Change of heart

Transitions spawn rewarding career for this Arizona hygienist

Frances Dean Wolfe

"The only constant in life," wrote Benjamin Disraeli, "is change." This adage has proved doubly true for Cindy Kleiman, an Arizona hygienist whose career has thrived in spite of — or perhaps because of — life`s inconstancies.

Kleiman calls her entry into the field a fluke. It was Irene Woodall, director of her college`s dental hygiene program, who persuaded her to enter the field. "At the time, I had no interest in caring for disabled or mentally compromised patients," she recalls.

Woodall recruited Kleiman for the position of dental health coordinator at Moss Rehabilitation Hospital in Philadelphia. Working at this facility quickly converted Kleiman into a dedicated advocate for better oral health care for the disabled. She was fortunate to find mentorship and support from two dentists on the staff, Dr. Gilbert Zayon and Dr. Jack Zafran, whose technical skills and teaching ability had a lasting impact on her professional life. Kleiman credits these two for not only teaching her how to provide care to medically compromised and handicapped patients, but for instilling a passion within her for the field.

Early independence marks her career

Kleiman made the transition west to Phoenix, Az. Without a job, but still wanting to provide rehabilitative care, she began knocking on doors. Kleiman soon created a position for herself at Good Samaritan Rehabilitation Center in central Phoenix.

"I was the first hygienist working there," she recalls. "At the time, I could only floss and brush patients` teeth and teach them how to relearn their oral hygiene skills post-injury." She also worked with mentally challenged children and adults in area schools, whose ages ranged from 10 to 90.

Her initiative evolved into a comprehensive program of clinical dental care, and included a dentist on staff. One of Kleiman`s more ingenious inventions was a mouth stick to help patients with spinal cord injuries manage their environment with their jaws. Kleiman considers working with "special needs" patients — those who suffered strokes and spinal cord injuries — the most fulfilling part of her years at Good Samaritan.

The grant money on which Kleiman`s program depended expired, forcing yet another transition. But, in typical "making lemonade out of lemons" fashion, Kleiman soon secured another. With a grant from the Flinn Foundation, the state of Arizona Health Services, along with Northern Arizona University and Phoenix College, hired her as the coordinator of an oral healthcare program for homebound patients. The program provided portable equipment, which Kleiman took into private homes, nursing homes, and special needs schools. Kleiman also trained other dental hygienists to work with the physically challenged.

Kleiman recalls that the most rewarding aspect of the job was getting to know the patients. "It`s very different when you`re in their homes, very different from ... the clinical environment." Meeting the patients` families, and interacting with them in their homes year after year, was very fulfilling. The freedom and autonomy to work without direct supervision was also gratifying; however, she did work under certain restrictions. She could not, for example, administer anesthesia to her homebound patients.

Yet another transition led Kleiman down her most exciting career path, one that continues with great success today — teaching other professionals and caregivers how to provide oral healthcare for medically compromised patients. Since 1996, Kleiman has built a career giving educational presentations to dental and allied healthcare groups around the country.

One of the many hallmarks of Kleiman`s presentations is an opening slide of a homebound patient named Marjorie. Marjorie`s oral health had been severely compromised when the medications she took dried up her oral tissues — a fact none of her healthcare providers realized.

Kleiman states, "Patients and their care providers didn`t know much about products, fluorides or other devices to help disabled or medically compromised patients keep their mouths healthier and more comfortable."

Marjorie`s dilemma galvanized Kleiman. She began speaking and giving presentations locally to nursing homes, then to larger groups at regional, state and national meetings. Kleiman found there was often a real gap in the knowledge of nurses and other professionals regarding oral healthcare. She relates, "I decided I would try to educate other healthcare providers. Today, I`m a professional speaker because of Marjorie and all the patients with similar needs who require improved oral care."

Teaching the teachers rewarding

Kleiman enjoys "teaching the teachers." She especially focuses her outreach with nurses and occupational therapists — those who provide the care. "I`m very passionate about what I do and want to improve the quality of oral healthcare," she says. "I hope oral healthcare gets better from a nursing perspective," she adds.

Experience has shown Kleiman that if the director of nursing of an extended care facility is motivated regarding oral healthcare, it funnels down to the staff. "I try to excite them and give nurses aides free samples, free brushes, and floss. I get them more excited about their own care," she explains.

Kleiman`s career continues to evolve. In addition to her much-in-demand seminars and speaking engagements, she is an adjunct faculty member at Phoenix College, where she teaches emergency medicine to dental assistants and dental hygiene students.

Kleiman credits her success partially to persistence and networking. She regularly sought advice on fees, marketing support, and feedback on her presentations. She also obtained guidance on how to make PowerPoint slides and organized a home office. Her best advice: "Don`t be afraid to ask for help!"

Kleiman advises other hygienists whose careers are in transition to create their own special niches. "Do what your heart moves you to do. Go where your passions and desires are."

Does she have an ultimate career goal? "I`ll let you know when I get there — I haven`t reached it yet!" Kleiman adds, "My goal is to get the attention of as many healthcare providers as I can ... to improve the quality of oral hygiene people receive. I don`t think my goal will ever be met ... {or ever} totally satisfied."

Frances Dean Wolfe is the pen name of a frequent contributor to RDH.

Interested dental healthcare professionals needing more information about this article can reach Ms. Kleiman personally at 17 W. Kathleen Rd., Phoenix, AZ 85023. She can be reached via telephone at (602) 375-2737, via fax at (623) 974-0132, or via e-mail at [email protected].