Perspective for Care

Phil Dubois

Phil DuBois is an award-winning long-term care administrator, and his years of experience in the field illustrate his credentials. But it was a tragic night in 2007 that gave him the firsthand experience of being an LTC patient that makes him the emphatic leader that he is today.

Professionally, Phil DuBois had a noteworthy first few months of 2007. Market Square Health Care Center, the long-term care (LTC) facility where he served as administrator in South Paris, Maine, received multiple awards for its dedication to excellence and quality care. By March, the American Health Care Association had chosen DuBois as a Future Leader in the field, one of its highest honors.

However, as DuBois’ professional life continued its upward climb, a tragic car accident in April of that year left him a patient in his own facility. He remained there for two and a half months, observing the same staff and daily operations he once oversaw.

DuBois’ time on the other side of the clipboard – as resident, not administrator – gave him rare and valuable insight into the LTC field. His experiences have armed him with the knowledge and the compassion that, as he transitions to program manager of Saint Joseph’s online LTC administration program, will lead the College into this increasingly patient-centered field.

In April 2007, DuBois and his wife, Tammy, traveled to North Carolina to introduce their newly adopted son, 13-year-old Jamie, to family. During their visit, while riding in their uncle’s minivan after eating dinner out, DuBois, Tammy, Jamie and four of their relatives were involved in a head-on car collision. According to the accident report, a 26-year-old female with a revoked license, driving an uninsured, unregistered car at 60 miles per hour in a 45-mph zone, crossed the centerline and struck their minivan.

Tammy did not survive the crash, nor did DuBois’ uncle Reverend Wendell DuBois and cousin Virgene Hughes. DuBois, Jamie and two of his aunts suffered serious injuries. DuBois’ injury list included a dislocated and pulverized left hip, a cracked pelvis, broken ribs, a broken elbow, a torn rotator cuff and a concussion. He underwent four surgeries and was diagnosed with anemia, pneumonia and post-traumatic stress disorder. After two weeks in a North Carolina hospital, he was transferred by air ambulance to Market Square Health Care Center in Maine – the LTC facility where he was administrator.

A pastor’s son, DuBois became interested in LTC at a young age. “I always enjoyed working with the elderly. My dad was a minister, and he very much believed in visitation to the elderly. He’d often take me with him.” After earning two bachelor degrees in theology-related fields, DuBois earned his master’s in health care administration in 2002 from California College for Health Sciences. By December of the same year, he had become administrator at Market Square. Though lauded for his accomplishments in LTC before his accident, DuBois believes the months spent as a patient made him a better administrator.

“It gave me perspective,” says DuBois. “I remember thinking, ‘This is how it feels. Now I get it.’”

As a resident he realized the importance of word choice. Much of what he learned had to do with industry slang.

“I once heard a nurse who was standing outside the door to my room shout to another staff member, ‘No, I can’t help you. I have three more to do before lunch.’ I’d heard that type of language all the time as administrator, but now it was in reference to me. I was that thing that needed to get ‘done’ before lunch. You do laundry, you do dishes. You don’t do people. It was dehumanizing.”

Phil Dubois gets congratulationsSaint Joseph’s is the only college to have undergraduate and graduate programs accredited by the National Association of Boards of Examiners of Long-Term Care Administrators. Present at NAB’s November 2012 meeting in San Diego was (left to right) Randy Snyder, chairman of the board for NAB; Phil DuBois; and Jennifer Johs-Artisensi, chair of the Education Committee for NAB.

Beyond terminology, DuBois found some of Market Square’s rules, which were regulated by federal laws, to be unnecessary and potentially counterproductive to recovery. One such rule required residents, if they had left the facility’s grounds, to return by midnight.

DuBois was still a resident on the Fourth of July in 2007, but he hoped to see fireworks and a concert in New Hampshire that night. Yet, since it was impossible for him to make it back to Market Square before curfew, he met a roadblock.

“I’m an adult. It didn’t present any health risks. But because of this arbitrary rule, I couldn’t go. Well … we bent the rules quite severely, and I did go. Getting out and spending time with my friend raised my spirits.”

DuBois’ insight into the resident side of LTC will prove especially crucial in the coming years. As baby boomers gradually enter long-term care centers, the field will become increasingly focused on the individual, not the facility.

“Baby boomers are a very consumer-driven group,” says DuBois. “Before baby boomers, long-term care facilities said, ‘adopt our institutional mindset.’ There’s a new trend – a culture change that’s been going on for years – to become resident-centered, resident-driven. That’s challenged everything we thought we knew about long-term care.”

Fortunately, DuBois is well-prepared to help Saint Joseph’s meet this movement. A faculty  member at the College since December 2011, DuBois is on track to become program manager of LTC administration this July, a position currently held by John Pratt.

Pratt, who joined Saint Joseph’s in 1989, literally wrote the book on long-term care. He authored the first edition of Long-Term Care: Managing Across the Continuum in 1999. Today, 50 colleges including Saint Joseph’s use it in their long-term care courses.

Although DuBois says he has “huge shoes to fill” as Pratt’s soon-to-be successor, Pratt personally sought out DuBois for the job. Before DuBois had any affiliation with Saint Joseph’s, he, Pratt and three others resurrected the Maine chapter of the American College of Health Care Administrators (ACHCA). DuBois became the first chapter president and impressed Pratt so much he recruited DuBois for Saint Joseph’s.

Like DuBois, Pratt also spent time in intensive rehabilitation due to a serious car accident after his freshman year of college. He believes his experiences had the same effect on him as DuBois’ did: It made him a better administrator.

“Phil understands the importance of the little things,” says Pratt. “Like showering. If you’re used to showering daily, and then you can only shower weekly, it’s a big change. He knows what that means to people.”

As residents continue to take more control over the care they receive, DuBois is ready to do more than just understand their needs; he’s ready to teach others how to understand too.

“Too often, as caregivers, our day is focused on our own routine, our own tasks,” says DuBois. “It’s our job to see the world from the resident’s eyes. It takes energy, it takes work, it’s an imperfect art, but that’s why we do it. It’s not about you, it’s about them. Put your shoe on the other foot and see how it feels.

“We need to teach the critical, analytical skills,” DuBois says, “that will help students evaluate change. Long-term care’s changing quickly and sometimes unpredictably.”

by Alanna Conn