes to an hour to two hours, depending on what they need.

Karen Cointot: Fortunately, all of my patients understand that if I'm running late and I don't get a chance to call it's because I'm very far behind but they also understand that when I get to them, it doesn't mean that they're going to have any less time than they would normally have. I have one person in particular, my sweet Italian lady, I love her. She is a godsend and she is so cute, but she likes to pick on me the minute I walk in her door and she says, "Oh, . There you are. It's late. God forbid. You're never on time for me." And it doesn't matter what time of the day I schedule her, whether it's the last appointment for the day, during my lunch hour, it doesn't matter, I'm always late for her. The one day I showed up at two minutes before my appointment and she just turned around and laughed and she said, "That's it. Heck's frozen over." But she knows when I'm there. Even if I'm 15 minutes late, a half an hour late, or even an hour late, she knows that she still gets the same amount of time to talk to me so that we can go through what she needs to do, what resources she needs. You know, she thought about her final expenses and getting her funeral arrangements made, things like that, and just taking some time to give her that hug that she needs at the end of our visit. And she knows I'll be back in a few weeks to torment her even more.

Heather Andres: Jane Anne just had a patient this past month, and she went to their house. They couldn't get home health because they lived too far out. We're talking 45 minutes away. And the woman was living on a loveseat, like, that's where she slept. No bed. She needed neck surgery. They refused to do neck surgery until she had a bed. She didn't have any way to get a bed. So, the foundation bought her a bed, they delivered it to her house. Jane Ann went up and put the bed together for her, and now she could have neck surgery.

Karen Cointot: That simple. But without the finances, those simple things can't be done.

Heather Andres: And without us visiting, no one would know. And she just would go without having neck surgery, because she didn't know what to do.

Karen Cointot: And probably multiple more admissions because of the chronic pain that she's going to be in. And yeah, it's just something simple like that. We have quite a few patients that are just that way. That when we make them, when we can feel like we lift them up and they feel that we actually do care, they are able to take control of their health better.

Heather Andres: And they do.

Karen Cointot: And they do it. And they do it. I mean, I had a gentleman that he just continued to miss his appointments. He was just forgetting what day of the week it was even though he had his sister calling him who lives in another state to remind him of his doctor's appointments. He'd hang up the phone and totally forget that in two hours he was supposed to be at a doctor's appointment. He was just missing them. He just kept forgetting so I gave him a dementia clock that I had bought for a previous patient. And when she passed away, I took it back and just kept it and I gave it to him. And when I saw him last week, he was very thankful because he didn't miss a single appointment that week. He was able to get to his doctor's appointment. And simple things, but he didn't even have the simple $25 to pay for a dementia clock to keep him straightened out and just some things we do are just like that and you can lift them up. They feel like they are in better controll to take care of themselves.

Host: Thank you, dear listeners, for joining us on this empowering episode of In Their Words. We invite you to continue this incredible journey with us. So, mark your calendars. Be sure to tune in every second Tuesday for more inspiring stories and insights from the UPMC Pinnacle Foundation and UPMC in Central PA.

This podcast is brought to you by the UPMC Pinnacle Foundation and UPMC in Central PA. UPMC in Central PA has seven acute care hospitals with 1,160 licensed beds, over 160 outpatient clinics and ancillary facilities, and more than 2,900 physicians and allied health professionals, and approximately 11,000 employees in Central PA. It is a healthcare hub serving Dauphin, Cumberland, Perry, York, Lancaster, Lebanon, Juniata, Franklin, Adams and parts of Snyder Counties.

The UPMC Pinnacle Foundation exists to provide resources to meet the needs of our most vulnerable patients, promote health and lifelong wellness in our communities and support our workforce so we can attract, train and retain the best and brightest talent at UPMC in Central PA. To make a difference and join their philanthropic mission, visit upmcpinnaclefoundation.org.