Latest / The Retirement Navigator / Episode 9: Dementia Warning Signs to Watch for the Next Time You Visit a Parent

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Episode 9: Dementia Warning Signs to Watch for the Next Time You Visit a Parent · The Retirement Navigator

0:00
SPEAKER_02: Welcome to Retirement Navigator, the podcast for adults 55 and above who are ready to make their next chapter their best one.
0:08
SPEAKER_02: I am your host Kwame Kwade, co-founder of Next Chapter Media and Adjunct Professor of Finance at Johns Hopkins University, Kerry Business School.
0:18
SPEAKER_02: Joining me today is Gina Negri.
0:20
SPEAKER_02: Gina is a clinician and trained nurse practitioner specializing in elder care with more than three decades of experience supporting older adults across the continuum of care.
0:33
SPEAKER_02: Her career expans bedside nursing, nurse practitioner practice, leadership in long-term care, quality management, and home care operations, giving her a uniquely broad perspective on aging and caregiving.
0:50
SPEAKER_02: Today, she advises and advocates for families navigating the complexities of dementia care, aging in place, and long-term care decisions.
1:00
SPEAKER_02: Gina is passionate about helping families prepare, ask the right questions, and make informed choices before a crisis happens.
1:10
SPEAKER_02: We are excited to have her today to share her insight on caregiving, memory care, and what families need to know as they plan for the road ahead.
1:35
SPEAKER_00: Hi Kwame, thank you.
1:37
SPEAKER_00: Thank you for the invitation.
1:38
SPEAKER_00: Thanks for having me.
1:40
SPEAKER_02: So out of the gate, you and I know each other from our membership of the Entrepreneurs Organization, and it's been a while since I have seen you.
1:48
SPEAKER_02: So, you know, I know that you are um a clinician, a nurse practitioner, and your journey has taken you in many, many uh directions, and now you are um where you are now.
2:02
SPEAKER_02: So, can you walk us through you know what made you land where you are with being a patient advocate right now?
2:11
SPEAKER_00: Well, well, I've had a really interesting for healthcare.
2:17
SPEAKER_00: I like to say that I studied in healthcare since I was about 14, 16 years old, if you believe that.
2:25
SPEAKER_00: When everyone was babysitting children, I was um sitting uh older adults, and that's how I actually entered into healthcare.
2:36
SPEAKER_00: Interestingly enough, when I went to college, I graduated with a sociology degree.
2:41
SPEAKER_00: I studied demographics and entered health care as a hospital administrator.
2:49
SPEAKER_00: Uh, however, it was the time when they were changing from a per diemel way of paying care to uh a more managed care.
3:00
SPEAKER_00: And uh it appeared that the nurses were more knowledgeable.
3:04
SPEAKER_00: And as an administrator, I felt lacking by not having the knowledge that the nurses had, and I enrolled into nursing school, so yes, so nursing is my second baccalaureate degree, and um I tell you it was a calling because being at the bedside made me feel I touched people, and that's really what uh is and I abandoned um administration for a while because I enjoy being a bedside nurse so much.
3:42
SPEAKER_00: I worked um in oncology uh as high as bone marrow transplantation, which is the uh borderline of life and death sometimes for for some patients.
3:55
SPEAKER_00: Um then I went on, I became a nurse practitioner, uh, being in the community, working in primary care, uh, I which I also enjoyed uh very much.
4:08
SPEAKER_00: Uh I worked in long-term care.
4:11
SPEAKER_00: One to keep patients from having to be hospitalized.
4:17
SPEAKER_00: So if you had uh a little problem with pneumonia or uh a UTI, we would keep them in a nursing um home and cared for them uh that way.
4:29
SPEAKER_00: But when some of my patients were discharged, they would return.
4:34
SPEAKER_00: And the problem was um when they got home, families were not prepared.
4:42
SPEAKER_00: So um that gave me some thought.
4:45
SPEAKER_00: Um, so being in oncology was an issue, seeing people dying and not being able to be with their loved ones.
4:53
SPEAKER_00: Then as a nurse practitioner, I saw that people were very confused when they got home.
4:58
SPEAKER_00: I was also director of nursing in a long-term care facility, and same issues.
5:04
SPEAKER_00: I was in utilization management, quality management, which was um in terms of monitoring care, the quality of care that we delivered.
5:15
SPEAKER_00: Um, and then I went on to become a home care agency owner because I saw what the need was to be in the home.
5:27
SPEAKER_00: You really had to be in the community to make a difference um to in people's lives.
5:33
SPEAKER_00: Right.
5:34
SPEAKER_00: I I really enjoyed it.
5:35
SPEAKER_00: And now with uh dementia care, which is really we're almost at an epidemic with uh such a large amount of people being affected, we're looking at six to seven million worldwide in the next few years, and families are in great need of our services.
5:57
SPEAKER_00: They really need to understand what the healthcare continuum is all about.
6:03
SPEAKER_00: So that's who I am.
6:05
SPEAKER_00: Now I wanna it's a long-winded answer, but that's the no no no you you actually gave me a lot, a lot.
6:12
SPEAKER_02: Um I wanna I want to touch on your entrepreneurial journey a little bit because I mean you and I met because we're both entrepreneurs and and and our path crossed then, and you mentioned that you were um a home care agency owner.
6:25
SPEAKER_02: Can you talk a little bit about how that has shaped where you have landed now?
6:33
SPEAKER_00: Well, believe it or not, I was a home agency owner for 17 years.
6:38
SPEAKER_00: It was a long time.
6:39
SPEAKER_00: Yeah, it was a long time.
6:41
SPEAKER_00: The time really grew very quickly.
6:44
SPEAKER_01: Right.
6:44
SPEAKER_00: Um, well, because even as an agency owner, I took, I worked with clients who needed my services in terms of care coordination um and care management.
6:58
SPEAKER_00: I would go in, I would teach them about medication, I would um make sure the medications from uh the nursing home or from the hospital when they're discharged, uh, which is something we call reconciliation.
7:12
SPEAKER_00: I made sure that they were appropriate.
7:13
SPEAKER_00: I would contact the physicians, uh, talk to physicians and ask them whether the the clients really needed certain medications or maybe they would do better with another medication.
7:24
SPEAKER_00: Um I would teach the family what um services and and really long-term planning because some some um of the families really were the here and now, let's solve the problem here and now.
7:40
SPEAKER_00: And I helped them through um what we call life care planning for themselves and for their families.
7:47
SPEAKER_00: So it was just a a a natural progression for me to be where I am currently.
7:52
SPEAKER_02: Okay, and now you have a new focus.
7:54
SPEAKER_02: Can you tell us about that?
7:56
SPEAKER_00: My focus really is uh right now is in educating, advocating, care coordination, and uh care management.
8:04
SPEAKER_02: Okay, and so to somebody that does not know what that industry is, what does that mean on a day-to-day basis?
8:12
SPEAKER_02: Who are you working with?
8:14
SPEAKER_00: Well, basically I work mainly my focus is within dementia.
8:19
SPEAKER_00: Okay, and um I work with families who are now faced with um caring for someone with dementia.
8:27
SPEAKER_02: Right.
8:27
SPEAKER_02: And you mentioned earlier that dementia is becoming an epidemic.
8:32
SPEAKER_02: Um and and a lot of people may, you know, think that that is something that happens at the end stage of life or at a certain age.
8:42
SPEAKER_02: What do you think is happening that we are not seeing that is increasing based on just your knowledge, the rate of dementia going up?
8:52
SPEAKER_00: Well, it's uh it's really a lot of reasons.
8:55
SPEAKER_00: So, first let's recap in terms of uh what is dementia, right?
9:01
SPEAKER_00: Um, because dementia doesn't just affect memory, it impacts safety, decision making, relationships, long-term care planning, uh, and families struggle to navigate medical care and making decisions, supporting um daily support, uh, and once and often in a crisis mode.
9:24
SPEAKER_00: So let's go back in terms of understanding what exactly dementia is.
9:28
SPEAKER_00: Right.
9:30
SPEAKER_00: So dementia is not a single disease per se, it's really a general catch-all term uh for decline in brain function, uh, which interferes with daily life.
9:42
SPEAKER_00: Um, most people just think of memory loss, but it's really brother than that.
9:48
SPEAKER_00: It it affects judgment.
9:50
SPEAKER_00: That's where safety becomes an issue.
9:52
SPEAKER_00: Language, uh, when people are no longer able to express themselves, their behavior.
9:58
SPEAKER_00: People might see um certain behaviors that they think is really strange, uh because mom and dad or their cousin or their brother or whomever is different and they're not sure, not recognizing them, or maybe become really spiteful.
10:18
SPEAKER_00: Some people even lash out.
10:20
SPEAKER_00: Um, yeah, personality changes, so it's not the same person.
10:26
SPEAKER_00: Uh, although then there are some people really quiet and and and uh into themselves, people who've been quiet or tend to be more quiet, people to who tend to be angry tend to be more angry, yeah, yeah.
10:44
SPEAKER_02: So so my understanding is that there are different types of dementia.
10:49
SPEAKER_02: Yes.
10:49
SPEAKER_02: Can you talk about that?
10:51
SPEAKER_00: Yes, yeah, I'll briefly, but also let me add, um, beside all of these um features that I mentioned before, you also have uh people have trouble managing finance uh in in in dementia, following conversation or recognizing familiar faces, like I mentioned before.
11:13
SPEAKER_00: So the key distinction is that dementia is not a normal sign of aging.
11:18
SPEAKER_00: It's not normal.
11:19
SPEAKER_00: Uh it's a rare, it's it's a level of change that basically disrupt their independence, you know, and there's no cure, so it's progressive.
11:29
SPEAKER_00: Now, in terms of uh types of dementia, we have Alzheimer's.
11:34
SPEAKER_00: Alzheimer's is the most prevalent, it's it ranges between 60 to 80 percent of dementia, uh diagnosed dementia.
11:43
SPEAKER_00: And uh basically it starts with memory loss.
11:46
SPEAKER_00: We also have what we call vascular dementia, and vascular dementia affect um those who have reduced blood flow uh to the brain, right?
11:59
SPEAKER_00: Uh, especially people who have uh hypertension then develop strokes.
12:06
SPEAKER_00: There are some people who develop mini strokes, tiny strokes, or bleeding strokes, and that's vascular dementia.
12:14
SPEAKER_00: If you that's that's not reversible.
12:19
SPEAKER_00: We have another type which is called Louis body dementia.
12:23
SPEAKER_00: Um, and that one is a little bit more disturbing because it also includes visual um hallucinations.
12:32
SPEAKER_00: Oh wow, yeah, yeah, it's sleep disturbances.
12:37
SPEAKER_00: Um sometimes people have their day and nights reversed, which is really disturbing.
12:44
SPEAKER_00: When they think it's 4 o'clock in the afternoon, it's actually 2 o'clock in the morning, and then you have a family member taking care of them who has to go to work.
12:51
SPEAKER_00: Um, yeah, we they also have um movement issues like rigidity.
12:57
SPEAKER_00: Um they're have difficulty moving, right?
13:02
SPEAKER_00: They have a hunch posture, they shuffle walk, um, they have trouble um initiating movement, and sometimes family thinks it's Parkinson's.
13:14
SPEAKER_00: It's similar to Parkinson's disease, but it's not Parkinson's disease.
13:18
SPEAKER_00: So they also call it Parkinson's disease dementia, right?
13:22
SPEAKER_00: Right, right.
13:23
SPEAKER_00: Now there's a couple more.
13:26
SPEAKER_00: Um there's temporal uh frontal temporal dementia, um, which is also could be caused by uh traumatic brain injury, you know, athletes, uh, and this is people who have repetitive uh hits to their head, right?
13:42
SPEAKER_00: And sometimes falls uh cause that as well.
13:46
SPEAKER_00: And then we have mixed dementia, uh, where this person has different types, they could have Alzheimer's and vascular dementia at the same times.
13:57
SPEAKER_00: Wow, yeah, yeah, yeah, yeah.
14:00
SPEAKER_02: So you mentioned that obviously this it's not curable, so it's progressive.
14:06
SPEAKER_02: And so is there a way to predict who will be affected uh earlier on?
14:15
SPEAKER_00: There's no single predictor.
14:18
SPEAKER_00: Okay, yeah, but we do know the strongest risk factor is age.
14:23
SPEAKER_00: Okay, and the reason uh dementia is so prevalent is because we're all we're aging gracefully, right?
14:32
SPEAKER_00: Uh now we're expecting people to live a hundred plus.
14:37
SPEAKER_02: Right.
14:38
SPEAKER_00: I've had clients who are 102 who still wanted to be taken to to the casino.
14:45
SPEAKER_00: Right?
14:46
SPEAKER_02: Yeah.
14:46
SPEAKER_00: Uh my oldest client was 106 years old.
14:50
SPEAKER_02: Wow.
14:51
SPEAKER_00: And she lived independently up until she was 104.
14:55
SPEAKER_00: Right?
14:56
SPEAKER_01: Right.
14:57
SPEAKER_00: Um, so that's that's the really uh single predictor.
15:01
SPEAKER_00: However, here are some other key factors.
15:04
SPEAKER_00: Uh cardiovascular health, uh, which means um high blood pressure, controlling your your pressure, diabetes, stroke history, or stroke.
15:17
SPEAKER_00: If you know stroke runs in a family, diabetes runs in the family, hypertension runs in the family.
15:22
SPEAKER_00: Um, so it's best to really learn how how to control and manage it.
15:27
SPEAKER_02: Okay.
15:27
SPEAKER_02: So so you're saying that, you know, that's very helpful for my audience.
15:32
SPEAKER_02: So if you have a history, family history of, you know, you know, high blood pressure, hypertension, or diabetes, or or or stroke, then it's like you are paying attention to managing those symptoms or those those those conditions early because you're saying that it could then progress into some form of dementia.
15:54
SPEAKER_00: Yeah, because poorly managed high blood pressure um could cause strokes.
16:00
SPEAKER_01: Yeah.
16:01
SPEAKER_00: And strokes is a leading predictor of vascular dementia.
16:06
SPEAKER_00: Yeah.
16:07
SPEAKER_00: Okay.
16:08
SPEAKER_00: Yeah.
16:08
SPEAKER_00: Genetics also, we have certain type of dementia uh where there's certain genes that are prevalent that are is a precursor of dementia.
16:19
SPEAKER_00: And the big uh one is actually lifestyle factors.
16:24
SPEAKER_00: For example, yeah, physical inactivity.
16:28
SPEAKER_00: Uh they predict if you sit at at your desk like now most of us do uh with a computer in hand, 12 hours or more a day, that's an issue, right?
16:40
SPEAKER_02: Which is what I do.
16:42
SPEAKER_00: That's right.
16:43
SPEAKER_00: So the idea is at least maybe every hour or beginning of your day, the end of your day, really take a walk.
16:50
SPEAKER_01: Yeah.
16:51
SPEAKER_01: Right.
16:52
SPEAKER_00: And of course, poor diet.
16:53
SPEAKER_01: Right.
16:54
SPEAKER_00: Um, poor diet.
16:55
SPEAKER_00: Right.
16:56
SPEAKER_00: Yeah, I want to uh qualify poor diet.
17:00
SPEAKER_00: Uh actually, yesterday I was at a conference and we sat at a table and discussed that.
17:05
SPEAKER_00: Uh, poor diet may mean eating certain foods that are not inherently uh good for you.
17:15
SPEAKER_00: Um one of the best books that I ate that I read, it was uh, and I really forgot the name of the author, but it's really um it, which was called um the long life diet.
17:31
SPEAKER_00: And basically in it, he really recommend that you eat based on how your great-grandparents, so we're your great-grandparents, ate.
17:42
SPEAKER_00: Okay, simply with genetics, your body is basically programmed to eat and absorb a certain way, right?
17:50
SPEAKER_00: Because when you look at all over the world, different regions have different diets.
17:55
SPEAKER_00: And what affects certain people doesn't affect others, which is really strange, right?
18:01
SPEAKER_02: Interesting, yeah.
18:02
SPEAKER_00: Yeah, yeah.
18:03
SPEAKER_00: So if you eat differently, especially if you move from one region to another and you start adopting um the diet of your new environment, your body may not build for it.
18:20
SPEAKER_00: Okay, and therefore your body is fighting against what it thinks is foreign object.
18:25
SPEAKER_01: Right.
18:26
SPEAKER_00: You think it's it's it in it it's actually it's poor diet, but not in the sense that most people assume.
18:32
SPEAKER_02: No, that that makes a lot of sense.
18:34
SPEAKER_00: Yeah, yeah.
18:36
SPEAKER_00: Social isolation.
18:38
SPEAKER_00: I'm sorry.
18:39
SPEAKER_00: No, go ahead.
18:40
SPEAKER_00: Yeah, social isolation is found uh to be another predictor of dementia, and they found that out, especially during uh the COVID epidemic, right?
18:51
SPEAKER_00: Where um older people were isolated, there there was no so social interaction uh with anyone, um, these people for some reason became um more with more memory uh disturbances.
19:07
SPEAKER_00: And of course, what we call social determinants, and social determinants means the quality of food that's available for consumption, right?
19:17
SPEAKER_00: Yeah, yeah, that's that's that's definitely a social determinant, and it's not really geared to any specific group, it's basically geared to people who do not have access to quality food, right?
19:29
SPEAKER_00: Right, um, education is an is an issue, uh access to care.
19:37
SPEAKER_00: And access to care means having access to localities that have maybe more advanced treatment or even physician.
19:49
SPEAKER_00: Um, like I said yesterday I sat at a table at this uh young lady who mentioned that her family moved a lot.
19:57
SPEAKER_00: And because her family moved a lot, they didn't have one group of medical clinicians who followed them throughout life.
20:09
SPEAKER_00: So they were starting over wherever they were, so they didn't have access to care.
20:15
SPEAKER_00: Right.
20:16
SPEAKER_00: Continuous care.
20:17
SPEAKER_00: Transportation is an issue of people who live in rural areas.
20:21
SPEAKER_00: Um, in terms of if they need an advanced um examination, they do not have access to it because they are unable to get to that facility.
20:33
SPEAKER_00: So consistent care.
20:35
SPEAKER_00: Yes.
20:36
SPEAKER_00: Uh-huh.
20:36
SPEAKER_02: One of the things that you said, which I wanted to mention quickly before I forget, does dementia run in families?
20:45
SPEAKER_00: Yes.
20:46
SPEAKER_00: Um, because families, we genetic is one thing, but also lifestyle is another.
20:53
SPEAKER_00: Okay.
20:53
SPEAKER_00: But we tend to do the same things that our parents have done.
20:57
SPEAKER_00: So therefore, it's it's a two uh-edged sword uh in terms of both genetics and also lifestyle.
21:06
SPEAKER_02: Okay, so let's say that somebody is listening to this podcast and they're thinking, How can I know if somebody I love, a parent, a parent or somebody that I love, how can I know that they are in the on stages of dementia?
21:25
SPEAKER_02: What are some of the symptoms that I can pick up on?
21:29
SPEAKER_00: Yeah.
21:30
SPEAKER_00: Um, basically, you'll you'll you'll see on first their inability to complete their activities of daily living.
21:38
SPEAKER_01: Okay.
21:39
SPEAKER_00: For example, we call ADLs.
21:41
SPEAKER_00: And yeah, they can't do it without supervision.
21:45
SPEAKER_00: And also, usually there's another group called instrumental activity of daily living, is they're usually that's what's first affected.
21:56
SPEAKER_00: And they're not able to manage their home.
21:58
SPEAKER_01: Okay.
21:59
SPEAKER_00: The home is messy.
22:00
SPEAKER_00: It looks like they're hoarding, but the fact is they just never finish any task.
22:05
SPEAKER_00: Um, their financial affairs are a mess.
22:08
SPEAKER_00: Unpaid bill, turn off notices.
22:11
SPEAKER_00: Um they shop, or if they continue to drive, they they have duplicates of everything, right?
22:18
SPEAKER_00: In the cupboard because they forgot that they've uh purchased something, or they fail to organize groceries, or you'll find uh uh a can of beans maybe in the bathroom, right?
22:31
SPEAKER_00: Yeah, yeah.
22:33
SPEAKER_00: Putting things away.
22:34
SPEAKER_00: It's yeah, yeah.
22:35
SPEAKER_01: Right.
22:36
SPEAKER_00: Uh so transportation, they get lost.
22:39
SPEAKER_00: Yeah, they get lost.
22:40
SPEAKER_00: I had a uh a friend, a family member, they live in Fort Lauderdale, and they were they ended up in Key West in Florida, yeah.
22:49
SPEAKER_00: But because they kept driving, they they forgot how to to get home.
22:53
SPEAKER_02: Yeah, right.
22:54
SPEAKER_02: Right and and families typically, you know, especially a lot of people who want an age in place, when you know, can you speak to the fact that when these symptoms start developing, you know, the parents or the person may resist, you know, a change in environment.
23:14
SPEAKER_02: So if you start picking up on this symptoms or uh signs, what do you do?
23:22
SPEAKER_00: Yeah, you really have to start a conversation.
23:26
SPEAKER_00: Uh oh the elderly are very resistant because they've been around for a long time, they've been doing things uh the same way for a long time, and they still look at you, um the the child as their child, right?
23:42
SPEAKER_00: Uh sometimes they're not really uh responsive to your want uh um to to assist them.
23:50
SPEAKER_00: And that that it's sometimes maybe it's time to bring somebody in, you know, but first have a conversation.
23:56
SPEAKER_01: Okay.
23:57
SPEAKER_00: Um in my years of work, I found that a lot of children do not know their parents.
24:04
SPEAKER_00: Okay, it it's it's really interesting uh because when you ask, well, what what's what's mom's pattern, what's dad's pattern, they're like, I don't know.
24:15
SPEAKER_00: Because of course they've grown, they've left home for a long time.
24:19
SPEAKER_00: Mom and dad have been managing uh fine, or it's a distant aunt who's who's now they're responsible for they have no idea what their lifestyle is, their wants, their likes.
24:31
SPEAKER_01: Right.
24:31
SPEAKER_00: Um, yeah, so so having that conversation, but do make an effort to get to know them, uh, or have them write things down.
24:40
SPEAKER_00: I've started doing that for my kids.
24:43
SPEAKER_00: Yeah.
24:44
SPEAKER_02: And then you said have the conversation and then bring somebody in.
24:48
SPEAKER_02: Consider bringing somebody in.
24:49
SPEAKER_02: Who would that be?
24:51
SPEAKER_00: Huh.
24:52
SPEAKER_00: Okay.
24:54
SPEAKER_00: In my opinion, uh most families, being that I I wasn't uh home care agency owner, most family care calls would call our agency for assistance.
25:10
SPEAKER_00: So the truth is they needed more help than that.
25:14
SPEAKER_00: Right?
25:15
SPEAKER_00: Uh, they really need somebody who can organize this whole system for them.
25:23
SPEAKER_00: Uh, what to expect, what's what what what could possibly happen.
25:28
SPEAKER_00: Okay, so that's where planning becomes incredibly powerful.
25:33
SPEAKER_00: So preparation isn't about just assuming dementia uh will happen, even if they see what's going on.
25:40
SPEAKER_00: Maybe it's just something temporary, but it's about protecting um their independence early on, right?
25:47
SPEAKER_00: So, which means um you start with financial planning, right, for long-term care.
25:54
SPEAKER_00: Um the legal documents, like powers of attorney and advanced directives.
26:01
SPEAKER_00: You have to understand the legal portion is really important because once the person is is diagnosed, then they're unable to make decisions.
26:11
SPEAKER_00: Right.
26:12
SPEAKER_00: So we have to think about that.
26:14
SPEAKER_02: Right, right, right.
26:15
SPEAKER_02: And I've heard that a lot where like, you know, even before, even if there's nothing going on, it's important for you know children of of older parents to really think about that legal angle of things because you know, if it the documents are not in place and God forbid something happens, then now you get into you know a legal nightmare because you don't have the authority to make certain decisions on behalf of your own parents.
26:46
SPEAKER_02: Correct.
26:46
SPEAKER_02: Um, so I've heard that a few times already on this podcast.
26:50
SPEAKER_02: So um, so now this is a good segue to two events that are happening soon.
26:56
SPEAKER_02: We have Mother's Day coming, we have Father's Day coming.
26:59
SPEAKER_02: You know, what should families look for?
27:02
SPEAKER_00: Many of the signs that I mentioned above um before, um, which means just chaos, messiness, um odor, right?
27:13
SPEAKER_00: Um being disheveled, you know, thinking that they they showered or they bathed and didn't, right?
27:20
SPEAKER_00: Um, yeah.
27:21
SPEAKER_00: Uh with Mother's Day and Father's Day, usually families saw each other maybe six months ago during the high holidays, right?
27:29
SPEAKER_00: Maybe there's some weight loss, yeah.
27:32
SPEAKER_00: Incontinence, personality changes.
27:35
SPEAKER_00: Yeah.
27:36
SPEAKER_02: And how about, you know, people who are unmarried or without children?
27:42
SPEAKER_02: How do they how do they navigate this?
27:45
SPEAKER_00: Yeah, yeah.
27:46
SPEAKER_00: We we do have a group called solo agers right now.
27:51
SPEAKER_00: Yeah, and it's it's really uh they are relying on neighbors.
27:58
SPEAKER_00: So it's really important.
27:59
SPEAKER_00: If you have a neighbor who is alone, uh reach out, reach out.
28:04
SPEAKER_02: Yeah, they can you say can you say that again?
28:07
SPEAKER_02: Because I I think we underestimate you know how important this is because there's also demographic data that shows, for example, you have you know you know, it's a fact that men die early than the the the women, and so you have a lot of elderly women living alone independently, and you know, if nobody's checking up on them and these things are happening, you wouldn't know.
28:35
SPEAKER_02: So, can you speak again to the fact that it is important for people to, you know, at least if you know that you have an elderly neighbor that lives alone, that you are checking up on that person if patterns are shifting or you're not you're noticing something that's out of the ordinary, that you realize that it's more than just that, oh, they may not want to be bothered, it's just something else may be going on.
28:57
SPEAKER_00: Yes, yes, it's really important that neighbors or even um long families, distance family, right?
29:06
SPEAKER_00: Um, a cousin, you know, check on your cousin, right?
29:10
SPEAKER_00: Check um nephews, check on your auntie, right?
29:13
SPEAKER_00: Uh call them, see what's going on.
29:15
SPEAKER_00: But again, neighbors, um and and employees of other institutions, for example, banks, right?
29:25
SPEAKER_00: Because the elderly, especially solo agers, are very vulnerable to fraud and abuse.
29:31
SPEAKER_00: So if someone's working at a bank and they're seeing unusual activities in um a person's account, it's really time to alert someone.
29:43
SPEAKER_00: Right.
29:43
SPEAKER_00: So it's really we have to have a community approach to caring for our elders.
29:48
SPEAKER_02: No, I I totally agree.
29:50
SPEAKER_02: And and and that's a good segue to now focusing on you know um care management in your world.
29:59
SPEAKER_02: So what does a care manager do when working with somebody with dementia?
30:05
SPEAKER_00: Well, care management is we're here to navigate the entire healthcare system uh for um the public.
30:19
SPEAKER_00: Okay.
30:20
SPEAKER_00: Um essentially, we're a central hub of support.
30:25
SPEAKER_00: We access the the person holistic.
30:28
SPEAKER_00: We have a holistic approach.
30:29
SPEAKER_00: We look at their medical needs, we look at their cognitive status, their their home safety, we look at their social support, we look at their long-term risk, okay, and then create a coordinated plan.
30:44
SPEAKER_00: But more importantly, uh you implement and adjust scare over time, because it's not a one-size-fits-all at this present time, right?
30:54
SPEAKER_00: Because people uh age gradually and uh changes occur over time.
31:00
SPEAKER_00: So you coordinate, I coordinate uh personally, and most care managers we coordinate with physicians with the different specialties because a lot of people have they have their primary care physician, they may have a neurologist, they may have a rheumatologist, they may have a pain management person.
31:18
SPEAKER_00: Uh basically, and none of these people talk to each other, right?
31:24
SPEAKER_00: So the care manager just brings all of the players.
31:28
SPEAKER_00: Um, yeah, it's not unusual for someone to have different um medications from different sources.
31:36
SPEAKER_00: Um, yeah, so that that's the role of the care manager.
31:40
SPEAKER_00: We manage the medications and of course any care transitions.
31:45
SPEAKER_00: If from home, from other uh localities, we have families understand what to expect next because we've seen it over time, and also preventing crises like hospitalizations or any unsafe living uh situation.
32:01
SPEAKER_00: That's the role of a care manager, right?
32:04
SPEAKER_02: So so then it it brings the question picking the right care manager is critical.
32:11
SPEAKER_02: So, what should one look for when trying to hire a care manager?
32:16
SPEAKER_00: Well, you first you have to get along with the person, right?
32:19
SPEAKER_00: You have to have a level of ease with the person because this is such a personal um situation.
32:27
SPEAKER_00: Um, and then of course, you have to look for expertise.
32:30
SPEAKER_00: Yeah, um, the person has to have um some experience navigating um through uh the medical system.
32:41
SPEAKER_00: It it's also helpful if the person has a degree of medical knowledge, uh, not just social knowledge, because uh you do have to understand whether medication is necessary or not.
32:57
SPEAKER_00: For example, when I manage a home care agency, and like I said, I was doing this work, um, promo pro bono, you could say, uh, I would go in and and explain whether or not the the medication was necessary.
33:13
SPEAKER_00: I'll say, well, give your physician a call and find out.
33:16
SPEAKER_00: And usually they would eliminate because people can easily have like 11 to 12 medications and would eliminate three or four of them, that would actually pay for itself.
33:30
SPEAKER_01: Right.
33:30
SPEAKER_00: Uh in terms, yeah.
33:32
SPEAKER_00: So having uh a medical uh background, uh it's so it's important that the the advocate becomes an an advocate and a translator, someone who can take the complex medical um and system information and make it really actionable um for the family.
33:51
SPEAKER_02: Yeah, no, that makes sense.
33:53
SPEAKER_02: And and and so um how is your approach different in terms of how you handle uh from what other organizations are providing in this space?
34:05
SPEAKER_00: Yeah, well, uh because I have such a breadth of experience, right?
34:11
SPEAKER_00: So I have both clinical depth and a world practicality.
34:15
SPEAKER_00: So I've been on both sides, uh, more or less, uh, with families, both in a hospital situation, in a long-term care situation, in a home situation.
34:26
SPEAKER_00: And um like I I worked as a nurse as an administrator, so I I I understand not just what should happen in health care, but what actually happens because I know systems break down because I was a quality manager, right?
34:46
SPEAKER_00: And uh I know how to navigate around these gaps.
34:49
SPEAKER_00: Yeah, um, yeah, and I focus really on personalization.
34:54
SPEAKER_00: Right.
34:55
SPEAKER_00: It's it's it's a personal service.
34:57
SPEAKER_02: Yeah.
34:58
SPEAKER_02: So so now let's talk about your your your business now, what you do now.
35:04
SPEAKER_02: Can you just tell us in plain language what you do, who you help, and how you help them?
35:13
SPEAKER_00: Well, families basically call me.
35:15
SPEAKER_00: They call uh this is the situation.
35:18
SPEAKER_00: We we are facing um this well, I'll I'll give you a plain example.
35:23
SPEAKER_00: We have a solo ager.
35:25
SPEAKER_00: He is only 72 years old, and um he's never left home.
35:31
SPEAKER_00: He took care of his mom and dad, and he worked, but now that family has passed and he's aged himself, and you know, at 72, and has um the uh the Parkinson's-like dementia.
35:49
SPEAKER_00: Yeah, yeah.
35:51
SPEAKER_00: He also has uh visual issues, and his cousin actually called me from out of town and asked to help.
36:03
SPEAKER_00: Right, and asked to help, and they also engaged two neighbors in the um uh from his neighborhood, his next door neighbor who became his power of attorney.
36:13
SPEAKER_00: And the neighbor has her own issues, right?
36:17
SPEAKER_00: She's jailing herself, she's babysitting her grand uh son, and now she has to take care of this gentleman.
36:24
SPEAKER_00: And my role is to go in and um uh assist in looking at his medical issues, look at his um finances, and um deciding on exactly how we're going to position him now, currently, um maybe just staying at home, and then eventually um moving him through the transitions of care.
36:50
SPEAKER_02: Yeah.
36:50
SPEAKER_02: So just so that to build on that, can you give me like three or four situations where somebody will call you in addition to what you just told us so that people will have kind of a breadth of the services that you're providing?
37:05
SPEAKER_02: Because when it comes to mention, you had talked about how it is so so many things are lumped into that, and for us, we just see a symptom or we see a behavior, and then we know we need help.
37:20
SPEAKER_02: So, can you give us a few scenarios of what people call you for so that we can put them in categories and then our audience can really understand the help that you provide?
37:30
SPEAKER_00: Yes, yes.
37:31
SPEAKER_00: Um, well, the first we need the family to acknowledge that it's it's their situation is complex.
37:38
SPEAKER_00: Um, we have sons who are dealing with mothers.
37:44
SPEAKER_00: I've had a son who's she was this brilliant woman.
37:48
SPEAKER_00: She was an accountant, she was a bookkeeper, an accountant, worked her entire life, was sharp as attack.
37:55
SPEAKER_00: All it took is for her to fall and hit her head, right?
38:01
SPEAKER_00: Which is a traumatic brain injury.
38:04
SPEAKER_00: Right.
38:04
SPEAKER_00: And she was never the same.
38:07
SPEAKER_00: So the son had to quit his job, right?
38:11
SPEAKER_00: Quit his job to take care of his mom full-time.
38:14
SPEAKER_00: Okay.
38:15
SPEAKER_00: This is someone who's basically almost at the height of his career.
38:19
SPEAKER_00: Right.
38:19
SPEAKER_00: Okay, to take care of his mom.
38:22
SPEAKER_00: And he needed help, obviously, right?
38:25
SPEAKER_00: Uh, how do I who am I hire going to hire?
38:29
SPEAKER_00: Who's going to take care of mom?
38:31
SPEAKER_00: So I needed to go in and put all the pieces in into place and help him decide because it's such an emotional time.
38:39
SPEAKER_02: Right.
38:40
SPEAKER_02: Yeah.
38:40
SPEAKER_02: So does that does that also mean that in a case like that, that you're also recommending hiring a home, somebody coming in to support daily activities?
38:51
SPEAKER_02: Does that include part of what you're coordinating?
38:54
SPEAKER_00: I can do that.
38:55
SPEAKER_00: Yes, yes, I can do that.
38:56
SPEAKER_00: If family, if there's not enough family members to carry the weight, yes, yes, I can do that.
39:03
SPEAKER_02: So you're coming in and assessing the situation and then determining what course of action is going to, based on what you see, is going to help this person be able to pretty much what is the outcome?
39:15
SPEAKER_02: Live comfortably, live functioning, what is the outcome you're trying to achieve?
39:21
SPEAKER_00: Yes, yes.
39:22
SPEAKER_00: And that's exactly what I help uh family members and neighbors or uh friends uh determine what is the goal of care?
39:30
SPEAKER_02: Okay, goal of care.
39:32
SPEAKER_00: Yeah, what is the goal of care?
39:33
SPEAKER_00: What is the best for this particular person?
39:38
SPEAKER_00: It's it's it's not uh one size fits all, right, right, yeah.
39:42
SPEAKER_00: That makes sense.
39:43
SPEAKER_02: So um the last question I'm gonna ask you is how we can reach you.
39:47
SPEAKER_02: But before I do that, is there any question I haven't asked you?
39:51
SPEAKER_02: Is there anything you wanted to talk about?
39:52
SPEAKER_02: Anything on your mind you wanted to share with our audience that I haven't asked you yet?
39:57
SPEAKER_00: Yes, yes.
39:58
SPEAKER_00: Um I just want to reassure families, they don't have all the answers and that they actually need the right guidance.
40:08
SPEAKER_00: You know, having one conversation with someone like me or with a care uh manager can bring clarity, and from there we can break things down into manageable steps, which is really key.
40:22
SPEAKER_00: What needs attention now, what can wait, and how can we build a plan moving forward?
40:27
SPEAKER_00: It's very important that families uh recognize that.
40:31
SPEAKER_00: So basically, the first step for families to reach out for a conversation.
40:36
SPEAKER_00: Um I offer an initial consultation where we can uh talk through what the situation is, identify what the immediate concerns are, and outline what support might look like.
40:50
SPEAKER_02: Okay.
40:51
SPEAKER_02: Yeah.
40:52
SPEAKER_02: And and the big thing I have learned today is is that you know, from the service that you provide, um the the key question is what is the goal of care?
41:05
SPEAKER_02: So that's what I'm gonna remember.
41:06
SPEAKER_02: You know, what is the goal of care?
41:08
SPEAKER_02: And I think a lot of families are struggling because they don't know there's so many things coming from different places, and to have someone like you come in and help them figure that out is such a such a big help.
41:20
SPEAKER_02: So, how can we reach you?
41:21
SPEAKER_02: What what how can we reach you uh for your services?
41:25
SPEAKER_00: Well, right now, I'm really recommending that people reach you via email, and I'll tell you why, Pwami, is because just the act of sitting at the computer or even on their phone and thinking things through what's going on in typing through this is the situation I'm having with my mom, this is the situation with my dad, we'll start giving the person just some clarity or having them slow down for a little bit, okay, so they can uh reflect on okay, how do I want to use this woman's talent in helping me?
42:03
SPEAKER_02: Right now, one thing that I I forgot to mention is there particular area that you cover, particular states?
42:11
SPEAKER_02: Do you do remote consultation?
42:12
SPEAKER_02: How does that work?
42:14
SPEAKER_00: I do remote consultation.
42:16
SPEAKER_00: I prefer to practice in areas where um I can travel to if necessary.
42:24
SPEAKER_00: Yeah, because um I do like sometimes to just eyeball.
42:30
SPEAKER_00: Right.
42:30
SPEAKER_00: Uh because I can see certain things that families do not see as a nurse.
42:36
SPEAKER_02: Yeah, yeah.
42:37
SPEAKER_02: So what states would that be?
42:40
SPEAKER_00: Where do you cover the immediate surrounding area?
42:44
SPEAKER_00: I would say definitely Maryland, Pennsylvania, Delaware.
42:47
SPEAKER_00: Um, but I'm also open to any of the compact states, the compact is our uh states where nurses are able to practice uh with that additional licensure.
42:58
SPEAKER_00: Um yeah, um, because my approach is as a nurse um consultant, as a nurse care manager.
43:07
SPEAKER_00: Yes, and I offer temporary help too.
43:10
SPEAKER_00: If somebody's in a crisis, you you need something immediate.
43:13
SPEAKER_00: Uh, just email me real quickly, we'll get on a calendar, uh, get on my calendar, we'll do a zoom call and we'll talk really um really quickly.
43:22
SPEAKER_00: My uh website will be up.
43:24
SPEAKER_00: It's uh guidance care management is is the name of the company, the the agency that uh that I work we work with.
43:34
SPEAKER_00: Uh and it's GCMFix.
43:37
SPEAKER_00: The idea is to try to fix the situation.
43:40
SPEAKER_00: So gcmfix.com.
43:43
SPEAKER_00: Uh it'll be up shortly.
43:44
SPEAKER_00: We're just making some uh revisions to it.
43:47
SPEAKER_02: Welcome.
43:47
SPEAKER_02: Easy enough.
43:48
SPEAKER_02: Easy enough.
43:51
SPEAKER_00: Email is Gina at gcmfix.com.
43:55
SPEAKER_02: Yeah, and all that information will be provided in the show notes for this podcast.
43:58
SPEAKER_02: So is that Find out where you want to part with.
44:01
SPEAKER_00: Yes, I'll I also like to encourage people to embrace some technology because technology is becoming a very powerful uh ally in dementia care, uh, especially in the early in people who are in the early stages.
44:18
SPEAKER_00: Uh, we have a lot of AI supportive uh tools that can track daily patterns, which is really important.
44:25
SPEAKER_00: Uh, you'll know when mom and dad, when they go to sleep, when they wake up, how often they're going to the bathroom, things like that, or they're taking their medications, reminding about taking medication, uh, ill or families about any changes that are taking place very early on, right?
44:41
SPEAKER_00: If they're falling.
44:43
SPEAKER_00: Um, so uh the AI technology is is progressive um in uh helping us do that.
44:51
SPEAKER_00: Okay, so I always emphasize uh technology doesn't replace human care, but it actually enhances it.
44:59
SPEAKER_00: Um yeah, it's so it's an extra layer of support, which is 24-7, uh, where you as a family member you really can't be.
45:08
SPEAKER_00: Okay.
45:08
SPEAKER_00: Awesome.
45:09
SPEAKER_02: No, this has been really good.
45:10
SPEAKER_02: Thank you, Gina, for joining the Retirement Navigator podcast.
45:14
SPEAKER_02: And uh hopefully we'll have a version two at some point as technology and other things progresses.
45:19
SPEAKER_02: We may you know bring you back for a second conversation to just see how the management of care is improving and progressing.
45:26
SPEAKER_02: So thank you for being here today.
45:28
SPEAKER_00: Oh, absolutely.
45:29
SPEAKER_00: Please don't wait for a crisis to get help, the right guidance early on makes a world of difference.
45:35
SPEAKER_02: Thank you.
45:36
SPEAKER_00: Thank you.
45:37
SPEAKER_02: And to our listeners, thank you for spending part of your day with me today.
45:41
SPEAKER_02: I hope that you found this conversation with Gina very helpful.
45:45
SPEAKER_02: And I want to encourage you to consider subscribing to the Retirement Navigator podcast so that you would not miss a future episode.
45:53
SPEAKER_02: And if you want to go deeper on this conversation, consider joining our community on the school platform.
46:00
SPEAKER_02: It is the Benefits Insider community where we go deeper on these topics.
46:04
SPEAKER_02: You get access to me to ask questions, your retirement questions on social security, disability, Medicare, Medicaid, and more.
46:13
SPEAKER_02: And until the next episode, remember that retirement is not the end of the road, it is a new season to navigate with clarity and confidence.
46:24
SPEAKER_02: I will see you next week on a new episode of the Retirement Navigator Podcast.
46:29
SPEAKER_02: Thank you for watching!