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Episode 106: Erika Esnard

Young leader. Miss Geriatrics. Erika Esnard finds her North Star in caring for her grandmother and her passion for serving aging adults grows.

Lucas: Welcome to Bridge the Gap Podcast, the senior living podcast with Josh and Lucas. We are having an incredible time here in Atlanta. We’re laughing, we’re having a good time and I want to introduce our audience to someone very special that we’ve met here at this industry conference. You guys have heard probably before of Miss Congeniality, but today on the program we have Erica Esnard who is Miss Geriatrics. Welcome to the program.


Erika: Thanks for having me. Really excited to be here. 


Lucas: I got it right. Well, so you have an incredible story. We’ve had some chances to sit back and kind of talk to you. You immediately approached us when we got here and you’re like, I love the podcast. I love what you guys are doing. Let me tell you about why I’m so passionate about older adults. You have a fascinating background. Why don’t you tell our audience, your background and why you’ve gotten into this field?


Erika: That’s a great question. So my background is in really long term care and administration. However, I really focus on hospice and palliative care. And the reason why I focused on hospice and palliative care is because I had the opportunity at 19 years old to become a primary caregiver for the love of my life. My Awilla or grandmother she is our, or was, I actually still struggle with saying was so she is like the most important human being in my life. And she was diagnosed with stage four lung cancer and I took on the role as her primary caregiver while being a student at the University of Florida. And through that experience I saw an immense amount of suffering. There’s nothing like watching the most important human being in your life deteriorate day by day and almost coming from a stance of being helpless.

But as a caregiver, you’re not helpless, you’re actually really, really changing the life of the person that you’re caring for. So part of the work that I do now is really involved with helping caregivers take care of themselves with a special program that I’m a part of, which is Powerful Tools for Caregivers. It is a program that was developed by Stanford University and we are implementing it in 43 different states. So I am a certified class leader with that as well. So really I got here because this is kind of just where the journey has taken me and just super, super grateful to be here.


Lucas: Tell the backstory of how your close bond with your grandmother, how did that come about?


Erika: So I think a lot of it is we were, we believed that we were from a different planet. Actually. We believe that our love was something that was not known. It just from the second I was born, if I even look at photos of her looking at me when I was a child, it was like we were soulmates. And so we, she didn’t want anyone else to take care of her. She would actually go on strike if I wasn’t there. Like if I was in class at UF, because by the way, as a student at University of Florida, and living in Miami. I was driving to U F about four times a week from Miami. So that’s a six hour drive. Yeah. So also as a caregiver, I ended up just developing things that were stress related because it’s such an intense experience. And I also believe that it’s attributed to my background.

So I’m Cuban and Israeli -Juban is actually what they call it. And and so being a part of that culture, it’s just your grandparents are so, so impactful. And that’s also something I’ve done a little bit of research with in regards to, o care and culture and ethnogeriatrics is actually what we call it. So yeah.


Lucas: I want to know more about that.


Erika: Ethnogeriatrics. So I’ve planted seeds actually with Stanford University because they have one of the largest research hubs for ethnogeriatrics. And so what that is about is really the difference in care from the difference of care from your cultural background. Right. So even in senior living as a longterm care ombudsman, actually the youngest longterm care ombudsman in the state of Florida, I’ve learned or seen from my own eyes that when I’m visiting or doing an assessment on a Spanish speaking facility versus an English or American facility or community, I like to call it, versus a facility. The verbiage does count. So the difference in care is exponential due to culture. We call it we call it (Spanish translation) or compassion in, in Cuban or Spanish.


Josh: I have to take the opportunity, and this is probably taking the discussion in a little bit different direction, but we talk a lot on our show to a lot of thought leaders, people that have tons of experience in the space. And one of the just consistent themes. As a matter of fact, we just had Discovery Living on recently. We were talking with them that one of our biggest challenges we see and opportunities as an industry is to better communicate and educate a young workforce like yourself that may have never heard of senior living and are out there. They’re very passionate. They’re looking for something to not only make a living doing, but fills something deeper than that, like a mission, a purpose. We think that’s a great opportunity, but we recognize our space has done a really bad job of communicating that. So as a young person you’re not too far away from the university space, you still work with universities and things like that. Give us some insight to what we can do better from the millennial you know, to the senior living industry.


Erika: Absolutely. I think it’s all about giving hugs. I think if we’re coming from a high level, meaning if you’re talking a nursing home administrator or assisted living communities, that administrator ED, you’re going to want to treat your staff with compassion. I think that’s the first step. I think also it kind of boils down to a quote actually. It’s he who has a why to live can bear anyhow. And the reason why I bring that up, it’s actually a quote by Frederick Nietzsche because I think millennials and our generation were really lacking a sense of purpose or a sense of meaning or more so even just some depth. Right? And so I think being able to share that working with older adults or geriatric patients would also give you a sense of purpose in addition to also having the opportunity to receive income by living your purpose, like a passion for your paycheck. I think that’s irreplaceable, right? And that meaning and that purpose, I think we’re finding like just what we’re seeing, at least with my generation, what I’m seeing is that we’re really lacking that piece to the puzzle. And that’s all we see. Other things on the rise. But if we were really working from a place of volunteering with older adults working from a place of working with meaning, I think we would find we would have different results. Yeah, absolutely.


Josh: So that’s really good. And so I, I firmly believe we have like the ingredient that many of the younger generation are looking for for that fulfillment, that purpose, and be able to marry that with actually how to actually get out and do something you enjoy doing every day and actually make it living doing that, I feel like we fail is how we communicate that. It seems like we’re very dated in our communication methods. Maybe we’re not, as my grandfather would have said, you know, we’re not fishing in the right hole, you know, so like, where, where, and how do we communicate this message? Like, how are you guys receiving information? Put you on the spot. Yeah.


Erika: I want to say social media. And, and, and this, this may sound wrong, but I kind of try my best to separate myself from my generation. I actually think it’s because of the work that I do kind of like it’s allowed me to make a step forward. But anyways I think definitely social media. I also think starting with education so part of my role is actually the inaugural ambassador for USF School of Aging Studies. And one of the things, which, by the way, I mean an amazing institution. One of the things that we’re working on is really getting the message out and sharing why it’s important to work with geriatric patients and why it’s a good field to go into. Right. and it’s needed. Oh my gosh.

Like we could just talk, we could talk about the need of really the demand for the workforce with the generic population. So I think starting with education is definitely the first step. And that’s actually something that I’m working on. And, and podcasts like this, right? Me sharing this with the people that I know, right, that are my agent and word of mouth and spreading our passion like that, to me, that’s the best way and breaking these stigmas. And that’s actually part of the reason. Lucas and I were talking before the show, why they started calling me Miss Geriatrics or how that even came into play is because if you’re walking down the street or when I used to walk down the street and someone would ask me what I was studying and I would say geriatrics, they had no idea what that was. But if I said pediatrics, they would be able to recognize that immediately. So why is that? Right? And I think that also comes down to the stigmas of aging. It’s not a surface level answer. I think it’s a lot deeper and by having these types of conversations, we’re moving forward. Absolutely.


Josh: Well, and I think that’s part of what Lucas and I were hoping to create. And I think some of the voices like you coming on the show and sharing that and then being the torchbearers for that are just amazing. And part of that catalyst that has to start the fire. So, what does a day in the life of your world life like?


Erika: Well, right now I work, I obviously have to pay my bills, right? So I work with a company that’s actually here. And what we’re doing is we are implementing smart locks for home care. So hospice and palliative care patients can receive in-home care without having the risk of falling on the way to open the door or reducing missed visits, etc. However, a day in the life of my life is usually if I’m not working in that role, I’m visiting facilities or communities across the state of Florida and doing assessments on their quality of care as an ombudsman, as well as visiting patients with my life path hospice role. So that’s spending about four hours a day with a hospice patient or taking visual calls. So if the hospice has a patient that’s near death or death is imminent, I’m reporting immediately and holding space for that dying soul.


Josh: Wow. You’re not ambitious at all. I can tell. Not, not at all. So what is, what is it on your you seem like someone that’s really very forward looking you know, where you’re going. So what are some of your goals over the next several years of where you see yourself? Things you want to create, what you want to do? 


Erika: That’s a great question. So right now I can say off the bat there, my North star is caring for the alone and dying. That will always be my compass and I will always come back to that. I think it’s important for everyone to have a North star, whether it’s in senior living, geriatrics, whatever it is, human connection. You’re in sales. It’s important to have a North star, if anything, that’s what you have. So for me, my actually, my end goal is, is owning my own holistic hospice. 


Josh: Wow. So explain to me holistic, holistic hospice. What is that?


Erika: So the way that patients die here in America is more often than not in a morphine coma. And obviously we know why because we want to reduce pain and that’s where palliative care comes into play. But the average hospice stay right now is one to three days. So I would love to have a space and it doesn’t need to be, you know, it’s, I want it to be sustainable. I don’t need it to be, you know, I don’t need to have a hundred franchise. And you know, you understand what I’m saying? But really allowing people the opportunity to pass with dignity and not have to be, I don’t want to say medicated because we really, really alleviate a lot of suffering with medication, but there has to be a better way and I want to find that way.


Josh: So is holistic hospice, is that an industry right now or is that something that’s working on being created? 


Erika: So I’m not sure if you’re familiar with Dr. BJ Miller. So he actually runs the Zen hospice project in San Francisco. And a funny story you want to talk about ambition. I recently was in San Francisco and I had reached out to them many, many times, but they never got back to me, which is completely, I completely understand. So when I went to San Francisco, I waited in their office of We Works for two hours with no meeting whatsoever. And I said, I’m not leaving until I meet an Dr. BJ Miller wasn’t there, but I answered a meeting with the executive director and since then we’ve continued communication and what their whole hospice house was actually based off philanthropic funds. So unfortunately had to close down recently. But what they were doing is they were filling their home with fresh baked cookies and they were, when people would die, they would put flowers on their deathbed and they would just treat them with compassion and care and not walk on eggshells because it seems as though death, let me speak about death and dying. It’s walking on eggshells.


Josh: Very interesting. So you have this goal: holistic hospice. You’ve already started, you know, demanding a presence in meeting and, and taking steps towards that. So what do you foresee as some of your big obstacles to meeting that challenge?


Erika: Well, actually right now it would be it would actually be paying my bills. Honestly it’s an important thing. Yeah, it is. And I think that stops a lot of us. Right. cause if the question, you know, if nothing mattered, what would you be doing? Or if you got $10 million today, would you still be doing what you’re doing right now? Tomorrow? That’s a great question. So for me, what, what’s really stopping me is actually like education, right? Going further in my studies, which I actually was studying. I was earning my second bachelor’s in biomedical sciences to become a hospice and palliative care physician. And then family kind of interjected and I had to start paying my bills. So that’s why I actually have to have the job that I have right now. But I will, that will 100% if, if that is what’s meant for me, that will be.


Josh: I, you know, I applaud that you have identified your North star. I like how you mentioned that you have very ambitious goals wish you the best and achieving those. It’s just a very encouraging, don’t you think, Lucas, to be with someone so young, so passionate, shares our passion for the aging and older adults in our industry. 


Lucas: Absolutely. Absolutely. I want to go back to, let’s unpack some of those conversations that you have with some of your peers when they’re just learning about who you are and the type of work that you do. I imagine that some of it just goes in one ear and out the other. Some of it resonates. How do you communicate that to your peers? And then what has been the response back from them?


Erika: Oh, that’s a great question. So it’s either a conversation piece or it’s a conversation ender. They think I’m crazy is actually what they think. Like I will be at a patient’s home and I’ll leave and I’ll call my best friend and I’ll say, you know, she said, what are you doing? I said, you know, I’m just leaving, you know, patient’s home, and I’m perfect. Right? I’m smiling. No, tears are coming down my face. Or if I was crying with them, I immediately separate myself. Anyways, that’s a whole other conversation, which by the way, I just want to say one thing. One of the greatest lessons I’ve learned in hospice and palliative care, and this applies to everyone, is you share, but you do not own, you share what you can share. You share your passion, you share your love, you share your assets, but you do not own the result.

Because once you own that result, you’re now focusing on an outcome that you actually have no control over. So besides that my friends think I’m crazy. None of my other friends really are pursuing anything that has anything to do with this. I try to spread the word as much as possible, right? Meaning what I’m doing. Because I think that breaks stigmas and barriers and having a young person focus on something like this is a really big deal. But the people around me, even my own family think that I would be depressed my whole life and that I am setting myself up for an outcome that is negative, which I see it as the exact opposite. I see it as it makes me, it sparked so much joy in my life to be in the presence of someone that is dying because for a second, if you take yourself out of it and you’re there for that other person, you’re not thinking about yourself. I’m not thinking about how sad this is or how sad I am or how sad this is making me. I’m thinking about the impact that I’m making on that person’s life. Whether it’s five hours or whether it’s three days, I’m sorry, like, no one deserves to die alone. I refuse. I want to be like the next Dr. Elizabeth Kubler Ross like that is my, I pray that I can make that type of difference.


Lucas: So I’m gonna, I’m gonna kind of peel back a little bit. Clearly, you are not the norm. I mean, this is, you are, like you said with your grandmother, you guys are from another planet. An amazing planet and the world needs more people with your mindset. The truth of that is, is that there’s probably not many people. You’re in a very small group. Let’s focus more on the macro. That’s micro. Let’s go macro. And hearkening back to a conversation with Discovery’s Richard Hutchinson. We talked about going to the deans of certain colleges and institutions where they’re studying hospitality and services for hotels and food service. Let’s, I mean, let’s just brainstorm. Is there an opportunity there for us to take senior living to the people that may be wanting to get into a service based business and show them that this of doing well and doing good could be way more rewarding than selling another $150 a night hotel room?


Erika: So, quick question. Did you hear about USC and what they’re doing? Oh my God. USC’s Davis School of Gerontology, I believe it’s Davis school of Gerontology. They actually, spring 2020, they’re starting their first master’s program in senior living hospitality. Really? Yeah. And actually thought about applying. I know, I know. Cause there’s so much room for growth in that industry, but absolutely. Like just as Josh and I were talking about earlier, it starts with education. It starts with spreading the message. So I definitely, I would do that, right? Like if I had that opportunity, I would do that in a heartbeat because our only guarantee in life is that we have a moment of death. And whether that comes at 30, 50, you know, God willing, you know, 80, 85, whatever quality over quantity, whatever you want to call it, we need to care for older adults and we’re going to be there one day.

Right? So how do you want, what do you want your care to look like? Like what does, you know and I’m saying what do you want your care to look like in 30 years, 40 years, right? So that’s where we need to be. We need to be working from a space of what would we want our grandmother to do or what, or what kind of typical would we want our own grandmother to receive? So anyways, absolutely. I think that that would be a great place to start. And if you guys do that, let me know. Cause I would love to be a part.


Josh: Well I may be the courage to hear about the program that you mentioned and I think there needs to be more of those kind of programs. And I think you know, our industry needs to embrace and partner with those because I think there are programs popping up and there’s some progress being made, but obviously so much work to be done, which again, as we’ve said, anytime there’s a problem, there’s a great opportunity and I think we need to be the catalyst for that. Right. 


Erika: Yeah, I agree. I agree. 


Lucas: Such a great conversation Erica, our listeners, I know right now they’re like, how, what, what? I just want to know more. How can I get in touch with Miss Geriatrics? And this is like a collision course because miss geriatrics is now sitting and talking to the senior living fan. We’ll definitely connect with you in the notes, but where do you live online?


Erika: So my Instagram is it’s @geriatriguru. Email at I am open to any type of dialogue whether that’s grabbing a cup of coffee and just discussing how we can create a more age friendly environment. Just quick little thing. The John Hartford Foundation in New York, a great place to start. Meaning just what the type of work that that, excuse me that they’re doing. The Grant, geriatric workforce enhancement program, grant teaching physicians how to be more well versed in geriatric care. But anyways, Erika and my Instagram and that’s where you can find me. Awesome. Yeah. Yeah.


Lucas: We’re going to connect with you in the show notes and our listeners are going to enjoy getting bits and pieces of you all week as this content comes out on a great topic about changing the narrative and making it more age friendly culture.


Erika: Yeah, absolutely. I’m all for it. 


Lucas: Let’s do it. Let’s do it. Let’s do it. 


Erika: And thanks to you guys for what you do. Seriously. We need this dialogue. 


Lucas: I’m glad that we found each other. Well, thank you all so much today for listening to another great episode of Bridge the Gap. High five. Awesome. This was amazing. So fun.

Thank you to our supporting partners NRC Health, OneDay, TIS, Morrison Living, Argentum, Solinity, and The Bridge Group Construction. 

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Episode 106: Erika Esnard