Ep. 12: Changing Hearts and Minds with Dr. Tom Pomeranz [TRANSCRIPT]
Abby Rose Esposito, MediSked:
Hello, and welcome back to the MediSked podcast. I am your host, Abby Rose Esposito, senior marketing strategist at MediSked. Today I’m joined by Dr. Tom Pomeranz, a nationally recognized authority trainer, clinician and consultant in the field of services for people with disabilities for over 55 years, as well as a longtime member of the MediSked Advisor Council. Tom is the president and CEO of Universal Lifestyles, a nationally acclaimed consulting and training organization. Tom, thank you for being here.
Dr. Tom Pomeranz, Universal LifeStiles:
Well, Abby, thank you for inviting me. I’m really looking forward to the conversation we’re about to have.
Abby Rose Esposito, MediSked:
Awesome. Well, why don’t you start by telling us about how you got involved in the industry and what led you to found universal lifestyles?
Dr. Tom Pomeranz, Universal LifeStiles:
Oh, what a question. Let me, let me break that down in two parts if I may. The first part is how did I get involved? And that is a question that causes me quite a bit of emotion. Okay. So I’m gonna back up and I think I’ve only been asked that question one other time. So it’s, it’s a pretty direct question and a very, and a very person, a very personal question. When I was 12 years old, I developed a very serious condition called Capital Femoral Slipped Epiphysis. I know it’s a really long name, but [Slipped capital femoral epiphysis (SCFE)]. And it is a condition where the hip dislocates and I had that occur in both my hips, it’s the disease kind of process. In my particular case, it wasn’t diagnosed early, and the femur nearly pinched off the major arteries, femoral arteries in my legs.
Dr. Tom Pomeranz, Universal LifeStiles:
So it was really a horrible situation. And I ended up having four major surgeries on my hips and steel pins in my hips. Bottom line is schools then, when I was 12 years old, given my age, this is back in probably 58, 9, 19 58, 19 59, and by the way, Abby, that’s 1958, not 1858. Just wanna make sure you got that. Kids were highly segregated. So I ended up going to a special school called Em Morris School. I could no longer attend school with my same age peers. And this school my gosh, there was one, one room for children. They used to call him TMRs, trainable, mentally retarded, horrible name. Right? They were in one room, and then the kids who were considered edibles, EMRs, they put them in another room. And I was in the room with kids who had orthopedic impairment and other kinds of physical disabilities.
Dr. Tom Pomeranz, Universal LifeStiles:
Kids, you know, of normal intelligence, average competency, but who had cerebral palsy, spina bifida, things of that nature. And I was in that class, totally segregated from my same age peers. And I remember, you know, waiting for the cab in the morning. They didn’t have any kneeling buses or anything like that. And a cab would come to pick me up. I used a wheelchair part of the time, and I was on crutches. And, and we were in these special schools because regular schools were not accessible. You know, there were stairs and you couldn’t, you know, get through the school. And I remember waiting for the bus one morning and looking out the window, front window of my home. And a group of my friends who I had attended school with were all standing around the corner waiting for the bus. And I remember I couldn’t be with them.
Dr. Tom Pomeranz, Universal LifeStiles:
So I was with these, these other kids. And then summer came and it was time to go to camp. I always used to go to a Y M C A camp in, in Michigan, could no longer attend the camp because of my physical challenges. And so my parents sent me to what I refer to as a deviancy camp. This is a camp with kids who have special needs. That word special is really an important, by the way, Abby, every time you hear the word special substitute, the word segregator works perfectly every time. Mm-Hmm. <affirmative>. So I’m in this special camp, and ugh, I hated that camp. I remember being there with, cuz I didn’t see myself like these other kids. Most of these other kids had, you know, prenatal conditions, neonatal conditions, kids with down syndrome. I mean, I remember sitting across from this little girl one morning at breakfast, and she had been in this horrible fire, and her nose was burned off.
Dr. Tom Pomeranz, Universal LifeStiles:
She didn’t have any ears. It was just horrible. And kids with muscular dystrophy who were in the latter stages who were near death and just hated it. But next summer, I still could not go to a regular camp. I was probably 13 at this time, and I went back to the camp it was called Camp Millhouse, by the way. And you know, it wasn’t quite as bad the second year as it was the first year, and went back the next year. And I was fortunate that I ended up not having any residual kind of physical impairment. And I was able to go to a regular high school at that time. And somewhere along, maybe my junior year, between my junior and senior year in high school, I knew I wanted to go to college, but my parents didn’t have the finances to support me.
Dr. Tom Pomeranz, Universal LifeStiles:
So I knew I had to get a job during somebody, and I’m looking for a job and couldn’t find a job. I thought, well, what if I became a counselor at Camp Millhouse? I became a counselor at Camp Millhouse. Voila. Wow. And that sort of, yeah, it sort of sealed the deal, right? And so then when it was time to go to college, I wanted to do something. And I decided to major in music therapy. I played violin from the time that I was seven, but unfortunately, I didn’t have a level of proficiency in piano that one needed in order to be a music therapist. I had taken piano lessons, but more per theory than real competence in piano. And so I ended up in the area that I am in a combination of psychology, special education, mental health administration, and moved all through school.
Dr. Tom Pomeranz, Universal LifeStiles:
And that, that is the history of how I became involved. And, and there’s no doubt in my mind, Abby, that the experiences that I had when I was 12 years old and realizing what it felt like to be segregated from your same age peers, and I couldn’t do the kind of things with them anymore. You know, you couldn’t go down to the corner and, and shoot hoops anymore. And it just, it, it altered how I saw myself, it altered my relationship with my same, a same age peers, and was a real motivating factor for a lot of the thought that I have today about what we need to consider to enhance the quality of life of people who we support. So that’s how I got involved in, in the field, if you will. Wow. Thank you for asking me.
Abby Rose Esposito, MediSked:
What a story <laugh>. So what led you to, how did you decide to start your consulting organization? Universal Lifestyles?
Dr. Tom Pomeranz, Universal LifeStiles:
Sure. That’s another really good question is that I started Universal Lifestyles in 1999, and I had an opportunity to have a wide range of jobs during that period of time. My first employment was back in 1971, somewhere around there in 1970. And in, I had been working for a company from 1986 to 1999, that was the second largest provider to provide residential supports and day supports to people with developmental disabilities. Second largest. We operated in 13 states and so forth. And I was vice president of operations and Chief Clinical Officer. Well, as one might suspect either you’re, either you gobble up other companies or you’re gobbled up. So we were acquired in 1999 by the largest provider in the country. And it is not uncommon that when organizations, businesses are acquired, they do not retain their officers. Don’t feel bad for me, Abby.
Dr. Tom Pomeranz, Universal LifeStiles:
I mean, we’re all doing great. So in 1999, because I loved working where I was working, I pro I probably never would’ve left there. I mean, it was just a wonderful place to work. And when we were acquired, I then had the opportunity to make some decisions about what I wanted to do professionally. And regardless of the role that I had held over the years, I have always considered myself a teacher and a trainer first and foremost. Even though I’ve held many major management clinical kinds of roles, I was always training and always consulting in every one of those roles. And because of the years I had been in the field, I had the opportunity to form many valued relationships professionally and otherwise. And I made the decision to train and consult full-time. And that’s what I’ve been doing since 1999. It is not what I do, Abby. It is who I am. Okay.
Abby Rose Esposito, MediSked:
<Laugh> seems that way. I love it. Yeah. <laugh>. So as a fierce advocate for de-institutionalization and person-centeredness, what was it like living through the beginning of those initiatives?
Dr. Tom Pomeranz, Universal LifeStiles:
Oh my gosh. I mean, I could probably spend hours just talking about that. Let me structure my response in a three-part re response in order to appreciate and understand what was happening during this period of, they called it either downsizing de-institutionalization and forth so forth. We have to put it in the context so that, let let that be the first part of my answer. Large state institutions were self-sustaining. And many of the listeners know that it was not unusual places like Meca State School and Hospital located in southern Indiana. It was located on nearly 12,000 acres of land. And the state legislatures in most states would appropriate one acre of land for everyone who resided there. And there were nearly 12,000 people with intellectual disabilities. And, you know, we used the R word back then, but intellectual disabilities who lived there, totally self-sustaining. They raised their own crops.
Dr. Tom Pomeranz, Universal LifeStiles:
They had their own dairy herds. They had slaughter houses where they, you know produce their meat. And who ran the institutions was basically the residents that lived there. The people who were very capable, incompetent. They call ’em the high grades. That’s what they called them, the high grades, right? And they had their, their large commercial kitchens where all the food was, you know, prepared and produced. They had commercial laundries on campus where everybody’s laundry was cleaned, and the people who were the high grades worked in the kitchens. They worked in the laundries and the people who were the high grades, literally, I mean, I was, I was working in these places, you know, as a professional at that time. And we’d have the high grades in the la in the laundry, take tongue depressors, and they would take diapers and literally scrape, spend their whole day scraping fecal matter off the diapers.
Dr. Tom Pomeranz, Universal LifeStiles:
There was no disposables back then. I mean, disposable undergarments were unheard of. And they literally would spend their whole day, and this is the kind of thing that they would do. We, we had clothing warehouses. People didn’t go to, you know, pennies or Sears or Walmart or wherever to buy clothes. We had clothing warehouses. So the whole place was a self-sustaining city where the high grades really ran the institution to a great extent. And the low grades that people are less capable were cared for by the high grades. And on these wards, by the way, we would have 75 to a hundred people per ward. Can you even imagine that? Long hauls bed, bed, bed, bed, bed, bed, bed. Literally. I mean, there weren’t bedrooms. We had these long hauls, and the staff ratios were somewhere around one to 30. That’s one staff to 30 people.
Dr. Tom Pomeranz, Universal LifeStiles:
And you wonder how in the world for people who were in incontinent, they needed pervasive supports. They couldn’t feed themselves independently. How did one staff do that? One staff couldn’t do it. The people who were the high grades would come to the wards in the morning. They would call them duty women duty, because these were the women who were very capable and competent today. Many of these women wouldn’t even be recognized as having an intellectual disability. They were so competent. Mm-Hmm. They, in, many of them ended up there because they gave birth out of wedlock. And back then it was perceived, if you were, so, if you had a child outside of a marital relationship, obviously you have diminished intelligence, or you would not have engaged in that conduct. And they were placed in these institutions. Many children were born in the institutions to these women.
Dr. Tom Pomeranz, Universal LifeStiles:
So that’s when I experienced, in my early days, the first place the institution I worked was Northern Indiana Children’s Hospital. And it was totally focused on children who were medically fragile. Horrible, horrible, horrible. I mean, I remember coming home from work, and my wife would always say, don’t bring your work home with you. And by that, what she meant is I’d walk in the door and she literally could smell the place. I mean, the, the smells were actually so horrible. And all the, all the, the wards, the doors were internally key locked, highly restricted kind of environments. And people were basically seen, I don’t know, I’m gonna give you a metaphor, Abby, cause I don’t know how else to describe it as chess pieces on a chess table. They were inanimate objects. They weren’t really perceived as human. You did things to them. You fed, bathed, and toileted them.
Dr. Tom Pomeranz, Universal LifeStiles:
Now those words are important. Those were the actual words that were used. You bathe, feed, and toilet. And the whole focus was on doing four people not doing with not promoting any sense of independence. So that’s the first phase. And that’s how, you know, we had that for a hundred years or more in this country. And then two things happened. Second phase is that in 1969, Congress passed a very important piece of legislation, and excuse me, for using the ‘R’ word, ICFMR, intermediate care facilities for people with mental retardation. It’s now ICFDD, intermediate care facilities for people with developmental disabilities. And that infused huge amounts of money into the institutions to try to change the conditions. Please understand, there was never a discussion of quality of life. Q O L did not exist. No one said we were there to improve quality of life.
Dr. Tom Pomeranz, Universal LifeStiles:
We were there to help eliminate inhumane conditions. That basically was the purpose of ICF terms, you know, like active treatment were introduced because prior to that time, places were custodial medical model oriented kind of places concepts. We, we developed human rights committees because there was some concern about how people were mechanically restrained for ours and being put in time out rooms. So we had these human rights committees, but again, the concept of quality of life did not exist. So we had this, this infusion of ICFMR dollars rules and regulations that these institutions had to follow that would, would alter some of the inhumane conditions that existed simultaneously with that, there were a large number of suits, federal suits filed across the country because of these inhumane conditions. The Wyatt Stickney case in Alabama involving three state institutions in Alabama, including Partlow, which was a horrible institution, closed under court order ultimately.
Dr. Tom Pomeranz, Universal LifeStiles:
So I’m not being negative. I’m, you know, it’s just absolutely the truth. So the, these federal court cases had a huge impact. Certainly Willowbrook, which many people are familiar with, was another major federal case. Cambridge facility in Minnesota was another major one. And these, the, the Department of Justice put in place consent decrees. And these institutions had to agree that they were going to take certain action, which by the way, that whole process is continuing to this day. And I’m still involved in that, in that process. And part of the consent decrees included downsizing the institutions, moving people out. So there were fewer people in the institution. Now, at the same time, we had the ICFMR dollars, which also could be used in community-based settings because states weren’t, didn’t really have the money to pay for the kind of supports and services.
Dr. Tom Pomeranz, Universal LifeStiles:
So the ICFMR dollars were then used for the development of group homes. So we saw back in 1972, 74, 76, the development of thousands of these group homes. Eight person, 15 person group homes. You say 15 people in a group home. Yeah. Think about it. A tremendous improvement over what we have versus having 75 to a hundred people in award. Now, we had a washer and dryer in the house. We didn’t have a commercial laundry. We had something that looked like a regular kitchen, okay? Mm-Hmm. <affirmative>. So that was the second phase. The development of all these group homes, people leaving the institution because of the court orders, as well as the states are just having so much difficulty trying to operate these places that they just start and became very expensive. Because every time somebody leaves a state operated institution, the cost for each person goes up.
Dr. Tom Pomeranz, Universal LifeStiles:
Because you have fewer people, people to, to, to divide that cost by. And remember, these institutions were huge places. The costs were astronomical. They had their own power plants. You know, we had our own security force. We had our own fire department. So just think as the institution started to downsize, the cost per person became astronomical. 3000, $4,000 per day per person. So that when you looked at a community-based group home with a per diem rate, per day rate of 250, 300, $400 that was a bargain compared to, and plus the problems that ensued. So that was the second phase. Okay. Now, the third phase of this whole deinstitutionalization process is a growing recognition that though people were living in smaller congregate environments, for the most part, they weren’t being treated much differently than they were in the institution. In other words, what’s the point?
Dr. Tom Pomeranz, Universal LifeStiles:
If you have staff in a kitchen that are preparing people’s meals, right? E you know, that’s no different than what was happening in the state institution. If you have staff who are doing people’s laundry and people are not being involved in their life, then send them back to Partlow, send them back to [inaudible]. It is out of that, that I grew a recognition that an institution is not a place, it is a state of mind, and you can’t close it up, you know, and it can’t blow it up. What the fact is, most people moved from one institution to another. That’s just a fact. It’s not an opinion. The only difference is the one they moved into has fewer people than the one they just moved out of. That’s the only difference. So that third phase was a growing recognition that we had to alter how we saw folks.
Dr. Tom Pomeranz, Universal LifeStiles:
We no longer could see them as these chess pieces on the chess board, but they needed to participate in their life. A recognition that you can’t have a life unless you participate in it. Right? And that, that concept started to develop around 19 86, 19 87, that people needed to participate in their life. And it was like pulling teeth. I mean, and it was just because we had people historically that we hired, we called them direct care staff, direct care <laugh>, and then we started to introduce the concept of direct support professional. Well, my gosh, we were training people to care for people. And now we’re saying, oh, well, all this training that we have been doing about how you prepare their meals and how you put the spoon in their mouth, and now the spoons supposed to go in their hand, your hand’s supposed to go over their hand, you’re supposed to help them become independent.
Dr. Tom Pomeranz, Universal LifeStiles:
Staff are looking at us like we’ve just lost our mind. <Laugh>. I mean, because we were saying, Hey, this is the right way to do it. Right? So those are the three phases of the de-institutionalization process. And if you were to ask me, and I think part of the question was, how do I perceive it? How did I feel about it? How do I, because it, it’s not an event and it’s a process. It has not stopped. Okay. And it’s, it’s torturous, torturous, I don’t know how else to say it, is that you feel like you’re in constant conflict with so many people who have a variety of ideas. It’s sort of like the political process in this co country. It’s torturous. Especially when one is hired as I am to be the facilitator of change, you know, it becomes really difficult because you’re perceived as the bad guy, if you will. So, that’s my answer, Abby.
Abby Rose Esposito, MediSked:
Yeah, man, nobody likes change, but it, this has been a long time coming, <laugh>, you’ve been doing this for so long.
Dr. Tom Pomeranz, Universal LifeStiles:
I say about that, Abby, when you say no one likes change, there’s a great maxim. There’s nothing wrong with change as long as it doesn’t affect me. You know, when we say, Hey, I wanna make all these changes in this group home, you know, the staff are going, oh my gosh, we gotta do that. But the staff who, for the same agency who work in the day program, the same great idea. I think you ought to be doing that in that home, right? Yeah.
Abby Rose Esposito, MediSked:
<Laugh>, for sure. So what still needs to be done in this movement towards deinstitutionalization and home and community-based services? Yeah, I’m sure you could go on about this for a while <laugh>.
Dr. Tom Pomeranz, Universal LifeStiles:
Yeah. I guess the best way I could sum it up is what needs to be done is changing hearts and minds. You, you know, we know what we need to do. There is nothing new. But the change has been so slow. I’m quite convinced if the computer industry would innovate at the same rate we do in our service system, we’d still be doing math with an abacus. Yeah. Now, I’m not kidding. I mean, we have known now for decades what we need to do. So I’m, I’m just gonna describe this as simply as possible, though, that question of what we need to do is what I do for a living in order to transition people to a life like yours and mine. And that’s, that’s it. I mean, that is the vision, right? And where there is no vision that people perish, but the vision is having lives like yours and mine.
Dr. Tom Pomeranz, Universal LifeStiles:
We know what that means. I mean, if I ask you, can you describe your life? You’re gonna tell me, well, I’m involved with my family. I have friends. I go out, you know, we go to a bar. I’m in a bowling league, I go to a church or a synagogue, and I develop relationships. They’re, I volunteer a few times a year. I’m employed. I earn money, I have relationships with my friends at work. That’s what we need to do. It’s not complicated, you know, it, it, it is understanding what a life is and helping people into it. You know, giving people a life and coaching them into it is the intervention. I’m gonna say that again. Giving people a life and coaching them into it is the intervention. We used to think the intervention had something to do with task analysis and instructional objectives, and teaching people how to put on un underarm deodorant.
Dr. Tom Pomeranz, Universal LifeStiles:
I’m not kidding. You know, underarm deodorant is not where it’s at. I mean, I want people to learn how to brush their teeth, but that’s not, that’s not it. You’ll, you learn these skills by participating in life. So the bottom line is we’ve got to give people an opportunity to participate in all aspects of their life. That is it. And people will become then part of their community, if you will. People said, commonly will ask me is, well, how else can you describe what it is we need to do? And I’m gonna say it in one word, cheers. And I’ll usually pause and people say, cheers. I said, yeah, the television program. And then someone will yell out, oh, you mean where everybody knows your name? You got it <laugh>. That’s it. Well, you know, if you’re too young, you maybe never heard of the duh, but you, but what is Cheers about Cheers is about a group of heterogeneous people, people who are very different.
Dr. Tom Pomeranz, Universal LifeStiles:
The guy who’s a lawyer, the woman who’s a flue, the guy who’s an alcoholic, and they just sort of interact with each other and they get to know each other. And guess what? When one of them is not there, they are missed. Yeah. Excuse me. That, that almost brings me to tears when I say it. Yeah, yeah, it does. Because the people who we support more often are not, more often than not, are not missed when they’re away. They’re not. I mean, people commonly won’t say as, you know, gee I haven’t seen Bill for the last three Sundays. He normally sits over there in that Pew church, you know, but that’s what it’s about. Being missed when you’re away. In order to be missed when you’re away, you have to have a presence. A presence. You hear agencies say, we have an inclusionary program.
Dr. Tom Pomeranz, Universal LifeStiles:
What in the world is a what are you gonna program somebody? You know, you program computers, not human beings. Programming is what the Communist Chinese do to the common people. You don’t program people. You know, you give them an opportunity to be active participants in all aspects of their life. Now, what does that mean? That means they need to be volunteering. Why giving and doing for others? Being part of your community, you can’t just be on the receiving end of giving. You have to give, we value people who give. It means being employed. And I don’t care if the person’s curled up into a fetal position with their thumb in their mouth functioning at six months gestation, having, you know, profound intellectual challenges. I expect them to be supported and giving and doing for others. We gotta be able to say, figure it out. It’s having leisure opportunities where you’re integrated not being on a deviancy bowling league with other people who necessarily have a disability.
Dr. Tom Pomeranz, Universal LifeStiles:
It’s being in a regular bowling league. And somebody says, well, Tommy only bowls at 85 and everyone else has two 10. How can you expect them to be, you know, there’s an interesting thing, Abby, in sports, and it’s called giving people a handicap, right? Mm-Hmm. <Affirmative>, you give ’em a handicap. The irony is, the only people we don’t give a handicap to in sports are people who have one. Yeah. I mean, yeah. I mean, we, what? So we all have to put ’em with their own kind, right? They have to be with their own kind. So it is promoting opportunities for people to be active participants in community settings, and not in segregated kind of environments where they can form valued relationships with other people. And they are missed when they are away. Now I’m just hitting a few highlights, but that’s what we’re about. And we know what that means because we have to look.
Dr. Tom Pomeranz, Universal LifeStiles:
All you have to do is look at our own life. You know, everything I train on is under this really large umbrella, and it’s called Universal Enhancement. And one of the books I wrote, it’s called The Principles and Practices of Universal Enhancement. And people say, well, what does that mean? Well, sometimes people come to my training and they think Tom’s gonna give us a new method, a new technique, a new strategy we can use on people with developmental disabilities. Watch out. Those people are dangerous. These are the same people who think they’re special strategies for African Americans, Jews, Catholics, Romanians, and people from Omaha. Hey, there are no special strategies. The strategies that you and I use to enhance the quality of our lives are the exact same strategies we use to enhance the quality of lives of the people we support. There is no specialty.
Dr. Tom Pomeranz, Universal LifeStiles:
I mean, they are universal strategies and we know what they are. And you know what’s really cool, Abby? All the strategies that we need to use are free. You can’t, you can’t get ’em through a purchase order. All the strategies are consistent with the rules and regulations under which we have to operate. And I’m pretty familiar with them. And number three, our staff can use them. And we don’t need anybody’s permission. We don’t, you know, they’re, they’re not some complex kind of thing that you have to get a doctor’s order to do these things. It just doesn’t work that way. And the reason I came up with those three points, that they’re free consistent with rules and regulations, and you don’t need anyone’s permission. I wanna make sure we have no excuses, because there are people who will stay awake at night trying to come up with some excuse why we don’t do this. They’re not mean spirited, they just don’t get it. They can’t suck. Mm-Hmm. <Affirmative>, you know, if you can’t keep your mother-in-law out of your own business, how in the heck you gonna make this work? Right? I mean, if you do a really good job of overcoming the challenges in your personal life, you’ll do a pretty good job of helping the people we support overcome their challenges as well. I don’t know if that answered the question, Abby, but that’s my thought.
Abby Rose Esposito, MediSked:
It did, it was great. Thank you. It does also bring us into my next question for you. So we know you’re a firm believer that community isn’t a place, but is something to be created. What are ways that you recommend for community to be built?
Dr. Tom Pomeranz, Universal LifeStiles:
Yeah. <laugh>, you hear sometimes an agency say we’re going to the community, we’re gonna go to the community. Somebody comes back into the house and one of the staff says, did you have a good time on your community outing? And or one of the staff says, oh, hey, I’m looking for the keys to the van. We’re gonna have a community activity. And I’ll say to the staff, when was the last time you went home on a Thursday and told your kids, okay, kids we’re all going to the community <laugh>. Well, and what’s further fascinating is that many of these residences, the places where people live, when you drive down the street, they look like any other home. You know, it’s a place where three folks live, four folks, those like any other house on the block. And the question becomes, how many of the other people on that block are saying, we’re gonna go on a community out near community activity.
Dr. Tom Pomeranz, Universal LifeStiles:
The question is, why do we tend to say we’re gonna go on a community outing to our community activity and the rest of the block, all these other people, they don’t say they’re gonna go to the community. Well, I think in part, it is a residual from the old days, the institutional days of when we were in these highly segregated environments, these campuses, these state operated facilities, and we were gonna leave that geographic location and take people to a movie theater in a community setting, rather than watching a movie in the g the gym as we commonly did. Or the, the recreation room part of it is that, here’s the other part, I think it is an unconscious understanding on behalf of the staff, not just direct support staff, but management clinical and administrative staff, that these people are not part of their community. If they were really part of their community, we wouldn’t say we’re going to go to the community because we’d understand that we are already part of it, and it must be built.
Dr. Tom Pomeranz, Universal LifeStiles:
And we build it by having people actively participate in community activities. And it may be something, Abby, just as simple as being part of your, your neighborhood association, right? Some, some neighborhoods like our neighborhood, we have an annual Christmas party, or they call it a winter party and a summer picnic. And we go to these activities that makes me part of the community. Or we have signs along our street that says Neighborhood Watch program, you know, literally where people are sort of looking out if there’s an issue, then you, you call 9 1 1. And so I, when I go to many of these residences where I coach on site, I’ll say, I, I see the sign out there for Neighborhood Watch Association, any of your folks involved in that? And many of the staff are not even aware the sign has been out, you know, on, on the block mm-hmm. <Affirmative>.
Dr. Tom Pomeranz, Universal LifeStiles:
And I said, Hey, that one guy, Bob over there, he, you know, who lives in the house? He’s 23, he has autism, he spends half his day standing in front of the window looking outside. I says, if he’s gonna do that, let’s make him part of the Neighborhood Watch association. Yeah. So you, you take the person’s challenge and you make it their strength. You know, you build on that. So that’s how we build community, like all those little tiny things, whether it’s the neighborhood watches, oh, or it’s growing tomatoes in the backyard, you know, maybe a raised bed, cuz you have some folks that use wheelchairs and giving some of the extra tomatoes to your neighbor. Yeah. It’s knowing that across the street there’s an older woman and her husband just passed away. And the the three folks that live in, in the residence are really challenged cognitively.
Dr. Tom Pomeranz, Universal LifeStiles:
And they may not even understand the concept of death. The staff support them in making some cookies and they take ’em across the street to the woman because her husband passed away. That’s how you build community and it’s all these little steps. Right? You know, I think a lot of people believe that we build community through policy, procedure, rule and regulation. And it’s been my position that policies, rules and regulations keep bad things from happening. Good people cause good things to happen. I can’t write a policy that you’re supposed to make cookies when somebody husband passes away across the street. Or if you have some extra tomatoes, give ’em to your neighbor. You know, you, you write policies to make sure that your medication in their home is locked up if that’s determined, necessary. Or there are maybe regulations about checking the temperature of the hot water so somebody doesn’t get scalded that’s keeping bad things from happening.
Dr. Tom Pomeranz, Universal LifeStiles:
But what we’re trying to do here, and I gotta go back to the earlier part of the conversation, a it’s changing hearts and minds. You know, a lot of these things have been, and many people don’t recognize it, have come about through ada and that’s Americans with Disabilities Act. And if I ask most people, well, tell me what ADA is, and they’re gonna say, well, it’s about cutting curbs, widening doorframes, and expanding bathroom stalls. But that’s not really it. You know, who cares whether you can expand a doorframe and somebody can get their wheelchair through it if when they get to the other side, they’re not embraced, they’re not wanted, they’re not valued. So it’s not the simple things of just merely widening the doorframe. It’s changing hearts and minds. I’ll give you another response here to your question about how you build community. It’s the difference between asking somebody to the dance versus asking them to dance.
Dr. Tom Pomeranz, Universal LifeStiles:
See, that’s profound. I’m gonna say it again. It’s a difference between asking somebody to the dance versus, versus asking someone to dance. And building community is relationship based. It’s inclusiveness. It’s not merely integration. Integration means the act of a physical presence. So there’s really three components to building community. The first is you have to have a physical presence that’s integration. The second component is participation. You can’t just be isolated. You can, you could go to the park, but if you’re just sitting there on the bench by yourself, you’re integrated, but it’s not gonna lead anywhere. So the second part is participation. I’m gonna have you adopt the park, we’re gonna clean up the trash, right. And I’m gonna support you. And the third part is inclusiveness. Because when you come to the park and you’re picking up the trash, you know, you’re interacting with people, you’re talking to them. If you have people who support you too. So those are the three components. It’s integration, participation, inclusion, which is relationship.
Abby Rose Esposito, MediSked:
Oh man. I feel like we’re giving people such a great resource for free.
Dr. Tom Pomeranz, Universal LifeStiles:
Yeah.
Abby Rose Esposito, MediSked:
People are taking notes, <laugh>, so you’ve already mentioned some of them, but your website features many of your own trademarked maxims. Could you share a few more of them with us and what they mean to you?
Dr. Tom Pomeranz, Universal LifeStiles:
Sure. Yeah. I, I would like to do that, but just let me say this is that <laugh>, there are so many wonderful, and I would encourage people to go to my website and lo look at the maxims, right? Maxims, if you’re, if people are not familiar with the word, they’re pithy, p i t h y, little phrases that concretize complex concepts to make things memorable, if you will. You like the word concretize? Abby isn’t a good word.
Abby Rose Esposito, MediSked:
So
Dr. Tom Pomeranz, Universal LifeStiles:
Big actually, it’s not a word. I made it up. Don’t take it. It’s my word. Okay. So, and and also, you know, there are so many wonderful of these pithy little phrases maxims on the website. The vast majority of them are not mine. And I really wanted to celebrate so many of the wonderful maxims that, that people use. I’ll share some of mine with you that, that hold significant importance to me. But one of them I had all I just shared, and that was from Todd Risley. He passed away a number of years ago. He was a professor, I believe the University of Alaska. And his whole, you know, his whole thing is how, how can I best say that is that you can’t merely improve quality of life through programs. So he came up with the ideas, getting a life for people and coaching them into it.
Dr. Tom Pomeranz, Universal LifeStiles:
Is the intervention, getting a life for people and coaching them into it is the intervention. And I wanted to do his first. I didn’t want, I don’t necessarily wanted to share the ones that I have evolved over time and the maxims that are, they have little TM next to it for trademark kind of thing. And it’s not like I sat down and said, gee, I think I’m gonna come up with a maxim. I mean, it just doesn’t work that way. You know, you’re training, I realized, I said, I said that, you know. Yeah, yeah. One of the wonderful ones of a friend of mine came up with is, the worst thing we can do for people is to do for people. Isn’t that great? The worst thing we can do for people is to do for people. So that, that really moves me.
Dr. Tom Pomeranz, Universal LifeStiles:
Okay. in terms of maxims that I, I mean a lot to me, an institution’s not a place, it is a state of mind. That was probably the first one I came up with. And an another really an important one is how people live should be determined by how they wish to live and not their diagnosis. I’m gonna say that one again because I wanna just talk about it just briefly. How people live should be determined by how they wish to live and not their diagnosis. And people say, everyone say, well, of course that’s true. But so, so often throughout the country, we develop programs for people so that there’s a home for people with autism. Of course, they all have to live with their own kind, don’t they? Right. See, yeah. So it’s not how he wants to live. That’s where he goes.
Dr. Tom Pomeranz, Universal LifeStiles:
Or a home for people that are medically fragile. So, and they’ll even refer to it as a wheelchair home, right? Or you get these behavior day programs where people eat their tennis shoes and they go from one room to another and don’t use doors, and they put ’em all in the same building thinking that something good is gonna happen. So their diagnosis should not determine, you know, how they live. It’s how they would wish to live would determine their diagnosis. Another one that’s really important to me is every reason that we give why we shouldn’t is the justification for doing it. Every reason that we give why we shouldn’t. So I say, why don’t you have bill vacuum the floor? And the staff says, well, Tom, he can, he has cerebral pals, he has contractures, and he has a lot of atrophy in his arm because he doesn’t use it.
Dr. Tom Pomeranz, Universal LifeStiles:
His, his muscles are poor, very poor muscle tone. Well, that’s the reason he should be vacuuming the floor. How can you improve your extension and your range of motion? How can you improve the strength in your arm if you don’t use your arm? Or I’ll say to somebody is the staff is taking a key and unlocking the front door. I said, Hey, why don’t you have Jimmy unlock the front door? Well, Tom, he can’t unlock the door. He doesn’t have piner grass. Pincer is when you have put something between your thumb and your forefinger like a spoon, right? And I said, but that’s why he needs to unlock the door. You need to put the key between his thumb and his forefinger. Put your hand over his hand and assist him in doing it. So that’s a really important one too. Every reason that we get what we shouldn’t is a justification for doing it. Another important one, an adult is determined by virtue of age and not competence. An adult is determined by virtue of age and not competence. It’s not how smart you are that determines your adult’s status. It’s the number of years that you have lived. And so those are some that stick out to, oh, I’ll give you another one. It’s like, really important. Not no, but how,
Abby Rose Esposito, MediSked:
Ah, yes, that is gun uses that a lot.
Dr. Tom Pomeranz, Universal LifeStiles:
How we are going to figure it out. You know, there are two columns in life, right? There’s a column in life of things that are under our control and a column of things that are beyond our control. I can’t change the temperature outside today. I’d like to, it’s pretty cold here. <Laugh>. And so we have to be empowered. We have to focus in life on the controllable column and you know, we’ll figure it out. Now, we put a man on, think about this. It was John F. Kennedy, I don’t know, was this, my gosh, early 62 maybe. And we had a black and white television set. And this guy gets on TV and he announced that by the end of the decade we were going to put a man on the moon. That was John Kennedy. Long before your time, 1962 <laugh>. And I’m thinking, a man on the moon.
Dr. Tom Pomeranz, Universal LifeStiles:
Are you kidding me? The moon is a quarter of a million miles away. There’s no air on the moon, there’s no water, there’s no gravity. What was the status of computers in 1962? Not Farfield from the ABAs <laugh>, but the people at NASA weren’t saying, we can’t go to the moon. Guess what? Right? What? 69, whatever, 68 mm-hmm. <Affirmative>. We put a man on the moon. Now no one is asking us in our field to put a man on the moon. What we’re being asked to do is to help people have an improved quality of life. It’s totally doable. Totally doable. So th those are some of my maxims. Abby,
Abby Rose Esposito, MediSked:
Those are great. Thank you for sharing them. Sure. So we’re really excited to have you join us for a webinar with Inc. Or in May on the leader’s role in implementing significant change, achieving a cultural shift. Could you give our listeners a little sneak peek on what you’ll be sharing during that lesson?
Dr. Tom Pomeranz, Universal LifeStiles:
I would love to. I can’t wait till that session. That’s gonna be a lot of fun. And yeah, let me just do four bullets maybe and we’ll make them sort of quick in terms of highlights. And I hope to hit about a hundred points during that actual session. The first one, in terms of creating that cultural shift, it’s really important that we as managers, supervisors, administrators, bond with our staff. We have emotional connectivity. You like that word? Yeah, that word. By the way, bond was never in my vocabulary. I was trained as a radical behaviorist. We don’t use the word bond by the way. I married a social worker and got over it. Okay, <laugh>. So, but with, because when you bond with people, they’re less likely to behave in a way to disappoint you. Now I can’t prove that, but I believe that.
Dr. Tom Pomeranz, Universal LifeStiles:
So part of the cultural shift process is our ability to emotionally connect with our staff so that they will do everything they can to take on these challenges and make them happy. Another point is that we have to walk the talk. Maha Ma Gandhi had it right, be the change in the world you wish to see. So as we talk about a cultural shift in an organization as just one quick example, language is going to be very important in shifting the culture. You can’t refer to a home as a facility and hope that you’re going to have a culture. A facility is a toilet. They’re meant to be flushed, not lived in the institutions where facilities, or you can’t name a home after a street. What is that? The Oak Street Group Home? Does your home have a name? Abby. Okay. So the managers and supervisors have to walk the talk.
Dr. Tom Pomeranz, Universal LifeStiles:
I don’t care whether it’s language, how they interact with people using age appropriate vocal tones. Not talking about people in front of them is if they’re not, they’re, we have to be the change in the world. We wish to see. Third point. And all of these require a lot of discussion. They’re expansive points. Staff are more comfortable with change when they understand it. Why are we doing this? So it’s an educational process. People fear change. People fear failure. People, you know, may perceive a sense of loss of autonomy and their independence or control, which by the way, a lot of that is really true because part of the cultural changes, we are going to put the people in charge who we support, right? We work for them, you know, they don’t work for us. So that’s, that’s fearful. So educating our staff so they truly understand what is behind these changes.
Dr. Tom Pomeranz, Universal LifeStiles:
And here’s another little subpoint of that, helping them understand that though were asking them to do these new things, what they had been doing was not wrong. In other words, you weren’t doing the wrong thing. We are just going to do things better. We don’t want staff to beat themselves up because what they had been doing, we taught ’em how to do that. Right? and a fourth one, start low, go slow. When we’re implementing change, we need this to support staff at the level they are willing and capable of participating. Start low, go slow. There was a very important person in our field died a number of years ago, one of two who I consider the most important. Dr. Burton Blatt. He, he’s the author of what many consider the most important work ever produced. And it’s called Christmas and Purgatory photo essay developed in the late 1950s, early sixties.
Dr. Tom Pomeranz, Universal LifeStiles:
He and a colleague went undercover to seven institutions in the northeast part of the United States, I believe, including Willow Willowbrook. And they took thousands of pictures, black and white pictures. The photographer had a camera on his belt, miniaturization was not then what it is today. And they, the, the pictures are horrible, you know, and I, I will say to the listeners, you know, the book is no longer published. It was published by Syracuse University. So the pictures are now in the public sector. You can go online, go to the web and bring them up, but be prepared for what you’re going to see. And Dr. Blatt was one of these huge, and I’m bringing this up because he was a, a cultural shift agent. I mean, he was so dramatic and so dynamic. People would go to his lectures, they’d get up and walk out, you know, so when I came across what I’m about to share with you, a a maxim that he used, I went, holy mackerel.
Dr. Tom Pomeranz, Universal LifeStiles:
That that’s his maxim. Cause it didn’t seem consistent with how I knew him, but here was his maxim. Think radically behave conservatively. And, and so that will be my, my final bullet in just answering your question real quick about what is a highlight, but it’s think radically. We have to think radically, but we have to behave conservatively. If, you know, when I was vice president of these various organizations, if I behaved the same way that you hear me verbalize, they’d throw me out in two minutes and I’d scare everyone away, <laugh>. So that’s part of the whole change process. Yeah.
Abby Rose Esposito, MediSked:
Wow. I am so excited for that session. It’s gonna be great.
Dr. Tom Pomeranz, Universal LifeStiles:
Thank you Abby. Me too.
Abby Rose Esposito, MediSked:
Is there anything else you’d like to share with our listeners?
Dr. Tom Pomeranz, Universal LifeStiles:
Yes, there is. Abby. I wanna leave everyone with this and I’m gonna do it twice. Are you ready? Good. Better, best. Never let it rest until your good is better. And your better is your best. Good, better, best. Never let it rest until your good is better and your better is your best. I’d like to leave everyone with that. Thank you, Abby.
Abby Rose Esposito, MediSked:
That was awesome. Thank you so much for being here and we look forward to seeing you in May.
Dr. Tom Pomeranz, Universal LifeStiles:
Oh, thank you.
