Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:20):
Welcome to another episode of Always Ageless, where we believe
that growing older is not about decline, but it's about
living fully, with purpose, dignity, and definitely with joy. Today's
guest is someone whose work has impacted thousands of families
who are navigating like we are one of life's most
emotional and challenging seasons. Amy Cameron o Rourke is a
(00:45):
nationally respected advocate, author, and care manager who brings not
only decades of professional experience, but also an incredible depth
of heart. When I first started the show, so I
hoped that someday she would be my guest, and so
this is really a special day for me as well,
(01:07):
and I'm so happy to bring her to you, my
listeners and my viewers. Her book, The Fragile Years. The
Fragile Years, Proven Strategies for the care and of aging
loved Ones is a guide that I believe every family
should have on hand. We all need one. In it,
she combines wisdom, clarity, and grace to out families like
(01:30):
ours make thoughtful, loving decisions in the face of uncertainty,
and goodness knows, there's plenty of that. So whether you're
an older adult yourself or the adult child of someone
aging or like some of us, you're both of those things.
Today's conversation will open your heart and give you tools
that you can actually use. So let's begin, Amy Karen o'burke,
(01:53):
welcome sincerely to always ageless Valerie.
Speaker 2 (01:58):
Thank you for having me.
Speaker 1 (02:00):
You are so welcome. There's so much that we can
talk about today, and we got a little bit. We
cheated a little bit ahead of time and talked a
little bit already. But let's talk about what is What
is the fragile years? What does that term really mean?
Speaker 2 (02:15):
What it really means is the fragile years is a stage.
It's a stage like being pregnant, terrible twos, menopause, midlife
crisis is a stage. It's a recognizable stage, but it's
an unknown stage, and it's for older adults usually. And
keep in mind I talk in the bell curve, acknowledging
that there are ninety year old and one hundred and
(02:36):
five year olds out there that are breaking the Bell curve.
But for the most part, in your eighties, there's three
to five years of what I call fragility, and you
can see it if you know what to look for.
And so what I like people to do is just observe.
(02:56):
If you have a family member or a friend or
somebody in your world, just observe and there might be
an event. There might be like a car wreck or
a hospital stay or something, but there might not be.
There might just be what I call the slowing down period,
and you can think about what a person normally does.
Like my mother in law plays bridge three times a
(03:16):
week now, if she goes to playing bridge one time
a week now she's ninety, I'm gonna I'm gonna log that,
not that I'm gonna do anything, but I'm gonna log
that she stopped driving at night. Okay, that's not a
big deal. But if she starts not going to water aerobics, Oh,
that would be a bit. Yeah, that would be. So
(03:39):
in your world with your person or persons you're looking at,
are they slowing down pace of walk, pace of eating,
pace of drinking? And for those years, I like to
say less is more like you know, there's there's incidences
and I've I've had this happen where you know, the
(04:02):
adult daughter comes in and dad's fallen and broken his hip.
That's his event, and he's in the fragile years and
she's fixated on getting him back home and back to normal.
And what I like to explain to people is that
you don't want to be disconnected from the stage that
they're in. Meaning Dad's broken a hip. He's going to
(04:25):
get better, perhaps perhaps not, but he's not going to
be where he was before, more than likely. And keep
in mind there are people that break them, but more
than likely he's not going to return. So there's a
pressure you can take off yourself if you're taking care
of someone, to stop pressuring yourself to get them back
to the way they were, help them, support them, and
(04:47):
see where they land and be with them in that
new stage and see how they go from there.
Speaker 1 (04:56):
Their new reality, so to speak.
Speaker 2 (04:57):
The new reality. Yeah, you kind of got to re
set and in this stage. And Valarie, this is why
I wrote the book. This is literally why I wrote
the book. I had family member after family member come
in front of me and they're shocked, surprised, blindsided. They're
(05:18):
looking at me like I cannot believe this is happening
to my mother. And I heard that over and over.
And I had a lawyer friend of mine and she said,
you got to write a book, You got to put
this on paper because people are coming in they're shocked
and you're not. And that was that was my reality.
I thought, how do you not know this? And so
(05:38):
I wrote the book to help people understand. You know,
we're talking more and more about menopause, which I think
is fantastic. The more we talk about it, the more
we're ready for it. It's the same with the fragile years.
Speaker 1 (05:50):
I think that we talk about this, some of our
colleagues and our morning call talk about this that we
don't know what we don't know. And I've said this
so often and talk about it so much that especially
for those of us who are the adult children of
aging parents, which we can talk about again and talk
(06:12):
about for hours, but we don't know, we don't know
what to expect, we don't know how long they're going
to live, like, we don't know that this is their
new reality. And people will say often well, and have said,
you know, once they go to the hospital for something,
then that changes everything. Well did that change it or
was it going to change anywhere or did it already change?
(06:33):
And that just one thing proves that they were in
that new stage right right.
Speaker 2 (06:40):
And what I would say to you is the way
you express that Valerie like talking about what you don't know.
The biggest thing that stops people from doing well in
the stage is ego, a lack of humility. Really yeah,
Like people people used to ask me when I ran
(07:01):
this company care management company. They would say, who's your competitor?
And I said, it's the family member that thinks they
know what they're doing, you know what I mean? Like,
they think they're know what they're doing, and it's nothing
wrong with that, but they don't kind of let down
their guard, open themselves up and ask questions to say,
what do I need to know here? What I'm seeing
on my end? You say, hospitals stay, I see Medicare,
(07:24):
Medicare advantage, pharmacy changes, going to the rehab, going to
hospital rehab, all those healthcare systems and financial systems that
a family member has to understand to make good decisions
for their family member fast. Everybody in the healthcare system
is pushing hard and fast, and I like to help
(07:46):
people slow that decision making down so that they can
make a thoughtful, prepared decision for their family member.
Speaker 1 (07:55):
I think, and I've talked with our friend Catherine about this.
We talk about doing community workshops and information and knowledge
and education for the aging adult, for the older people
people might I don't know about yours, yet I almost
think that there should be the same amount of education
(08:19):
focused on the people who are the adult child of
the aging parent.
Speaker 2 (08:23):
One hundred percent when I talked about classes for them,
exactly exactly, because there's two different audiences. When I talked
to I went to a retirement center. The guy that
led the workshop was on the fragile years. He's ninety two,
minister lovely man. I loved this man. We had almost
(08:44):
one hundred people attend the event. They were all older adults,
none of the family members, and I didn't know that
they would be as interested as they were. They bought
a ton of my books and they gave it to
their family members, And so it was again a reminder
that you know, it's education for the older adult. How
do I tell my children what I want? How do
(09:05):
I do that? And when I can't talk for myself,
what should I do to let them know it's okay
for me not to have that surgery? For example? It
really has two separate audiences.
Speaker 1 (09:16):
It is it is and I so our friend Catherine says, yes,
but will they come to those educational events. They may
not come to the first one, but I think eventually
we all. If I knew I was going to be
in a room of us, we all have the same question.
I would want to know that you met a lady
(09:37):
and maybe in Florida who made the movie Wine, Women
and Dementia and her which we're going to bring to
Orange County to a private theater here and show it
at the first of November. And her her movie is
about the children and what they went through. She didn't
interview the parents. She interviewed the children and what were
(09:58):
we going through and the questions that they had and
the fragile years. Should be a manual four it is.
It should be looked at as a manual for us
as well as for our aging parents.
Speaker 2 (10:12):
That's right, that's right. And the thing for me, I
had a daughter working with her mother. Mother's ninety four,
and I was at the house and she was one
of those ninety four year old that had the cold
bottle glasses and their really curly kind of blue hair
and cute. She was so cute, she was so cute.
(10:33):
She's sitting on the couch with me and the daughter's
running around, running around like you know a frantic daughter does.
And the mother looks at me and she says, I'm
ready to go. And I said, does your daughter know?
And she says, I'm trying to tell her. I try
(10:53):
to tell her, And so I asked the daughter to
come over and she sat down, and all that tightness
and stress and control anxiety. I asked her to just
listen to her mother, that her mother had some things
to say, and the daughter was able to hear where
the mother was, so all the decisions for the next
(11:16):
three years were easy because she had that conversation with
her mother about let me be where I am. Just
let me be where I am, And there's some meaning
if you can get past the grief and the denial
and listen. There's nothing more heartbreaking than watching your parent decline.
I mean, there's a lot of things more painful than that,
(11:37):
but it's really painful, very sad. I turned my head
many many times taking care of my dad and my mother.
I had to turn away, like to just cry so
they couldn't see. And that there's grief and people don't
really bring that to the forefront because they think they
haven't died, so they're not in grief.
Speaker 1 (11:59):
And sometimes you learn things afterwards. My dad, we took
my dad to a board and care home because he
was kicked out at a hospital and then he was
kicked out of the now they're home skilled nursing, not
kicked out, but because it was his time was up there,
we had to put him in a board and care
and and I took him there, and I remember when
(12:20):
I willed him in and he said, is this a house?
And I thought he's getting really old with ninety nine.
But after he passed away, then we realized it couldn't
see and we didn't know it. And so so many things.
There's so many things about discovery, you know, that we
need to watch out for. So you've talked about let's
get back to the book book and you we've talked
(12:41):
about some things that when your loved one slows down.
Are there any other things that identify the fragile years?
You say it's when they're about eighty. Is that because
something happens to the body about that time.
Speaker 2 (12:57):
Well, it's in your eighties, eighty one, might be eighty five,
somewhere in your eighties. I think our life expectancy kind
of drives that, you know, our life expectancy. There's a
lot more women that are retired than men. We outlive
the guys. So when we're talking about, you know, people
in their fragile years, there's a lot more women than men.
(13:18):
And what indicates that is the the slowing down and
then the need for help and the resistance to help.
So and it's always there and it's normal to be there,
(13:40):
and they're the common conversation is my mother, my aunt,
my grandmother won't take the help. And from the family member,
they want eight hours a day right from the get go,
or they want to move them too, assisted living right
from the get go. But needing help should start in
the fragile years with something very very small, almost meaningless.
(14:05):
And you'll know what that would be by observing the
person that you're concerned about and seeing where they might
accept help in asking them is picking up your mail?
Is that something you'd want me to do? You know?
Is there do you see a need at all for
me to have a housekeeper come in every other month?
(14:28):
Like just open ended questions and if they say no,
that's the answer, you're not you can't. You're not going
to have a one and done. You're not gonna have
one conversation and they're going to take the help right away,
because because from the older person's perspective, once I accept help,
it's the beginning of the end.
Speaker 1 (14:45):
Right So that's my question to you is does you
know we teach our kids. You know, someone says no,
they mean no. But when your moms is ninety and
she says no, does she mean no?
Speaker 2 (14:55):
Does she mean what? Does she mean? No?
Speaker 1 (14:58):
I can handle it, but I wouldn't mind if I
had some help? How do you follow that?
Speaker 2 (15:05):
What I like to advise help people do is ask
really open ended questions and spend time connecting emotionally. Because
what might work for my mother is not going to
work for your mother. So you have to be really
emotionally open and in tune with yourself one and you're
(15:27):
asking yourself, do I have an outcome in mind? Do
I want to relieve my stress? Am I preparing? If
they get help, then I'm going to feel better? Like
what are your motives? And get cleared that you're only
wanting to offer help. And then you have a person
that's really clear they say no, they mean no. Then
you have the older adult that's a little muddled, maybe
(15:47):
a little impaired judgment. And then you know, I say,
try a few things. You know, maybe you put down
a meat loaf and broccoli dinner. Maybe maybe it's just
maybe you go over and you eat with them once
a week. Maybe you empty out garbage while you're there.
Maybe so you're gonna just experiment with different ways to
be involved without doing a frontal attack with you need
(16:10):
four hours a day, you know, seven days a week.
Speaker 1 (16:15):
Okay, all right? And then and I'm kind of wandering around,
but I think these are important issues, and what do
you do if you're not there. I'm in California and
this isn't the case, but and my mom lives in Minnesota.
What about those kids? What about those loved ones? And
(16:37):
just we just don't know how to handle this. Do
we put cameras in their home? I mean, how can
we care for our loved ones when we're not there?
Speaker 2 (16:47):
So I would re remiss if I didn't bring up
the concept of role reversal. And one thing I would
recommend you not do is start talking to you parents,
to your parent or your family member that's long distance,
as if they're a child and they need to do
what you recommend doing. That will be a failure, and
(17:09):
people do it because they don't know how else to act.
So really, what you're trying to establish with a long
distance person is collaboration, working together and then involving them
in where you are. And what's reality is what do
I do in case of an emergency? Who do I call?
(17:30):
Who are your friends? Have you been visiting? And if
you've not been visiting, you need to be visiting. There's
a book out there it's called My Mother, Your Mother.
It was written in eight by doctor Dennis McCullough, and
he talks about the seventy two hour visit and making
sure and I know I'm People that are listening are
(17:51):
like my dad and I never got along. I'm not
flying how HIGHO to see him? You know? So, But
ideally you would visit without having an outcome in mind,
because if you only fly in when you're needed, they
think you're coming in because it's the beginning of the end. Oh,
they think I'm going to die and then they shut down.
So if you kind of planned all along, you're visiting,
(18:14):
you're calling, you have a and then you're meeting people
that they know. You can hire a care manager, you
can go on the website aginglifecare dot org. You know,
for some people they can't afford it. If you can,
that's a great way to have a boots on the ground,
if you will, in the city that your family member
lives in. But you want to start establishing a communication
(18:36):
that says, how if you become unable to speak for yourself,
how do you want me to handle you and your affairs?
What best way? Like include them in that conversation. You know,
give me your idea, give me your vision, give me
your best case scenario so I can know you deeply
(18:58):
regards to your healthcare and not make as many mistakes
as I might make under stress.
Speaker 1 (19:04):
And I read something in your book. I mean I
read something in your book a case where someone took
care of their mom or their mother in law and
they weren't that close to them, but you thought that
it was really gracious how they handled it because it
was the right thing to do, and they cared for
their loved one even though they didn't have a close relationship.
(19:26):
And I think of this that maybe you can just
go to them, would you say, Look, you know, I
just want to know how to help you if there
is an emergency, if there's an event or sometime comes,
I just want you to know that I care enough
about you that I'm here for you. And I thought
that was a great story.
Speaker 2 (19:47):
It is because you know, I meet people that say,
my parents and I we didn't have a good relationship.
They weren't that great to me. And I've had family
members say that to me and it helps so much
to clear the air so that I have expectations that
are in reality. And I think those are the unsung heroes,
like wow, you go to bat for your parent when
(20:10):
they weren't there for you. But that's you know, that
takes a lot of depth emotionally.
Speaker 1 (20:16):
It does. It does, but they're your family and family
is family, and that's a whole another story, whole, another story,
I'm sure, So you tell us. Let's take a minute
to talk about what is a care manager? I think
because a lot of people don't know, and I think
that's a relatively new position, is it not?
Speaker 2 (20:39):
The aging life Yeah, the aging life care manager aginglifecare
dot org. The profession is forty years old. People don't
know about it because people don't know what they don't know.
They don't know that there's a profession out there that
helps people. And I like to think have people think
about this time of life. You need three legged stool
is healthcare manager, a lawyer, and the finances and those
(21:03):
three things have to be worked through in order to
accommodate the goals and the needs of the older person.
So a care manager, a certified care manager and they
know you go on the website and see them. You
want to make sure they're certified, and they'll have a
CMC or a CCM after their name. They will have
(21:25):
a bachelor's degree or a master's degree, and they will
be certified, which means that they have had supervision either
two years for a bachelor's one year for a master's,
and they've taken a certification exam, which means that they
know what you want them to know to help your
(21:46):
family member. And in addition to that, in their profile,
they will list the things that they're good at. You
can have an RN who's a care manager. You're going
to have a social worker that's a care manager. Well,
my mother and she was met complex. I wanted a
nurse care manager. Okay, okay, okay. If I was just
(22:07):
trying to find a place for my mother to live,
maybe I'm looking at a continue the aging life care community.
Maybe I'm looking maybe I want my mother's long term
care insurance. Looked at well, social worker they can do that.
Our nurse can do it also, But look at what
they say they're good at, and call and get an
idea of how they work.
Speaker 1 (22:28):
And so a care manager is someone who they would
handle everything. They would kind of be your your estate manager,
so to speak. Is that a kind of a good term.
Speaker 2 (22:42):
It's close, it's close ballery, and the way you're grappling
with is very very normal because really the way it
works is the care manager meets the person and then
they will outline ways that they can help. And what
I like to do is work with the family members
on what they wanted me to do and what they
were going to do. We work on a budget. So
(23:05):
let's say mom was at home and we needed home
care and the family didn't think that she was getting
a good diagnosis. So going to the doctor, interfacing with
the doctor, making sure that all the specialists were talking
to each other, make sure that the medication was known
by all, and then if they went to the hospital,
we would agree, do you want me to go to
the hospital, Do you want me to run interference at
(23:27):
the hospital. Do you want to go and use me
as your coach on the side. Do you want me
to supervise the care. Do you want me to find
equipment to make it easier for your mother to get
a bath? Do you want me to train the aide
in dementia if there's a memory impairment and your mom's
acting a little weird, so you tailor make the plan
based on the budget and based on your need. If
(23:51):
you're working full time and you can handle the nights,
maybe it's the daytime that you need to help and
going to all these appointments.
Speaker 1 (23:59):
Let me ask you a question of the people who
hire you, how many of them are local to their
loved ones versus far away from their loved ones.
Speaker 2 (24:07):
I'm going to say fifty percent.
Speaker 1 (24:10):
Really, Yeah, So people hire you even though they're close by.
Speaker 2 (24:14):
Even though they're close by because they're working full time,
or they're taking care of their own children.
Speaker 1 (24:20):
Yeah, yeah, or all of those things.
Speaker 2 (24:23):
Yeah.
Speaker 1 (24:24):
Sure. One of the things I have felt was really
important isn't isn't just a plain old advocate? And I
think it first came to mind and I read it
in your book. Is in the medical situation and advocate
at the hospital and advocate with their medication, an advocate
(24:44):
if you put them in assistant living or even in
a boarding care home. I wish I'd had an advocate
for my dad because I somebody said, okay, we're going
to do this. I didn't know if that was okay
or not. Somebody called me from the hospital and said,
we're discharging him this afternoon. What am I going to
do with them? I wish I'd had an advocate.
Speaker 2 (25:06):
Valor, your honesty is so refreshing, and that's the most
satisfying part of the job of a care manager, advocate,
whatever you want to call us, is when you're in
the hospital, there's techniques that you can use to keep
them in the hospital, and there's techniques that you can
use to get them out of the hospital. There's techniques
to slow down a discharge. There's techniques that you know
(25:29):
will help you land in the right rehab facility. There's
techniques to prevent a crisis. There's language that can be used,
you know with the hospital. There one get them out,
get them out, get them out, which happens all the time.
And if you said something like I want to I
want to have a discharge that results in him not returning,
because hospitals get penalized if you return within thirty days.
(25:52):
And the conversation becomes, we're working together to prevent a return,
and we've also got you know, if you appeal the discharge,
you've got you've bought seventy two hours to figure out
what you want to do. The four o'clock eight o'clock
discharge on a Friday afternoon. I don't like I don't
like admissions on a weekend anywhere. And I'll say something negative,
(26:15):
and I only say it because I'd like something to change.
Each individual healthcare system assisted living, hospital, nursing home, rehab center,
hospital rehab. They're all silos or compartments, and they don't
talk to each other, and then they all have their
own dysfunction. And so you're in one system and then
(26:36):
you jump over to the next system. You just got
where you kind of understood the language, and then you're
in a brand new environment and then you got to
know that the financial systems. Well, if you're being bombarded,
but you have time, and you have an advocate that
can you can call and say, this is what they said.
Is that right? You know, can they do that? And
(26:57):
we can be your professional courage if you will, to
have those conversations that will put you more in the
driver's seat instead of being in that reaction reactionary state.
Speaker 1 (27:11):
And that's kind of how most of us are. We
just I'd like to have somebody I can call and say, okay,
even if I just did they just said, this, is
that right? And then if you say yes, that's right,
I'd say, okay, fine, I'm good with that, right. And
you know, and look, I'm in I've been in real
estate my whole life, so I understand, and I think
that people should trust me for my knowledge. If someone
(27:32):
says this should be happening, this should happen, I can
say no, no, no, we're not going to do it that way,
or we don't have to, or we should or we shouldn't.
And so I respect that, and I respect that in professionals,
we hire attorneys for those reasons, and actually we hire
doctors for those reasons. But if you're in the hospital
and one person gives you a medication, you don't know
whether that's a good thing or not, or if they
(27:54):
even look to see what you're already taking, right, And
they only have. Everybody has their own interests, right, they
have their own roles in the hospital, but they have
their own responsibility. My job is to discharge this person
because we need the bet right right, something like.
Speaker 2 (28:11):
That, exactly exactly, And I guess, I guess the most
important thing to me is you know when you say
the lawyer, think about doing your taxes on your own,
think about suing someone on your own. Yeah, that's how
(28:33):
I feel when someone says, oh, yeah, I've taken care
of my mother and they're not getting any help. That's
that's how I feel, like, Oh my gosh, they have
no idea. I had a son bragging to me about
being with his mother in the hospital nine times last year,
and I said, well, eight times too many? Like that
(28:56):
that's something might be bragging about. Like what is information?
Could you have had to have her? Who wants to
be in an ambulance every other week? Like you get
taken to the hospital. The hospital's like, you're here, so
you must want us to fix you. So we're gonna
do surgery, we're gonna do test. Well, if that's not
what you want, why are you going?
Speaker 1 (29:18):
Right? Even as simple as getting in the ambulance and
letting them tell you where they're going to take you, right.
Speaker 2 (29:27):
Yeah, And I don't know if this is nationwide, but
it probably is. An ambulance has a contract with a
county and they're required to take you to the nearest
receiving facility. People don't know that. But they also don't
know if you land at that hospital and you want
to be one to get transferred.
Speaker 1 (29:48):
Yeah, but they don't know that. They don't know that, right,
my dad would get an ambulance. I want to go
to Hope. Oh might not going to Hope today? Oh no,
I want to go to Hope. Well that's not an option.
And then he gets there, and then of course they can,
and then it's my I didn't know amy at the time,
so it became my problem. Let's talk about where people
should should live. You must have so many decisions to
(30:12):
help families with as far as assisted living, if it's
a memory care that's needed, should they live at home?
How do you even begin to tackle that discussion with
a family.
Speaker 2 (30:25):
So hopefully you start early, and a lot of times
you don't. You're in the middle of a crisis. So
I don't fault anybody for not doing this early. The
biggest thing that needs to be known is money. What's afforded?
What can you afford? The other thing is some emotional
discernment over your own risk tolerance, And by that I mean,
(30:50):
guess talk about that. I have a high risk tolerance.
And I had a lady you know, at home with
a memory impairment, and she never wandered at night, never,
so she had help during the day, but at night
she was on her own. Well, the power of attorney
was a little nervous, Nelly, And I said, I'm not nervous.
(31:13):
We can put care in there. But she's going to
be out of money at land in the nursing home.
But I can bet you we have alarms on the
door cameras. She's not going to leave that house and
she didn't for four years. So what's your risk tolerance?
What can you afford? And then this is a hard one.
But some people you know, have a hard and past.
(31:36):
Don't ever put me in a facility, will ever ever
do that? Well, I've seen people, particularly those with memory impairment,
they move into a community and they thrive because their
memory impairment is not You're not pressured to know things
that you don't know. It's your weird behavior of stealing
(31:58):
somebody's socks or somebody's somebody's dentures. That's normal. Like, no
one's pitching a fit over what you're doing. You know,
like it. And so the person with a memory pairment
can't say but they're relieved because they don't have that
pressure anymore.
Speaker 1 (32:13):
Interesting And I think they know that.
Speaker 2 (32:18):
I think emotionally they do. I absolutely do. And if
you think about it, and I'll use my dad, you know,
calling me twenty times to help them with his remote. Okay,
there's a common one. And I get laughs everywhere because
that somehow, that remote with older people, but particularly the
memory impairment, drives people crazy. Well, if you're in a
(32:41):
memory unit or memory care, nobody's gonna do anything about
a remote one. You won't be watching TV because you're
gonna be involved in something else. But you can. You
can tell your story over and over and over and
people aren't going to give you that exasperated look, like
can you imagine if you can't you're telling a story,
(33:02):
it's the first time. You think it's the first time,
and then you get a look from someone and you're
like hurt, your feelings are hurt or if someone if
there's an AID in the house and they've been trained
in memory, they're not gonna they're not gonna they're gonna
act like every single time they hear that story is
the first.
Speaker 1 (33:21):
Time, right, yeah, yes.
Speaker 2 (33:25):
And the other thing is you've got introverted personalities and
extroverted personalities. You've got people people and people that really
get their energy from being on their own alone, and
so you have to have a lot of emotional awareness
to say, dad can't afford home care at home, we're
(33:46):
gonna move them into a community. But tell the staff
don't bug him to go out to meals every day, Like,
don't bug him to go out because he's not gonna
do all those activities. He wants to be on his own.
So kind of help the staff learn your family member
so that they're not trying to get them to be
somebody that they're not. Well, he sits in his room
(34:08):
all day, Well he did that. He worked and went
home and set on his own all day.
Speaker 1 (34:14):
Right, So it's about managing expectations also exactly that's what
that's his normal. Then it's not going to change just
because he goes into assisted living. Right if he's in
a community. Let's say, for example, he's in a fifty
five plus community where they've got activities at the clubhouse,
but he never goes there. Probably in the assisted living,
he's not going to go there every minute just because
(34:35):
there's thirteen activities that afternoon. That's right, right, at least
maybe he'll work into it.
Speaker 2 (34:41):
But yeah, and you know, my dad used to say,
you know, I am never playing bingo. Don't put me
in one of those places. And you know, right, I mean,
if there's some common scenarios out there, well, when his
mind went just he was playing bingo with six cards,
having the time of his life. Sure, so you might
(35:02):
have one thought, but you got to be opened at
something might change.
Speaker 1 (35:07):
Right. Amy helped me with a question that so many,
I know so many of our viewers and listeners have,
is how do you make the decision between home care
and assisted living? Because if you have home care, you
can have somebody come three four or five mornings a
month or a week at three four hours a day.
(35:30):
But then and you mentioned this earlier, but then maybe
they fall at night, all right, and you can put
but that's not free. There's a cost to that. Or
you can put them in assisted living at maybe about
the same cost. How do families decide really what's the best.
Speaker 2 (35:49):
So there's a couple different strategies. The common rule of
thumb is when the person needs ten to twelve hours
a day at home, that's about assisted living costs.
Speaker 1 (36:02):
That's a comparison, right, right, So if you're deciding at
what point do we make the move, it's financially driven.
Speaker 2 (36:10):
If your budget is X amount of dollars per month,
you do it at home as long as you can
afford it. When you get to that ten to twelve hour,
then you make the change because you can't increase it, okay.
And the other factor is there are some people that
you can go four hour and there's a four hour minimum,
so you got to pay four hours on whatever the
going rate is in the state that you live in.
(36:32):
If you can give them four hours, maybe it's ten
to two, maybe it's nine to one, maybe it's one
to five, and they're fine the rest of the time,
that's great. That if they need four in the morning
and four at night, then you have the issue of
staff because people that are working part time are looking
for that full time job, so you have high turnover
(36:53):
with a part time worker. That's just normal. You're not
going to have, you know, Sally coming over three times
a weeket four hours a day and keep sally most
of the time. So that's another kind of practical consideration
is when do they need that help? And if they're
at risk at night and you do the ten hours
at night and they're fine during the day, then you're
(37:14):
going to look for evening care. Okay. Typically assisted living
is more affordable when you need twenty four within a
twenty four hour period of time, you need someone checking
in on you, and it could be the different time
during the day.
Speaker 1 (37:34):
But assisted living isn't isn't meant to be a place
where they're going to go and be given medical care either,
right the typical standard. Some of them are, but most
of them are not.
Speaker 2 (37:48):
Right.
Speaker 1 (37:48):
It's not a place where if you have isn't Is
it not true that if you have, if they need
medical care or medication, that that's an extra charger you
have to bring somebody else in to do some of
those things for them.
Speaker 2 (38:00):
You might not know how smart that question is, but
that's a really smart question, and that is I didn't know.
Speaker 1 (38:09):
Thank you very much.
Speaker 2 (38:11):
I feel very brilliant right now.
Speaker 1 (38:13):
Yeah, I'll feel brilliant when I know the answer.
Speaker 2 (38:18):
So, if you are person has a lot of medical diagnoses,
you want to make sure that there's a nurse on
staff in assisted living, because assisted living with no nurse
on staff and medically complex, and by medically complex, I
would say three chronic diagnoses or more, or a chronic
(38:42):
diagnosis that requires a lot of attention, like diabetes, you're
going to want to make sure. And the biggest flaw
in assisted living right now is they're selling medical care,
but they're providing a social model, so the expectation is
not met. Families move them in because they think they're
going to get that medical care. Well, a nurse might
(39:04):
have forty people and the person that's giving the medications
is a med tech and they might have six hours
of training. So and then I'll also add to that
assisted living or bored in care. I don't know what
the language might be different in everything, but assisted living
means that you need assist us with getting a bath
and getting dressed most of the time. If you need
(39:29):
skilled nursing care or nursing home care, you need total
help getting bathed and dressed. Using an example, of bathing.
You need to be wheeled into the bathroom. You need
to set down in the chair. Someone's got to, you know,
get you all wet, soap, you down, wash your hair,
and do everything that's skill nursing. And you cannot even
(39:51):
believe my dad's face the first time he got bathed
by somebody. Oh my god, he was terrified. He called,
he was terrified. You'll never never believe what happened to me.
This woman came in and like, oh my god, drag
me into you know, he was very dramatic, drag me
into the bathroom. But if you're in assisted living or
just assistant you're gonna be escorted to the bathroom and
(40:15):
maybe they help you sit down, maybe you use the
bar soap for the top part of your body, maybe
you get help with your hair. Like that's assisted.
Speaker 1 (40:22):
Care, the none so intimate part of it, right.
Speaker 2 (40:26):
Mine so intimate? Yeah, tell me.
Speaker 1 (40:33):
To tell me what it is about being a care
manager that gives you so much gratification, because I know
it does.
Speaker 2 (40:48):
Watchings people's anxiety go down and watching them cry with
relief that they're not alone. It's a very isolating experience
as being a caregiver it's very isolating, and if you
are in a world where no one else is taken
care of an older person, they don't really understand. You know.
(41:09):
It's kind of like talking about the birth of your
child to somebody who's never had a baby, Like they
don't get it. Like I don't have any empathy. I
don't have children. So watching that happen and then helping
people get connections, real emotional connections with their person because
(41:30):
they're not chronically running through their head everything they have
to do. I got to get the medication. I got
to pick up the medicine. I got to do their laundry,
got to label their laundry, I got to get in
the hot Like all that work can be divided up.
So when they go over and they've had a meaningful conversation,
or they've played bingo with their dad, which I did, like,
oh my god, watching that meaningful conversations the first time
(41:57):
a child says to me, I slept through the night.
Slept through the night. Or I gave a talk at
a university, and I hope I don't cry when I
relay this, but I gave a talk at a university.
When I was done, this woman literally ran up to
me crying that I'd helped her with her parents however
many years ago, and she never forgot it. And I
(42:20):
started crying because that's why I do what I do.
I'm touched by an older person just because they're vulnerable
and real and what you see is what you get.
But if it's not your mother, it's very different. So
it's it's that part is very gratifying to me. And
(42:42):
then and then seeing the older person, and I had
this said to me, can you get your can you
get my kids off my back? They're bugging me, they're
trying to control me. We want to make all my decisions.
You know, I had a woman pay me to help
(43:04):
her daughter stop bugging her.
Speaker 1 (43:06):
Oh gosh, yeah, how funny.
Speaker 2 (43:10):
I had explained with the daughter, like how much stress
she was causing. She just didn't know it, and she,
you know, I sent her to a therapist, oh you know,
like talk over some of these because she was acting
trying to do as much as she could because she
felt guilty. Oh. So, you know, helping people get clear
(43:30):
on emotional motivations and you know, letting their own emotional
issues get supported so that they're not bringing all that
into helping their parents in this new stage of life.
Speaker 1 (43:45):
Well, I now spend a fair amount of time out
visiting living communities and memory care communities, and then I
go home and tell my mom about it, just subtly
thinking that someday she might say, oh, could I go
with you and look at them? Right, which has not
yet happened. But she does call my sister and say, okay,
Valerie says, I'm moving to this one. She didn't even
(44:09):
tell me, she didn't even take me there. She's moving
me there just because I came back and said, oh,
I went to this really pretty assistant living community today, Mom,
you might like it. You should go look at it
with me. So she thinks, just as you're saying, right,
they think you've already made the decision for them.
Speaker 2 (44:26):
Yeah, because she's afraid, very afraid. She's very afraid, and
it's a very you know, it is a scary proposition.
What's going to happen to me? I'm at the end
in you know, one O five ninety. They don't know
when the end it's going to be, So they are
at the end.
Speaker 1 (44:43):
No, no, and we don't know either, so it's hard
for us to make the decision. My mom's doctor says,
it's not my decision to make, and God will decide
when that time is. In the meantime, I just keep
doing my job. Oh, that's destoried our house. I want
to just take a few minutes and talk about memory
and dementia because that's such a important topic to families
(45:06):
right now. What makes dementia or memory care really challenging?
The uncertainty? One day they're clear as about the next day,
they're not the repetition over and over and over. They're
asking the same thing they said. I didn't come and
(45:27):
see them, and I just.
Speaker 2 (45:28):
Left the low grade anxiety that they might put something
on the stove and forget to turn it off. Safety issues,
and then not really knowing the stages of dementia, you know, mild, moderate, severe, early, middle, late,
there's lots of other different stages. But and then how
(45:51):
do you communicate in a way that doesn't make the
conversation worse?
Speaker 1 (45:58):
Yes, I talk about that. Given some examples in your book,
and they're brilliant. I think let's talk about that.
Speaker 2 (46:04):
Well, let's just say that you know you've got an
accountant or an engineer who values accuracy. Those are the worst.
Those are the worst, you know what I mean?
Speaker 1 (46:18):
The artists have even in memory care, they're the worst.
Speaker 2 (46:21):
Do they know I'm not this person that the person
caring for them?
Speaker 1 (46:25):
Oh?
Speaker 2 (46:25):
Yes, okay, No, you want an account to be accurate.
But if you want to be accurate, you're talking to
somebody that a memory impairment. You got to give that
up because they're going to like, you didn't visit me,
and you want to say I was just there. Well,
that's going to escalate them.
Speaker 1 (46:41):
So how do you handle that?
Speaker 2 (46:43):
You change the subject, you read direct, you try to
start another conversation, or you say something very affirming, like
how much you care for them? And I just had
this memory of you the other day and can I
share it with you? And you know, kind of bring
them back to a positive experience, and they might bring
it up again. And this is what makes it so tiring.
(47:03):
How come you don't visit me? Right? How come you're
not here? I never see you anymore? And you continue
to do that same strategy or change the subject or ignore,
or you'd redirect or focus on painting a picture, or
play a game of cards, or take them on a walk,
(47:24):
or and you continue to use these non confrontational techniques,
because when a person has a memory impairment, what I've
noticed is when they get agitated, they have a harder
time recovering, like settling back down. And so if you
(47:47):
repeatedly correct them and they continue to escalate, they have
a harder time coming down. So the goal would be
keep them calm and feeling because think about it. Think
about well, you wake up in the morning and you
don't know where you are, but it's been your home
for fifty years. How stressed your nervous system would be?
How did I get there? Where am I? Who am I? Like?
(48:10):
You know, I had a son walk in to see
his mother and the mother thought it was her husband.
Oh oh yeah, and he knew enough, he knew enough
to play along and then he called me crying, you know,
(48:31):
like so and the other The other suggestion I would
you know by the book The thirty six Hour Day,
probably the first book that was ever written. Yeah, meet
a couple people. You don't have to meet an army,
but meet a couple people that are taking care of
somebody with a memory impairment, so that you have a comrade,
(48:55):
you've got somebody you can call and go, Well, let
me tell you what I did that with my dad.
I called my buddy. I'd say, you will never believe
what my dad said today. Just it's just shocking. She
could hear me on a deeper level than someone you
had never taken care of their parents. When I told
her what my dad did, it was kind of like shocking.
(49:16):
And my other friends would have been, oh my god,
are you going to put him in the hospital? Oh,
you know, and my other.
Speaker 3 (49:21):
Girlfriend, I'm just telling them right with anything right not,
I'm just right.
Speaker 2 (49:32):
And then you have the moving target of grief, like
they're there, you love them, they remember you, and then
they don't, and then you have it's ambiguous loss. It's
it's a really weird grief because you leave when you're sad.
They're physically there, they don't remember you, but they haven't died,
(49:55):
and then a complicated emotion of thinking I wish they
would die.
Speaker 1 (50:00):
I know. It's terrible.
Speaker 2 (50:02):
It's a very real thing, and people need to say it.
Not that they're going to go out and you know,
euthanize their dad, but you need to say those things
because it is stressful and you're in deep grief, but
they're not gone yet.
Speaker 1 (50:21):
Yes, yes, you are all of those things. Amy, give
us a story. What is your best story when you
think of what you've done over the years and all
of the people you've helped successfully and who love you
for what you've done for them, what's one or two
stories that really comes to mind.
Speaker 2 (50:40):
Well? I had one one where I had two sons
who said, we'll take you to the house, but mom's
not going to let you help her. She's just not
going to let you help her. So I walked in
the house at the time, months and this woman had
a memory impairment, and she's very entitled, and she had
a reason to be. She had a lot of money,
(51:01):
you know. And I walked in and she said, what
the hell are you doing here? Get out of my house. Okay,
So I left. I went around the back door. I
came in the back door, walked in a gang because
you never know, a memory impairment.
Speaker 1 (51:18):
Okay, man.
Speaker 2 (51:19):
She looked at me, she said, thank god you're here.
That other woman was a bitch, Oh my gosh, and
she let me in.
Speaker 1 (51:29):
Oh my gosh.
Speaker 2 (51:30):
Right right, and the suns had been all tensed up,
and they walked out the front porch and just like
everything in them let go, and the mother and I
bonded and we were able to care for her, I
want to say, for eight years in her home.
Speaker 1 (51:48):
Oh my goodness.
Speaker 2 (51:50):
Right, so people think, oh, you'll never get in the house,
which most of the time people say you'll never get in. Well,
that's what we do for It's like telling the plumber
my toilet's broken, you'll never be able to fix it,
like no, no. And the other one, the other one
was a woman in a skilled nursing facility was dying
(52:16):
and the staff hadn't told the daughter that she was dying.
And I called the daughter and I said, can you
meet me this afternoon at your mom's room? And I
talked to her about where her mother was. And she
was a big lawyer and the daughter had, you know,
(52:37):
busy schedule, and I said, I don't know how important
this will be for you, but if your mother dies
and you're working, if you're going to be okay with that,
keep working, But if you're not, I would want you
to be here. And she canceled her appointments. She sat
with her mother and she was with her when she died.
(53:01):
And you know, I have a lot of them. When
you say, just tell me a couple stories. I got
a boatload. Oh, I'm sure you do. It's powerful. It's
powerful to be able to professionally see something help a
family member see it also. And then the daughter asked
me later, why did the nursing home tell me that's
not their training?
Speaker 1 (53:24):
Yeah, no it's not, it's not.
Speaker 2 (53:28):
Amy.
Speaker 1 (53:28):
Thank you. We need to have you come back again.
I hope that you please will do that. As conversation
has been heartfelt and deeply important to so many of us.
They're going through this every day and facing it or
think we're about to. Your insights have helped us lift
the fog that so many families live in when they
enter the fragile years or are already in them. Reminded
(53:52):
us the importance of preparation and that love can be
shown in practical ways, and that aging, even when it's hard,
can still be full of meaning and connection. Thank you
so very much. Until the next time, we ask our
listeners to be sure to stay curious, stay compassionate, and
remember you are never too old. It's never too late
(54:14):
to live a life that is always ageless. Thank you, Amy,
Cameron or Rourke.
Speaker 2 (54:19):
Thank you Valerie
Welcome to another episode of Always Ageless, where we believe
that growing older is not about decline, but it's about
living fully, with purpose, dignity, and definitely with joy. Today's
guest is someone whose work has impacted thousands of families
who are navigating like we are one of life's most
emotional and challenging seasons. Amy Cameron o Rourke is a
(00:45):
nationally respected advocate, author, and care manager who brings not
only decades of professional experience, but also an incredible depth
of heart. When I first started the show, so I
hoped that someday she would be my guest, and so
this is really a special day for me as well,
(01:07):
and I'm so happy to bring her to you, my
listeners and my viewers. Her book, The Fragile Years. The
Fragile Years, Proven Strategies for the care and of aging
loved Ones is a guide that I believe every family
should have on hand. We all need one. In it,
she combines wisdom, clarity, and grace to out families like
(01:30):
ours make thoughtful, loving decisions in the face of uncertainty,
and goodness knows, there's plenty of that. So whether you're
an older adult yourself or the adult child of someone
aging or like some of us, you're both of those things.
Today's conversation will open your heart and give you tools
that you can actually use. So let's begin, Amy Karen o'burke,
(01:53):
welcome sincerely to always ageless Valerie.
Speaker 2 (01:58):
Thank you for having me.
Speaker 1 (02:00):
You are so welcome. There's so much that we can
talk about today, and we got a little bit. We
cheated a little bit ahead of time and talked a
little bit already. But let's talk about what is What
is the fragile years? What does that term really mean?
Speaker 2 (02:15):
What it really means is the fragile years is a stage.
It's a stage like being pregnant, terrible twos, menopause, midlife
crisis is a stage. It's a recognizable stage, but it's
an unknown stage, and it's for older adults usually. And
keep in mind I talk in the bell curve, acknowledging
that there are ninety year old and one hundred and
(02:36):
five year olds out there that are breaking the Bell curve.
But for the most part, in your eighties, there's three
to five years of what I call fragility, and you
can see it if you know what to look for.
And so what I like people to do is just observe.
(02:56):
If you have a family member or a friend or
somebody in your world, just observe and there might be
an event. There might be like a car wreck or
a hospital stay or something, but there might not be.
There might just be what I call the slowing down period,
and you can think about what a person normally does.
Like my mother in law plays bridge three times a
(03:16):
week now, if she goes to playing bridge one time
a week now she's ninety, I'm gonna I'm gonna log that,
not that I'm gonna do anything, but I'm gonna log
that she stopped driving at night. Okay, that's not a
big deal. But if she starts not going to water aerobics, Oh,
that would be a bit. Yeah, that would be. So
(03:39):
in your world with your person or persons you're looking at,
are they slowing down pace of walk, pace of eating,
pace of drinking? And for those years, I like to
say less is more like you know, there's there's incidences
and I've I've had this happen where you know, the
(04:02):
adult daughter comes in and dad's fallen and broken his hip.
That's his event, and he's in the fragile years and
she's fixated on getting him back home and back to normal.
And what I like to explain to people is that
you don't want to be disconnected from the stage that
they're in. Meaning Dad's broken a hip. He's going to
(04:25):
get better, perhaps perhaps not, but he's not going to
be where he was before, more than likely. And keep
in mind there are people that break them, but more
than likely he's not going to return. So there's a
pressure you can take off yourself if you're taking care
of someone, to stop pressuring yourself to get them back
to the way they were, help them, support them, and
(04:47):
see where they land and be with them in that
new stage and see how they go from there.
Speaker 1 (04:56):
Their new reality, so to speak.
Speaker 2 (04:57):
The new reality. Yeah, you kind of got to re
set and in this stage. And Valarie, this is why
I wrote the book. This is literally why I wrote
the book. I had family member after family member come
in front of me and they're shocked, surprised, blindsided. They're
(05:18):
looking at me like I cannot believe this is happening
to my mother. And I heard that over and over.
And I had a lawyer friend of mine and she said,
you got to write a book, You got to put
this on paper because people are coming in they're shocked
and you're not. And that was that was my reality.
I thought, how do you not know this? And so
(05:38):
I wrote the book to help people understand. You know,
we're talking more and more about menopause, which I think
is fantastic. The more we talk about it, the more
we're ready for it. It's the same with the fragile years.
Speaker 1 (05:50):
I think that we talk about this, some of our
colleagues and our morning call talk about this that we
don't know what we don't know. And I've said this
so often and talk about it so much that especially
for those of us who are the adult children of
aging parents, which we can talk about again and talk
(06:12):
about for hours, but we don't know, we don't know
what to expect, we don't know how long they're going
to live, like, we don't know that this is their
new reality. And people will say often well, and have said,
you know, once they go to the hospital for something,
then that changes everything. Well did that change it or
was it going to change anywhere or did it already change?
(06:33):
And that just one thing proves that they were in
that new stage right right.
Speaker 2 (06:40):
And what I would say to you is the way
you express that Valerie like talking about what you don't know.
The biggest thing that stops people from doing well in
the stage is ego, a lack of humility. Really yeah,
Like people people used to ask me when I ran
(07:01):
this company care management company. They would say, who's your competitor?
And I said, it's the family member that thinks they
know what they're doing, you know what I mean? Like,
they think they're know what they're doing, and it's nothing
wrong with that, but they don't kind of let down
their guard, open themselves up and ask questions to say,
what do I need to know here? What I'm seeing
on my end? You say, hospitals stay, I see Medicare,
(07:24):
Medicare advantage, pharmacy changes, going to the rehab, going to
hospital rehab, all those healthcare systems and financial systems that
a family member has to understand to make good decisions
for their family member fast. Everybody in the healthcare system
is pushing hard and fast, and I like to help
(07:46):
people slow that decision making down so that they can
make a thoughtful, prepared decision for their family member.
Speaker 1 (07:55):
I think, and I've talked with our friend Catherine about this.
We talk about doing community workshops and information and knowledge
and education for the aging adult, for the older people
people might I don't know about yours, yet I almost
think that there should be the same amount of education
(08:19):
focused on the people who are the adult child of
the aging parent.
Speaker 2 (08:23):
One hundred percent when I talked about classes for them,
exactly exactly, because there's two different audiences. When I talked
to I went to a retirement center. The guy that
led the workshop was on the fragile years. He's ninety two,
minister lovely man. I loved this man. We had almost
(08:44):
one hundred people attend the event. They were all older adults,
none of the family members, and I didn't know that
they would be as interested as they were. They bought
a ton of my books and they gave it to
their family members, And so it was again a reminder
that you know, it's education for the older adult. How
do I tell my children what I want? How do
(09:05):
I do that? And when I can't talk for myself,
what should I do to let them know it's okay
for me not to have that surgery? For example? It
really has two separate audiences.
Speaker 1 (09:16):
It is it is and I so our friend Catherine says, yes,
but will they come to those educational events. They may
not come to the first one, but I think eventually
we all. If I knew I was going to be
in a room of us, we all have the same question.
I would want to know that you met a lady
(09:37):
and maybe in Florida who made the movie Wine, Women
and Dementia and her which we're going to bring to
Orange County to a private theater here and show it
at the first of November. And her her movie is
about the children and what they went through. She didn't
interview the parents. She interviewed the children and what were
(09:58):
we going through and the questions that they had and
the fragile years. Should be a manual four it is.
It should be looked at as a manual for us
as well as for our aging parents.
Speaker 2 (10:12):
That's right, that's right. And the thing for me, I
had a daughter working with her mother. Mother's ninety four,
and I was at the house and she was one
of those ninety four year old that had the cold
bottle glasses and their really curly kind of blue hair
and cute. She was so cute, she was so cute.
(10:33):
She's sitting on the couch with me and the daughter's
running around, running around like you know a frantic daughter does.
And the mother looks at me and she says, I'm
ready to go. And I said, does your daughter know?
And she says, I'm trying to tell her. I try
(10:53):
to tell her, And so I asked the daughter to
come over and she sat down, and all that tightness
and stress and control anxiety. I asked her to just
listen to her mother, that her mother had some things
to say, and the daughter was able to hear where
the mother was, so all the decisions for the next
(11:16):
three years were easy because she had that conversation with
her mother about let me be where I am. Just
let me be where I am, And there's some meaning
if you can get past the grief and the denial
and listen. There's nothing more heartbreaking than watching your parent decline.
I mean, there's a lot of things more painful than that,
(11:37):
but it's really painful, very sad. I turned my head
many many times taking care of my dad and my mother.
I had to turn away, like to just cry so
they couldn't see. And that there's grief and people don't
really bring that to the forefront because they think they
haven't died, so they're not in grief.
Speaker 1 (11:59):
And sometimes you learn things afterwards. My dad, we took
my dad to a board and care home because he
was kicked out at a hospital and then he was
kicked out of the now they're home skilled nursing, not
kicked out, but because it was his time was up there,
we had to put him in a board and care
and and I took him there, and I remember when
(12:20):
I willed him in and he said, is this a house?
And I thought he's getting really old with ninety nine.
But after he passed away, then we realized it couldn't
see and we didn't know it. And so so many things.
There's so many things about discovery, you know, that we
need to watch out for. So you've talked about let's
get back to the book book and you we've talked
(12:41):
about some things that when your loved one slows down.
Are there any other things that identify the fragile years?
You say it's when they're about eighty. Is that because
something happens to the body about that time.
Speaker 2 (12:57):
Well, it's in your eighties, eighty one, might be eighty five,
somewhere in your eighties. I think our life expectancy kind
of drives that, you know, our life expectancy. There's a
lot more women that are retired than men. We outlive
the guys. So when we're talking about, you know, people
in their fragile years, there's a lot more women than men.
(13:18):
And what indicates that is the the slowing down and
then the need for help and the resistance to help.
So and it's always there and it's normal to be there,
(13:40):
and they're the common conversation is my mother, my aunt,
my grandmother won't take the help. And from the family member,
they want eight hours a day right from the get go,
or they want to move them too, assisted living right
from the get go. But needing help should start in
the fragile years with something very very small, almost meaningless.
(14:05):
And you'll know what that would be by observing the
person that you're concerned about and seeing where they might
accept help in asking them is picking up your mail?
Is that something you'd want me to do? You know?
Is there do you see a need at all for
me to have a housekeeper come in every other month?
(14:28):
Like just open ended questions and if they say no,
that's the answer, you're not you can't. You're not going
to have a one and done. You're not gonna have
one conversation and they're going to take the help right away,
because because from the older person's perspective, once I accept help,
it's the beginning of the end.
Speaker 1 (14:45):
Right So that's my question to you is does you
know we teach our kids. You know, someone says no,
they mean no. But when your moms is ninety and
she says no, does she mean no?
Speaker 2 (14:55):
Does she mean what? Does she mean? No?
Speaker 1 (14:58):
I can handle it, but I wouldn't mind if I
had some help? How do you follow that?
Speaker 2 (15:05):
What I like to advise help people do is ask
really open ended questions and spend time connecting emotionally. Because
what might work for my mother is not going to
work for your mother. So you have to be really
emotionally open and in tune with yourself one and you're
(15:27):
asking yourself, do I have an outcome in mind? Do
I want to relieve my stress? Am I preparing? If
they get help, then I'm going to feel better? Like
what are your motives? And get cleared that you're only
wanting to offer help. And then you have a person
that's really clear they say no, they mean no. Then
you have the older adult that's a little muddled, maybe
(15:47):
a little impaired judgment. And then you know, I say,
try a few things. You know, maybe you put down
a meat loaf and broccoli dinner. Maybe maybe it's just
maybe you go over and you eat with them once
a week. Maybe you empty out garbage while you're there.
Maybe so you're gonna just experiment with different ways to
be involved without doing a frontal attack with you need
(16:10):
four hours a day, you know, seven days a week.
Speaker 1 (16:15):
Okay, all right? And then and I'm kind of wandering around,
but I think these are important issues, and what do
you do if you're not there. I'm in California and
this isn't the case, but and my mom lives in Minnesota.
What about those kids? What about those loved ones? And
(16:37):
just we just don't know how to handle this. Do
we put cameras in their home? I mean, how can
we care for our loved ones when we're not there?
Speaker 2 (16:47):
So I would re remiss if I didn't bring up
the concept of role reversal. And one thing I would
recommend you not do is start talking to you parents,
to your parent or your family member that's long distance,
as if they're a child and they need to do
what you recommend doing. That will be a failure, and
(17:09):
people do it because they don't know how else to act.
So really, what you're trying to establish with a long
distance person is collaboration, working together and then involving them
in where you are. And what's reality is what do
I do in case of an emergency? Who do I call?
(17:30):
Who are your friends? Have you been visiting? And if
you've not been visiting, you need to be visiting. There's
a book out there it's called My Mother, Your Mother.
It was written in eight by doctor Dennis McCullough, and
he talks about the seventy two hour visit and making
sure and I know I'm People that are listening are
(17:51):
like my dad and I never got along. I'm not
flying how HIGHO to see him? You know? So, But
ideally you would visit without having an outcome in mind,
because if you only fly in when you're needed, they
think you're coming in because it's the beginning of the end. Oh,
they think I'm going to die and then they shut down.
So if you kind of planned all along, you're visiting,
(18:14):
you're calling, you have a and then you're meeting people
that they know. You can hire a care manager, you
can go on the website aginglifecare dot org. You know,
for some people they can't afford it. If you can,
that's a great way to have a boots on the ground,
if you will, in the city that your family member
lives in. But you want to start establishing a communication
(18:36):
that says, how if you become unable to speak for yourself,
how do you want me to handle you and your affairs?
What best way? Like include them in that conversation. You know,
give me your idea, give me your vision, give me
your best case scenario so I can know you deeply
(18:58):
regards to your healthcare and not make as many mistakes
as I might make under stress.
Speaker 1 (19:04):
And I read something in your book. I mean I
read something in your book a case where someone took
care of their mom or their mother in law and
they weren't that close to them, but you thought that
it was really gracious how they handled it because it
was the right thing to do, and they cared for
their loved one even though they didn't have a close relationship.
(19:26):
And I think of this that maybe you can just
go to them, would you say, Look, you know, I
just want to know how to help you if there
is an emergency, if there's an event or sometime comes,
I just want you to know that I care enough
about you that I'm here for you. And I thought
that was a great story.
Speaker 2 (19:47):
It is because you know, I meet people that say,
my parents and I we didn't have a good relationship.
They weren't that great to me. And I've had family
members say that to me and it helps so much
to clear the air so that I have expectations that
are in reality. And I think those are the unsung heroes,
like wow, you go to bat for your parent when
(20:10):
they weren't there for you. But that's you know, that
takes a lot of depth emotionally.
Speaker 1 (20:16):
It does. It does, but they're your family and family
is family, and that's a whole another story, whole, another story,
I'm sure, So you tell us. Let's take a minute
to talk about what is a care manager? I think
because a lot of people don't know, and I think
that's a relatively new position, is it not?
Speaker 2 (20:39):
The aging life Yeah, the aging life care manager aginglifecare
dot org. The profession is forty years old. People don't
know about it because people don't know what they don't know.
They don't know that there's a profession out there that
helps people. And I like to think have people think
about this time of life. You need three legged stool
is healthcare manager, a lawyer, and the finances and those
(21:03):
three things have to be worked through in order to
accommodate the goals and the needs of the older person.
So a care manager, a certified care manager and they
know you go on the website and see them. You
want to make sure they're certified, and they'll have a
CMC or a CCM after their name. They will have
(21:25):
a bachelor's degree or a master's degree, and they will
be certified, which means that they have had supervision either
two years for a bachelor's one year for a master's,
and they've taken a certification exam, which means that they
know what you want them to know to help your
(21:46):
family member. And in addition to that, in their profile,
they will list the things that they're good at. You
can have an RN who's a care manager. You're going
to have a social worker that's a care manager. Well,
my mother and she was met complex. I wanted a
nurse care manager. Okay, okay, okay. If I was just
(22:07):
trying to find a place for my mother to live,
maybe I'm looking at a continue the aging life care community.
Maybe I'm looking maybe I want my mother's long term
care insurance. Looked at well, social worker they can do that.
Our nurse can do it also, But look at what
they say they're good at, and call and get an
idea of how they work.
Speaker 1 (22:28):
And so a care manager is someone who they would
handle everything. They would kind of be your your estate manager,
so to speak. Is that a kind of a good term.
Speaker 2 (22:42):
It's close, it's close ballery, and the way you're grappling
with is very very normal because really the way it
works is the care manager meets the person and then
they will outline ways that they can help. And what
I like to do is work with the family members
on what they wanted me to do and what they
were going to do. We work on a budget. So
(23:05):
let's say mom was at home and we needed home
care and the family didn't think that she was getting
a good diagnosis. So going to the doctor, interfacing with
the doctor, making sure that all the specialists were talking
to each other, make sure that the medication was known
by all, and then if they went to the hospital,
we would agree, do you want me to go to
the hospital, Do you want me to run interference at
(23:27):
the hospital. Do you want to go and use me
as your coach on the side. Do you want me
to supervise the care. Do you want me to find
equipment to make it easier for your mother to get
a bath? Do you want me to train the aide
in dementia if there's a memory impairment and your mom's
acting a little weird, so you tailor make the plan
based on the budget and based on your need. If
(23:51):
you're working full time and you can handle the nights,
maybe it's the daytime that you need to help and
going to all these appointments.
Speaker 1 (23:59):
Let me ask you a question of the people who
hire you, how many of them are local to their
loved ones versus far away from their loved ones.
Speaker 2 (24:07):
I'm going to say fifty percent.
Speaker 1 (24:10):
Really, Yeah, So people hire you even though they're close by.
Speaker 2 (24:14):
Even though they're close by because they're working full time,
or they're taking care of their own children.
Speaker 1 (24:20):
Yeah, yeah, or all of those things.
Speaker 2 (24:23):
Yeah.
Speaker 1 (24:24):
Sure. One of the things I have felt was really
important isn't isn't just a plain old advocate? And I
think it first came to mind and I read it
in your book. Is in the medical situation and advocate
at the hospital and advocate with their medication, an advocate
(24:44):
if you put them in assistant living or even in
a boarding care home. I wish I'd had an advocate
for my dad because I somebody said, okay, we're going
to do this. I didn't know if that was okay
or not. Somebody called me from the hospital and said,
we're discharging him this afternoon. What am I going to
do with them? I wish I'd had an advocate.
Speaker 2 (25:06):
Valor, your honesty is so refreshing, and that's the most
satisfying part of the job of a care manager, advocate,
whatever you want to call us, is when you're in
the hospital, there's techniques that you can use to keep
them in the hospital, and there's techniques that you can
use to get them out of the hospital. There's techniques
to slow down a discharge. There's techniques that you know
(25:29):
will help you land in the right rehab facility. There's
techniques to prevent a crisis. There's language that can be used,
you know with the hospital. There one get them out,
get them out, get them out, which happens all the time.
And if you said something like I want to I
want to have a discharge that results in him not returning,
because hospitals get penalized if you return within thirty days.
(25:52):
And the conversation becomes, we're working together to prevent a return,
and we've also got you know, if you appeal the discharge,
you've got you've bought seventy two hours to figure out
what you want to do. The four o'clock eight o'clock
discharge on a Friday afternoon. I don't like I don't
like admissions on a weekend anywhere. And I'll say something negative,
(26:15):
and I only say it because I'd like something to change.
Each individual healthcare system assisted living, hospital, nursing home, rehab center,
hospital rehab. They're all silos or compartments, and they don't
talk to each other, and then they all have their
own dysfunction. And so you're in one system and then
(26:36):
you jump over to the next system. You just got
where you kind of understood the language, and then you're
in a brand new environment and then you got to
know that the financial systems. Well, if you're being bombarded,
but you have time, and you have an advocate that
can you can call and say, this is what they said.
Is that right? You know, can they do that? And
(26:57):
we can be your professional courage if you will, to
have those conversations that will put you more in the
driver's seat instead of being in that reaction reactionary state.
Speaker 1 (27:11):
And that's kind of how most of us are. We
just I'd like to have somebody I can call and say, okay,
even if I just did they just said, this, is
that right? And then if you say yes, that's right,
I'd say, okay, fine, I'm good with that, right. And
you know, and look, I'm in I've been in real
estate my whole life, so I understand, and I think
that people should trust me for my knowledge. If someone
(27:32):
says this should be happening, this should happen, I can
say no, no, no, we're not going to do it that way,
or we don't have to, or we should or we shouldn't.
And so I respect that, and I respect that in professionals,
we hire attorneys for those reasons, and actually we hire
doctors for those reasons. But if you're in the hospital
and one person gives you a medication, you don't know
whether that's a good thing or not, or if they
(27:54):
even look to see what you're already taking, right, And
they only have. Everybody has their own interests, right, they
have their own roles in the hospital, but they have
their own responsibility. My job is to discharge this person
because we need the bet right right, something like.
Speaker 2 (28:11):
That, exactly exactly, And I guess, I guess the most
important thing to me is you know when you say
the lawyer, think about doing your taxes on your own,
think about suing someone on your own. Yeah, that's how
(28:33):
I feel when someone says, oh, yeah, I've taken care
of my mother and they're not getting any help. That's
that's how I feel, like, Oh my gosh, they have
no idea. I had a son bragging to me about
being with his mother in the hospital nine times last year,
and I said, well, eight times too many? Like that
(28:56):
that's something might be bragging about. Like what is information?
Could you have had to have her? Who wants to
be in an ambulance every other week? Like you get
taken to the hospital. The hospital's like, you're here, so
you must want us to fix you. So we're gonna
do surgery, we're gonna do test. Well, if that's not
what you want, why are you going?
Speaker 1 (29:18):
Right? Even as simple as getting in the ambulance and
letting them tell you where they're going to take you, right.
Speaker 2 (29:27):
Yeah, And I don't know if this is nationwide, but
it probably is. An ambulance has a contract with a
county and they're required to take you to the nearest
receiving facility. People don't know that. But they also don't
know if you land at that hospital and you want
to be one to get transferred.
Speaker 1 (29:48):
Yeah, but they don't know that. They don't know that, right,
my dad would get an ambulance. I want to go
to Hope. Oh might not going to Hope today? Oh no,
I want to go to Hope. Well that's not an option.
And then he gets there, and then of course they can,
and then it's my I didn't know amy at the time,
so it became my problem. Let's talk about where people
should should live. You must have so many decisions to
(30:12):
help families with as far as assisted living, if it's
a memory care that's needed, should they live at home?
How do you even begin to tackle that discussion with
a family.
Speaker 2 (30:25):
So hopefully you start early, and a lot of times
you don't. You're in the middle of a crisis. So
I don't fault anybody for not doing this early. The
biggest thing that needs to be known is money. What's afforded?
What can you afford? The other thing is some emotional
discernment over your own risk tolerance, And by that I mean,
(30:50):
guess talk about that. I have a high risk tolerance.
And I had a lady you know, at home with
a memory impairment, and she never wandered at night, never,
so she had help during the day, but at night
she was on her own. Well, the power of attorney
was a little nervous, Nelly, And I said, I'm not nervous.
(31:13):
We can put care in there. But she's going to
be out of money at land in the nursing home.
But I can bet you we have alarms on the
door cameras. She's not going to leave that house and
she didn't for four years. So what's your risk tolerance?
What can you afford? And then this is a hard one.
But some people you know, have a hard and past.
(31:36):
Don't ever put me in a facility, will ever ever
do that? Well, I've seen people, particularly those with memory impairment,
they move into a community and they thrive because their
memory impairment is not You're not pressured to know things
that you don't know. It's your weird behavior of stealing
(31:58):
somebody's socks or somebody's somebody's dentures. That's normal. Like, no
one's pitching a fit over what you're doing. You know,
like it. And so the person with a memory pairment
can't say but they're relieved because they don't have that
pressure anymore.
Speaker 1 (32:13):
Interesting And I think they know that.
Speaker 2 (32:18):
I think emotionally they do. I absolutely do. And if
you think about it, and I'll use my dad, you know,
calling me twenty times to help them with his remote. Okay,
there's a common one. And I get laughs everywhere because
that somehow, that remote with older people, but particularly the
memory impairment, drives people crazy. Well, if you're in a
(32:41):
memory unit or memory care, nobody's gonna do anything about
a remote one. You won't be watching TV because you're
gonna be involved in something else. But you can. You
can tell your story over and over and over and
people aren't going to give you that exasperated look, like
can you imagine if you can't you're telling a story,
(33:02):
it's the first time. You think it's the first time,
and then you get a look from someone and you're
like hurt, your feelings are hurt or if someone if
there's an AID in the house and they've been trained
in memory, they're not gonna they're not gonna they're gonna
act like every single time they hear that story is
the first.
Speaker 1 (33:21):
Time, right, yeah, yes.
Speaker 2 (33:25):
And the other thing is you've got introverted personalities and
extroverted personalities. You've got people people and people that really
get their energy from being on their own alone, and
so you have to have a lot of emotional awareness
to say, dad can't afford home care at home, we're
(33:46):
gonna move them into a community. But tell the staff
don't bug him to go out to meals every day, Like,
don't bug him to go out because he's not gonna
do all those activities. He wants to be on his own.
So kind of help the staff learn your family member
so that they're not trying to get them to be
somebody that they're not. Well, he sits in his room
(34:08):
all day, Well he did that. He worked and went
home and set on his own all day.
Speaker 1 (34:14):
Right, So it's about managing expectations also exactly that's what
that's his normal. Then it's not going to change just
because he goes into assisted living. Right if he's in
a community. Let's say, for example, he's in a fifty
five plus community where they've got activities at the clubhouse,
but he never goes there. Probably in the assisted living,
he's not going to go there every minute just because
(34:35):
there's thirteen activities that afternoon. That's right, right, at least
maybe he'll work into it.
Speaker 2 (34:41):
But yeah, and you know, my dad used to say,
you know, I am never playing bingo. Don't put me
in one of those places. And you know, right, I mean,
if there's some common scenarios out there, well, when his
mind went just he was playing bingo with six cards,
having the time of his life. Sure, so you might
(35:02):
have one thought, but you got to be opened at
something might change.
Speaker 1 (35:07):
Right. Amy helped me with a question that so many,
I know so many of our viewers and listeners have,
is how do you make the decision between home care
and assisted living? Because if you have home care, you
can have somebody come three four or five mornings a
month or a week at three four hours a day.
(35:30):
But then and you mentioned this earlier, but then maybe
they fall at night, all right, and you can put
but that's not free. There's a cost to that. Or
you can put them in assisted living at maybe about
the same cost. How do families decide really what's the best.
Speaker 2 (35:49):
So there's a couple different strategies. The common rule of
thumb is when the person needs ten to twelve hours
a day at home, that's about assisted living costs.
Speaker 1 (36:02):
That's a comparison, right, right, So if you're deciding at
what point do we make the move, it's financially driven.
Speaker 2 (36:10):
If your budget is X amount of dollars per month,
you do it at home as long as you can
afford it. When you get to that ten to twelve hour,
then you make the change because you can't increase it, okay.
And the other factor is there are some people that
you can go four hour and there's a four hour minimum,
so you got to pay four hours on whatever the
going rate is in the state that you live in.
(36:32):
If you can give them four hours, maybe it's ten
to two, maybe it's nine to one, maybe it's one
to five, and they're fine the rest of the time,
that's great. That if they need four in the morning
and four at night, then you have the issue of
staff because people that are working part time are looking
for that full time job, so you have high turnover
(36:53):
with a part time worker. That's just normal. You're not
going to have, you know, Sally coming over three times
a weeket four hours a day and keep sally most
of the time. So that's another kind of practical consideration
is when do they need that help? And if they're
at risk at night and you do the ten hours
at night and they're fine during the day, then you're
(37:14):
going to look for evening care. Okay. Typically assisted living
is more affordable when you need twenty four within a
twenty four hour period of time, you need someone checking
in on you, and it could be the different time
during the day.
Speaker 1 (37:34):
But assisted living isn't isn't meant to be a place
where they're going to go and be given medical care either,
right the typical standard. Some of them are, but most
of them are not.
Speaker 2 (37:48):
Right.
Speaker 1 (37:48):
It's not a place where if you have isn't Is
it not true that if you have, if they need
medical care or medication, that that's an extra charger you
have to bring somebody else in to do some of
those things for them.
Speaker 2 (38:00):
You might not know how smart that question is, but
that's a really smart question, and that is I didn't know.
Speaker 1 (38:09):
Thank you very much.
Speaker 2 (38:11):
I feel very brilliant right now.
Speaker 1 (38:13):
Yeah, I'll feel brilliant when I know the answer.
Speaker 2 (38:18):
So, if you are person has a lot of medical diagnoses,
you want to make sure that there's a nurse on
staff in assisted living, because assisted living with no nurse
on staff and medically complex, and by medically complex, I
would say three chronic diagnoses or more, or a chronic
(38:42):
diagnosis that requires a lot of attention, like diabetes, you're
going to want to make sure. And the biggest flaw
in assisted living right now is they're selling medical care,
but they're providing a social model, so the expectation is
not met. Families move them in because they think they're
going to get that medical care. Well, a nurse might
(39:04):
have forty people and the person that's giving the medications
is a med tech and they might have six hours
of training. So and then I'll also add to that
assisted living or bored in care. I don't know what
the language might be different in everything, but assisted living
means that you need assist us with getting a bath
and getting dressed most of the time. If you need
(39:29):
skilled nursing care or nursing home care, you need total
help getting bathed and dressed. Using an example, of bathing.
You need to be wheeled into the bathroom. You need
to set down in the chair. Someone's got to, you know,
get you all wet, soap, you down, wash your hair,
and do everything that's skill nursing. And you cannot even
(39:51):
believe my dad's face the first time he got bathed
by somebody. Oh my god, he was terrified. He called,
he was terrified. You'll never never believe what happened to me.
This woman came in and like, oh my god, drag
me into you know, he was very dramatic, drag me
into the bathroom. But if you're in assisted living or
just assistant you're gonna be escorted to the bathroom and
(40:15):
maybe they help you sit down, maybe you use the
bar soap for the top part of your body, maybe
you get help with your hair. Like that's assisted.
Speaker 1 (40:22):
Care, the none so intimate part of it, right.
Speaker 2 (40:26):
Mine so intimate? Yeah, tell me.
Speaker 1 (40:33):
To tell me what it is about being a care
manager that gives you so much gratification, because I know
it does.
Speaker 2 (40:48):
Watchings people's anxiety go down and watching them cry with
relief that they're not alone. It's a very isolating experience
as being a caregiver it's very isolating, and if you
are in a world where no one else is taken
care of an older person, they don't really understand. You know.
(41:09):
It's kind of like talking about the birth of your
child to somebody who's never had a baby, Like they
don't get it. Like I don't have any empathy. I
don't have children. So watching that happen and then helping
people get connections, real emotional connections with their person because
(41:30):
they're not chronically running through their head everything they have
to do. I got to get the medication. I got
to pick up the medicine. I got to do their laundry,
got to label their laundry, I got to get in
the hot Like all that work can be divided up.
So when they go over and they've had a meaningful conversation,
or they've played bingo with their dad, which I did, like,
oh my god, watching that meaningful conversations the first time
(41:57):
a child says to me, I slept through the night.
Slept through the night. Or I gave a talk at
a university, and I hope I don't cry when I
relay this, but I gave a talk at a university.
When I was done, this woman literally ran up to
me crying that I'd helped her with her parents however
many years ago, and she never forgot it. And I
(42:20):
started crying because that's why I do what I do.
I'm touched by an older person just because they're vulnerable
and real and what you see is what you get.
But if it's not your mother, it's very different. So
it's it's that part is very gratifying to me. And
(42:42):
then and then seeing the older person, and I had
this said to me, can you get your can you
get my kids off my back? They're bugging me, they're
trying to control me. We want to make all my decisions.
You know, I had a woman pay me to help
(43:04):
her daughter stop bugging her.
Speaker 1 (43:06):
Oh gosh, yeah, how funny.
Speaker 2 (43:10):
I had explained with the daughter, like how much stress
she was causing. She just didn't know it, and she,
you know, I sent her to a therapist, oh you know,
like talk over some of these because she was acting
trying to do as much as she could because she
felt guilty. Oh. So, you know, helping people get clear
(43:30):
on emotional motivations and you know, letting their own emotional
issues get supported so that they're not bringing all that
into helping their parents in this new stage of life.
Speaker 1 (43:45):
Well, I now spend a fair amount of time out
visiting living communities and memory care communities, and then I
go home and tell my mom about it, just subtly
thinking that someday she might say, oh, could I go
with you and look at them? Right, which has not
yet happened. But she does call my sister and say, okay,
Valerie says, I'm moving to this one. She didn't even
(44:09):
tell me, she didn't even take me there. She's moving
me there just because I came back and said, oh,
I went to this really pretty assistant living community today, Mom,
you might like it. You should go look at it
with me. So she thinks, just as you're saying, right,
they think you've already made the decision for them.
Speaker 2 (44:26):
Yeah, because she's afraid, very afraid. She's very afraid, and
it's a very you know, it is a scary proposition.
What's going to happen to me? I'm at the end
in you know, one O five ninety. They don't know
when the end it's going to be, So they are
at the end.
Speaker 1 (44:43):
No, no, and we don't know either, so it's hard
for us to make the decision. My mom's doctor says,
it's not my decision to make, and God will decide
when that time is. In the meantime, I just keep
doing my job. Oh, that's destoried our house. I want
to just take a few minutes and talk about memory
and dementia because that's such a important topic to families
(45:06):
right now. What makes dementia or memory care really challenging?
The uncertainty? One day they're clear as about the next day,
they're not the repetition over and over and over. They're
asking the same thing they said. I didn't come and
(45:27):
see them, and I just.
Speaker 2 (45:28):
Left the low grade anxiety that they might put something
on the stove and forget to turn it off. Safety issues,
and then not really knowing the stages of dementia, you know, mild, moderate, severe, early, middle, late,
there's lots of other different stages. But and then how
(45:51):
do you communicate in a way that doesn't make the
conversation worse?
Speaker 1 (45:58):
Yes, I talk about that. Given some examples in your book,
and they're brilliant. I think let's talk about that.
Speaker 2 (46:04):
Well, let's just say that you know you've got an
accountant or an engineer who values accuracy. Those are the worst.
Those are the worst, you know what I mean?
Speaker 1 (46:18):
The artists have even in memory care, they're the worst.
Speaker 2 (46:21):
Do they know I'm not this person that the person
caring for them?
Speaker 1 (46:25):
Oh?
Speaker 2 (46:25):
Yes, okay, No, you want an account to be accurate.
But if you want to be accurate, you're talking to
somebody that a memory impairment. You got to give that
up because they're going to like, you didn't visit me,
and you want to say I was just there. Well,
that's going to escalate them.
Speaker 1 (46:41):
So how do you handle that?
Speaker 2 (46:43):
You change the subject, you read direct, you try to
start another conversation, or you say something very affirming, like
how much you care for them? And I just had
this memory of you the other day and can I
share it with you? And you know, kind of bring
them back to a positive experience, and they might bring
it up again. And this is what makes it so tiring.
(47:03):
How come you don't visit me? Right? How come you're
not here? I never see you anymore? And you continue
to do that same strategy or change the subject or ignore,
or you'd redirect or focus on painting a picture, or
play a game of cards, or take them on a walk,
(47:24):
or and you continue to use these non confrontational techniques,
because when a person has a memory impairment, what I've
noticed is when they get agitated, they have a harder
time recovering, like settling back down. And so if you
(47:47):
repeatedly correct them and they continue to escalate, they have
a harder time coming down. So the goal would be
keep them calm and feeling because think about it. Think
about well, you wake up in the morning and you
don't know where you are, but it's been your home
for fifty years. How stressed your nervous system would be?
How did I get there? Where am I? Who am I? Like?
(48:10):
You know, I had a son walk in to see
his mother and the mother thought it was her husband.
Oh oh yeah, and he knew enough, he knew enough
to play along and then he called me crying, you know,
(48:31):
like so and the other The other suggestion I would
you know by the book The thirty six Hour Day,
probably the first book that was ever written. Yeah, meet
a couple people. You don't have to meet an army,
but meet a couple people that are taking care of
somebody with a memory impairment, so that you have a comrade,
(48:55):
you've got somebody you can call and go, Well, let
me tell you what I did that with my dad.
I called my buddy. I'd say, you will never believe
what my dad said today. Just it's just shocking. She
could hear me on a deeper level than someone you
had never taken care of their parents. When I told
her what my dad did, it was kind of like shocking.
(49:16):
And my other friends would have been, oh my god,
are you going to put him in the hospital? Oh,
you know, and my other.
Speaker 3 (49:21):
Girlfriend, I'm just telling them right with anything right not,
I'm just right.
Speaker 2 (49:32):
And then you have the moving target of grief, like
they're there, you love them, they remember you, and then
they don't, and then you have it's ambiguous loss. It's
it's a really weird grief because you leave when you're sad.
They're physically there, they don't remember you, but they haven't died,
(49:55):
and then a complicated emotion of thinking I wish they
would die.
Speaker 1 (50:00):
I know. It's terrible.
Speaker 2 (50:02):
It's a very real thing, and people need to say it.
Not that they're going to go out and you know,
euthanize their dad, but you need to say those things
because it is stressful and you're in deep grief, but
they're not gone yet.
Speaker 1 (50:21):
Yes, yes, you are all of those things. Amy, give
us a story. What is your best story when you
think of what you've done over the years and all
of the people you've helped successfully and who love you
for what you've done for them, what's one or two
stories that really comes to mind.
Speaker 2 (50:40):
Well? I had one one where I had two sons
who said, we'll take you to the house, but mom's
not going to let you help her. She's just not
going to let you help her. So I walked in
the house at the time, months and this woman had
a memory impairment, and she's very entitled, and she had
a reason to be. She had a lot of money,
(51:01):
you know. And I walked in and she said, what
the hell are you doing here? Get out of my house. Okay,
So I left. I went around the back door. I
came in the back door, walked in a gang because
you never know, a memory impairment.
Speaker 1 (51:18):
Okay, man.
Speaker 2 (51:19):
She looked at me, she said, thank god you're here.
That other woman was a bitch, Oh my gosh, and
she let me in.
Speaker 1 (51:29):
Oh my gosh.
Speaker 2 (51:30):
Right right, and the suns had been all tensed up,
and they walked out the front porch and just like
everything in them let go, and the mother and I
bonded and we were able to care for her, I
want to say, for eight years in her home.
Speaker 1 (51:48):
Oh my goodness.
Speaker 2 (51:50):
Right, so people think, oh, you'll never get in the house,
which most of the time people say you'll never get in. Well,
that's what we do for It's like telling the plumber
my toilet's broken, you'll never be able to fix it,
like no, no. And the other one, the other one
was a woman in a skilled nursing facility was dying
(52:16):
and the staff hadn't told the daughter that she was dying.
And I called the daughter and I said, can you
meet me this afternoon at your mom's room? And I
talked to her about where her mother was. And she
was a big lawyer and the daughter had, you know,
(52:37):
busy schedule, and I said, I don't know how important
this will be for you, but if your mother dies
and you're working, if you're going to be okay with that,
keep working, But if you're not, I would want you
to be here. And she canceled her appointments. She sat
with her mother and she was with her when she died.
(53:01):
And you know, I have a lot of them. When
you say, just tell me a couple stories. I got
a boatload. Oh, I'm sure you do. It's powerful. It's
powerful to be able to professionally see something help a
family member see it also. And then the daughter asked
me later, why did the nursing home tell me that's
not their training?
Speaker 1 (53:24):
Yeah, no it's not, it's not.
Speaker 2 (53:28):
Amy.
Speaker 1 (53:28):
Thank you. We need to have you come back again.
I hope that you please will do that. As conversation
has been heartfelt and deeply important to so many of us.
They're going through this every day and facing it or
think we're about to. Your insights have helped us lift
the fog that so many families live in when they
enter the fragile years or are already in them. Reminded
(53:52):
us the importance of preparation and that love can be
shown in practical ways, and that aging, even when it's hard,
can still be full of meaning and connection. Thank you
so very much. Until the next time, we ask our
listeners to be sure to stay curious, stay compassionate, and
remember you are never too old. It's never too late
(54:14):
to live a life that is always ageless. Thank you, Amy,
Cameron or Rourke.
Speaker 2 (54:19):
Thank you Valerie
Popular Podcasts
New Heights with Jason & Travis Kelce
Football’s funniest family duo — Jason Kelce of the Philadelphia Eagles and Travis Kelce of the Kansas City Chiefs — team up to provide next-level access to life in the league as it unfolds. The two brothers and Super Bowl champions drop weekly insights about the weekly slate of games and share their INSIDE perspectives on trending NFL news and sports headlines. They also endlessly rag on each other as brothers do, chat the latest in pop culture and welcome some very popular and well-known friends to chat with them. Check out new episodes every Wednesday. Follow New Heights on the Wondery App, YouTube or wherever you get your podcasts. You can listen to new episodes early and ad-free, and get exclusive content on Wondery+. Join Wondery+ in the Wondery App, Apple Podcasts or Spotify. And join our new membership for a unique fan experience by going to the New Heights YouTube channel now!
Dateline NBC
Current and classic episodes, featuring compelling true-crime mysteries, powerful documentaries and in-depth investigations. Follow now to get the latest episodes of Dateline NBC completely free, or subscribe to Dateline Premium for ad-free listening and exclusive bonus content: DatelinePremium.com
24/7 News: The Latest
The latest news in 4 minutes updated every hour, every day.