Caring for Residents with Traumatic Brain Injuries (TBI) in Assisted Living

Transcript

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hey friend it is Brandon Gustafson with Assisted Living investing I help beginners like you launch their Assisted Living business in the next 12 months excit to have you here with me on the channel today we're talking about TBI traumatic brain injury in Assisted Living I have actually been getting a ton of comments on this on YouTube uh questions in the Facebook group and so I wanted to address that here for you all in a live video today um if you are new here to the channel and you're catching

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one of these type in newbie below I love seeing all the new people as they are getting started and and trying to figure out how to launch their Assisted Living business so make sure you type that in and um with that I'm G to shift this over make sure you go grab your free business plan checklist as well um go to Assisted Living investing. netb checklist um I've got that it'll be down here on the bottom of the the corner I think it's I don't know right there um you should be able to go and grab that

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uh free checklist to help you out as you're launching your assisted business it is one of the key components that you need to have a business plan uh in order for you to launch your Assisted Living business and for those of you who are on the live today I have time for some Q&A but I do have a commitment right after this so I have a little bit of time so if you can queue up your questions for me um early on that would be great and if I do not get to them I apologize but please put them in the comments and then

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I can um get get to you afterwards either in the comments or in in uh specific video on uh on that for you so with that said I'm going to grab a link here and make sure this gets into our Facebook group and we'll post that there and let's go ahead and get started so for those of you who don't know who I am my name is Brandon gustofson I own and operate two assisted living facilities I've been doing this since 2020 I do it out of state so I live in Utah one of my facilities is in uh Colorado the other

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one is in Idaho and uh have been doing that for like I said since 2020 I've secured over $1 and a half million dollars in SBA funding I I'm very familiar with that process um I also have a masters in healthcare administration so I've worked in the healthcare industry now for over a decade have a lot of experience uh just kind of working and understanding exactly how to operate these these businesses and and how to navigate all of the things that come with working in the healthcare industry and love helping

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and coaching people along the way now with that said let's talk about TBI so TBI I'm just going to refer to it as that going forward so I don't have to say the full name um because this is Healthcare we love acronyms but TBI stands for traumatic brain injury typically what happens is uh well typically this happens because there is an injury that occurs to the head that disrupts normal brain function that could be a fall a car accident Strokes sports injuries military related trauma could be any number of things uh like

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there's there's no specific reason why somebody would get TBI versus somebody that doesn't if they were to fall it just kind of happens um there are two types of TBI as well so with TBI there's mild TBI and this is temporary effects that can still impact your daily life but generally you're able to function pretty at a pretty high level um and you probably have bad days and then there's also severe TBI which is Perman permanent cognitive emotional and physical impairments that that's

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permanent and it there's not a lot of fluctuation it is it's just it's just bad all the time um there's a lot of people that have TBI that suffer from TBI I did some research here um these are from the Brain Injury Association of America um over 5.3 million Americans which is approximately one in every 60 people live with TBI which is crazy to think about that it's one in every 60 people you just go to the grocery store you're probably interacting with somebody that has TBI

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um is probably more on the mild side but you're still going to be interacting with them so to that point a lot of them are normal like you you wouldn't know they just sometimes they have bad bad days and sometimes they had good days it's very similar to working with somebody that has like bipolar disorder or schizophrenia some days they're really good uh like in in that case they're on their medications that they're doing fine and if they go off it they they struggle uh you're going to

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deal with some of that with with people that that have tbii as well um and also um each year like on an annual basis 2.8 million people are sustaining tbii so the the the rate at which people are getting TBI feels like it's going up so this is the the reason why people are looking at this is from an assisted living standpoint is um states there are some states that are doing higher rates for this and so I wanted to get out in front of it because it's a an interesting population to serve um and

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that that's one of the cool things that I love about assisted living is you can be so niched down in the group that you want to be serving and who you want to be helping it's it's really kind of a fun thing to to be able to do so if you're super passionate about helping uh people with Autism or serving a mental health population or TBI or seniors like you can create your own facility that kind of just focuses in on that and that's that's something that that's really interesting so if you have been

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impacted by TBI comment TBI down below would love to hear from you but also um it's something that if you've been impacted by it and you have a personal story you can really take leverage that as you're building out your business plan and and trying to work with people and telling your personal story of how you were impacted by TBI whether that was you that had it or a loved one that had it um and maybe they passed away or maybe they're dealing with it right now it can help you build your story which really

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can create a lot of trust for you when people are looking for facilities which is something and it's one of those things where there's a fine line between like taking advantage of it and leveraging it and you telling your story is is helpful to a lot of people it allows you to to come off as a person that like is authentic and and wants to help them and and move things forward and so that's something that I want you to keep in mind as you're looking at this and looking at TBI because because

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of the prevalence the chances of several of you watching my videos having dealt with somebody with TBI I would say is pretty high um and and and so it's something that you should be considering here if that's a population you want to serve and want to help there's a need out there and you can do that here in in Assisted Living so I did want to talk a little bit here about the difference between TBI and memory care because they are totally different things but I think uh having seen some of the comments and things I

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think there's a lot of um confusion between what TBI is versus what memory care is and and do you have to have a memory care license if you want to be serving a a TBI resident or what does that look like so I wanted to give you kind of a quick overview of what that actually looks like and the difference between the two so that you know what's going on here and something that I want to make sure is explicit is the needs of a TBI resident it can vary widely from date today whereas Memory Care is is

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pretty consistently um declining or in in a high need state so the um let's see I want to check something over here really quick I just want make sure I'm gonna tell you something that that's not on the chart here really fast from a licensing perspective um Memory Care licenses it's it's a separate license so um I've done a video on this in the past where you have like your your kind of like Care Home license and then you have assisted living and you have memory care and then you have nursing home so it's

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kind of Step Up Memory Care is a higher level of care than Assisted Living generally uh slightly higher but you're still below nursing homes um you have to have a certain type of license that just basically States uh you're you're providing your staff with more training around Memory Care issues dementia Alzheimer's uh those types of of of diseases that individuals could have um there's extra training that goes on there also you're going to be dealing likely with flight risks so often time

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because they just they forget um and so you're going to be uh needing to have a locked facilities is kind of what you're going to see in a Memory Care Facility uh an individual with TBI could be in a Memory Care Facility it's fine Memory Care Facilities can step down and have residents below their level of care but a a resident that has severe dimentia and needs Memory Care needs to move from assisted living up to Memory Care okay um a a resident with TBI more than likely can be in a traditional Assisted

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Living uh under under that license um type okay so I just want to clarify there the the difference in in licenses so let's look at uh cognitive cognitive changes between TBI and and memory care so with TBI it varies widely um you might have some clear Mo clear moments of of thought process thought processes um and you may have some periods of confusion as well it just kind of depends and it's going to depend on severity of of of the of of the TBI that the individual has whereas with memory

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care it is progressively declining over time um generally with an individual that has a Memory Care issue they will continue to um go down and you're not going to see Improvement very much you may see static uh you may see something that doesn't move but it doesn't start getting better it just continues to go down now changes in technology you know three years from now or 10 years from now or whatever it is that could change for sure um but as we stand today as a recording of This in 2025 um it it

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declines um progressively over time now let's talk about personality shifts so with and I I have a lot of experience actually not with TBI but working with mental health so one of my facilities works with mental health and so a lot of what I see here as I was doing the research on TBI I was like oh man that's it's very analogous to um my work with with the mental health population in my facility um and so I see a lot of this so let's talk about personality shifts um with TBI you're going to often

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include impulsivity aggression depression um you're going to see a lot of that whereas with memory care it typically is going to be confusion and forgetfulness which can result in anger and aggression for sure but the root cause of that is going to be they're confused or they're they they just don't remember something whereas with TBI the the aggression um that that happens is um it's much more a result of of the of the the injury to the brain um it's it's not born out of confusion and

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forgetfulness if hopefully that makes sense but it is it's different um the way that that that you work through those things let's talk about care needs so with TBI you're going to have something that may need some Behavioral Management or Physical Therapy um to get back Behavioral Management is a huge thing in Assisted Living especially mental health but um as people start to age and decline there's a lot of Behavioral Management that goes into assisted living and and caring for

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residents um and you're going to see that a lot with TBI whereas with memory care um those care needs are focused on routine and memory support um I was talking with a buddy of mine who's in Idaho and he wants to create a memory care village I like I love the idea of what he's doing but a part of that is creating this this space that is you have goats or you have animals you have an old truck for for people to work on um you have something that is very consistent and maybe takes them back a

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few years um having some pet therapy um those types of things in in the fac in the facility in the ecosystem because doing those things and having it be super consistent everything is is regimented and and you know exactly what's going to happen helps individuals with memory care issues with memory loss Alzheimer's dementia those types of things because it is so consistent you may have it may feel repetitive to you as a worker um but to the individual that's that's suffering from that not so

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much it really helps them out a lot whereas with TBI you're working on uh more Behavioral Management types of things um is what you're going to be dealing with and then the progression um so with an individual with TBI and we see this with memory with mental health issues as well individuals can stabilize they like they can improve over time with therapy uh with medication they can get better to the point that they may not need assisted living any longer and so that's something that you should keep

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in mind as well um you you can help people um and they can be in that position for a really long time whereas Memory Care issues it will progressively decline always over time to the point that um and individual will pass away from it um so those are some of the big differences there's a lot of differences between TBI and memory care it's a different license uh there's a lot that that goes into that and hopefully that gives some clarity to people that are just trying to figure out exactly what

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that looks like the best way to serve your residents that have TBI is you want to train your staff in behavioral and cognitive challenges that is something that working in a traditional Assisted Living that's Elderly Care you may not see as much of working in that's mental health we get it all the time and you need to train your staff on how to handle those situations because they can arise and it can be rough like it can be uh a little more physically demanding uh it can be very mentally taxing when you

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have to deal with that and so that's something that that I want you to be aware of as well um you need to design the home for safety and functionality um safety for the resident themselves for the other residents for the staff make sure that that everything's okay um there because when somebody has a behavioral Outburst it it can potentially become dangerous and so that's something that you want to be aware of it's not always the case um but that's where learning how to deescalate

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a situation and have conversations and building good relationships and handling those behavioral challenges uh is really important um creating individualized care plans this a requirement across assisted living but is is very important for TBI and to not just like throw them into you know help yep you you've got that here's your care plan we're going to do these things every single day and it needs to be very individualized um that is super important for assisted living in general but you need to have

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something that's very personal um and you need to work with families and Specialists make sure that people know how things are going are they progressing are they declining um do adjustments need to be made to the care plan to medication to therapy to whatever you need to have those convers ation to be very open about it uh because it allows you to make sure you're serving your residents to um to the level that they need their their service uh very very important for you to do that let's talk about challenges of

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working with TBI residents so there's licensing and compliance um that that's going to be a challenge I mean challenge overall in assisted living but um what you're going to want to do as you do that is um you want to make sure you have very specific policies that um state how you're going to work with residents with TBI the license itself is more than likely just a normal Assisted Living license there may be some extra boxes you need to check there but um there there's not going to be much that

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that goes into that if you're going to serve a Medicaid population there may be some extra boxes you need to check to make sure that you are certified to work with residents that would have TBI um so that's something you might need to do but the the application process itself is not not overly complicated compared to anything else um that that you're going to be doing but you will likely need to have specific policies on how you work with residents who have TBI how you handle certain situations those

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behavioral issues that come up um how you're going to do mediation if you needed to uh with a resident that has an outburst uh those are the types of things that you really need to to have policies for because it allows you and your staff to know how to handle those situations when they come up and they they will um when you're working with a population like this like it's just going to happen it's the reality of it and so it's better for you to have that under wraps and if you don't have that

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policy when the situation does arise after it do kind of a little bit of a a debrief with you and your team and then write a policy on how to do it so you know how to handle those situations in the future um really important for you to do those types of things as well it's it keeps you in compliance uh allows you to know allows you and your staff to know how to handle those situations as well speaking of Staffing um there's potential for higher Staffing ratios it depends on the severity of of the

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reactions that an individual with TBI has so if you have a really high needs resident there's potential for more Staffing just for protection um although a lot of the times when you need more Staffing it's because a staff can't handle things physically uh which means um like lifting people so as long as you have individuals that are able to physically be autonomous um the chances of you needing to bring in more staff is is probably um actually reduced from traditional Assisted Living um but it's

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something you want to keep in mind as well it may shift maybe you need to have larger physical Mills there just in case something does happen um with it so it might shift a little bit the the way that you're looking at at how to handle um handle staff those are case-by case situations and you want to look at it and and make sure you are meeting the needs of the resident um based off of their care plan um but that's that's something for you to to keep in mind that Staffing ratios may be adjusted when you're working with

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with this population and you're going to be dealing with behavioral issues and that means you need staff that know how to handle those how to deescalate those situations how to work with people um and to understand that the behavioral issues are maybe not quite as physically taxing as you might see if you had to do lifts or helping people out with toileting or or ba bathing or things like that but it can be very mentally taxing because you are dealing with people um who are acting out who are

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having issues um and so that's something there's a lot of training that goes involved that is involved with it and and you want to make sure that that staff understand kind of what that's going to look like and how it's going to impact their day-to-day work um it can can be hard like it really really can be because it's different from a lot of people it takes a very special person to work with those behavioral issues and so that's something you want to be aware of now all of that said you may have a

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resident that has TBI that has no behavioral issues and and there's just some other cognitive issues or things like that and they're they're totally fine like that happens all the time uh even in mental health it happens but you still want to just kind of be aware of of what's going on and and and make sure you are accounting for that as you move into that so um that that's TBI that's all traumatic traumatic Varian injuries hope you like that uh if you did make sure you like the video subscribe ring

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the bell uh so you get notified every time we put out content like this uh for those of you that are here live go ahead and start typing in your questions uh and I'll get to those here I just want to make sure I've got enough time to hit those um before I uh before I have to jump off to another meeting um but if you need help as you're trying to figure out this process specifically like with TBI and licensing process and what that's going to look like for you and making sure you have the house that's

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going to work would love to see if I can help you out you can go check out my accelerator course Assisted Living investing. net accelerator uh orala sorry and that will allow you to um get a a process a five-phase process that can really help you make progress towards launching your own Assisted Living business because I my my goal here is to help you launch your Assisted Living business in the next 12 months so let's go ahead and get over to our Q&A um type in your questions down below

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like the video subscribe ring the bell do all those things so you get notified uh I just recorded a bunch of like amazing videos that are going to come out soon um earlier today super excited to get those out to you um and so if you are doing all those things and you'll get notified when we when we put it out there for you um all righty let's shift over to this screen here all righty um questions all right we got a bunch of you in here so if you got questions I got like five minutes to answer whatever

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questions you got um one thing that I I I I want to make sure is is really clear as you're working with TBI is it is it's not something to be scared of at all it's something that like you can have a huge impact on people's lives when you're doing this I I when we started our facilities uh our our one in Colorado works with the mental health population and for me it was totally different not what I was expecting at all but I love going and visiting those residents like they're super uh they're

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they're just so much fun to talk to and get to know and understand where they're coming from and their life experiences and man it is it is just like one of the most rewarding things um to to be working with that population and while I don't work with directly with um individuals with TBI um my experience working with that mental health population uh leads me to just have a a better understanding of the type of um care and love that it takes to to be working with uh with residents uh that

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that deal with these more uh unique um situations they go through in their lives so I just want to make sure that that is that's super clear uh well with that I'm going to close things out because I'm not getting any questions so I want to thank everybody for watching uh thanks for being here want to remind you go grab that free business plan checklist um grab that tool so that you can make some progress on your journey to launching your Assisted Living business uh and um yeah does residential

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Assisted Living sound interesting to you but you don't know how to get started at Assisted Living investing I'm here to help beginners like you launch their Assisted Living business in the next 12 months love helping and coaching people just like you and making progress and want to remind you that it doesn't take a lot just a little bit just keep going step by step and I promise you if you do and you're consistent and persistent you're going to be successful and with that I now have questions that are

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popping up in here so we're going to do a couple of those super fast um before I log off so Dana uh you were just diagnosed with TBI last week after being assaulted by a 700 pound autistic man and adult daycare man I'm so sorry to hear that Dana that is that's rough um I'm sorry to hear that um I don't know where to go so I'm just move on to the next one that that's really rough I I apologize to hear that um sh uh this was very helpful thank you you are so welcome thank you for um thanks for

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hopping on here uh Dana should you disclose that to your to your residents um I no I mean you could I don't think there's anything wrong with disclosing that um and and you don't need to be sorry you're good um uh I I don't know that you need to expose it I think it's helpful for people to know it I would maybe even reach out to an attorney um and and and ask them their their thought there I don't think is going to be any legal reason why you should do that um it would just maybe be a transparency

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thing but you could look at um how it's impacting you your your TBI how that's impacting you and is it impacting your ability to run the business in which case if it is and it's negative impacting it you might just need to bring other people in because like you you could still be super passionate about the work that you're doing um even with TBI like that's not going to impact your ability and and your desire to help people and and move things forward right um at all and and so I think it's more

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of a personal decision now if it starts impacting your ability and and you are feeling some of that aggression and things are starting to go downhill from you for you at that point um you might want to take a step back just so that you are are aware of doing that but sharing that I think could have a positive impact as well on working on getting people to be like oh man like Dana is doing this with the TBI and I would love to go to her house like there there's kind of a give and take there uh

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to see what what's going to work for you so hopefully that that helps you out um yeah glad glad things are getting better for you um yeah totally um but thank you for sharing that like that's that's rough it's not not easy to go through hope hopefully that helped you out a little bit um all right I got a jop for my uh my other call but I want to thank you all again for watching uh remind you you know does residential Assisted Living sound interesting but you don't know how to get started I can you know at

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assisted Liv investing I'm here to help beginners like you launch their Assisted Living business and remember doesn't take a lot just a little bit keep going step by step by step and I promise you if you do and your consistent and persistent you're going to be successful thanks again for watching and we will talk to you next