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Caregiver’s Toolbox Ep. 42 “Understanding Sepsis”

Speaker 1:

Welcome to The Caregiver’s Toolbox, Tools for Everyday Caregiving. We provide education and information on senior care topics. Here’s your host, Ryan McEniff.

Ryan McEniff:

Hello everybody and welcome to another overdue episode of the Caregiver’s Toolbox. My name is Ryan McEniff, I’m here with Janet. We are back together doing another episode, it has been way too long. Today we’re talking about something very timely. We are talking about sepsis, which has been brought up in the news because of our past President, George H.W. Bush, got it and was hospitalized with it after his untimely death of his wife, and so we thought this would be a goo time to talk about it because it’s not something that everybody knows about. People don’t talk about it much but it causes a lot of chaos and a lot of people can pass away from it. Janet, you’re my clinical person, you’re amazing at all this stuff. We’ve always been you’re clinical, I am the business side of things. What is sepsis?

Janet:

Well, sepsis, it’s also called septicemia. Some people generally refer to it as a form of blood poisoning. It’s one of those things that it affects a large population and yet only a third of Americans have ever even heard of it or know what it is. It’s due to an infection that usually when you get an infection your body fights it off. You get a fever and that’s your body fighting it off. What sepsis is, is when your body goes into hyper-drive to try and kill an infection and it ends up turning on your body and it ends up damaging healthy stuff and oftentimes it can be fatal.

Ryan McEniff:

Obviously, it was close… He was in critical condition at one point in time with this so it certainly is an example of how quickly it seems to come on and the damage that it can do.

Janet:

Yeah, and it’s one of those things that even for doctors can sometimes be a little bit difficult to pick up because the initial symptoms mimic a lot of other symptoms so it can be a little tough. The elderly are really susceptible to it because they probably already have some underlying medical conditions so their immune system isn’t that great to begin with. People that are diabetics, they tend to have wounds that don’t heal in a timely way and especially people that have to use catheters, IVs, feeding tubes, anything that allows …

Ryan McEniff:

Is foreign, yeah.

Janet:

… Germs to come internal to the body. You think of former President Bush, he covers all categories. The man has Parkinson’s. The man is elderly. The man’s immune system was very low, just as part of the mourning process of having lost his wife. What happens is your body just all of a sudden turns on itself to try and get rid of this germs and it can cause organ failure, organ damage, cognitive disabilities, and in some cases it can move very quickly once you get it. It’s one of those things where about 50% of people that contract it do poorly or fail or, at the very least, end up re-hospitalized within three months.

Ryan McEniff:

Yeah, and I was going to mention just because you get over the initial diagnosis and you recuperate, that doesn’t mean that there aren’t lasting effects and ongoing complications that can come with this.

Janet:

Yes, and cognitive abilities are one of the things that can come up. I was looking at some statistics and I was even looking for the papers to see what people had to say about sepsis as a result of President Bush and 40% of sepsis patients are re-hospitalized within three months and these initial hospitalizations, that costs our healthcare system $5.5 billion, and that’s only the first time in the hospital.

Ryan McEniff:

Yeah.

Janet:

That doesn’t count re-hospitalizations, nursing homes, BNAs coming, private home care or families that cut back on their jobs to support caregivers, and some of this damage can be permanent, lasting, people needing organ transplants, forms of dementia. One study that I was just reading up the other day said there’s, on average, 20,000 new dementia cases in the elderly annually because of sepsis. A lot of people when they hear dementia they think Alzheimer’s but this is something that has nothing to do with Alzheimer’s, this is an infection and it results in permanent dementia.

Ryan McEniff:

Yeah, and obviously 5.6 billion a year isn’t pocket change. Like you said, that doesn’t even include whatever re-hospitalizations come with it because people leave the hospital just because they might not for the same exact ailment, if they’re so weak that they fall or they’re so weak that they come back for another disease that because their immune system is so low and they’re fighting, it just becomes a vicious cycle of going in and out of the hospital and, as we’ve said in other podcasts, in general, one of the worst places to take elderly people is the emergency room in the hospital because there’s a bunch of sick people there. Everybody’s sick in there and it can be easy to come out just as sick, if not sicker, than when you went in. That’s not a knock on the hospital system, they’re doing a great job, but it’s just the nature of the beast.

             So many times we’ve seen patients, we’ve seen clients, and we’ve heard about where people go into the hospital and people have an idea that mom will get better, everything will be okay and they’ll come home feeling great. They come home weighing less, less body mass or muscle mass, they’re dehydrated, just because being in a different facility than being home causes stresses as well as being sick and trying to cope and get over with what they’re doing. There are plenty of different things that can occur once somebody’s in the home that maybe you weren’t expecting that is going to be that collateral damage from this disease and from this infection … Excuse me, not disease, this infection.

Janet:

Yep, and bacteria we know, it’s like we joke around and talk about daycares being little Petri dishes …

Ryan McEniff:

Yeah.

Janet:

… And every kid shares it. The same thing can happen to adult daycare centers, any place that there is a congregation of germy people.

Ryan McEniff:

Absolutely.

Janet:

As a result, the last thing you want to do is have to take mom and dad to the hospital or even doctor’s appointments during flu season or things of that nature and it’s really, really important to watch. Oftentimes, this can come around as a result of pneumonia, which is very, very common in the elderly so you have to watch that. That’s why … To your point, the hydration and making sure they’re getting enough fluids, which is probably the number one problem with elderly people because they’re concerned about getting to the bathroom so they don’t drink, and we’ve talked about UTIs. UTIs can become …

Ryan McEniff:

A nightmare real quick.

Janet:

Septic very, very easily and people just don’t have the health and the energy to fight it off. I mean, you think President Bush had the best of care around the clock with his Parkinson’s and yet this is the situation he found himself in.

Ryan McEniff:

Absolutely, so it’s not … Just because you have the means to be able to pay for it doesn’t mean that it’s not going to happen for you.

Janet:

Yeah.

Ryan McEniff:

Well, something I was looking at here. I mean, there’s a nice little acronym for sepsis and The Sepsis Alliance offers the following acronym to help the public easily remember the telltale signs of sepsis. S is shivering due to a fever over 101, E is extreme pain or general discomfort. That’s a little vague but we’ll work with it. P is pale or discolored skin, that should be easy to see. The next S in sepsis is for sleepiness, confusion or changes in consciousness, and then the I is I feel like I might die or similar remarks from a patient. That kind of goes back to the extreme pain or general discomfort. Then the final S is shortness of breath.

             Kind of going back to what you said as I’m sure that I don’t know The Sepsis Alliance that well, I’m sure they’re all good people over there trying to do their part, but there’s a lot vague descriptions or symptoms in that acronym, right? You’re dealing with extreme pain, general discomfort, shivering due to a fever, so maybe you think somebody just has the cold or the flu. It just proves your point where you’re talking about that it’s not exactly the easiest to pinpoint and say, “Oh, this is that right there, I know exactly what this is,” because it’s a lot of vague, general symptoms that accumulates at one time.

Janet:

Right, and in some cases, depending upon what the other underlying medical conditions are, if someone suffers from shortness of breath …

Ryan McEniff:

Yeah …

Janet:

That’s their baseline so I think what they’re trying to get to with acronyms like this is, if these things are not part of the norm or, as the clinical people call it, the baseline for that person. At the same time, if an elderly person has underlying medical conditions and they develop a fever or have a cold you got to watch them that much closer because you and I can maybe be out a day if it’s a really bad cold and we bounce back. This can quickly go downhill for an elderly person so it’s really what is their norm and of these things, as far as shivering, the aging process thins your skin and you go to an assisted living, you go to a nursing home and people have got their ski jackets on in July and you go into their room and you could grow orchids in there because they keep the heat so high.

Ryan McEniff:

Absolutely.

Janet:

There’s what is normal but then there’s this is more so.

Ryan McEniff:

Absolutely.

Janet:

That’s when you have to watch it most.

Ryan McEniff:

Because everybody’s baseline is different and so you’re going to have to, just like you said, take that into consideration. If somebody’s always wanting it to be warm, that doesn’t necessarily mean that they have a disease, that might just be what their baseline is. That’s interesting. It’s so …

Janet:

And stress low is your immune system.

Ryan McEniff:

Yeah.

Janet:

I mean, George Bush, who knew his wife since he was 17 or something, that was a tremendous loss to him. Other family members, when they lose a spouse, their immune system is very vulnerable. Or certain holiday seasons, especially if someone has some kind of dementia because there’s memories, and it wears you down. You know how you’re tired after a major event. Well, if you got a low immune system you’re a little more fragile,

Ryan McEniff:

It completely makes sense and I’m sure there are plenty of people out there that just thought he was sick or just saw … They chop it up to just, “Oh, his was immune system, a bug got in, a bug.” Well, this bug is a serious issue and it causes a lot of damage throughout the country on a yearly basis when it comes to hospitalizations, re-hospitalizations, and obviously people’s health.

Janet:

Yep.

Ryan McEniff:

Then people like us get calls where it’s like, “Hey, we need private home care,” because somebody needs to be there around the clock to make sure they get better for the three or four days, the week, the two weeks, whatever it is until they get back on the mend.

Janet:

When they come home doesn’t mean they’re better.

Ryan McEniff:

Unfortunately, that’s the case. Well, excellent. Well, thank you, Janet, and thank you all for listening to The Caregiver’s Toolbox, Tools for Everyday Caregiving. We will see you on the next go round. Thank you.

About Us

Minute Women Home Care is a premium, non-medical, live-in care, and in-home care service provider that enables our clients to live at home with dignity and respect by assisting with their activities of daily living. We support families in senior home care within their mission to allow their parents to age in place rather than transition to a nursing facility.

Minute Women Home Care | Home Care Services Since 1969

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Caregiver’s Toolbox Ep. 41 “How Many People Are Employed By A Healthcare Company?”

Speaker 1:

Welcome to The Caregiver’s Toolbox, tools for everyday caregiving. We provide education and information on senior care topics. Here’s your host, Ryan McEniff.

Ryan McEniff:

Hello everybody. Welcome to another episode of Caregiver’s Toolbox, tools for everyday caregiving. My name is Ryan McEniff, I’m here with Janet. Janet, we are back. Last week, I did one. It was, what I call, a blitz podcast, where I just rant for four minutes about stuff. You’re not involved, just because, when we get busy at work, sometimes I just do one from home real quick, but Janet is back with us.

Janet:

I’m here.

Ryan McEniff:

We have the yin and the yan, the good and the bad. I guess it’s up to you to decide who’s what, right?

Janet:

That’s right. Naughty and nice. It’s the season.

Ryan McEniff:

But it is the season. One of the things that I was going to do, kind of a blitz podcast on, but since we’re here and we’re talking about… This probably will be a shorter one. But this was something that I saw on the interweb, on the internet somewhere. It was a few weeks back, and I kind of put it into my Evernote as, “This would be a good one to do a blitz on,” but then I did a blitz on something else, I can’t remember what it was. It was on an article on baby boomers. It wasn’t on baby boomers it was on how one in five people, one in five households in America doesn’t have net positive, net worth.

Janet:

That I’ll believe.

Ryan McEniff:

It was all about like, do these people… Everybody tells me like how, oh, it’s so great, you own a home healthcare company, it’s going to be making you tons of money. Usually the two things I say is, “Well, there are a lot of competitors, one, so it’s not like I’m the only one here. I’m not like John D Rockefeller with standard oil where I own the whole, the whole industry. Two, you know, I’m pretty concerned about baby boomer is not having money to pay for these things because the mentality, at least around here, I mean I’m not from the Midwest, but you see how in California, at least this the 4,000 square foot house, the three car garage, the truck, the BMW, and then the minivan or the SUV or whatever you want to call it that stuff costs money. And that means a lot of money isn’t getting saved.”

Janet:

Exactly. Well now there’s even ads on TV for different financial companies where it’s the idea of have you planned, do you have enough money to live out your life on?

Ryan McEniff:

Yeah.

Janet:

They have these different gimmicky, this is when you think you need to start a saving. When reality says you got to save there. A lot of people are concerned about outliving their money.

Ryan McEniff:

I think that’s a real concern.

Janet:

Absolutely.

Ryan McEniff:

You don’t know if like my mom, you don’t know if you’re the person that gets cancer at 65, or you’re the person that lives to 95, and he had only saved for 85 years on this earth.

Janet:

Yep.

Ryan McEniff:

So, but one of the things that we were going to talk about today and do a podcast on, and I’ll try to get this up tomorrow, tomorrow being Friday, today’s Thursday, the 14th. We didn’t have the time to get one out on Tuesday. It’s been you over here, but is this map I saw? I was on the internet and I, and just like the blitz podcast last week, I like talking about, reading about, and being knowledgeable about finance. I subscribe to the Wall Street Journal, not to really deal with the politics, but I like the business, the economy side. I think that stuff’s interesting.

             So, I saw this map of the nation, and the article is about who is the biggest employer in all of the United States. From looking at this map, who would you say is the biggest employer of all the United States?

Janet:

Walmart USA.

Ryan McEniff:

Walmart USA. All right. You might say, well, why the heck am I listening to the Caregiver’s Toolbox talk about Walmart being the biggest employer in the country, and you would absolutely be right in thinking that. The reason why I found this map so interesting is not because it talks about if Amazon and Walmart are going to go head to head being the biggest employers in the near future. But it’s because of the things I noticed on the map. Janet, I’ll just talk for a moment, then you give me your opinion on this.

             Most of the south and Midwest is dominated by Walmart, but then we’ll start from left to right from the west coast to the east coast, to the things that I found interesting. Oregon, Oregon, biggest provider, biggest employer, Providence health services, Idaho, St. Luke’s health services, Utah, Intermountain healthcare, North Dakota, Sanford health, South Dakota, Avera health. Minnesota, the Mayo clinic. Pennsylvania, University of Pittsburgh medical center center. Connecticut, Yale health systems. Rhode Island, Lifespan system of hospitals. Massachusetts is of course, Partners healthcare, God emperor partners healthcare, and then of course, University of Vermont medical center in Vermont is the number one employer there.

             Basically what this map showed that out of the states, 22 of these states were Walmart was the biggest employer of that in the next 12 states, it was healthcare systems. So though it wasn’t under the same umbrella of one company, it shows you how big the industry is of healthcare. That in 12 states, the number one employer is a hospital, or a medical center, or an insurance company. What do you think about that, Janet?

Janet:

It really is mind boggling and it would be interesting to see what that map would look like if you looked at healthcare companies that were national companies; because there are companies like Steward healthcare, they’re not based in Massachusetts, but they have a number of Massachusetts facilities. Or in the assisted livings, there are places that are regional, they’re multi-state. So it’s in some ways, even bigger than the list you came up with, it’s clearly the largest employer in our country.

Ryan McEniff:

Yeah, I would imagine that. I mean, just to guess, but if you start putting together all the hospitals, all the sniffs, all the assisted livings, the home health agencies, the VNA’s, and anything that’s related to that, whether that’s durable medical equipment companies, hospice companies, if I didn’t mention them already.

Janet:

Pharmaceuticals.

Ryan McEniff:

Pharmaceuticals.

Janet:

Huge.

Ryan McEniff:

Yeah. I mean, I would imagine the healthcare system overall might employ more people in the United States, whether that’s a percentage or an overall number, than maybe any other industry that’s out. I could be completely wrong. Maybe it’s the government. Maybe because you have these, the government would be number one, but maybe in the private sector it would be a healthcare system. Who knows, maybe retail with Walmart and all the retailers might be number one, but either way, it was a map that kind of surprised me on how dependent not only are we on healthcare to stay alive, but how dependent we are on healthcare to for our jobs, for our economy, for all of the different industries that are involved in that when it goes all the way down to the CVS’s and the Walgreens that are, yeah, they’re kind of convenience stores, but they’re really pharmacies, and they’re there to help out with healthcare needs.

Janet:

CVS, I think, is looking to merge, or buy, or something.

Ryan McEniff:

Already bought. Already purchased.

Janet:

Is it Aetna or someone?

Ryan McEniff:

Aetna, CVS bought Aetna, which is a whole nother. I didn’t even do a podcast on that because I don’t, it’s like, it’s so big.

Janet:

Just boggles the mind.

Ryan McEniff:

I don’t even know how you even eat that whale. I don’t know where that’s you’re going to find out the good, the bad, and the ugly like five years from now of like whether that works out or not. But I mean it’s got to be one of those, those things where the amounts of people that are involved in the healthcare system is monumental. It kind of made me think like, “Wow, I’m involved in it, and my employees are involved in it, and all of those things that are part of a system in helping sick people.”

Janet:

It defines where people live for access to these things. There was an article, I want to say it was this past week and it was maybe in the Boston globe, I’m sure it’s elsewhere that they ranked the number one state. The healthiest state in the country to live in. For the previous five years, Hawaii held the title. Well, this year, Massachusetts beat out Hawaii, and they listed what the criteria was. One of the places where Massachusetts pulled ahead was access to mental health services. So it’s not even just what we think of as the traditional physical medical conditions, but also mental health and what that brings.

Ryan McEniff:

Yeah, that makes sense. We didn’t even mention the mental health side of things. Maybe we forget about that because we don’t… One, I think you, when you think of somebody sick, you think physically, right.

Janet:

Right.

Ryan McEniff:

You think somebody’s injured, or somebody has a disease and we’re not in the mental health industry, so that’s maybe something that’s kind of an out of sight out of mind.

Janet:

And, it’s a funding issue and all of that.

Ryan McEniff:

Yeah, absolutely. It’s probably been out of sight out of mind for many different people, including important people that make big decisions in this country. That’s absolutely a good point. You know, how many people feel that they need mental health help, and that’s a whole nother segment of the industry that’s involved. It was just an interesting thing, and if you want to look it up, you just basically type into Google, the mapping, the largest employers in America, and there will be multiple websites that came up.

             I just printed this one out because I liked the map that it represented, I thought it was an easy to see map versus sometimes they do all the logos for each employer. I thought it was, I thought it was interesting, and I think it would be good to hear the feedback from the listeners that are on our Facebook page, on who are you employed by, and what are your thoughts on being in one of those states that their biggest employer is the healthcare industry? I mean, it’s got to be so important. I have friends that live in Connecticut and Connecticut, i think it’s a bit of a stereotype that it’s all rich, because you think about the people from Manhattan that live in the Southern tip of Connecticut, and what is it, and the Greenwich county or whatever that county is down there.

             But there’s a very big swath of Connecticut that is not filled with millionaires and billionaires it’s filled with thousandaires. I know that with my friends that are down there in the towns that are, even in the beach community towns. It’s either you’re a cop, you’re a fireman, or you’re a nurse, or a doctor. I mean, it’s one of those services where you’re either a government service worker, you’re working at Electric Boat, and Electric Boat is based in New London, and they’re a government contractor, or you’re in the healthcare industry. That’s what’s keeping things going down there versus, there’s no big, huge industry that’s down there right now, and the industry that they did have, which was insurance companies, they’re all leaving.

Janet:

That’s right. In rural parts of the country where small hospitals are finding it hard to keep their head above water, and are in fact closing, that’s devastating the economy in those areas.

Ryan McEniff:

Sure.

Janet:

It’s not like it’s something they don’t need, but if you have a 45 minute in an ambulance to get somewhere, that’s a whole nother world and that’s a significant part of our country that has to start dealing with that.

Ryan McEniff:

Sure. I mean, I remember the friend that I have down there, she’s a nurse and they had a bad night where there were two or three, I can’t remember. There were a couple major accidents that involved multiple cars and multiple people in them. Then they all went to this community hospital and the hospitals, “I can’t take care of 10 emergencies people at once.” So then they’re getting Medivacs out there and they’re just getting medical helicopters in and out to bring them to Providence or bring them to another one, because these small community hospitals are run on a shoestring budget. When those big disasters occur, they’re like, we’re not staffed for this amount of people. That costs lives when somebody’s got to be transported by ambulance or even the helicopter. It still takes time.

Janet:

Yep.

Ryan McEniff:

It still takes valuable time to get somebody up and get somebody into a facility that’s going to be equipped to handle whatever’s going on.

Janet:

Right.

Ryan McEniff:

So anyways, I thought that was just a good, interesting article. It doesn’t necessarily deal with home health, but it’s in our segment of healthcare. So take a look at that. I found it interesting. We’d love your feedback on the Caregiver’s Toolbox on Facebook. Look us up, please interact with us. We’ll certainly interact with you and give us your thoughts and opinions on things.

             Thank you very much, Janet.

Janet:

My pleasure.

Ryan McEniff:

Thank you for listening and we will catch you on the next one.

About Us

Minute Women Home Care is a premium, non-medical, live-in care, and in-home care service provider that enables our clients to live at home with dignity and respect by assisting with their activities of daily living. We support families in senior home care within their mission to allow their parents to age in place rather than transition to a nursing facility.

Minute Women Home Care | Home Care Services Since 1969

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Caregiver’s Toolbox Ep. 36 “When Elders and Medical Culture Collide”

Speaker 1:

Welcome to The Caregiver’s Toolbox. Tools for everyday caregiving, weer by education and information on senior care topics. Here’s your host, Ryan McEniff

Ryan McEniff:

What’s going on everybody. My name is Ryan McEniff. Janet, today we’re talking about when elders and medical culture collide. And they’re colliding right now.

Janet:

Like a supernova.

Ryan McEniff:

Like a supernova, creating a black hole which will suck us all in and we’ll all be destroyed.

Janet:

That’s right.

Ryan McEniff:

So Janet, give me an idea. What are we talking about today?

Janet:

Well, I think today we’re so comfortable with the whole concept of global society and you’ve got, especially in our Boston area, we have a melting pot. We have all different backgrounds and we also have some of the finest teaching hospitals in the world.

Janet:

So you’ve got all of this change, all of this wonderful things going forward, but a number of their patients, if, if any of our viewers are 50 year old or your parents or your grandparents, this is foreign territory to them. And they have developed a mindset of what medical services are and you need to keep that in mind. You’re not going to get them for the most part to just graciously go into the seven-minute visit, do the test, check out your notes on your laptop when the doctor sends it through the medical email. This is just not where they’re at.

Janet:

I think of my grandmother, I think of my own parents, and they thought the idea of a seven-minute visit was just absolutely horrible. And that had become the standard because the doctors, what do they need, got you in, got you out. And on the post acute side, meaning whether you need a nursing home or elder care or whatever, these are all things that did not exist a generation or more ago. You didn’t have elder daycare. Assisted living, that was grandma came to live with you. It was things like that. So to try and have your parent or your grandparent feel comfortable with this is really tough. I don’t know how your dad is navigating the system. He seems computer savvy so he’s probably doing great with it.

Ryan McEniff:

We’ll see.

Janet:

My dad is computer savvy so he loves looking up test results. My mother cannot for the life of her understand why things are the way they are. And that’s something that you, as the family caregiver, you have to be mindful of that mindset. My grandmother didn’t think that women could be doctors. So the doctor would come in and for all that she cared, it was the nurse. And the doctor had a God complex. You never questioned them. So as a caregiver or as an advocate for your family member, you need to be an unapologetic caregiver. If you need more time, if you need more information for them, you kind of need to fight for it, and that’s kind of unfortunate these days.

Ryan McEniff:

Yeah, absolutely. I mean, you have, generally well-known that the vast majority of dollars that are spent on your healthcare are later in life, right? 60 years old and after, because that’s when things start breaking down. Just like in a car, you’re not spending maintenance dollars for the first a hundred thousand miles, as much as you are spending it after the first hundred thousand miles, because that’s when things, wear and tear, takes on with vehicles, same with people. So you have younger people that were used to going to see the doctor regularly. Every single year, they went to the doctor. They had those experiences.

Ryan McEniff:

And then, for a lot of people, right around 25, 30 probably years old, doctors appointments aren’t as big of deal, right? Because I’m fine. Everything’s going, well. I spend this money or I see the doctor. I don’t need to see them. Same with dentists. My teeth are fine. I chew with them every day. They’re perfectly fine. Then, 20 years goes by with maybe a doctor’s visit here and there when the occasional flat tire occur and you just need to get it quickly fixed or whatever is going on, and then you get into a system of that it looks completely different than what you were used to when you were growing up and younger. And even every few years when you went there, maybe you don’t remember it as well, and how quickly that doctor was in there, did a bunch of things on his computer, talks to you for 30 seconds, gone. It’s a different world when you get into a hospital and they’re looking at you in a completely different mindset.

Janet:

Right. And there was no such thing as a walk-in. If anybody walked in, it was, in my grandmother’s generation, they walked into your home with their little black bag. You had this one doctor that knew you from womb to tomb in many cases.

Ryan McEniff:

Sure.

Janet:

Now, it’s this one does your physical, and this one looks at your eyes, and this one takes care of something else. And so, we’ve learned to adapt to that. But if you have … and it’s even more frightening in many cases, if the person has any form of a dementia or it’s just plain getting forgetful and it’s like, I have to keep this appointment and that appointment. I mean, I had to laugh myself. I was used to going to my doctor to get my physical and I have a new doctor this year, and it’s like, this one does this part of it and this one does that part of it. I’m like, it’s just a physical. I thought it was like getting oil changed on the car.

Janet:

And I mentioned, even to my parents and they’re like, “What? It was just a physical, but there’s three different people get this done?” We have to be sensitive to that, and understand that you are not going to change that mindset. That’s something that’s burned into their mind. You have to prepare to take them to an appointment, to answer questions for them, to let them know what’s going to happen before the visit. I think parents do a great job doing that with their kids, but I often say, elderly people are tall kids and that’s really the case.

Janet:

But we assume that just like us, we became adults. And as we go along, we know these things. We think our parents do too, or our grandparents do too. And they don’t. I find that it’s very helpful for us as a private home care to be upfront and ask questions about things that involve someone’s mindset. I will point blank, I will ask if someone is going to have an issue. If a caregiver is someone of color. It doesn’t mean they’re a bigot. It doesn’t mean they’re a racist. It’s just something they’re not familiar with. Or then there’s the association of, well, is English their second language. These are all things that you’re going to bring this into somebody’s home and they have to have a comfort level. You have to keep the mindset.

Ryan McEniff:

Absolutely, and it’s managing expectations as well. Somebody might be going in there and thinking that, using the example you used that you go in, you meet with one person, they handle everything, and things are good. And then you find out that generalist then refers out to a bunch of specialists and you just went from having one … or your parent has gone from thinking they just have one visit to do, that it’s just gone to three or four visits because you have to go see the difference, but you got to go do the blood work here, and then you got to do this, and then you got to do that, then we got to have you come back in and we’ll go over all the tests and we’ll explain to you what happened. When you’re used to, “I just went and saw one guy, not even a female, one guy, and he said everything and he knew everything. And if they said to put salt on it, then that would fix it,” when it might not necessarily be the case anymore.

Janet:

Absolutely. Some people, and some of the doctors to their credit, they’re coming up with the latest and greatest of techniques and medications and all these other things when someone’s thinking tea and honey and wearing socks to bed is going to solve what they need.

Janet:

Just recently, I was having a conversation with my parents about a friend of theirs that, I don’t know if it was a knee replacement, a hip replacement, whatever they needed, and these people are having a conversation about a particular Boston hospital which is world renowned for were doing knees and hips and that kind of thing. The person said, “That’s where I have to go.” Yet, a friend of theirs said, “Yeah, well, mine was fixed, but a couple months later I was in as much pain as I was before.” I’m trying to explain to my parents that, “Well, they are world renowned and take care of all these great athletes. But that athlete that has a hip problem is what, 21? And he’s got good muscles and he’s got got nothing but the best. If you’ve got someone who’s 90 and doesn’t get any exercise and now they need a knee replacement, they’re not going to have the same results at that world renowned hospital.

Janet:

So it’s the whole understanding of the mindset of what good care is that it needs to be taken seriously and respected as much as anything else.

Ryan McEniff:

Absolutely. I mean, and we can do a whole another show on the fact of that mindset with older adults when deciding on what care to get. Right? So we’ve had seen cases where people drag their feet a little bit, something catastrophic happens to mom or dad, and then the result is that they never get back to the baseline that they were at already. Their baseline has changed. Their basic ability to do certain things has gone down and they’re more than likely never going to get past that. Those are those types of things that you talk about with your parents of like, you need to, going off of what you said with the baseball player and that that expectation of you might not bounce back or your bounce back might be completely different. You might have pain in your knee for the rest of your life. It just won’t be as severe as it was before you got the knee replacement surgery, using an example which may or may not even be true.

Ryan McEniff:

Because we see it all the time where people take their time in finding care and think, and there’s that mindset because you’re 40, you’re 50 years old, you’re still young, or I’m 30. You’re still young enough that if you do fall, it’s not the end of the world. You generally get back up. Maybe you’re sore for a little bit longer than you would’ve been when you’re 20, but you’re thinking this mindset of, “Well, they’ll just go to the hospital. They’ll get better. And then they’ll be back to normal.” It doesn’t work out that way. What happens is that they fall, they injure themselves, and then their independence is shot for the rest of their life rather than getting back to where they can live on their own and they can walk up and down the stairs and still do their gardening that they love doing every single time. So, that’s a really great point that you make with that comparison of the age difference and the expectation level that will come when you’re dealing with somebody who’s younger versus somebody who’s older.

Janet:

Even to use that same example, we kind of ended the conversation just before the hockey game came on, and I was saying that, “Okay, how young did Bobby Orr stop playing because of his knees?” These athletes that can get the best care in the world, but they’re retired in their thirties. And then you find out they get to their sixties, the knees have been replaced, the hips have been replaced, and they still have trouble just getting around. So some of it is the kind of shape you were in when you got hurt, but there’s also just some things that as your body ages and certain things slow and certain things become brittle that you need to keep that in mind.

Ryan McEniff:

Absolutely. That’s another very good point. That wear and tear is an accumulated effect.

Janet:

Absolutely.

Ryan McEniff:

You see these people that do the same thing over and over and over again at a high level like an athlete, and it just wears their body down that much faster versus doing it sparingly over time. You can play basketball once or twice a week and probably do that till you’re 60 or 70 years old. But if you want to play at the highest level that you can, that’s going to take a toll on your body that’s completely different. It’s the same thing just on a different scale with everyday people.

Janet:

Exactly. There was a Red Sox game a few months back and up in the booth was Eckersley and Jerry Remy. It really was a funny conversation because you look at Eckersley and he looks like the picture of health. Even Jerry Remy was looking pretty good for someone who’s dealing with cancer and all kinds of things. But they were going on and on of just how broken their bodies are and how they could barely move. Eckersley, his shoulder is totally shredded. And there’s Remy saying, “Ugh, if I drop something, I can’t bend down to pick it up.” This guy was, was a great baseball player. It’s just they got old at 30 because of the toll in their body. So, you need to keep that in mind. You can’t think because you go to the best physician that he is going to make you younger. I think in some ways is what the hope is.

Ryan McEniff:

It’s going to magically fix everything. I mean, they can only bring you so far. And then additionally, there’s a lot of rehab involved. There’s a lot of, you hear about, and I’m guilty of this too so I’m not on my high horse, but you get injured and then you’re told you need to do these exercises every day or two times a day or three times a week or whatever it is. People don’t do it. And then, so they go, “Oh, well the surgery didn’t work.” Well, the surgery did work, but you didn’t strengthen the area with your rehabilitation to get to that next level, to get back to exactly where you were.

Janet:

Exactly.

Ryan McEniff:

That’s another problem that we see with this medical culture of, “Hey, you go to the doctor, it gets fixed and you go home.” Well, there’s a lot of rehab that’s needed in that and if you stay on that course with that rehab, you’re going to exceed far further than if you don’t. I’ve been guilty of that and I’ve made that mistake and I’m not going to make that mistake again.

Janet:

Guilty as charged. I think the athletes and all, they stick with that because they’re under contractual agreement to make sure-

Ryan McEniff:

There’s a lot money on the line. But when it comes with your parents, you need to be the one that’s hounding them and reminding them, “This is your independence on the line” or “You’re going to an assisted living” or “You’re moving in with me” or whatever case scenario occurs that you need to go there and get this done and explain to them what’s going to be happening.

Janet:

Yep, absolutely.

Ryan McEniff:

So anyways, that will wrap up our discussion on elders and medical culturing, excuse me, medical culture colliding. My name is Ryan McEniff. This is Janet. We are going to be … we didn’t do our little ad, but that’s okay. But one thing I would like to say is, please like us on Facebook, look up our page, The Caregiver’s Toolbox. There we can get your feedback on things. If you have certain topics you want to hear about, please let us know about it. We are also videotaping these podcasts so that we can put them onto Facebook video, onto YouTube. I think maybe in the future we’ll try to do some live videos, but we’ll see. We’re just testing this out. We really love the podcast, but I know that some people out there really like watching video as well. So that’s kind of why we went into this format. So, check it, so whether it’s on YouTube, whether it’s on Facebook, it’s going to be under The Caregiver’s Toolbox. We’ll see you next week. Thanks, goodbye.

About Us

Minute Women Home Care is a premium, non-medical, live-in care, and in-home care service provider that enables our clients to live at home with dignity and respect by assisting with their activities of daily living. We support families in senior home care within their mission to allow their parents to age in place rather than transition to a nursing facility.

Minute Women Home Care | Home Care Services Since 1969

Connect With Us

Facebook

LinkedIn

Subscribe to The Caregiver’s Toolbox Podcast

iTunes

Google Podcasts

Stitcher

Spotify

Click here to view our Podcast Directory

Caregiver’s Toolbox Ep. 36 “When Elders and Medical Culture Collide”

Speaker 1:

Welcome to The Caregiver’s Toolbox. Tools for everyday caregiving, weer by education and information on senior care topics. Here’s your host, Ryan McEniff

Ryan McEniff:

What’s going on everybody. My name is Ryan McEniff. Janet, today we’re talking about when elders and medical culture collide. And they’re colliding right now.

Janet:

Like a supernova.

Ryan McEniff:

Like a supernova, creating a black hole which will suck us all in and we’ll all be destroyed.

Janet:

That’s right.

Ryan McEniff:

So Janet, give me an idea. What are we talking about today?

Janet:

Well, I think today we’re so comfortable with the whole concept of global society and you’ve got, especially in our Boston area, we have a melting pot. We have all different backgrounds and we also have some of the finest teaching hospitals in the world.

Janet:

So you’ve got all of this change, all of this wonderful things going forward, but a number of their patients, if, if any of our viewers are 50 year old or your parents or your grandparents, this is foreign territory to them. And they have developed a mindset of what medical services are and you need to keep that in mind. You’re not going to get them for the most part to just graciously go into the seven-minute visit, do the test, check out your notes on your laptop when the doctor sends it through the medical email. This is just not where they’re at.

Janet:

I think of my grandmother, I think of my own parents, and they thought the idea of a seven-minute visit was just absolutely horrible. And that had become the standard because the doctors, what do they need, got you in, got you out. And on the post acute side, meaning whether you need a nursing home or elder care or whatever, these are all things that did not exist a generation or more ago. You didn’t have elder daycare. Assisted living, that was grandma came to live with you. It was things like that. So to try and have your parent or your grandparent feel comfortable with this is really tough. I don’t know how your dad is navigating the system. He seems computer savvy so he’s probably doing great with it.

Ryan McEniff:

We’ll see.

Janet:

My dad is computer savvy so he loves looking up test results. My mother cannot for the life of her understand why things are the way they are. And that’s something that you, as the family caregiver, you have to be mindful of that mindset. My grandmother didn’t think that women could be doctors. So the doctor would come in and for all that she cared, it was the nurse. And the doctor had a God complex. You never questioned them. So as a caregiver or as an advocate for your family member, you need to be an unapologetic caregiver. If you need more time, if you need more information for them, you kind of need to fight for it, and that’s kind of unfortunate these days.

Ryan McEniff:

Yeah, absolutely. I mean, you have, generally well-known that the vast majority of dollars that are spent on your healthcare are later in life, right? 60 years old and after, because that’s when things start breaking down. Just like in a car, you’re not spending maintenance dollars for the first a hundred thousand miles, as much as you are spending it after the first hundred thousand miles, because that’s when things, wear and tear, takes on with vehicles, same with people. So you have younger people that were used to going to see the doctor regularly. Every single year, they went to the doctor. They had those experiences.

Ryan McEniff:

And then, for a lot of people, right around 25, 30 probably years old, doctors appointments aren’t as big of deal, right? Because I’m fine. Everything’s going, well. I spend this money or I see the doctor. I don’t need to see them. Same with dentists. My teeth are fine. I chew with them every day. They’re perfectly fine. Then, 20 years goes by with maybe a doctor’s visit here and there when the occasional flat tire occur and you just need to get it quickly fixed or whatever is going on, and then you get into a system of that it looks completely different than what you were used to when you were growing up and younger. And even every few years when you went there, maybe you don’t remember it as well, and how quickly that doctor was in there, did a bunch of things on his computer, talks to you for 30 seconds, gone. It’s a different world when you get into a hospital and they’re looking at you in a completely different mindset.

Janet:

Right. And there was no such thing as a walk-in. If anybody walked in, it was, in my grandmother’s generation, they walked into your home with their little black bag. You had this one doctor that knew you from womb to tomb in many cases.

Ryan McEniff:

Sure.

Janet:

Now, it’s this one does your physical, and this one looks at your eyes, and this one takes care of something else. And so, we’ve learned to adapt to that. But if you have … and it’s even more frightening in many cases, if the person has any form of a dementia or it’s just plain getting forgetful and it’s like, I have to keep this appointment and that appointment. I mean, I had to laugh myself. I was used to going to my doctor to get my physical and I have a new doctor this year, and it’s like, this one does this part of it and this one does that part of it. I’m like, it’s just a physical. I thought it was like getting oil changed on the car.

Janet:

And I mentioned, even to my parents and they’re like, “What? It was just a physical, but there’s three different people get this done?” We have to be sensitive to that, and understand that you are not going to change that mindset. That’s something that’s burned into their mind. You have to prepare to take them to an appointment, to answer questions for them, to let them know what’s going to happen before the visit. I think parents do a great job doing that with their kids, but I often say, elderly people are tall kids and that’s really the case.

Janet:

But we assume that just like us, we became adults. And as we go along, we know these things. We think our parents do too, or our grandparents do too. And they don’t. I find that it’s very helpful for us as a private home care to be upfront and ask questions about things that involve someone’s mindset. I will point blank, I will ask if someone is going to have an issue. If a caregiver is someone of color. It doesn’t mean they’re a bigot. It doesn’t mean they’re a racist. It’s just something they’re not familiar with. Or then there’s the association of, well, is English their second language. These are all things that you’re going to bring this into somebody’s home and they have to have a comfort level. You have to keep the mindset.

Ryan McEniff:

Absolutely, and it’s managing expectations as well. Somebody might be going in there and thinking that, using the example you used that you go in, you meet with one person, they handle everything, and things are good. And then you find out that generalist then refers out to a bunch of specialists and you just went from having one … or your parent has gone from thinking they just have one visit to do, that it’s just gone to three or four visits because you have to go see the difference, but you got to go do the blood work here, and then you got to do this, and then you got to do that, then we got to have you come back in and we’ll go over all the tests and we’ll explain to you what happened. When you’re used to, “I just went and saw one guy, not even a female, one guy, and he said everything and he knew everything. And if they said to put salt on it, then that would fix it,” when it might not necessarily be the case anymore.

Janet:

Absolutely. Some people, and some of the doctors to their credit, they’re coming up with the latest and greatest of techniques and medications and all these other things when someone’s thinking tea and honey and wearing socks to bed is going to solve what they need.

Janet:

Just recently, I was having a conversation with my parents about a friend of theirs that, I don’t know if it was a knee replacement, a hip replacement, whatever they needed, and these people are having a conversation about a particular Boston hospital which is world renowned for were doing knees and hips and that kind of thing. The person said, “That’s where I have to go.” Yet, a friend of theirs said, “Yeah, well, mine was fixed, but a couple months later I was in as much pain as I was before.” I’m trying to explain to my parents that, “Well, they are world renowned and take care of all these great athletes. But that athlete that has a hip problem is what, 21? And he’s got good muscles and he’s got got nothing but the best. If you’ve got someone who’s 90 and doesn’t get any exercise and now they need a knee replacement, they’re not going to have the same results at that world renowned hospital.

Janet:

So it’s the whole understanding of the mindset of what good care is that it needs to be taken seriously and respected as much as anything else.

Ryan McEniff:

Absolutely. I mean, and we can do a whole another show on the fact of that mindset with older adults when deciding on what care to get. Right? So we’ve had seen cases where people drag their feet a little bit, something catastrophic happens to mom or dad, and then the result is that they never get back to the baseline that they were at already. Their baseline has changed. Their basic ability to do certain things has gone down and they’re more than likely never going to get past that. Those are those types of things that you talk about with your parents of like, you need to, going off of what you said with the baseball player and that that expectation of you might not bounce back or your bounce back might be completely different. You might have pain in your knee for the rest of your life. It just won’t be as severe as it was before you got the knee replacement surgery, using an example which may or may not even be true.

Ryan McEniff:

Because we see it all the time where people take their time in finding care and think, and there’s that mindset because you’re 40, you’re 50 years old, you’re still young, or I’m 30. You’re still young enough that if you do fall, it’s not the end of the world. You generally get back up. Maybe you’re sore for a little bit longer than you would’ve been when you’re 20, but you’re thinking this mindset of, “Well, they’ll just go to the hospital. They’ll get better. And then they’ll be back to normal.” It doesn’t work out that way. What happens is that they fall, they injure themselves, and then their independence is shot for the rest of their life rather than getting back to where they can live on their own and they can walk up and down the stairs and still do their gardening that they love doing every single time. So, that’s a really great point that you make with that comparison of the age difference and the expectation level that will come when you’re dealing with somebody who’s younger versus somebody who’s older.

Janet:

Even to use that same example, we kind of ended the conversation just before the hockey game came on, and I was saying that, “Okay, how young did Bobby Orr stop playing because of his knees?” These athletes that can get the best care in the world, but they’re retired in their thirties. And then you find out they get to their sixties, the knees have been replaced, the hips have been replaced, and they still have trouble just getting around. So some of it is the kind of shape you were in when you got hurt, but there’s also just some things that as your body ages and certain things slow and certain things become brittle that you need to keep that in mind.

Ryan McEniff:

Absolutely. That’s another very good point. That wear and tear is an accumulated effect.

Janet:

Absolutely.

Ryan McEniff:

You see these people that do the same thing over and over and over again at a high level like an athlete, and it just wears their body down that much faster versus doing it sparingly over time. You can play basketball once or twice a week and probably do that till you’re 60 or 70 years old. But if you want to play at the highest level that you can, that’s going to take a toll on your body that’s completely different. It’s the same thing just on a different scale with everyday people.

Janet:

Exactly. There was a Red Sox game a few months back and up in the booth was Eckersley and Jerry Remy. It really was a funny conversation because you look at Eckersley and he looks like the picture of health. Even Jerry Remy was looking pretty good for someone who’s dealing with cancer and all kinds of things. But they were going on and on of just how broken their bodies are and how they could barely move. Eckersley, his shoulder is totally shredded. And there’s Remy saying, “Ugh, if I drop something, I can’t bend down to pick it up.” This guy was, was a great baseball player. It’s just they got old at 30 because of the toll in their body. So, you need to keep that in mind. You can’t think because you go to the best physician that he is going to make you younger. I think in some ways is what the hope is.

Ryan McEniff:

It’s going to magically fix everything. I mean, they can only bring you so far. And then additionally, there’s a lot of rehab involved. There’s a lot of, you hear about, and I’m guilty of this too so I’m not on my high horse, but you get injured and then you’re told you need to do these exercises every day or two times a day or three times a week or whatever it is. People don’t do it. And then, so they go, “Oh, well the surgery didn’t work.” Well, the surgery did work, but you didn’t strengthen the area with your rehabilitation to get to that next level, to get back to exactly where you were.

Janet:

Exactly.

Ryan McEniff:

That’s another problem that we see with this medical culture of, “Hey, you go to the doctor, it gets fixed and you go home.” Well, there’s a lot of rehab that’s needed in that and if you stay on that course with that rehab, you’re going to exceed far further than if you don’t. I’ve been guilty of that and I’ve made that mistake and I’m not going to make that mistake again.

Janet:

Guilty as charged. I think the athletes and all, they stick with that because they’re under contractual agreement to make sure-

Ryan McEniff:

There’s a lot money on the line. But when it comes with your parents, you need to be the one that’s hounding them and reminding them, “This is your independence on the line” or “You’re going to an assisted living” or “You’re moving in with me” or whatever case scenario occurs that you need to go there and get this done and explain to them what’s going to be happening.

Janet:

Yep, absolutely.

Ryan McEniff:

So anyways, that will wrap up our discussion on elders and medical culturing, excuse me, medical culture colliding. My name is Ryan McEniff. This is Janet. We are going to be … we didn’t do our little ad, but that’s okay. But one thing I would like to say is, please like us on Facebook, look up our page, The Caregiver’s Toolbox. There we can get your feedback on things. If you have certain topics you want to hear about, please let us know about it. We are also videotaping these podcasts so that we can put them onto Facebook video, onto YouTube. I think maybe in the future we’ll try to do some live videos, but we’ll see. We’re just testing this out. We really love the podcast, but I know that some people out there really like watching video as well. So that’s kind of why we went into this format. So, check it, so whether it’s on YouTube, whether it’s on Facebook, it’s going to be under The Caregiver’s Toolbox. We’ll see you next week. Thanks, goodbye.

About Us

Minute Women Home Care is a premium, non-medical, live-in care, and in-home care service provider that enables our clients to live at home with dignity and respect by assisting with their activities of daily living. We support families in senior home care within their mission to allow their parents to age in place rather than transition to a nursing facility.

Minute Women Home Care | Home Care Services Since 1969

Connect With Us

Facebook

LinkedIn

Subscribe to The Caregiver’s Toolbox Podcast

iTunes

Google Podcasts

Stitcher

Spotify

Click here to view our Podcast Directory

Caregiver’s Toolbox Ep. 36 “When Elders and Medical Culture Collide”

Speaker 1:

Welcome to The Caregiver’s Toolbox. Tools for everyday caregiving, weer by education and information on senior care topics. Here’s your host, Ryan McEniff

Ryan McEniff:

What’s going on everybody. My name is Ryan McEniff. Janet, today we’re talking about when elders and medical culture collide. And they’re colliding right now.

Janet:

Like a supernova.

Ryan McEniff:

Like a supernova, creating a black hole which will suck us all in and we’ll all be destroyed.

Janet:

That’s right.

Ryan McEniff:

So Janet, give me an idea. What are we talking about today?

Janet:

Well, I think today we’re so comfortable with the whole concept of global society and you’ve got, especially in our Boston area, we have a melting pot. We have all different backgrounds and we also have some of the finest teaching hospitals in the world.

Janet:

So you’ve got all of this change, all of this wonderful things going forward, but a number of their patients, if, if any of our viewers are 50 year old or your parents or your grandparents, this is foreign territory to them. And they have developed a mindset of what medical services are and you need to keep that in mind. You’re not going to get them for the most part to just graciously go into the seven-minute visit, do the test, check out your notes on your laptop when the doctor sends it through the medical email. This is just not where they’re at.

Janet:

I think of my grandmother, I think of my own parents, and they thought the idea of a seven-minute visit was just absolutely horrible. And that had become the standard because the doctors, what do they need, got you in, got you out. And on the post acute side, meaning whether you need a nursing home or elder care or whatever, these are all things that did not exist a generation or more ago. You didn’t have elder daycare. Assisted living, that was grandma came to live with you. It was things like that. So to try and have your parent or your grandparent feel comfortable with this is really tough. I don’t know how your dad is navigating the system. He seems computer savvy so he’s probably doing great with it.

Ryan McEniff:

We’ll see.

Janet:

My dad is computer savvy so he loves looking up test results. My mother cannot for the life of her understand why things are the way they are. And that’s something that you, as the family caregiver, you have to be mindful of that mindset. My grandmother didn’t think that women could be doctors. So the doctor would come in and for all that she cared, it was the nurse. And the doctor had a God complex. You never questioned them. So as a caregiver or as an advocate for your family member, you need to be an unapologetic caregiver. If you need more time, if you need more information for them, you kind of need to fight for it, and that’s kind of unfortunate these days.

Ryan McEniff:

Yeah, absolutely. I mean, you have, generally well-known that the vast majority of dollars that are spent on your healthcare are later in life, right? 60 years old and after, because that’s when things start breaking down. Just like in a car, you’re not spending maintenance dollars for the first a hundred thousand miles, as much as you are spending it after the first hundred thousand miles, because that’s when things, wear and tear, takes on with vehicles, same with people. So you have younger people that were used to going to see the doctor regularly. Every single year, they went to the doctor. They had those experiences.

Ryan McEniff:

And then, for a lot of people, right around 25, 30 probably years old, doctors appointments aren’t as big of deal, right? Because I’m fine. Everything’s going, well. I spend this money or I see the doctor. I don’t need to see them. Same with dentists. My teeth are fine. I chew with them every day. They’re perfectly fine. Then, 20 years goes by with maybe a doctor’s visit here and there when the occasional flat tire occur and you just need to get it quickly fixed or whatever is going on, and then you get into a system of that it looks completely different than what you were used to when you were growing up and younger. And even every few years when you went there, maybe you don’t remember it as well, and how quickly that doctor was in there, did a bunch of things on his computer, talks to you for 30 seconds, gone. It’s a different world when you get into a hospital and they’re looking at you in a completely different mindset.

Janet:

Right. And there was no such thing as a walk-in. If anybody walked in, it was, in my grandmother’s generation, they walked into your home with their little black bag. You had this one doctor that knew you from womb to tomb in many cases.

Ryan McEniff:

Sure.

Janet:

Now, it’s this one does your physical, and this one looks at your eyes, and this one takes care of something else. And so, we’ve learned to adapt to that. But if you have … and it’s even more frightening in many cases, if the person has any form of a dementia or it’s just plain getting forgetful and it’s like, I have to keep this appointment and that appointment. I mean, I had to laugh myself. I was used to going to my doctor to get my physical and I have a new doctor this year, and it’s like, this one does this part of it and this one does that part of it. I’m like, it’s just a physical. I thought it was like getting oil changed on the car.

Janet:

And I mentioned, even to my parents and they’re like, “What? It was just a physical, but there’s three different people get this done?” We have to be sensitive to that, and understand that you are not going to change that mindset. That’s something that’s burned into their mind. You have to prepare to take them to an appointment, to answer questions for them, to let them know what’s going to happen before the visit. I think parents do a great job doing that with their kids, but I often say, elderly people are tall kids and that’s really the case.

Janet:

But we assume that just like us, we became adults. And as we go along, we know these things. We think our parents do too, or our grandparents do too. And they don’t. I find that it’s very helpful for us as a private home care to be upfront and ask questions about things that involve someone’s mindset. I will point blank, I will ask if someone is going to have an issue. If a caregiver is someone of color. It doesn’t mean they’re a bigot. It doesn’t mean they’re a racist. It’s just something they’re not familiar with. Or then there’s the association of, well, is English their second language. These are all things that you’re going to bring this into somebody’s home and they have to have a comfort level. You have to keep the mindset.

Ryan McEniff:

Absolutely, and it’s managing expectations as well. Somebody might be going in there and thinking that, using the example you used that you go in, you meet with one person, they handle everything, and things are good. And then you find out that generalist then refers out to a bunch of specialists and you just went from having one … or your parent has gone from thinking they just have one visit to do, that it’s just gone to three or four visits because you have to go see the difference, but you got to go do the blood work here, and then you got to do this, and then you got to do that, then we got to have you come back in and we’ll go over all the tests and we’ll explain to you what happened. When you’re used to, “I just went and saw one guy, not even a female, one guy, and he said everything and he knew everything. And if they said to put salt on it, then that would fix it,” when it might not necessarily be the case anymore.

Janet:

Absolutely. Some people, and some of the doctors to their credit, they’re coming up with the latest and greatest of techniques and medications and all these other things when someone’s thinking tea and honey and wearing socks to bed is going to solve what they need.

Janet:

Just recently, I was having a conversation with my parents about a friend of theirs that, I don’t know if it was a knee replacement, a hip replacement, whatever they needed, and these people are having a conversation about a particular Boston hospital which is world renowned for were doing knees and hips and that kind of thing. The person said, “That’s where I have to go.” Yet, a friend of theirs said, “Yeah, well, mine was fixed, but a couple months later I was in as much pain as I was before.” I’m trying to explain to my parents that, “Well, they are world renowned and take care of all these great athletes. But that athlete that has a hip problem is what, 21? And he’s got good muscles and he’s got got nothing but the best. If you’ve got someone who’s 90 and doesn’t get any exercise and now they need a knee replacement, they’re not going to have the same results at that world renowned hospital.

Janet:

So it’s the whole understanding of the mindset of what good care is that it needs to be taken seriously and respected as much as anything else.

Ryan McEniff:

Absolutely. I mean, and we can do a whole another show on the fact of that mindset with older adults when deciding on what care to get. Right? So we’ve had seen cases where people drag their feet a little bit, something catastrophic happens to mom or dad, and then the result is that they never get back to the baseline that they were at already. Their baseline has changed. Their basic ability to do certain things has gone down and they’re more than likely never going to get past that. Those are those types of things that you talk about with your parents of like, you need to, going off of what you said with the baseball player and that that expectation of you might not bounce back or your bounce back might be completely different. You might have pain in your knee for the rest of your life. It just won’t be as severe as it was before you got the knee replacement surgery, using an example which may or may not even be true.

Ryan McEniff:

Because we see it all the time where people take their time in finding care and think, and there’s that mindset because you’re 40, you’re 50 years old, you’re still young, or I’m 30. You’re still young enough that if you do fall, it’s not the end of the world. You generally get back up. Maybe you’re sore for a little bit longer than you would’ve been when you’re 20, but you’re thinking this mindset of, “Well, they’ll just go to the hospital. They’ll get better. And then they’ll be back to normal.” It doesn’t work out that way. What happens is that they fall, they injure themselves, and then their independence is shot for the rest of their life rather than getting back to where they can live on their own and they can walk up and down the stairs and still do their gardening that they love doing every single time. So, that’s a really great point that you make with that comparison of the age difference and the expectation level that will come when you’re dealing with somebody who’s younger versus somebody who’s older.

Janet:

Even to use that same example, we kind of ended the conversation just before the hockey game came on, and I was saying that, “Okay, how young did Bobby Orr stop playing because of his knees?” These athletes that can get the best care in the world, but they’re retired in their thirties. And then you find out they get to their sixties, the knees have been replaced, the hips have been replaced, and they still have trouble just getting around. So some of it is the kind of shape you were in when you got hurt, but there’s also just some things that as your body ages and certain things slow and certain things become brittle that you need to keep that in mind.

Ryan McEniff:

Absolutely. That’s another very good point. That wear and tear is an accumulated effect.

Janet:

Absolutely.

Ryan McEniff:

You see these people that do the same thing over and over and over again at a high level like an athlete, and it just wears their body down that much faster versus doing it sparingly over time. You can play basketball once or twice a week and probably do that till you’re 60 or 70 years old. But if you want to play at the highest level that you can, that’s going to take a toll on your body that’s completely different. It’s the same thing just on a different scale with everyday people.

Janet:

Exactly. There was a Red Sox game a few months back and up in the booth was Eckersley and Jerry Remy. It really was a funny conversation because you look at Eckersley and he looks like the picture of health. Even Jerry Remy was looking pretty good for someone who’s dealing with cancer and all kinds of things. But they were going on and on of just how broken their bodies are and how they could barely move. Eckersley, his shoulder is totally shredded. And there’s Remy saying, “Ugh, if I drop something, I can’t bend down to pick it up.” This guy was, was a great baseball player. It’s just they got old at 30 because of the toll in their body. So, you need to keep that in mind. You can’t think because you go to the best physician that he is going to make you younger. I think in some ways is what the hope is.

Ryan McEniff:

It’s going to magically fix everything. I mean, they can only bring you so far. And then additionally, there’s a lot of rehab involved. There’s a lot of, you hear about, and I’m guilty of this too so I’m not on my high horse, but you get injured and then you’re told you need to do these exercises every day or two times a day or three times a week or whatever it is. People don’t do it. And then, so they go, “Oh, well the surgery didn’t work.” Well, the surgery did work, but you didn’t strengthen the area with your rehabilitation to get to that next level, to get back to exactly where you were.

Janet:

Exactly.

Ryan McEniff:

That’s another problem that we see with this medical culture of, “Hey, you go to the doctor, it gets fixed and you go home.” Well, there’s a lot of rehab that’s needed in that and if you stay on that course with that rehab, you’re going to exceed far further than if you don’t. I’ve been guilty of that and I’ve made that mistake and I’m not going to make that mistake again.

Janet:

Guilty as charged. I think the athletes and all, they stick with that because they’re under contractual agreement to make sure-

Ryan McEniff:

There’s a lot money on the line. But when it comes with your parents, you need to be the one that’s hounding them and reminding them, “This is your independence on the line” or “You’re going to an assisted living” or “You’re moving in with me” or whatever case scenario occurs that you need to go there and get this done and explain to them what’s going to be happening.

Janet:

Yep, absolutely.

Ryan McEniff:

So anyways, that will wrap up our discussion on elders and medical culturing, excuse me, medical culture colliding. My name is Ryan McEniff. This is Janet. We are going to be … we didn’t do our little ad, but that’s okay. But one thing I would like to say is, please like us on Facebook, look up our page, The Caregiver’s Toolbox. There we can get your feedback on things. If you have certain topics you want to hear about, please let us know about it. We are also videotaping these podcasts so that we can put them onto Facebook video, onto YouTube. I think maybe in the future we’ll try to do some live videos, but we’ll see. We’re just testing this out. We really love the podcast, but I know that some people out there really like watching video as well. So that’s kind of why we went into this format. So, check it, so whether it’s on YouTube, whether it’s on Facebook, it’s going to be under The Caregiver’s Toolbox. We’ll see you next week. Thanks, goodbye.

About Us

Minute Women Home Care is a premium, non-medical, live-in care, and in-home care service provider that enables our clients to live at home with dignity and respect by assisting with their activities of daily living. We support families in senior home care within their mission to allow their parents to age in place rather than transition to a nursing facility.

Minute Women Home Care | Home Care Services Since 1969

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