June 13, 2025 • 50 mins
Do you ever feel dismissed or intimidated when advocating for your loved one in medical settings? That ends today.
In Episode 2 of our 'Detroit Cares About Caregivers' series, medical providers share the importance of caregivers in the healthcare process.
"I may know textbook, but you know your loved one," explains Dr. McNeill, Principal Investigator of the AGREED GWEP Program and the one who invited our team to create this insightful series!
Dr. McNeill and her colleagues shared game-changing insights in this powerful exploration of the caregiver-provider relationship. From Detroit's innovative Rosa Parks Geriatric Center, medical professionals reveal what they wish every family caregiver understood about being true healthcare partners.
The candid conversations unpack why the caregivers' perspective is invaluable in medical settings - not just welcomed, but essential. Dr. McNeill boldly repositions caregivers as "leaders of the healthcare team," pushing back against outdated hierarchies that diminish caregiver input. Meanwhile, geriatric specialists showcase thoughtful facility designs demonstrating how environments can better serve elderly patients and their caregivers.
Whether you're a seasoned caregiver or new to supporting an aging loved one, these conversations offer a roadmap for confidently navigating medical partnerships. Stop feeling like an outsider in your loved one's care and start embracing your rightful position as an essential healthcare ally with the expert guidance in this episode.
What conversation will you initiate with your loved one's healthcare provider after hearing these insights? Your voice matters more than you know.
For more information about the AGREED grant and resources for caregivers in Detroit, visit agreed.wayne.edu.
Host: J Smiles Comedy
Producer: Mia Hall
Editor: Annelise Udoye
This episode was filmed at Evry Media Studios in Detroit.
"Alzheimer's is heavy but we ain't gotta be!"
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:00):
I think that it's very important as a provider to
listen to the caregiver, thehusband or the wife or the child
, whoever is the main personinvolved, Because I may know
textbook right, but you knowyour loved one.
Speaker 3 (00:13):
What do you think caregivers can do, can learn,
can assist in this whole processof medicine management when it
comes to the elderly, Cattekersalso need to look after
themselves, especially if theyare caring for their loved ones
who have dementia, then reallythere is a lot involved.
(00:36):
You know they can get wound up.
Speaker 2 (00:39):
This sounds like a real relationship, doc.
Oh yes, it sounds like you areopen to, or at least suggesting
that, there is opencommunication, honest
communication, and that we wemeaning caregivers are giving
their provider a chance to say,okay, this didn't go so well.
(01:01):
But before I just quit you, I'mgoing to let you know, let's
work it out.
Speaker 1 (01:10):
Give me a chance.
I think I got to look into thecamera when I say this, so
listen here.
Speaker 2 (01:18):
Parenting Up Caregiving Adventures with
Comedian J Smiles is the intensejourney of unexpectedly being
fully responsible for my mama.
For over a decade I've beenchipping away at the unknown,
advocating for her and pushingAlzheimer's awareness on anyone
and anything with a heartbeat.
(01:39):
Spoiler alert this shit isheavy.
That's why I started doingcomedy.
So be ready for the jokes.
Caregiver newbies, ogs andvillage members just willing to
prop up a caregiver.
You are in the right place.
Hi, this is Zeddy.
(01:59):
I hope you enjoy my daughter'spodcast, is that okay?
Today's supporter shout out isalso from Detroit.
You know what we're doing thiswhole series.
We are Detroit ready.
(02:22):
Baby.
It's Dr Faith Hopp, associateProfessor, wayne State
University School of Social Work, agreed GWEP program.
Guess who is the principalinvestigator?
Dr McNeil, I told y'all she wasdope.
This is the shout out.
(02:42):
This is an amazing andinspiring podcast.
Double exclamation point OK.
One, two.
The caregivers, as Dr McNeilsays so eloquently, should be a
critical piece of the healthcare team team.
(03:07):
Our caregivers have shown ustheir passion, dedication and
commitment to their role and arean inspiration to all of us in
Detroit and beyond, and beyond.
Ow, I love it.
Thank you so much, dr Hopper.
If you would like to receive asupportive shout out.
You know what to do.
Leave a review on ApplePodcasts, ig or YouTube.
(03:29):
Parenting up we, the sameeverywhere, thank you.
We in Detroit, detroit, this isour first tour and it's
happening in Detroit.
Okay, you just get ready, baby.
You know how they do it up here.
What up, though.
What up, though.
(03:50):
And this is the day that we arebringing you that fire, that
Detroit fire.
So, wherever you listening,wherever you watching, just get
ready, baby, sit down, drinksomething, sip on something, eat
on something, but be safe.
Today's episode White Coat,wisdom, best Practices for Care
(04:12):
Partners what's up?
Parenting Up, family we stillin Detroit, y'all.
So you better be happy that I'meven awake and smiling enough
to talk to y'all, because youknow Detroit is a party.
What up, though?
What up though?
So this is episode two.
We are talking with medicalprofessionals getting their
(04:36):
point of view around caregivers,how caregivers can help more,
how caregivers can get help more.
Let's dig in and find out fromthe other side, right here, who
I got with me the one and onlyDr McNeil.
I call her Dr Detroit, though.
(04:57):
You know what I'm sayingBecause I got it like that.
But y'all, if you see her inthe street.
Don't do what I do.
You call her DrNeil, okay, whatup, doc?
What up, though?
You see what I'm saying.
You see what I'm saying.
Listen, you got a lot of fancythings, but look at this y'all,
look at all them things.
Can y'all zoom in and see allthese letters?
That's a.
That is everything in thealphabet.
(05:17):
She has the alphabet behind hername.
What that really means is shewent to school a lot, a whole
lot.
So can you tell us what?
You went to school?
A lot, a whole lot.
So can you tell us what youwent to school to?
Learn how to do which degree?
See what I'm saying.
See what I'm saying.
Okay, the ones, the degreesthat have to do with that white
coat, okay.
Speaker 1 (05:37):
So I have my doctorate from Wayne State
University.
I have a doctorate in Pause.
Speaker 2 (05:41):
Doctorate, that's what you call a terminal degree.
Okay, yes, pause, doctorate,that's what you call a terminal
degree.
Ok, I mean, you can't getnothing higher.
Than that Means you can't getfurther, further with an A on it
or head or her in that therething.
Speaker 1 (05:56):
Go ahead.
I have a doctorate in nursingpractice, which means I'm a
nurse practitioner with adoctorate degree.
Before that, I was a nurse formany years, working in health
care doctorate degree.
Speaker 2 (06:06):
Before that I was a nurse for many years working in
health care.
I can hand you a band-aid.
If you need more than aband-aid, go to Dr McNeil.
Please let everyone know aboutyour passion in even getting in
nursing, because nursing mightbe getting all the shine now,
(06:28):
especially post pandemic.
Nurses finally got what I'vethought for years should have
been.
A lot of accolades and thankyous came during the COVID
pandemic and it was so obviousthat nurses were holding us down
.
But you were nursing way beforethat.
Way before it was like the sexit was brought back.
(06:49):
What made you so excited aboutthat?
Speaker 1 (06:52):
field.
I mean, it's just my desire toserve, my desire to be a vessel.
You know, when you haveindividuals, that's at their
most weakest, vulnerable stateand they are relying on you, as
stranger, essentially to carefor them, and that's a big
responsibility.
And so that's something I donot take lightly and that is
something that I feel I do well,but one of the reasons why
(07:13):
nursing is one of the trustedprofessions and I take that to
heart.
Then, being able to be home inDetroit and being able to
address health disparities,using this talent, using this
skill, using what God gave me,it's kind of my calling, a
calling.
Speaker 2 (07:28):
So I like to how you can be called to do something
other than preach.
So people listen.
If you've been called to preach, by all means do that.
But I just want you to know youcan be called to do something
other than play basketball orpreach.
Look at that.
There's a third thing Well, Iwas called a comedy, so that's
at least four.
Ok, that's four things that youhave learned today that you can
(07:49):
be called to do.
And nursing yes, I'm sograteful for nurses.
I know how well nurses made somuch difference in my mom's
journey Well, I guess ourjourney in in her caregiving.
Wow, I love doctors and theymay have been the ones who did
the surgery and all the goodthings, but the nurses, what
(08:13):
they do and how they convey whatI see back to the doctors to
then change and or manage thecare, makes such a big
difference.
Speaker 1 (08:24):
Yes, and I think that it's very important to know
that you have different levelsof professionals, right?
So before I got my doctorate, Iwas a bedside nurse.
I was the one that was by yourside 12 hours while you were
sleeping.
I was the one that wasmonitoring you, I was the one
making sure that whatever orderscame in for you were for you,
that were appropriate for you,and I was protecting you when I
(08:44):
went back to get my terminaldegree, that put me in a
position of a provider.
So not only am I having tothink about what the nurses are
doing at the bedside, now I'm inresponsible.
I'm the person that's writingthe orders, creating the care
plans for the patients, andagain, it's another layer of
responsibility because you haveto know what you're doing and
then be able to execute this.
You have to know what you'redoing and then be able to
execute this, not just for thatfamily member, but for the whole
(09:06):
care team, the whole family, tobe able to get the best
outcomes.
Speaker 2 (09:12):
You talk about care team, oh, yes, oh, you're making
my heart pitter patter, doc.
You're making my heart pitterpatter because when you say care
team, I consider me a part ofmy mom's care team.
Absolutely.
I'm her daughter, yes, but I amher caregiver, her care partner
.
I've learned that term recentlyand I like it a lot because I
(09:44):
still consider my mother apartner in this.
Even though, cognitively, sheis not included in any of the
decisions, her spirit is stillwith me and it guides me because
I can tell when she don't likesomething.
And if I can tell she don'tlike it, I'm not going to do
that again.
So therefore, we are stillpartners in this.
When you talk about care team,do you consider the family
caregiver as a part of the team?
Speaker 1 (10:06):
Not only do I consider that part of the team,
they're leading the team Likethey're the ones that really are
telling the other members ofthe team what their goals are.
You know, because you're withme for 15, 20 minutes, whatever
the visit is, but you have to gohome.
So whatever plan we create hasto be done collectively and
together and you have to havebuy-in so that when you go home.
So whatever plan we create hasto be done collectively and
together and you have to havebuy-in so that when you go home,
(10:27):
we can make sure that thosethings are occurring.
If you tell me this, we're notdoing this, I would rather you
tell me we're not doing it thanme to come back two months later
, me thinking okay, we weregoing along with the plan, and
you said, no, I'm not, we're notdoing that.
So to have a great relationshipwith the health care provider
and the family, it has to behonesty, it has to be
accountability, and I think thatthose things are what make the
(10:48):
whole team work Fantastic.
What are some things that youhave noticed from the family
members, from the care partners,the caregivers, that have
worked well?
I think that it's veryimportant as a provider to
listen to the caregiver, thehusband or the wife or the child
(11:09):
, whoever is the main personinvolved, because I may know
textbook right, but you knowyour loved one and it really
should be a compromise we shouldbe talking about.
We both have a mutual goal ofgetting to, whatever the health
outcome is.
It should never be a situationwhere you feel like, oh,
whatever they said, you knowthey're the professionals.
No, in that moment you're theprofessional, especially if your
(11:31):
loved one can't advocate forthemselves.
And so I really want to empowercaregivers to kind of own that,
to own that when you're thereand don't let anyone make you
feel down or feel less thanbecause maybe you don't have a
white coat or you may not haveletters behind your name.
If you're caring for that lovedone, you have information I
need.
I need to know are they eating?
What are they eating?
(11:52):
What's going on with them?
I'm asking them, but I'm askingyou because maybe they're not
able to participate in theconversation, so you are
integral in kind of helping meunderstand what's going on when
we're not together.
Speaker 2 (12:05):
Y'all heard it first here Dr McNeil just gave me a
white coat.
I don't know if she should havedone that, and I don't know if
the rest of the world is readyfor all the trash.
I'm about to talk because Ijust it sounds to me like you
have emboldened me and empoweredme to go and give a whole lot
of people some orders.
I'm going to say what Dr McNeilsaid, to tell you that my mama
(12:31):
said that right now, I mean.
Speaker 1 (12:36):
But you do, you have to, you have to advocate.
Everybody's bringing somethingto the table, so what you're
bringing is not less than whatI'm bringing to the table.
I may be bringing someknowledge, I may be bringing
some textbook or someevidence-based practice, but
you're bringing lived experience, you're bringing the real.
So we need to have aconversation, honestly, to come
up with a plan that's unique foryour loved one, unique for your
(12:59):
situation.
Speaker 2 (13:00):
That is so powerful, doc, and I champion you for
taking that approach.
Not everyone in a white coat isas progressive as you are.
I'm doing my best to enunciateand say this politically correct
.
They just haven't had thatchange of heart, or perhaps they
(13:26):
actually do have some betterthan thou God type complex.
I'm the doctor, I know more.
I went to school for this.
I can write prescriptions,whatever the case may be.
And then you have the factor ofjust pure intimidation.
(13:47):
There are a lot of caregiversor just family members who are
intimidated the moment they wentinto, walk into a hospital or a
clinic or a doctor's office.
It's just like, oh like, banks,jails and hospitals just scared
the shit out of people youdon't even even want to go into.
The.
You know, keep, keep asking thequestions or go ahead and share
(14:29):
your thoughts or your concerns,even if you might naturally
feel a little intimidated youwhat closed mouths don't get fed
?
Speaker 1 (14:38):
is that the same?
Speaker 2 (14:39):
you know so that is one of them.
I'm about to tell you now.
I'm from, from Alabamaoriginally.
Honey, that definitely is oneof them.
Speaker 1 (14:44):
You.
You can't be intimidated towhere you would jeopardize the
best outcome for your loved one,or yourself for that matter.
You need to be empowered to askquestions.
You should understand what theplan of care is.
You should understand what isgoing on.
What should you anticipate next?
You should have thatunderstanding Now.
(15:10):
On the other end, you can't goto Dr Google and come into the
office and tell me some things.
You pulled off TikTok Now justto be fair, right, so again we
can Wait.
Speaker 2 (15:18):
Doc, now you're meddling.
Now, on behalf of the umpteencaregivers I know my grandfather
would say now you're meddling,now you're calling me out, now
you're not as a hit dog orholler, now you're going to say
can't go to Dr Google or TikTok.
Now you know.
Now you know, we go, listen, weare Googling while we in the
(15:41):
office with you.
As soon as you say it now, wemight misspell it.
Now that could also be aproblem.
Half the stuff that we areresearching, we might be
researching the wrong damndisease, because you spell it
with a P-H and we spelling itwith a F and we going I'm over
here in cancer and you trying totell me about dementia.
I got it all screwed up.
But what are we supposed to dothough?
Speaker 1 (16:02):
if we don't understand, okay, screwed up.
But what are we supposed to do,though, if we don't understand?
Okay.
So now that's why you have to.
You have to have a providerthat you have open conversations
with, that you have an openrelationship with.
I have no problems withpatients coming to me and saying
, okay, I heard about thismedication.
What do you, what do you think?
Or we can, I can, point you tosome reliable sources, right,
because everything on Google andeverything on TikTok we know is
(16:25):
not real.
Okay, and so no, yeah, girl, youwill be surprised.
That is not real, okay.
And so, again, don't feel asthough you can't come with some
research, but we all have to beon the same page, right?
Because you may hear somethingthat you think works well for
somebody else, but as ahealthcare provider, I know your
whole past medical history and,because of your heart condition
(16:47):
, this is not going to work forus, right.
And so being open to kind ofhearing that kind of feedback
and having that exchange, thesame works in reverse.
If I'm suggesting some evidencebased approaches to you that you
don't necessarily agree with oryou don't agree with your loved
one, let's have a conversationabout that.
Because, again, what I don'twant you to do is walk out of my
(17:07):
office and you say okay, andthen don't have no intentions of
following through.
We'll never get anywhere.
You know we'll be kind of atthis holding space, so honesty
is what I expect and then beable to tell us you don't have
to use big words, big fancywords Tell us what's going on,
so that we can provide you withthe necessary resources.
Speaker 2 (17:29):
This sounds like a real relationship, doc.
Oh yes, it sounds like you areopen to, or at least suggesting
that, there is opencommunication, honest
communication, and that we,meaning caregivers, are giving
their provider a chance to sayOK, this didn't go so well, but
(17:53):
before I just quit you, I'mgoing to let you know, let's
work it out.
Speaker 1 (18:00):
Give me a chance.
I think I got to look into thecamera when I say this, so
listen here.
It is very, very, very, veryimportant that we have open
communication, and so what I'mgoing to tell you is that you
have to have a primary careprovider.
Now I don't know what's wrongwith our people that think they
don't need a relationship with aprimary care provider.
(18:23):
They can use the urgent care.
They're going to use theemergency room.
This is my plea when you have aprimary care provider, and
primary care is my specialty.
So this is my plug.
I have a longstandingrelationship with you.
I have a longstandingrelationship with your
developments over the years.
I know you.
I've known you from thebeginning, developments over the
(18:46):
years.
I know you.
I've known you from thebeginning, and so now it's one
of those things where, if youjust go to the urgent care, they
don't know you.
It's true, they just know thatone symptom that you told them
about.
The same thing with theemergency department If you're
using the emergency departmentfor primary care, you're not
really getting the care that youdeserve or the care that you
really need, and I see a lot ofpeople come to the emergency
(19:07):
room and say, oh, I'm havingthis issue, do you have a
primary care provider?
No, I don't.
And so, again, emergency roomsare Band-Aids, right, they're
going to try to fix whatever andsend you back out to a primary
care provider.
Having that relationship evenwhen you're feeling well right,
because we don't want to alwayssee you when you're not feeling
well.
The relationship is longlasting, long standing, right.
(19:30):
So I see you in your good days,I see you in your bad days and
we kind of working through thatrelationship.
But that person is supposed toknow you.
So if you don't have thatrelationship, if you don't have
that relationship with your lovefor your loved one, a provider
that knows them, that can seechanges over a period of time,
that can further advocate oh,I've known this person for five
years, this is not theirbaseline, this is not who they
(19:52):
are Then that kind of addsdifficulty when you're trying to
get things done.
So, again, just have thatestablished relationships with
your provider before thingsstart to go bad.
Every year, annual physicals,every year, annual checkups, so
that when things start to goright, we then have an
opportunity to say, okay, now Isee slight changes and we can
(20:13):
jump in and intervene early.
Speaker 2 (20:19):
I mean, when you say it, it makes so much sense, yes,
it sounds so.
One plus one, yes, but whenyou're out there in that world,
doc, that thing sounds likerocket science math, chinese
math, sprinkled on top of oodlesand noodles.
You know what I'm saying, butI'm going to do better though.
(20:43):
Okay, you know what I'm saying,but I'm, I'm, I'm, I'm a do
better though.
Ok, I'm going to do better, andI'm going to encourage everyone
, in the sound of my voice or inthe view of my face, yes, to do
the same, because it does makea difference.
And I've seen it with, veryrecently, where there are
caregivers whose LO's will notgo to the doctor.
(21:06):
And let me tell you the ployI've been seeing, okay, and you
let me know if you've seen thisrecently Okay, lots of
appointments for elderlyindividuals are in the morning,
because initially, when they'remaking them, they say, yeah,
give me the eight o'clock, nineo'clock appointment, I want to
go ahead and start my day.
(21:27):
So I want to get on home becausethey want to be in the bed at 6
PM, okay, but come that morningthey don't feel like it.
Oh, I'm just not really up togetting dressed.
It's just a checkup.
Nothing's really wrong with me.
Can you reschedule?
Okay, when you go to reschedule, the reschedule is 90 days, 60
(21:49):
days, a hundred days, whatever.
It's not the next week or thenext day because there's no
emergency.
And family doctors, yourprimary care physicians, they
are booked out and out and out.
And so these seniors are reallyplaying hooky.
(22:09):
I think they are playing hookyfrom the regular doctor for
checkups because they're likeain't nothing wrong with me and
I don't really want to go.
And then they end up in the ERbecause they start feeling
poorly.
A family member freaks out.
This old person is in my housepanicking.
Speaker 1 (22:31):
What am I going to do with him?
Yeah, it's a loop, yeah, it isa vicious cycle, but again you
have to understand that people,for whatever reason, we think
hospital, I'm going to get thebest care if I go through the
emergency.
Now there's instances whereemergency room is necessary.
That's right, emergencies.
But there are things that wecan do preventatively to kind of
like the blood pressure, right.
(22:52):
So what I've learned from ourpeople is that if I feel good,
I'm good, right.
And then when you don't feelwell, that's when that emergency
occurs.
But it's like, okay, I've beenfeeling well all of this time.
I have no relationship with aprimary care provider.
I didn't know I was diagnosedwith high blood pressure because
I felt fine, so I never went togo get checked and so now I'm
(23:15):
in the emergency room with 200,over 100 blood pressure, right.
So I think just some of this,the mentality of even if you
don't feel like going, you feelfine, that's that maintenance,
even if it's a 15 minute checkhere, right.
So all changes for your carright now you know you don't get
an oil change for your car, youcould potentially be on the bus
and that and that potentiallybe on the bus will get you to
(23:38):
sit in that line, pay 60 bucksor more every you know every
amount of time to get your oilchange and you will pay that
money.
You'll sit in that line.
You'll do that because youdon't want to be stranded.
Speaker 2 (23:51):
No, I don't want my engine to lock up.
Speaker 1 (23:53):
Okay.
Speaker 2 (23:55):
I don't want a $30, $40 oil change to cost me
$20,000.
Speaker 1 (24:01):
So why you don't think about your health care in
that same kind of?
Speaker 2 (24:03):
way.
Well, I told you you meddling.
Now you know what I mean.
You know what I mean.
Doc is taking this personally.
We were supposed to be having aconversation about other people
.
Now how come I feel like sheover here grilling me?
It's a hit dog, holler, that'swhat my grandfather always said,
and I would be like we don'teven have a dog.
It took me so long to figureout that.
Figure out that phrase.
You're right.
You're right.
(24:24):
We know everybody out there.
We're going to do better, right, I know y'all are somewhere
shaking your head, clapping yourfingers, finger snapping.
We're going to do better, doc.
And for caregivers Listen, howexciting is it to know that
there are providers thatactually want us around, are
(24:46):
appreciative of our involvementand are open to greater
conversation, honesty, feedback,partnership.
I could cry.
Well, I ain't going to crybecause it'll mess up my beat
face, but anyway, we go.
They got beaters in Detroit.
(25:08):
Y'all DM me and I'll tell youwho did my face, but that's for
later.
Dr Detroit, thank you so verymuch.
Thank you, thank you so verymuch.
You have given us a wealth ofknowledge and and if anybody is
(25:31):
trying to figure out any of thestuff that you said and talked
about here right now, on thiscouch, I'm gonna just tell y'all
this you can google her now.
Don't google your disease, butyou can google her.
She is all over everywhereBillboards, telephone poles.
But we got even more for y'all.
We're about to go to the RosaParks Geriatric Center and chat
(25:55):
it up with even more medicalproviders about what we as
caregivers can do.
That makes it a little biteasier for them and even sweeter
for our LOs.
Speaker 1 (26:13):
So this is the team that really makes this happen.
So doing a geriatric grant ofthis size, really advocating for
change in how we provide carefor geriatrics in the state of
Michigan, cannot be done withoutclinicians that are here on
nine-to-five doing this type ofwork and telling us and advising
us on kind of what we need todo to improve the care and then
(26:34):
hopefully being a model so thatother clinics can be able to
follow their lead.
So this is the Rosa Parksclinic team and this is a team
that are also part of the grantas faculty and advisors to kind
of make sure that we're usingthese resources appropriately,
and they are also integral inmany parts of the grant.
They work with our students ineducating and training our
(26:55):
students that come to the clinic.
Actually quality improvement atthe site, at the primary care
and the long-term carefacilities, ensuring that we are
providing age-friendly healthcare to everyone that encounters
our system.
And so I couldn't do thiswithout them and I want to just
take this opportunity to thankthem so much for what they do
(27:16):
and you will get to know themvery shortly.
Speaker 2 (27:19):
Okay, dr Lisa.
Dr Lisa Benz-Emerick, did I getthat right?
Listen, I'm a comedian firstand then I'm a caregiver, but we
are here at the Rosa ParksGeriatric Center.
I can't thank you enough foreven being a part of a mission
and a clinic that provides carefor a population like this.
(27:43):
How did you even becomeinvolved with this facility?
Speaker 4 (27:48):
30 years ago, I became involved with this
facility.
I had lovely grandparents, andthat's what taught me the love
of the older adult, and so,after I got my master's degree,
this job became available and Icame here, and I've been here
ever since.
So 30 years, 30 years, yeah,taking care of older people and
their caregivers.
Speaker 2 (28:07):
Yeah, yeah, and I have a real passion for the
elderly population too.
It started for me with mygrandparents, so I understand
what you mean.
Now tell us real well in yourwords the difference between a
nurse practitioner which I thinky'all can do just about
everything as the MD, becauseyou can prescribe medicine and
(28:28):
you can see me and tell me if Ihave the flu.
Correct Sounds pretty good tome, right.
So what can't you?
Speaker 4 (28:34):
do Really nothing.
I can really pretty much doeverything.
Speaker 2 (28:38):
See there, I tell y'all.
So listen, when you go in yourMyChart and your doctor's not
available, go ahead to that NP.
I'm just trying to tell you,I've had such good experiences
with my.
Speaker 4 (28:48):
NP.
I think the patient benefitsfrom both.
I mean, the physician has theirperspective and I bring a
nursing perspective to things alittle bit more holistic
perspective.
Speaker 2 (28:59):
She's being kind, go to the nurse practitioner.
No shine or no hate on thedoctors, but I can say it, she
doesn't have to.
So we are in one of the roomswithin the Rosa Park Geriatric
Center and you're going to showus a little bit of the
difference of what a patient canget here that you wouldn't
(29:21):
necessarily get in a standarddoctor's office or facility.
That's correct.
I'm excited to see.
Speaker 4 (29:27):
Here we have hip high chairs.
They're the higher for theolder adult.
Oftentimes they have arthritisin their hips or their knees, so
it's easier for them to get upfrom a higher position than
sitting down low.
So this is one of the things wecreated when we brought the
clinic to inter-fruition is tohave hip high chairs for
patients.
They're also heavy so theydon't tip over, because older
(29:50):
adults don't get up as readilyas a younger person and so
they're heavier chairs.
Behind you there is a wheelchairscale.
Oftentimes, if you go to aregular doctor's office, they
have the little tittery scalethat people get on, and this
allows us to put an individualin a wheelchair there and weigh
(30:10):
them and then bring them overhere and then weigh the
wheelchair so you can really seewhat the individual's weight is
doing.
So that's another thing we havefor the older adult.
Other things when theindividuals come out to check in
, our counters are lower becauseoftentimes they're in
wheelchairs and so they're ableto then converse with the
(30:31):
individual receptionist withouthaving to have the counter there
in their eyesight.
Speaker 2 (30:38):
That is so powerful?
Did you all think that throughin advance?
And being designed for it?
Yeah, absolutely, absolutely.
That's magical.
My mom is still battlingdementia.
She has Alzheimer's.
We're currently in year 13.
And let me say, even though shecurrently is a part of a
(31:03):
dementia clinic All right, I'mgoing to pause for everybody to
digest that they don't haveeverything you just named in
terms of seating or a scale thatwould be easy for her to get on
, to get on while she's notcurrently using a wheelchair.
(31:24):
The fact that the scale youjust showed us is so low to the
ground and has that little like,I guess, a little small ramp
that would just be easier forher to even walk onto, let alone
a, I guess, just a lower heightum check-in area for a
reception, these things soundreal doable.
(31:44):
Not high technology, no, and itsounds like, I'm sorry, caring.
It sounds like caring.
Well, thank you.
Thank you so much.
So now we're going to go tosome other parts of the clinic
and see you guys in a second.
Speaker 4 (32:01):
Oftentimes, when an older adult goes to a regular
doctor's office, they havedifficulty getting on the exam
table, and so oftentimes they'reexamined in a wheelchair or in
the chair, and that's not reallya good examination to do for
the older adult.
So this goes up and down.
It's low to the ground, so theolder adult can get on it
without having to.
It's low to the ground so theolder adult can get on it
(32:22):
without having to um, you knowbe precarious.
And then this uh is able toyou're able to move it.
However you need up.
If again, if they havearthritis and they have hard
times sitting in low chairs,then we bring it up.
So it's, it's really for theolder adult, it's comfortable,
it has a you know, soft.
Speaker 2 (32:41):
So because a lot of times they're bony, yeah,
absolutely, I could take a goodnap in this thing too.
I mean, I know it's not for me,but they want to take it home
with them.
Speaker 4 (32:53):
I appreciate it and then again we have the lower
things for the older adults, sothe lower counter space and
stuff.
Speaker 2 (33:02):
Thank you so much Lisa I appreciate it.
All right, we'll be back in asec.
Dr Patel, thank you for talkingwith us.
Speaker 3 (33:12):
Well, thank you for taking time to come and see our
clinic.
This is one of a kind clinic.
It's a one-stop shop kind of athing for older adults, because
we not only provide primary carehere for the older adults but
also some of the subspecialtieslike cardiology,
gastroenterology, sleep medicine.
(33:34):
We have pharmacy, social work,nephrology all in this one
clinic.
So the older adult doesn't haveto really go out of this clinic
to another place to see adifferent provider, because you
know oftentimes, if they do,that their care is kind of
fragmented.
They get confused of where theyhave to go.
Instead, everything is donehere in one place.
(33:57):
So all their medicalspecialists and diagnosis and
everything is in one chart here.
Yes, makes it easy for them.
Speaker 2 (34:06):
That would be a lot easier, I think, for any of us,
definitely for their family,caregivers, for them to manage.
Speaker 3 (34:13):
Absolutely.
Speaker 2 (34:14):
Have you found that many family caregivers bring the
patients?
Speaker 3 (34:20):
here.
Yes, yes, most of our olderadults are accompanied by their
families son or daughter,grandchildren and it's nice to
see them involved in the care ofolder adults, because often the
older adults, for them, thistechnology and all can be a bit
(34:43):
too much, and so having thecaretakers involved in their
care is not only supportive butit kind of creates that healthy
environment for them.
It's very good to see that thenext of kin are involved at an
early stage of any disease,illness, and they are learning
(35:06):
and encouraging the older adultsto follow the medications, take
those medications on time andimprove their overall well-being
.
Speaker 2 (35:17):
Yes, sounds amazing.
As a family caregiver, I amhappy to hear that coming from
you, from a physician.
Do you have any advice or tips?
Is there something that youwould like the family caregivers
to do more?
(35:37):
If you're like, yeah, you know,maybe it would help if the
family caregivers could add thisor do this a little bit more,
as you are, as we are trying tohelp our mothers or our
grandparents.
Speaker 3 (36:06):
I think the one thing , as I mentioned, they can do,
is get involved early on,especially for some disease
process like dementia, becausethey start to have these memory
issues and it doesn't happen allof a sudden.
It's like slowly builds up overyears.
Initially they may have subtlememory lapses but then they
start having, you know, moreissues with recalling past
events and ultimately in theadvanced stages they just
completely forget of what'shappening.
But when they get involved thecaretakers, once they're
(36:28):
involved in early stages, thenthey also get to know what the
older adults really likes, howthey like the physician to
provide care to them.
So in the later aspect of thosediseases where they don't have
the ability to make the decision, the caretaker getting involved
(36:50):
early on knows what the lovedones would have preferred if
they would have wanted certainthings done certain way, if they
don't want these procedures oraggressive management and they
just want to live their life outmore comfortable, you know,
enjoy the remaining aspect oftheir life.
So I think the key is for thecaretaker to get involved early
(37:14):
on and then not to get anxiousif they learn about some disease
process like dementia and get,you know, really worried about
it, because now there are a lotof resources.
Caretakers also need to lookafter themselves, especially if
they are caring for their lovedones who have dementia, then
(37:34):
really there is a lot involved.
You know they can get burnedout.
Speaker 2 (37:38):
Doc, I have to ask you now now you're saying
something that makes me want to,uh, almost start tap dancing in
the room caregivers taking careof themselves.
It is.
It's hard.
We don't always know where tostart and how to do it.
Do you have any suggestions onhow a care taker could actually
(37:59):
do better with caring forthemselves?
Speaker 3 (38:02):
yeah, I think.
Um, so the caretaker,especially as we talk about,
let's say, disease like dementiaif it's a solo caretaker, then
it's overwhelming for thatperson and if the families
involved brothers, sisters,aunts, uncles or grandchildren
are involved, it makes it easyfor that one person because then
(38:24):
everybody can share in theworkload.
But the important thing is thatcaretakers should also look
after their health, Because whatwe see is that oftentimes a
solo caretaker often, you know,forget to take care of their
health.
They forget to look after theirmedical issues or go to doctor,
(38:46):
see them for preventive careand then ultimately can lead to
them having medical issues.
So there are resourcesavailable and if there is a
larger family involved in thecare, it makes it easier for
them to share the workload whilethey still stay active with
(39:09):
their daily life, you know,exercise, meditation, healthy
lifestyle so they are notoverwhelmed with one aspect, yes
.
Speaker 2 (39:19):
I'm only going to admit this because you have been
so calming and specific withyour advice.
I found out just last week, Doc, and I didn't know this.
I thought I was doing prettygood.
My primary care physiciancontacted me and said it's been
two years since my physical.
(39:41):
I had no idea I'm in year 13with my mom, but I to the point
you were making.
I thought if you had asked me Iwould have said no, I went last
year, but last year was twoyears ago, and so I received the
message you're giving us andthank you so much for sharing
(40:04):
your advice, sharing yourpassion, your understanding,
your expertise, and I know it'sgoing to be very helpful.
Speaker 3 (40:12):
Thank you.
I think it's very importantthat caretakers get this message
across that they got to lookafter themselves in the process
of taking care of their lovedones.
Otherwise, they are neglectingtheir care and they may put
themselves at more risk thanbenefit.
Speaker 2 (40:31):
Listen, he has the white coat on with the thing
with the comma and the MD behindhim.
So if you don't believe me,believe Dr Patel.
All right, we'll be back withsome more information about
caregivers and what you can do,pharmacy and geriatrics and old
(40:52):
people.
That sounds way confusing andcomplicated.
How do you make sure themedicines don't get messed up?
Candice, tell the truth.
Speaker 5 (41:06):
You know, there's so many ways that medicines can get
messed up.
First of all, we want to makesure that the patient is getting
the right medications.
So it's what is the right dose,what is the indication?
What do they need this for?
Also, there's the patient's endof it, right Like are they
taking it right?
So we problem solve through it.
Speaker 2 (41:32):
Are they taking it right as a caregiver?
Mom is in year 13 Alzheimer's.
I know for a fact she'sdepending on me for how she
takes it.
Where do caregivers come intoplay from your perspective as a
geriatric pharmacist?
Into play from your perspectiveas a geriatric pharmacist?
(41:54):
Well, I know you do more thangeriatrics, but that's your
specialty here at the Rosa ParksGeriatric Institute.
What do you think caregiverscan do, can learn, can assist in
this whole process of medicinemanagement?
When it comes to the elderly,you know a couple things.
Speaker 5 (42:13):
I think they can ask questions.
So asking questions of thedoctor, but asking the questions
of the pharmacist, you know, tomake sure that they're taking
it right.
The other thing, I think, ishaving a list being organized.
Some of our best caregiverswill keep a notebook and a
schedule and a calendar, and alot of times what I do in my
role here in the clinic is wecome up with a final medication
(42:36):
list and then I write it all outon a calendar.
I'll include the brand names,the generic names and what time
of day to take the medication,and I try to simplify the
schedule for the patients.
Like a lot of people think thatyou can't take two meds
together, so they'll scheduletheir medications out through
the whole day, which iscomplicated.
So a lot of times I'll just tryto simplify their regimen so
(42:59):
that they can take the leastmedications to get the most
effect out of them and tell themwhat time of day they can take
it and write it all down,because really, who can remember
all of that?
No one.
Speaker 2 (43:10):
You, you, the pharmacist, can remember it all
and I know this happens to meand you tell me if you've come
across this with othercaregivers.
You get all the medicines, youcall the pharmacy.
The pharmacy says hey, the waythe doctor told you to take that
(43:33):
is wrong.
What am I supposed to do as acaregiver if the pharmacist
that's feeling it says the waythe doctor is telling you to
take this just doesn't matchwith that medicine?
Speaker 5 (43:44):
Oh man, what am I supposed to do?
Yeah, you're kind of in themiddle of it, right, yeah?
So I think the first thing isto ask questions how should it
be taken properly?
Then verifying back with thedoctor's office.
You know, I'm told that Ishould be giving it this way.
Is that correct?
So that it's reconciled?
So that's our big buzzwordmedication reconciliation is it
(44:05):
needs to be reconciled, but it'scoming from this source, coming
from that source, anothersource.
How do we reconcile that sothat there's one accurate list?
So taking that list ofmedicines to every point of
healthcare is a really key waythat caregivers can help.
Speaker 2 (44:22):
That list.
You keep bringing up that list.
I guess it really matters tocaregivers that we have this
list and it's not permanent,right?
It seems to be changing it isevolving.
It is changing, much like manyof us.
Uh, we're changing and evolvingtoo.
What have you learned fromconscientious caregivers that
(44:48):
you're like, wow, I hadn'tthought about that they're doing
this activity, or I hadn'tthought about that they're doing
this activity, or they havethis habit.
That seems to be really useful.
Speaker 5 (44:56):
We have some great caregivers.
I mean a lot of them are justtrying to like get at like the
most effective, leastproblematic approach to
administering the medications totheir patient, to their you
know loved one, and so sometimesthey'll use like strategies of
like trying to distract them orlike giving it to them at their
(45:18):
best time of day.
Sometimes they'll put it intotheir food, you know, if it's a
medication that you can do thatwith.
Sometimes injections arehelpful when you know a patient
doesn't want to take oralmedications because it's kind of
like one and done.
You know, right, yeah, sothere's all kinds of different
(45:40):
strategies and approaches thatI've seen people do, but a lot
of it's kind of going at it withlike let's get this way
possible, yeah, okay.
Speaker 2 (45:53):
I have a final question for you.
Is there anything you cansuggest that a caregiver
probably should not do in theirapproach to a pharmacist?
Let's say we're a littlefrustrated and we're not trying
to take it out on the pharmacistLike, hey, the doctor screwed
(46:15):
up.
What is like a no-no in yourindustry?
Speaker 5 (46:19):
Oh man, pharmacists hate being yelled at.
Okay, they hate being yelled atby their patients and their
patients' caregivers.
You know, I think that we justwant to help right and so being
able to, like, have aconversation, a dialogue, a back
and forth.
Everybody's frustrated whenthings aren't going the way that
you want for them to.
You're like not getting themedication that you need.
(46:41):
Seeking to understand, don'tyell at your pharmacist.
Speaker 2 (46:46):
Okay, y'all got it here, okay.
So listen, go out in the car,scream to your favorite song and
then walk into the drugstore ina calm place.
All right, thank you so verymuch.
Thank you so very much.
It's been a pleasure, theSnuggle Up.
(47:07):
This time we had the pleasureof being in two places for one
episode the Rosa Parks geriatriccenter, and then actually in
studio.
We had medical professionals ina clinic and somebody telling
us about an academic perspective, a personal perspective.
(47:32):
How could you get any more?
You know what I'm saying.
What really struck me and whatI know I'm going to take away
from all that is these providerswant a real, honest and open
relationship with the caregivers.
They want us to be involved.
(47:53):
Now maybe you over there sayingJay Smiles, but you don't know
my mama's doctor, or you don'tknow my granddaddy's dialysis
giverer Okay, well then maybeyou need to change that person
that ain't the only dialysisgiver in your granddaddy's town,
because apparently there aresome providers who want to have
(48:17):
an open dialogue with us.
They realize that we are theboots on the ground, that we are
the person who is around theirpatient 24-7.
And without us they cannot giveadequate care to their patient.
So while you BSing, they can'teven really for real, for real,
(48:44):
fulfill that oath they tookeither to be a pharmacist, to be
a nurse practitioner, to be ageneral physician, to be a
neurologist.
They can't do none of thatright and well, to the best of
their ability, if they don't getinformation from us.
So what we got to do, we heardfrom them.
(49:05):
We got to ask more questionsand maybe be a little pushy when
we say, no doc, no nursing pool.
I said this what's happening atthe house?
You ain't got to be ugly withit, but go ahead and send that
(49:25):
second or third email in mychart or whatever version of
email in digital communicationyou have with your family
member's provider.
If you got to pull up on thedoctor's office when they keep
telling you they don't have nospace for an appointment, but
you see your LO is walkingaround the house talking to
(49:48):
spiders, pull up on that thing,pull up on that office.
Listen, not with violence, withcare and concern.
We just heard from and sawmultiple providers, multiple
genders, multiple ethnicitiesand religions.
They all said the same thingthey need us, and so do our LOs.
(50:14):
We got it and we gonna give it.
What up, though.
Thank you for tuning in.
I mean really, really, really.
Thank you so very much fortuning in, whether you're
watching this on YouTube or ifyou're listening on your
favorite podcast audio platform.
(50:35):
Either way, wherever you are,subscribe, come back.
That's the way you're going toknow when we do something next.
Y'all know how it is.
I'm Jay Smiles.
I might just drop something hotin the middle of the night.
I think that it's very important as a provider to
listen to the caregiver, thehusband or the wife or the child
, whoever is the main personinvolved, Because I may know
textbook right, but you knowyour loved one.
Speaker 3 (00:13):
What do you think caregivers can do, can learn,
can assist in this whole processof medicine management when it
comes to the elderly, Cattekersalso need to look after
themselves, especially if theyare caring for their loved ones
who have dementia, then reallythere is a lot involved.
(00:36):
You know they can get wound up.
Speaker 2 (00:39):
This sounds like a real relationship, doc.
Oh yes, it sounds like you areopen to, or at least suggesting
that, there is opencommunication, honest
communication, and that we wemeaning caregivers are giving
their provider a chance to say,okay, this didn't go so well.
(01:01):
But before I just quit you, I'mgoing to let you know, let's
work it out.
Speaker 1 (01:10):
Give me a chance.
I think I got to look into thecamera when I say this, so
listen here.
Speaker 2 (01:18):
Parenting Up Caregiving Adventures with
Comedian J Smiles is the intensejourney of unexpectedly being
fully responsible for my mama.
For over a decade I've beenchipping away at the unknown,
advocating for her and pushingAlzheimer's awareness on anyone
and anything with a heartbeat.
(01:39):
Spoiler alert this shit isheavy.
That's why I started doingcomedy.
So be ready for the jokes.
Caregiver newbies, ogs andvillage members just willing to
prop up a caregiver.
You are in the right place.
Hi, this is Zeddy.
(01:59):
I hope you enjoy my daughter'spodcast, is that okay?
Today's supporter shout out isalso from Detroit.
You know what we're doing thiswhole series.
We are Detroit ready.
(02:22):
Baby.
It's Dr Faith Hopp, associateProfessor, wayne State
University School of Social Work, agreed GWEP program.
Guess who is the principalinvestigator?
Dr McNeil, I told y'all she wasdope.
This is the shout out.
(02:42):
This is an amazing andinspiring podcast.
Double exclamation point OK.
One, two.
The caregivers, as Dr McNeilsays so eloquently, should be a
critical piece of the healthcare team team.
(03:07):
Our caregivers have shown ustheir passion, dedication and
commitment to their role and arean inspiration to all of us in
Detroit and beyond, and beyond.
Ow, I love it.
Thank you so much, dr Hopper.
If you would like to receive asupportive shout out.
You know what to do.
Leave a review on ApplePodcasts, ig or YouTube.
(03:29):
Parenting up we, the sameeverywhere, thank you.
We in Detroit, detroit, this isour first tour and it's
happening in Detroit.
Okay, you just get ready, baby.
You know how they do it up here.
What up, though.
What up, though.
(03:50):
And this is the day that we arebringing you that fire, that
Detroit fire.
So, wherever you listening,wherever you watching, just get
ready, baby, sit down, drinksomething, sip on something, eat
on something, but be safe.
Today's episode White Coat,wisdom, best Practices for Care
(04:12):
Partners what's up?
Parenting Up, family we stillin Detroit, y'all.
So you better be happy that I'meven awake and smiling enough
to talk to y'all, because youknow Detroit is a party.
What up, though?
What up though?
So this is episode two.
We are talking with medicalprofessionals getting their
(04:36):
point of view around caregivers,how caregivers can help more,
how caregivers can get help more.
Let's dig in and find out fromthe other side, right here, who
I got with me the one and onlyDr McNeil.
I call her Dr Detroit, though.
(04:57):
You know what I'm sayingBecause I got it like that.
But y'all, if you see her inthe street.
Don't do what I do.
You call her DrNeil, okay, whatup, doc?
What up, though?
You see what I'm saying.
You see what I'm saying.
Listen, you got a lot of fancythings, but look at this y'all,
look at all them things.
Can y'all zoom in and see allthese letters?
That's a.
That is everything in thealphabet.
(05:17):
She has the alphabet behind hername.
What that really means is shewent to school a lot, a whole
lot.
So can you tell us what?
You went to school?
A lot, a whole lot.
So can you tell us what youwent to school to?
Learn how to do which degree?
See what I'm saying.
See what I'm saying.
Okay, the ones, the degreesthat have to do with that white
coat, okay.
Speaker 1 (05:37):
So I have my doctorate from Wayne State
University.
I have a doctorate in Pause.
Speaker 2 (05:41):
Doctorate, that's what you call a terminal degree.
Okay, yes, pause, doctorate,that's what you call a terminal
degree.
Ok, I mean, you can't getnothing higher.
Than that Means you can't getfurther, further with an A on it
or head or her in that therething.
Speaker 1 (05:56):
Go ahead.
I have a doctorate in nursingpractice, which means I'm a
nurse practitioner with adoctorate degree.
Before that, I was a nurse formany years, working in health
care doctorate degree.
Speaker 2 (06:06):
Before that I was a nurse for many years working in
health care.
I can hand you a band-aid.
If you need more than aband-aid, go to Dr McNeil.
Please let everyone know aboutyour passion in even getting in
nursing, because nursing mightbe getting all the shine now,
(06:28):
especially post pandemic.
Nurses finally got what I'vethought for years should have
been.
A lot of accolades and thankyous came during the COVID
pandemic and it was so obviousthat nurses were holding us down
.
But you were nursing way beforethat.
Way before it was like the sexit was brought back.
(06:49):
What made you so excited aboutthat?
Speaker 1 (06:52):
field.
I mean, it's just my desire toserve, my desire to be a vessel.
You know, when you haveindividuals, that's at their
most weakest, vulnerable stateand they are relying on you, as
stranger, essentially to carefor them, and that's a big
responsibility.
And so that's something I donot take lightly and that is
something that I feel I do well,but one of the reasons why
(07:13):
nursing is one of the trustedprofessions and I take that to
heart.
Then, being able to be home inDetroit and being able to
address health disparities,using this talent, using this
skill, using what God gave me,it's kind of my calling, a
calling.
Speaker 2 (07:28):
So I like to how you can be called to do something
other than preach.
So people listen.
If you've been called to preach, by all means do that.
But I just want you to know youcan be called to do something
other than play basketball orpreach.
Look at that.
There's a third thing Well, Iwas called a comedy, so that's
at least four.
Ok, that's four things that youhave learned today that you can
(07:49):
be called to do.
And nursing yes, I'm sograteful for nurses.
I know how well nurses made somuch difference in my mom's
journey Well, I guess ourjourney in in her caregiving.
Wow, I love doctors and theymay have been the ones who did
the surgery and all the goodthings, but the nurses, what
(08:13):
they do and how they convey whatI see back to the doctors to
then change and or manage thecare, makes such a big
difference.
Speaker 1 (08:24):
Yes, and I think that it's very important to know
that you have different levelsof professionals, right?
So before I got my doctorate, Iwas a bedside nurse.
I was the one that was by yourside 12 hours while you were
sleeping.
I was the one that wasmonitoring you, I was the one
making sure that whatever orderscame in for you were for you,
that were appropriate for you,and I was protecting you when I
(08:44):
went back to get my terminaldegree, that put me in a
position of a provider.
So not only am I having tothink about what the nurses are
doing at the bedside, now I'm inresponsible.
I'm the person that's writingthe orders, creating the care
plans for the patients, andagain, it's another layer of
responsibility because you haveto know what you're doing and
then be able to execute this.
You have to know what you'redoing and then be able to
execute this, not just for thatfamily member, but for the whole
(09:06):
care team, the whole family, tobe able to get the best
outcomes.
Speaker 2 (09:12):
You talk about care team, oh, yes, oh, you're making
my heart pitter patter, doc.
You're making my heart pitterpatter because when you say care
team, I consider me a part ofmy mom's care team.
Absolutely.
I'm her daughter, yes, but I amher caregiver, her care partner
.
I've learned that term recentlyand I like it a lot because I
(09:44):
still consider my mother apartner in this.
Even though, cognitively, sheis not included in any of the
decisions, her spirit is stillwith me and it guides me because
I can tell when she don't likesomething.
And if I can tell she don'tlike it, I'm not going to do
that again.
So therefore, we are stillpartners in this.
When you talk about care team,do you consider the family
caregiver as a part of the team?
Speaker 1 (10:06):
Not only do I consider that part of the team,
they're leading the team Likethey're the ones that really are
telling the other members ofthe team what their goals are.
You know, because you're withme for 15, 20 minutes, whatever
the visit is, but you have to gohome.
So whatever plan we create hasto be done collectively and
together and you have to havebuy-in so that when you go home.
So whatever plan we create hasto be done collectively and
together and you have to havebuy-in so that when you go home,
(10:27):
we can make sure that thosethings are occurring.
If you tell me this, we're notdoing this, I would rather you
tell me we're not doing it thanme to come back two months later
, me thinking okay, we weregoing along with the plan, and
you said, no, I'm not, we're notdoing that.
So to have a great relationshipwith the health care provider
and the family, it has to behonesty, it has to be
accountability, and I think thatthose things are what make the
(10:48):
whole team work Fantastic.
What are some things that youhave noticed from the family
members, from the care partners,the caregivers, that have
worked well?
I think that it's veryimportant as a provider to
listen to the caregiver, thehusband or the wife or the child
(11:09):
, whoever is the main personinvolved, because I may know
textbook right, but you knowyour loved one and it really
should be a compromise we shouldbe talking about.
We both have a mutual goal ofgetting to, whatever the health
outcome is.
It should never be a situationwhere you feel like, oh,
whatever they said, you knowthey're the professionals.
No, in that moment you're theprofessional, especially if your
(11:31):
loved one can't advocate forthemselves.
And so I really want to empowercaregivers to kind of own that,
to own that when you're thereand don't let anyone make you
feel down or feel less thanbecause maybe you don't have a
white coat or you may not haveletters behind your name.
If you're caring for that lovedone, you have information I
need.
I need to know are they eating?
What are they eating?
(11:52):
What's going on with them?
I'm asking them, but I'm askingyou because maybe they're not
able to participate in theconversation, so you are
integral in kind of helping meunderstand what's going on when
we're not together.
Speaker 2 (12:05):
Y'all heard it first here Dr McNeil just gave me a
white coat.
I don't know if she should havedone that, and I don't know if
the rest of the world is readyfor all the trash.
I'm about to talk because Ijust it sounds to me like you
have emboldened me and empoweredme to go and give a whole lot
of people some orders.
I'm going to say what Dr McNeilsaid, to tell you that my mama
(12:31):
said that right now, I mean.
Speaker 1 (12:36):
But you do, you have to, you have to advocate.
Everybody's bringing somethingto the table, so what you're
bringing is not less than whatI'm bringing to the table.
I may be bringing someknowledge, I may be bringing
some textbook or someevidence-based practice, but
you're bringing lived experience, you're bringing the real.
So we need to have aconversation, honestly, to come
up with a plan that's unique foryour loved one, unique for your
(12:59):
situation.
Speaker 2 (13:00):
That is so powerful, doc, and I champion you for
taking that approach.
Not everyone in a white coat isas progressive as you are.
I'm doing my best to enunciateand say this politically correct
.
They just haven't had thatchange of heart, or perhaps they
(13:26):
actually do have some betterthan thou God type complex.
I'm the doctor, I know more.
I went to school for this.
I can write prescriptions,whatever the case may be.
And then you have the factor ofjust pure intimidation.
(13:47):
There are a lot of caregiversor just family members who are
intimidated the moment they wentinto, walk into a hospital or a
clinic or a doctor's office.
It's just like, oh like, banks,jails and hospitals just scared
the shit out of people youdon't even even want to go into.
The.
You know, keep, keep asking thequestions or go ahead and share
(14:29):
your thoughts or your concerns,even if you might naturally
feel a little intimidated youwhat closed mouths don't get fed
?
Speaker 1 (14:38):
is that the same?
Speaker 2 (14:39):
you know so that is one of them.
I'm about to tell you now.
I'm from, from Alabamaoriginally.
Honey, that definitely is oneof them.
Speaker 1 (14:44):
You.
You can't be intimidated towhere you would jeopardize the
best outcome for your loved one,or yourself for that matter.
You need to be empowered to askquestions.
You should understand what theplan of care is.
You should understand what isgoing on.
What should you anticipate next?
You should have thatunderstanding Now.
(15:10):
On the other end, you can't goto Dr Google and come into the
office and tell me some things.
You pulled off TikTok Now justto be fair, right, so again we
can Wait.
Speaker 2 (15:18):
Doc, now you're meddling.
Now, on behalf of the umpteencaregivers I know my grandfather
would say now you're meddling,now you're calling me out, now
you're not as a hit dog orholler, now you're going to say
can't go to Dr Google or TikTok.
Now you know.
Now you know, we go, listen, weare Googling while we in the
(15:41):
office with you.
As soon as you say it now, wemight misspell it.
Now that could also be aproblem.
Half the stuff that we areresearching, we might be
researching the wrong damndisease, because you spell it
with a P-H and we spelling itwith a F and we going I'm over
here in cancer and you trying totell me about dementia.
I got it all screwed up.
But what are we supposed to dothough?
Speaker 1 (16:02):
if we don't understand, okay, screwed up.
But what are we supposed to do,though, if we don't understand?
Okay.
So now that's why you have to.
You have to have a providerthat you have open conversations
with, that you have an openrelationship with.
I have no problems withpatients coming to me and saying
, okay, I heard about thismedication.
What do you, what do you think?
Or we can, I can, point you tosome reliable sources, right,
because everything on Google andeverything on TikTok we know is
(16:25):
not real.
Okay, and so no, yeah, girl, youwill be surprised.
That is not real, okay.
And so, again, don't feel asthough you can't come with some
research, but we all have to beon the same page, right?
Because you may hear somethingthat you think works well for
somebody else, but as ahealthcare provider, I know your
whole past medical history and,because of your heart condition
(16:47):
, this is not going to work forus, right.
And so being open to kind ofhearing that kind of feedback
and having that exchange, thesame works in reverse.
If I'm suggesting some evidencebased approaches to you that you
don't necessarily agree with oryou don't agree with your loved
one, let's have a conversationabout that.
Because, again, what I don'twant you to do is walk out of my
(17:07):
office and you say okay, andthen don't have no intentions of
following through.
We'll never get anywhere.
You know we'll be kind of atthis holding space, so honesty
is what I expect and then beable to tell us you don't have
to use big words, big fancywords Tell us what's going on,
so that we can provide you withthe necessary resources.
Speaker 2 (17:29):
This sounds like a real relationship, doc.
Oh yes, it sounds like you areopen to, or at least suggesting
that, there is opencommunication, honest
communication, and that we,meaning caregivers, are giving
their provider a chance to sayOK, this didn't go so well, but
(17:53):
before I just quit you, I'mgoing to let you know, let's
work it out.
Speaker 1 (18:00):
Give me a chance.
I think I got to look into thecamera when I say this, so
listen here.
It is very, very, very, veryimportant that we have open
communication, and so what I'mgoing to tell you is that you
have to have a primary careprovider.
Now I don't know what's wrongwith our people that think they
don't need a relationship with aprimary care provider.
(18:23):
They can use the urgent care.
They're going to use theemergency room.
This is my plea when you have aprimary care provider, and
primary care is my specialty.
So this is my plug.
I have a longstandingrelationship with you.
I have a longstandingrelationship with your
developments over the years.
I know you.
I've known you from thebeginning, developments over the
(18:46):
years.
I know you.
I've known you from thebeginning, and so now it's one
of those things where, if youjust go to the urgent care, they
don't know you.
It's true, they just know thatone symptom that you told them
about.
The same thing with theemergency department If you're
using the emergency departmentfor primary care, you're not
really getting the care that youdeserve or the care that you
really need, and I see a lot ofpeople come to the emergency
(19:07):
room and say, oh, I'm havingthis issue, do you have a
primary care provider?
No, I don't.
And so, again, emergency roomsare Band-Aids, right, they're
going to try to fix whatever andsend you back out to a primary
care provider.
Having that relationship evenwhen you're feeling well right,
because we don't want to alwayssee you when you're not feeling
well.
The relationship is longlasting, long standing, right.
(19:30):
So I see you in your good days,I see you in your bad days and
we kind of working through thatrelationship.
But that person is supposed toknow you.
So if you don't have thatrelationship, if you don't have
that relationship with your lovefor your loved one, a provider
that knows them, that can seechanges over a period of time,
that can further advocate oh,I've known this person for five
years, this is not theirbaseline, this is not who they
(19:52):
are Then that kind of addsdifficulty when you're trying to
get things done.
So, again, just have thatestablished relationships with
your provider before thingsstart to go bad.
Every year, annual physicals,every year, annual checkups, so
that when things start to goright, we then have an
opportunity to say, okay, now Isee slight changes and we can
(20:13):
jump in and intervene early.
Speaker 2 (20:19):
I mean, when you say it, it makes so much sense, yes,
it sounds so.
One plus one, yes, but whenyou're out there in that world,
doc, that thing sounds likerocket science math, chinese
math, sprinkled on top of oodlesand noodles.
You know what I'm saying, butI'm going to do better though.
(20:43):
Okay, you know what I'm saying,but I'm, I'm, I'm, I'm a do
better though.
Ok, I'm going to do better, andI'm going to encourage everyone
, in the sound of my voice or inthe view of my face, yes, to do
the same, because it does makea difference.
And I've seen it with, veryrecently, where there are
caregivers whose LO's will notgo to the doctor.
(21:06):
And let me tell you the ployI've been seeing, okay, and you
let me know if you've seen thisrecently Okay, lots of
appointments for elderlyindividuals are in the morning,
because initially, when they'remaking them, they say, yeah,
give me the eight o'clock, nineo'clock appointment, I want to
go ahead and start my day.
(21:27):
So I want to get on home becausethey want to be in the bed at 6
PM, okay, but come that morningthey don't feel like it.
Oh, I'm just not really up togetting dressed.
It's just a checkup.
Nothing's really wrong with me.
Can you reschedule?
Okay, when you go to reschedule, the reschedule is 90 days, 60
(21:49):
days, a hundred days, whatever.
It's not the next week or thenext day because there's no
emergency.
And family doctors, yourprimary care physicians, they
are booked out and out and out.
And so these seniors are reallyplaying hooky.
(22:09):
I think they are playing hookyfrom the regular doctor for
checkups because they're likeain't nothing wrong with me and
I don't really want to go.
And then they end up in the ERbecause they start feeling
poorly.
A family member freaks out.
This old person is in my housepanicking.
Speaker 1 (22:31):
What am I going to do with him?
Yeah, it's a loop, yeah, it isa vicious cycle, but again you
have to understand that people,for whatever reason, we think
hospital, I'm going to get thebest care if I go through the
emergency.
Now there's instances whereemergency room is necessary.
That's right, emergencies.
But there are things that wecan do preventatively to kind of
like the blood pressure, right.
(22:52):
So what I've learned from ourpeople is that if I feel good,
I'm good, right.
And then when you don't feelwell, that's when that emergency
occurs.
But it's like, okay, I've beenfeeling well all of this time.
I have no relationship with aprimary care provider.
I didn't know I was diagnosedwith high blood pressure because
I felt fine, so I never went togo get checked and so now I'm
(23:15):
in the emergency room with 200,over 100 blood pressure, right.
So I think just some of this,the mentality of even if you
don't feel like going, you feelfine, that's that maintenance,
even if it's a 15 minute checkhere, right.
So all changes for your carright now you know you don't get
an oil change for your car, youcould potentially be on the bus
and that and that potentiallybe on the bus will get you to
(23:38):
sit in that line, pay 60 bucksor more every you know every
amount of time to get your oilchange and you will pay that
money.
You'll sit in that line.
You'll do that because youdon't want to be stranded.
Speaker 2 (23:51):
No, I don't want my engine to lock up.
Speaker 1 (23:53):
Okay.
Speaker 2 (23:55):
I don't want a $30, $40 oil change to cost me
$20,000.
Speaker 1 (24:01):
So why you don't think about your health care in
that same kind of?
Speaker 2 (24:03):
way.
Well, I told you you meddling.
Now you know what I mean.
You know what I mean.
Doc is taking this personally.
We were supposed to be having aconversation about other people
.
Now how come I feel like sheover here grilling me?
It's a hit dog, holler, that'swhat my grandfather always said,
and I would be like we don'teven have a dog.
It took me so long to figureout that.
Figure out that phrase.
You're right.
You're right.
(24:24):
We know everybody out there.
We're going to do better, right, I know y'all are somewhere
shaking your head, clapping yourfingers, finger snapping.
We're going to do better, doc.
And for caregivers Listen, howexciting is it to know that
there are providers thatactually want us around, are
(24:46):
appreciative of our involvementand are open to greater
conversation, honesty, feedback,partnership.
I could cry.
Well, I ain't going to crybecause it'll mess up my beat
face, but anyway, we go.
They got beaters in Detroit.
(25:08):
Y'all DM me and I'll tell youwho did my face, but that's for
later.
Dr Detroit, thank you so verymuch.
Thank you, thank you so verymuch.
You have given us a wealth ofknowledge and and if anybody is
(25:31):
trying to figure out any of thestuff that you said and talked
about here right now, on thiscouch, I'm gonna just tell y'all
this you can google her now.
Don't google your disease, butyou can google her.
She is all over everywhereBillboards, telephone poles.
But we got even more for y'all.
We're about to go to the RosaParks Geriatric Center and chat
(25:55):
it up with even more medicalproviders about what we as
caregivers can do.
That makes it a little biteasier for them and even sweeter
for our LOs.
Speaker 1 (26:13):
So this is the team that really makes this happen.
So doing a geriatric grant ofthis size, really advocating for
change in how we provide carefor geriatrics in the state of
Michigan, cannot be done withoutclinicians that are here on
nine-to-five doing this type ofwork and telling us and advising
us on kind of what we need todo to improve the care and then
(26:34):
hopefully being a model so thatother clinics can be able to
follow their lead.
So this is the Rosa Parksclinic team and this is a team
that are also part of the grantas faculty and advisors to kind
of make sure that we're usingthese resources appropriately,
and they are also integral inmany parts of the grant.
They work with our students ineducating and training our
(26:55):
students that come to the clinic.
Actually quality improvement atthe site, at the primary care
and the long-term carefacilities, ensuring that we are
providing age-friendly healthcare to everyone that encounters
our system.
And so I couldn't do thiswithout them and I want to just
take this opportunity to thankthem so much for what they do
(27:16):
and you will get to know themvery shortly.
Speaker 2 (27:19):
Okay, dr Lisa.
Dr Lisa Benz-Emerick, did I getthat right?
Listen, I'm a comedian firstand then I'm a caregiver, but we
are here at the Rosa ParksGeriatric Center.
I can't thank you enough foreven being a part of a mission
and a clinic that provides carefor a population like this.
(27:43):
How did you even becomeinvolved with this facility?
Speaker 4 (27:48):
30 years ago, I became involved with this
facility.
I had lovely grandparents, andthat's what taught me the love
of the older adult, and so,after I got my master's degree,
this job became available and Icame here, and I've been here
ever since.
So 30 years, 30 years, yeah,taking care of older people and
their caregivers.
Speaker 2 (28:07):
Yeah, yeah, and I have a real passion for the
elderly population too.
It started for me with mygrandparents, so I understand
what you mean.
Now tell us real well in yourwords the difference between a
nurse practitioner which I thinky'all can do just about
everything as the MD, becauseyou can prescribe medicine and
(28:28):
you can see me and tell me if Ihave the flu.
Correct Sounds pretty good tome, right.
So what can't you?
Speaker 4 (28:34):
do Really nothing.
I can really pretty much doeverything.
Speaker 2 (28:38):
See there, I tell y'all.
So listen, when you go in yourMyChart and your doctor's not
available, go ahead to that NP.
I'm just trying to tell you,I've had such good experiences
with my.
Speaker 4 (28:48):
NP.
I think the patient benefitsfrom both.
I mean, the physician has theirperspective and I bring a
nursing perspective to things alittle bit more holistic
perspective.
Speaker 2 (28:59):
She's being kind, go to the nurse practitioner.
No shine or no hate on thedoctors, but I can say it, she
doesn't have to.
So we are in one of the roomswithin the Rosa Park Geriatric
Center and you're going to showus a little bit of the
difference of what a patient canget here that you wouldn't
(29:21):
necessarily get in a standarddoctor's office or facility.
That's correct.
I'm excited to see.
Speaker 4 (29:27):
Here we have hip high chairs.
They're the higher for theolder adult.
Oftentimes they have arthritisin their hips or their knees, so
it's easier for them to get upfrom a higher position than
sitting down low.
So this is one of the things wecreated when we brought the
clinic to inter-fruition is tohave hip high chairs for
patients.
They're also heavy so theydon't tip over, because older
(29:50):
adults don't get up as readilyas a younger person and so
they're heavier chairs.
Behind you there is a wheelchairscale.
Oftentimes, if you go to aregular doctor's office, they
have the little tittery scalethat people get on, and this
allows us to put an individualin a wheelchair there and weigh
(30:10):
them and then bring them overhere and then weigh the
wheelchair so you can really seewhat the individual's weight is
doing.
So that's another thing we havefor the older adult.
Other things when theindividuals come out to check in
, our counters are lower becauseoftentimes they're in
wheelchairs and so they're ableto then converse with the
(30:31):
individual receptionist withouthaving to have the counter there
in their eyesight.
Speaker 2 (30:38):
That is so powerful?
Did you all think that throughin advance?
And being designed for it?
Yeah, absolutely, absolutely.
That's magical.
My mom is still battlingdementia.
She has Alzheimer's.
We're currently in year 13.
And let me say, even though shecurrently is a part of a
(31:03):
dementia clinic All right, I'mgoing to pause for everybody to
digest that they don't haveeverything you just named in
terms of seating or a scale thatwould be easy for her to get on
, to get on while she's notcurrently using a wheelchair.
(31:24):
The fact that the scale youjust showed us is so low to the
ground and has that little like,I guess, a little small ramp
that would just be easier forher to even walk onto, let alone
a, I guess, just a lower heightum check-in area for a
reception, these things soundreal doable.
(31:44):
Not high technology, no, and itsounds like, I'm sorry, caring.
It sounds like caring.
Well, thank you.
Thank you so much.
So now we're going to go tosome other parts of the clinic
and see you guys in a second.
Speaker 4 (32:01):
Oftentimes, when an older adult goes to a regular
doctor's office, they havedifficulty getting on the exam
table, and so oftentimes they'reexamined in a wheelchair or in
the chair, and that's not reallya good examination to do for
the older adult.
So this goes up and down.
It's low to the ground, so theolder adult can get on it
without having to.
It's low to the ground so theolder adult can get on it
(32:22):
without having to um, you knowbe precarious.
And then this uh is able toyou're able to move it.
However you need up.
If again, if they havearthritis and they have hard
times sitting in low chairs,then we bring it up.
So it's, it's really for theolder adult, it's comfortable,
it has a you know, soft.
Speaker 2 (32:41):
So because a lot of times they're bony, yeah,
absolutely, I could take a goodnap in this thing too.
I mean, I know it's not for me,but they want to take it home
with them.
Speaker 4 (32:53):
I appreciate it and then again we have the lower
things for the older adults, sothe lower counter space and
stuff.
Speaker 2 (33:02):
Thank you so much Lisa I appreciate it.
All right, we'll be back in asec.
Dr Patel, thank you for talkingwith us.
Speaker 3 (33:12):
Well, thank you for taking time to come and see our
clinic.
This is one of a kind clinic.
It's a one-stop shop kind of athing for older adults, because
we not only provide primary carehere for the older adults but
also some of the subspecialtieslike cardiology,
gastroenterology, sleep medicine.
(33:34):
We have pharmacy, social work,nephrology all in this one
clinic.
So the older adult doesn't haveto really go out of this clinic
to another place to see adifferent provider, because you
know oftentimes, if they do,that their care is kind of
fragmented.
They get confused of where theyhave to go.
Instead, everything is donehere in one place.
(33:57):
So all their medicalspecialists and diagnosis and
everything is in one chart here.
Yes, makes it easy for them.
Speaker 2 (34:06):
That would be a lot easier, I think, for any of us,
definitely for their family,caregivers, for them to manage.
Speaker 3 (34:13):
Absolutely.
Speaker 2 (34:14):
Have you found that many family caregivers bring the
patients?
Speaker 3 (34:20):
here.
Yes, yes, most of our olderadults are accompanied by their
families son or daughter,grandchildren and it's nice to
see them involved in the care ofolder adults, because often the
older adults, for them, thistechnology and all can be a bit
(34:43):
too much, and so having thecaretakers involved in their
care is not only supportive butit kind of creates that healthy
environment for them.
It's very good to see that thenext of kin are involved at an
early stage of any disease,illness, and they are learning
(35:06):
and encouraging the older adultsto follow the medications, take
those medications on time andimprove their overall well-being
.
Speaker 2 (35:17):
Yes, sounds amazing.
As a family caregiver, I amhappy to hear that coming from
you, from a physician.
Do you have any advice or tips?
Is there something that youwould like the family caregivers
to do more?
(35:37):
If you're like, yeah, you know,maybe it would help if the
family caregivers could add thisor do this a little bit more,
as you are, as we are trying tohelp our mothers or our
grandparents.
Speaker 3 (36:06):
I think the one thing , as I mentioned, they can do,
is get involved early on,especially for some disease
process like dementia, becausethey start to have these memory
issues and it doesn't happen allof a sudden.
It's like slowly builds up overyears.
Initially they may have subtlememory lapses but then they
start having, you know, moreissues with recalling past
events and ultimately in theadvanced stages they just
completely forget of what'shappening.
But when they get involved thecaretakers, once they're
(36:28):
involved in early stages, thenthey also get to know what the
older adults really likes, howthey like the physician to
provide care to them.
So in the later aspect of thosediseases where they don't have
the ability to make the decision, the caretaker getting involved
(36:50):
early on knows what the lovedones would have preferred if
they would have wanted certainthings done certain way, if they
don't want these procedures oraggressive management and they
just want to live their life outmore comfortable, you know,
enjoy the remaining aspect oftheir life.
So I think the key is for thecaretaker to get involved early
(37:14):
on and then not to get anxiousif they learn about some disease
process like dementia and get,you know, really worried about
it, because now there are a lotof resources.
Caretakers also need to lookafter themselves, especially if
they are caring for their lovedones who have dementia, then
(37:34):
really there is a lot involved.
You know they can get burnedout.
Speaker 2 (37:38):
Doc, I have to ask you now now you're saying
something that makes me want to,uh, almost start tap dancing in
the room caregivers taking careof themselves.
It is.
It's hard.
We don't always know where tostart and how to do it.
Do you have any suggestions onhow a care taker could actually
(37:59):
do better with caring forthemselves?
Speaker 3 (38:02):
yeah, I think.
Um, so the caretaker,especially as we talk about,
let's say, disease like dementiaif it's a solo caretaker, then
it's overwhelming for thatperson and if the families
involved brothers, sisters,aunts, uncles or grandchildren
are involved, it makes it easyfor that one person because then
(38:24):
everybody can share in theworkload.
But the important thing is thatcaretakers should also look
after their health, Because whatwe see is that oftentimes a
solo caretaker often, you know,forget to take care of their
health.
They forget to look after theirmedical issues or go to doctor,
(38:46):
see them for preventive careand then ultimately can lead to
them having medical issues.
So there are resourcesavailable and if there is a
larger family involved in thecare, it makes it easier for
them to share the workload whilethey still stay active with
(39:09):
their daily life, you know,exercise, meditation, healthy
lifestyle so they are notoverwhelmed with one aspect, yes
.
Speaker 2 (39:19):
I'm only going to admit this because you have been
so calming and specific withyour advice.
I found out just last week, Doc, and I didn't know this.
I thought I was doing prettygood.
My primary care physiciancontacted me and said it's been
two years since my physical.
(39:41):
I had no idea I'm in year 13with my mom, but I to the point
you were making.
I thought if you had asked me Iwould have said no, I went last
year, but last year was twoyears ago, and so I received the
message you're giving us andthank you so much for sharing
(40:04):
your advice, sharing yourpassion, your understanding,
your expertise, and I know it'sgoing to be very helpful.
Speaker 3 (40:12):
Thank you.
I think it's very importantthat caretakers get this message
across that they got to lookafter themselves in the process
of taking care of their lovedones.
Otherwise, they are neglectingtheir care and they may put
themselves at more risk thanbenefit.
Speaker 2 (40:31):
Listen, he has the white coat on with the thing
with the comma and the MD behindhim.
So if you don't believe me,believe Dr Patel.
All right, we'll be back withsome more information about
caregivers and what you can do,pharmacy and geriatrics and old
(40:52):
people.
That sounds way confusing andcomplicated.
How do you make sure themedicines don't get messed up?
Candice, tell the truth.
Speaker 5 (41:06):
You know, there's so many ways that medicines can get
messed up.
First of all, we want to makesure that the patient is getting
the right medications.
So it's what is the right dose,what is the indication?
What do they need this for?
Also, there's the patient's endof it, right Like are they
taking it right?
So we problem solve through it.
Speaker 2 (41:32):
Are they taking it right as a caregiver?
Mom is in year 13 Alzheimer's.
I know for a fact she'sdepending on me for how she
takes it.
Where do caregivers come intoplay from your perspective as a
geriatric pharmacist?
Into play from your perspectiveas a geriatric pharmacist?
(41:54):
Well, I know you do more thangeriatrics, but that's your
specialty here at the Rosa ParksGeriatric Institute.
What do you think caregiverscan do, can learn, can assist in
this whole process of medicinemanagement?
When it comes to the elderly,you know a couple things.
Speaker 5 (42:13):
I think they can ask questions.
So asking questions of thedoctor, but asking the questions
of the pharmacist, you know, tomake sure that they're taking
it right.
The other thing, I think, ishaving a list being organized.
Some of our best caregiverswill keep a notebook and a
schedule and a calendar, and alot of times what I do in my
role here in the clinic is wecome up with a final medication
(42:36):
list and then I write it all outon a calendar.
I'll include the brand names,the generic names and what time
of day to take the medication,and I try to simplify the
schedule for the patients.
Like a lot of people think thatyou can't take two meds
together, so they'll scheduletheir medications out through
the whole day, which iscomplicated.
So a lot of times I'll just tryto simplify their regimen so
(42:59):
that they can take the leastmedications to get the most
effect out of them and tell themwhat time of day they can take
it and write it all down,because really, who can remember
all of that?
No one.
Speaker 2 (43:10):
You, you, the pharmacist, can remember it all
and I know this happens to meand you tell me if you've come
across this with othercaregivers.
You get all the medicines, youcall the pharmacy.
The pharmacy says hey, the waythe doctor told you to take that
(43:33):
is wrong.
What am I supposed to do as acaregiver if the pharmacist
that's feeling it says the waythe doctor is telling you to
take this just doesn't matchwith that medicine?
Speaker 5 (43:44):
Oh man, what am I supposed to do?
Yeah, you're kind of in themiddle of it, right, yeah?
So I think the first thing isto ask questions how should it
be taken properly?
Then verifying back with thedoctor's office.
You know, I'm told that Ishould be giving it this way.
Is that correct?
So that it's reconciled?
So that's our big buzzwordmedication reconciliation is it
(44:05):
needs to be reconciled, but it'scoming from this source, coming
from that source, anothersource.
How do we reconcile that sothat there's one accurate list?
So taking that list ofmedicines to every point of
healthcare is a really key waythat caregivers can help.
Speaker 2 (44:22):
That list.
You keep bringing up that list.
I guess it really matters tocaregivers that we have this
list and it's not permanent,right?
It seems to be changing it isevolving.
It is changing, much like manyof us.
Uh, we're changing and evolvingtoo.
What have you learned fromconscientious caregivers that
(44:48):
you're like, wow, I hadn'tthought about that they're doing
this activity, or I hadn'tthought about that they're doing
this activity, or they havethis habit.
That seems to be really useful.
Speaker 5 (44:56):
We have some great caregivers.
I mean a lot of them are justtrying to like get at like the
most effective, leastproblematic approach to
administering the medications totheir patient, to their you
know loved one, and so sometimesthey'll use like strategies of
like trying to distract them orlike giving it to them at their
(45:18):
best time of day.
Sometimes they'll put it intotheir food, you know, if it's a
medication that you can do thatwith.
Sometimes injections arehelpful when you know a patient
doesn't want to take oralmedications because it's kind of
like one and done.
You know, right, yeah, sothere's all kinds of different
(45:40):
strategies and approaches thatI've seen people do, but a lot
of it's kind of going at it withlike let's get this way
possible, yeah, okay.
Speaker 2 (45:53):
I have a final question for you.
Is there anything you cansuggest that a caregiver
probably should not do in theirapproach to a pharmacist?
Let's say we're a littlefrustrated and we're not trying
to take it out on the pharmacistLike, hey, the doctor screwed
(46:15):
up.
What is like a no-no in yourindustry?
Speaker 5 (46:19):
Oh man, pharmacists hate being yelled at.
Okay, they hate being yelled atby their patients and their
patients' caregivers.
You know, I think that we justwant to help right and so being
able to, like, have aconversation, a dialogue, a back
and forth.
Everybody's frustrated whenthings aren't going the way that
you want for them to.
You're like not getting themedication that you need.
(46:41):
Seeking to understand, don'tyell at your pharmacist.
Speaker 2 (46:46):
Okay, y'all got it here, okay.
So listen, go out in the car,scream to your favorite song and
then walk into the drugstore ina calm place.
All right, thank you so verymuch.
Thank you so very much.
It's been a pleasure, theSnuggle Up.
(47:07):
This time we had the pleasureof being in two places for one
episode the Rosa Parks geriatriccenter, and then actually in
studio.
We had medical professionals ina clinic and somebody telling
us about an academic perspective, a personal perspective.
(47:32):
How could you get any more?
You know what I'm saying.
What really struck me and whatI know I'm going to take away
from all that is these providerswant a real, honest and open
relationship with the caregivers.
They want us to be involved.
(47:53):
Now maybe you over there sayingJay Smiles, but you don't know
my mama's doctor, or you don'tknow my granddaddy's dialysis
giverer Okay, well then maybeyou need to change that person
that ain't the only dialysisgiver in your granddaddy's town,
because apparently there aresome providers who want to have
(48:17):
an open dialogue with us.
They realize that we are theboots on the ground, that we are
the person who is around theirpatient 24-7.
And without us they cannot giveadequate care to their patient.
So while you BSing, they can'teven really for real, for real,
(48:44):
fulfill that oath they tookeither to be a pharmacist, to be
a nurse practitioner, to be ageneral physician, to be a
neurologist.
They can't do none of thatright and well, to the best of
their ability, if they don't getinformation from us.
So what we got to do, we heardfrom them.
(49:05):
We got to ask more questionsand maybe be a little pushy when
we say, no doc, no nursing pool.
I said this what's happening atthe house?
You ain't got to be ugly withit, but go ahead and send that
(49:25):
second or third email in mychart or whatever version of
email in digital communicationyou have with your family
member's provider.
If you got to pull up on thedoctor's office when they keep
telling you they don't have nospace for an appointment, but
you see your LO is walkingaround the house talking to
(49:48):
spiders, pull up on that thing,pull up on that office.
Listen, not with violence, withcare and concern.
We just heard from and sawmultiple providers, multiple
genders, multiple ethnicitiesand religions.
They all said the same thingthey need us, and so do our LOs.
(50:14):
We got it and we gonna give it.
What up, though.
Thank you for tuning in.
I mean really, really, really.
Thank you so very much fortuning in, whether you're
watching this on YouTube or ifyou're listening on your
favorite podcast audio platform.
(50:35):
Either way, wherever you are,subscribe, come back.
That's the way you're going toknow when we do something next.
Y'all know how it is.
I'm Jay Smiles.
I might just drop something hotin the middle of the night.
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