Parenting UP! Caregiving adventures with comedian J Smiles

The Truth about Diabetes and Dementia

• J Smiles • Season 4 • Episode 12

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Navigating the range of emotions and decisions that come with caregiving, I found myself sharing the profound responsibility of caring for my mother as her memories began to fade into the shadows of dementia. Timothy Poore's mom also has dementia. It was a journey instigated by the silent toll of type 2 diabetes, a reality many are unaware of until it hits home. This episode is not just a sharing of his stories, but a conversation that brings to light the critical aspects of Alzheimer's awareness and caregiving, revealing the emotional, practical, and often hidden challenges families face. We discuss everything from the difficult decision to take away car keys to the transition to a memory care community, hoping to offer solace and understanding to those on a similar path.

When we consider the complications of type 2 diabetes, we often don't think about its connection to dementia, including forms like Lewy Body Dementia, which can lead to aggression and anger management issues. Our in-depth talk sheds light on the harsh reality of cognitive decline, the signs that creep in unnoticed, and the lifestyle choices that can accelerate these conditions. We peel back the curtain on medication management, and the impact of alcohol consumption, and share intimate family experiences that underscore the often-overlooked consequences of our daily habits.

In the final stretch of the episode, we anchor ourselves in the importance of case management in healthcare, and the power of having the right legal documents in place for healthcare decisions. Alongside our guest, we traverse the complexities of the healthcare system and the need for clear communication to ensure those we care for receive proper attention. We don't leave without a reminder about self-care, urging our listeners to remember their well-being as they pour into the lives of their loved ones. This conversation is for all those who stand in the role of caregiver, an ode to your strength, and a guide to navigating the waters of chronic illness and memory loss.

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#AlzheimersAwareness
#Type2Diabetes
#AlzheimersCare
#DementiaInsights
#CognitiveDeclineAwareness
#HealthcareManagement
#Healthcare
#SelfCare
#ChronicIllnessSupport

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J Smiles:

family. This is nuts. Okay, to me at least it's nuts. You know your person goes into the hospital, something's wrong with them, and then it's time for them to be let go discharged and go home. What if there's no home to go to? What if nobody shows up to pick them up? What is supposed to happen? You can't just stay in the hospital forever, or can you? Does the city keep you? Does the state keep you? Do you just become automatically without a home or unhoused? What in the whole hell? Anyway, today's guest is about to let us know what in the world goes down when a person might not have somebody to check on them. Alright, come on, lead in, listen, watch. I mean, I'm gonna make sure it's a little bit funny, but it hurts.

J Smiles:

Parenting up caregiving adventures with comedian J Smiles is the intense journey of unexpectedly being fully responsible for my mama. For over a decade I've been chipping away at the unknown, advocating for her and pushing Alzheimer's awareness on anyone and anything with a heartbeat. Spoiler alert I started comedy because this shit is so heavy, so be ready for the jokes. Caregiver newbies, ogs and village members just went in to prop up a caregiver. You are in the right place. Hi, this is Zeddy. I hope you enjoy my tortuers podcast the hard truth about diabetes and dementia. Our parenting up community is growing so fast I can't put out a episode as fast as we're growing. So text podcast to 404-737-1449 for updates, exclusives and suggestions on topics. While you're at it, share an episode with a caregiver you know. Review on Apple Podcasts and follow us on social media. Subscribe to our YouTube page. It really helps. You have a company that helps medical experts get it right for people like me. I cannot wait to dig into this a little bit more. So tell us about who it is you care for in your family.

Timothy Poore:

So right now my mom is our one remaining caregiver that we have. So my mom has dementia, has type 2 diabetes related dementia. It just comes from years and years of neglect and genes and the lottery. So it's been interesting. She has some interesting times. She recently actually had a transition into a community and the community has memory care and that sort of stuff for her when she progresses to that stage. But there was a lot that we had to do to set up for that and I worked with my sister. She was really great with that. It's been entertaining. It's been a bit of an adventure, especially like the little things like taking away the car keys and that sort of stuff. It's been a time. But it kind of helps us with our work. We assist mainly we assist hospitals with finding placement options for very challenging patients and unfortunately a lot of times we see folks with dementia and Alzheimer's fall into that category. The family just isn't quite prepared or on the same page and insanity ensues after that.

J Smiles:

Right Before we get into your company with your mom, you said dementia related type 2 diabetes. See, I knew you were about to give us something we hadn't talked about here before. So you tell me that your mom from diabetes actually sit on a banana pill into dementia, please let us know how that happened Because, listen, I'm from the deep South. I know people aren't around here thinking that the sugar could lead them into forgetting stuff. Please enlighten us.

Timothy Poore:

Yep. So there's three things that typically happen to individuals who have type 2 diabetes. One is an increased risk of cancer, another one's typically increased risk of heart disease and a third is increased risk of dementia. And that actually takes up a big chunk of people. And that crazy, right.

Timothy Poore:

And if you think about it, if your body isn't managing sugar properly, your brain is the one organ that says I need sugar because it needs the most of everybody, and there's so many other things that has to do, has to operate on. But if your body is managing that properly, that's going to lead to damage in the brain. I just simply see it as easy as that, right. And so that carries on into issues like with dementia. So if you mix that also with like how you're getting your carbs, like is it through alcohol or something like that, then we see it targeted on top of that to like lube body dementia. So you have, like you become violent and that sort of stuff different types of dementia on top of that. So yeah, it's not fun, but yeah it's.

Timothy Poore:

And now we're seeing that much more commonly associated with hospitals will actually say this is a type 2 type of diabetes associated dementia, as opposed to the patient just has straight up dementia or whatever it may be. They're actually clarifying this in many cases. So, and if you think about it, there's a tremendous amount of med management that you have to do for somebody. Does a dementia patient want to be pricked Right? It's like no, no, they don't. It's like those are gonna be challenges you have to kind of like to deal with and stuff like that. So you know, getting that sugar under control before God, sorry.

J Smiles:

No, did you mention that? That would remember I'm a comedian. Did you just say, oh, depending on how you get your carbs, say if it's alcoholism or if you were drinking, I was like, well, that's a way to get your car. I know a lot of people who get their carbs through their drinking and it can get out of control sometimes and I don't know that any of them have thought through this could lead. You know, people have thought about or talk about.

J Smiles:

I should say this I don't know what they're thinking, but they've thought about maybe liver damage, cancer, oh yeah you know, kidney, liver problems, cirrhosis of the liver, but not, oh man, I'm about to break my brain, which is what I affectionately call.

Timothy Poore:

Alzheimer's, yeah, but I never really put that. I never put, like you know, some types of dementia together with you know, with you know excessive drinking and stuff like that. And yeah, I grew up in Florida and Georgia, right. I mean it's kind of like, what else are you gonna do on a Saturday, right, I mean like hello, you know, I never really kind of put that together until I started working in healthcare and I said, yeah, first, as a history of drinking, you have dementia. And a nurse was saying no, no, absolutely not stay away, because that person's going to turn on you in a second and they're not going to know why. And it's because, yeah, because they just lose all regulation of you know anger control and that sort of stuff. So, and that's a whole different. You know type of dementia, a Lewy body dementia, and that's what. That's what scares the day like itself, providers, so much so we've had our fair share of those.

Timothy Poore:

I'm surprised. I'm surprised she doesn't, because I mean I love my mom to death but she, for 20 years she had a diet of Miller, miller light and jujubes Right, that was her diet, you know, and like you would. Finally jujubes like in her house. We find jujubes like all over the place still and it's been like you know years. Right, you know, it's like like my goodness now like Miller light. I mean, that's like really I don't know if you can really count that as beer. It's not the strongest, but to continuously like you'll be drinking like you know a couple and stuff like that. And you know, you know, a night I didn't really think that there was like a problem or anything until like until I had a friend of mine over I was a little kid and my best friend whole world and this first night he comes over to spend the night and he comes, he goes, you know, goes back home, we're hanging out the next day and he says I have some questions about your family.

J Smiles:

I was like well, what is?

Timothy Poore:

this Like. Well, I don't think they're alcoholics, but you know I was like. But they do drink a lot.

J Smiles:

You know I was like really Because, like I, just like I was, like you know, it's like you know, and it's kind of like I was talking to my sister- like a little while ago.

Timothy Poore:

It was just like, yeah, we the arch parents like drink like a lot, like I don't know if they were, but you know my mom definitely is, you know, having some of the issues with it, you know now on days and stuff, especially with type two diabetes and her dementia. So yeah, I was like it made some for some, for some interesting moments. But yeah, we'll still, we'll find candy in the house for for ages. I'm pretty sure whoever owns this house next is going to have, like you know, find like random boxes of jujubes hidden, stashed away.

J Smiles:

It's like it will be a delayed Easter egg hunt, or like a treasure find.

Timothy Poore:

Yeah.

J Smiles:

Or whoever.

Timothy Poore:

And the crazy thing is they stopped making those, like years ago.

J Smiles:

It's like, there's like this what is this?

Timothy Poore:

thing. Is it pet food? Is it like this or?

J Smiles:

goldfish. Yeah, what symptoms did your mom display to let you or what other family members say think that she needed medical intervention? Okay, this is not just mom acting a little wonky or a little quirky from her Miller light and her jujubes. This is something more serious.

Timothy Poore:

Yeah, well, I was taking place when we were taking care of my dad, right, and we started to notice that she was like she's paying attention to my dad. My dad had cancer, went out of liver, cancer, that's a clad skin tumor. I mean he's going to die. I mean it's just he put up like a hell of a fight. But she was so involved in that and she really wasn't even taking care of herself at all and, mind you, she didn't really take care of herself beforehand and so that really kind of like accelerated everything, the stress and dealing with all that your body just isn't going to hold up to it very well.

Timothy Poore:

And she was forgetting things. She was like leaving not one thing, like leaving the stove on but it's no thing, and terribly like forgetting how to drive a car and nearly running somebody over who was my son at the time, and then that's kind of like how we took the keys away. You're like, yeah, no, that's you don't get to drive anymore. Or just like not paying attention to the speed limit, like at all. It's like you know. It's like when you're like you're loading up in a car and mom's assisting on driving and stuff like that, and you're like you're. You're positioned to everybody in the car and basically who you love the most right. You know, the ones who really care about it are just sitting in the back.

J Smiles:

And you're like you're going to go into next one. Keep the window down so you can jump out, just in case you need to talk to them.

Timothy Poore:

You went one hand up and you don't have the one on the seatbelt case. You have to jump.

J Smiles:

Exactly Did she. She had Go ahead. No, no, she didn't.

Timothy Poore:

No, she didn't realize it was going on. You don't? You don't really I mean cause, you know, and what's, what's? What's? Individuals do realize this, usually too late. She, we were watching, we were watching Braveheart. One time my mom's from Scottish, I'm from Glasgow, right, but she was like she's, she was spent like four hours in Scotland, um, you know, but she considers herself Scottish, you know, and she grew up in Four hours.

J Smiles:

That's funny.

Timothy Poore:

Yeah, Literally like yeah, yeah, like they had like she popped out, they, they, they got onto a plane, they were like in the airport and then they left, right, I mean, or boat, whatever they took, and cause it was like the forties, right, and so the um, so we're watching Braveheart, which is, I mean, my mom treats it as a comedy because it's not like really factually accurate, like at all. It's like not close and but it was once seen by my mom from Glasgow and she's always been very proud of Glasgow and there's like a rival city called Enboro and Scotland and that's kind of like the, the, the New York versus Boston type of rivalry, right. And um, and my mom and sister says, and her cute little like like dementia is starting to kick in voice, oh, they filmed it on location, Like when they were showing like Enboro and it's like you know, it's like they're all like wearing kilts and it's like mud and it's like you know the 13th century. But yeah, she can recognize it as it being Enboro, like nothing ever changed and we just like coming.

Timothy Poore:

She was like very like sweet about it, but we just everyone is like I just busted out laughing at it. You know, it's like it was pretty, it was pretty fancy. You get like those kind of like moments, but you know, it was like we're not like quite connected, but those are that's kind of like a tale, like okay, like we're, we're not putting the pieces together here and sort of stuff. So it's it's. It has a lot of cute moments like that, but hopefully that's good Dry humor.

J Smiles:

I think David Letterman would have appreciated that comment, absolutely, absolutely. How long, how many years since our diagnosis?

Timothy Poore:

About five, about five years.

J Smiles:

Okay.

Timothy Poore:

Yeah, and we really worked pretty hard to get her sugar intake under control. Grocery shopping is fun with her. Let me tell you, you are the devil. She wants to buy every single candy, that there is every single alcohol. Now she's in a community. They're like, well, they let me have an alcohol and drink whatever I want in the community. I'm like, no, they fucking don't.

Timothy Poore:

Trust me on this one Like they're just giving you grape juice, mom, or cranberry juice, Okay, it's like, no, no, that's like not happening. And of course it's like and then you'll find like there's like, yeah, they'll have like people like stashed away beer because they just like like in ALFs they will serve alcohol, you know, because I mean they want to be like you know fun, like that, but they're not supposed to give it to everybody. And she's like on that list, like absolutely do not, because she will start dancing on tables. Yeah, Don't do that. Yeah, she's, she is, she is the party, she has to have the attention. And that's the other thing. Like to mention those, those types of behaviors can really kind of start to come out more. If your loved one was like a little bit manipulative beforehand, that's going to really kind of kick into high gear. They're really going to be more and more manipulative as it progresses. You know my mom's, my mom's always trying to pull something between me and my sister like all the time. It's just like she's our mom so yeah.

Timothy Poore:

It's like awful children are going to. How could you do this? They're the worst people ever. I'm like like, are you kidding? Like seriously, like, like I like I don't get it.

J Smiles:

But anyway, sister, on the typically on the same page with your mom's care.

Timothy Poore:

Oh, absolutely Same page, same medication, same alcohol, same same same everything. Yeah, we're, we match really good. It's like it doesn't always happen that way.

J Smiles:

Well, it's just like. It's just like it is.

Timothy Poore:

You have it parenting up, right, you can't, you can't, you and your spouse. It has to be on the same page with your children, right? Well, you and your siblings have to be on the same page with your parents, because, especially my mom, cause she's like pretty manipulative, she will, she will twist it, she tries to pit us against each other, like are you kidding me? Like how messed up is that, Like you know, and so like, well, like, there'll be times where she's like she's only talking to like one of us on top of that you know. So, like, right now, I'm, I'm the bad child. Like what the hell did I do?

J Smiles:

Will she tell you that she's upset with you, or does she only tell let your sister know.

Timothy Poore:

Usually only tells the other, only tells the other one, and the thing is that you want to know what you want to know what it is that I got to be the bad one for?

J Smiles:

Cause.

Timothy Poore:

usually in this case, you would think yeah, so my mom has her credit card still and that sort of stuff and she was spending a lot. You're going to spend yourself down really quickly and that's not an option we really want. So it wasn't even a discussion, it was just like we're going to take the credit cards away. My sister took the credit cards away and we give her a bank card. That could be, you could add value to it, you could put cash on it, whatever, so that could cover her needs, and so she doesn't end up broke. And my mom got furious at my sister for that at first, but then turned it towards us when I was talking to my mom and just totally said no, that's exactly what it was, because give you a week and you would be flat broke because you buy everything. And that happens too because you're trying to. Sometimes people are trying to fill in a loss or some sort of connection that they're looking for and you get that instant gratification when you buy something right. So you'll see people buy things a lot. My mom was like that.

Timothy Poore:

We had a case where there was like was that the hospital and the guy had like freaking Amazon Prime boxes throughout his room because he'd been ordering shit on Amazon. There, he, he or he'd been a hospital for so long. The guy ordered a Roomba. The guy ordered a Roomba and he had the Roomba was like going around the hospital. I was like that's really kind of cool. You guys have a Roomba in here. They're like no, the patient ordered that. He was like and I get up to him and he's like yeah, I felt like it should have helped quit, tidy up the place. You've been in there for so long. You know it was like and there's like you go in there. It was like you know there's there's probably about 60 Amazon boxes that hadn't even opened yet, right, and you know he's trying to like and I use it to mentor a guy, but he's just trying to feel that, feel that need. You know it's kind of like oh, we got something.

J Smiles:

No one stopped him like a nurse. Well, I guess for the Roomba they were like hey, this has been a fitting us.

Timothy Poore:

The CFO is probably like wow, he just saved him a labor hour.

J Smiles:

Absolutely.

Timothy Poore:

Let's talk about your company.

J Smiles:

Let's talk a little bit about your company. You have a special expertise because, yes, you're in healthcare. That is a broad, broad umbrella. Yeah, let me, let me see if. I can get it right, because it sounds really cool to me, but I'm going to say it in very casual terms, just whatever, I'll agree with it, go for it. Feed unicorns and help caregivers.

Timothy Poore:

If I talk to them, it's just you want to have them pointing the other way, right?

J Smiles:

Yeah, because the poop sparkles and therefore don't really know, but you, your company, assist hospitals with a patient after they leave the hospital.

Timothy Poore:

In order to. I actually had already, I had already get them out. So there's they're stuck in the hospital, there's no one's taken them, the family's given up, they're exhausted Right and they're at their wits end. Or there's needs that the patient has that the community can't address. They can't match it.

J Smiles:

Right.

J Smiles:

So in steps 10, yeah, in steps 10, because a family, there's a patient and they don't know whether they should be going to rehab or a nursing home or they should go home, or if there is a home and there there's not a family or some person who's healthy enough to come and actually pick them up. Think about how many of us would never have crossed that journey of saying, like I've been in the hospital, I've had nine surgeries and I've been in the hospital a lot of other times I've never had to wonder who was coming to pick me up or if I had a place to go and recover.

Timothy Poore:

Yeah, yeah.

J Smiles:

That means like, if you think about it, I figure the patient is pretty shitty right, I mean it's like you're like nobody cares, like you know.

Timothy Poore:

You're like what the hell you know and will he be like us? So you have like skilled nursing, right, and that's like you're going to go into there, and so skilled nursing, nursing homes, are basically the same thing, and you're going to get rehab for a brief period of time, and you may end up being a resident there. That's the last option that we want, because it's the most expensive and the quality of life is pretty low. And then you have like assisted living. You know it's basically a landlocked party ship, you know, for seniors, but you can get some rehab and that sort of stuff going on with them.

Timothy Poore:

Really, the best option, though, is always for the person to return home to a point right, and that's who we try to look to set up to, but, you know, for more and more folks, they just don't have that. They just don't have that social support, they don't have that family support, or the family just doesn't know what to do next, and they've drained all their resources or their availability. They've totally broken. They're like, just whatever, we don't care, send them out of state, that's fine, which really sucks, you know. So you know we try to work with families and the patients to the hospitals to get these issues like mitigated so that you know we can get, we can get the show on the road because you don't want to be in a hospital.

Timothy Poore:

After you've been in a hospital for 20 days, nothing good is going to happen. It's impossible. You're not like nothing is going to happen. We've seen like the craziest shit we saw like beds, like literally, like just like random things that we saw like a bed like flip on a patient one time, like like really like that could happen, yet broke the patient's spine Right and it wasn't was anything. We've seen like yeah, like just like crazy, like actual, genuinely like crazy shit. But we also seen like what were staff or it was like you know you're putting a burden on the hospital to continue to bring, to get provide care, just for that hospital to turn on the lights for your room at day, $100.

Timothy Poore:

Right, so like the shittiest hotel ever, right?

J Smiles:

I mean like it is. It's like 800 bucks, no room service.

Timothy Poore:

Yeah Well, no room service, no spa, no cream corn.

J Smiles:

No rooftop bar, cream corn and ginger ale what happened?

Timothy Poore:

The bar is cracked.

J Smiles:

The bar is cracked, the valet sucks. They don't ever really know where your car is.

Timothy Poore:

Lost my car, totally lost. Oh, we had to have one time lost the patient's car one time and end up at a hospital. What that was a different story for different story another day. Oh, yeah, guy was. Yeah, end up at a hospital, yeah.

J Smiles:

What has been one of the more challenging cases for you. Give us an example of a challenging case, because I got to tell you the majority of my listeners or my viewers they are family caregivers for a loved one, so they are individuals who have taken on the responsibility or are seriously considering it. So they are not the individuals who have tapped out quite yet, but it doesn't mean that they may not reach the end of their rope, so they may need to have this information and or pass it along to someone else. So this is kind of a I want to be able to. I want individuals to have the knowledge to say, hey, if I met my wits in.

J Smiles:

Because the one thing I think about is this Tim, yes, the first thing is for a dementia patient or anyone to be able to live and recover at home. But if, for some reason, you can't provide safe and adequate care, don't bring the person home. Like, don't bring them home and abuse them or neglect them. So it's better to be in touch with someone like yourself and your company. So give us please an example of when you should Like, an example of a case that is perfect for you. That's what I think of me, yeah.

Timothy Poore:

Well, it was, so we wanted to avoid me being called. Okay, we don't want me being called, because there's there's never a good situation. So what we want to do when we have it doesn't matter if your loved one has a dementia or Alzheimer's or not. Let's get a decision maker, a legal decision maker, in place sooner rather than later. It doesn't matter if you're married or whatever. Make sure there's a document that says this is who my decision maker is going to be. Right, so you have a power of attorney. That's a terrible power of attorney, ideally, and you can get these done. Actually, the healthier you are, the cheaper it is, and I would do this with an attorney.

Timothy Poore:

The other thing is you're going to want to look into a trust. I don't care if you make $700 a month on social security or if you make $7,000 a month on social security. You're going to want to look at a potential for there to be a trust involved in this. What do you need for a trust? And then the other thing is you're going to look at your state's requirements for Medicaid, because, at the end of the day, if you have a trust, you have a power of attorney and if you have a plan to get onto Medicaid. That means that there's going to be a long term care payer for you and we're not going to be burning the family Right, or you're not going to be burned by your loved one when they need this assistance because we got a payer. And if I'm a company I used to overseas still nursing facilities, I would much rather get paid by the state, even though it's going to be less than a private pay, than by an individual who I have to sit there and bill and chase down every single month for the rent. I would rather be paid by state and say it's on time. I know exactly how much it's going to be. You know so that those are the things we want to try to do to kind of avoid.

Timothy Poore:

So our toughest case ever and it wasn't like somebody who had like a criminal background or you know, or as a vent dialysis patient or this like huge, massive clinical complexity it was this 60 some odd year old lady. She's not even 65 yet. She has dementia, she has a little bit of a bipolar issue and you know she's. She's married and has some kids. Right, the kids are quite ready to take care of her. They're not quite old enough, and the husband's a little bit worn down, right, and he's well, they're found out. He was freaking over it, dude. He was like he, he was in a wall, he was nowhere to be found, and that was part of it, right. So, like, we're trying to reach out and communicate with this guy and he's not, he's not following up with us, so okay. So we got to like figure out who's going to pay for this, because there's no, she's in a hospital, there's no reason to keep her in a hospital and there's nothing for the hospital for her to do and there's being in that Medicare. Is it going to pay for her stay in a nursing home afterwards? You have to have a reason to be in a nursing home. Besides, there's no other place for you to go. You have to have, like she's going to go work on her hip or whatever it is.

Timothy Poore:

I meet this lady like in person, cause I show up and the nurse like sits there and says to me she's like, um, and she's been there, she's like one of those nurses that has been there like a while. She's like don't fall in love, like, what, like? So there's something like I'm missing here, right, you know, I type deal. I kind of like looked through the meds and that sort of stuff Nothing crazy, you know. There's like there's no like held all Sarah quill or anything like that. She doesn't have been restrained or that I go. Now we sit there, we have this like this lovely conversation for this lady, sweetest lady in the world, right, I'm like this is going to be freaking easy. Like it wasn't a big deal. She's been denied by a lot of places. Yeah, that's fine because her payers not great, but we got the pair of payments situation squared away, you know and once we did get the information from the kids were able to help us get the minute information for Medicaid.

Timothy Poore:

We were able to get into a building, right, cause, like the, now the building knows they're going to get paid and so she gets transferred. I should have kind of like realized that something was up in the hospital, transferred her like late at night, right. So the hospital transferred her like after dinner hours, right. So that's like usually like okay, that's not a good sign. The hospital wants her out for some reason.

Timothy Poore:

And she gets to the new facility and I get a call from that facility about two o'clock in the morning and which is really uncommon, and and they're not that far away, they're, they're only like about 30 minutes away. So like like well, I'll just go there and check it out. See what's going on. She's running around naked with her soil filled diaper, going like this in the hallways and that sort of stuff. And so the hospital had like left off some information about her medications. Family wasn't really too willing to share that information with the hospital either. The hospital sort of discovered it. I get to her room and she has. She had taken her soil diaper and spelled out H-E-L-L, and there, and I said she misspelled hello and she's just like I mean she's screaming up and down the hallways like a banshee and stuff like that you know.

Timothy Poore:

And so eventually we get, you know, a primary care physician in and we talked about. You know the advantages of the held all patch. You know that the last a month for her and get her settled down a little bit. But you know the fact that there was no communication between the family and the hospital. That was that was made things very challenging. Had the family and the hospital been communicating, that would have helped out a lot. And especially if you ever have to go to hospital, your best friend is not the nurse, it's not the physician, it's not the freaking CFO or whoever it is. Ask a nice person to know they might pick up your lunch bill, but it's actually just that case manager, right, and that's the person who's coordinating all the care. That that's that's been going on both inside the hospital for your loved one and outside hospital. That's the person you need to be up with, friends with.

J Smiles:

Okay, hold on, tim. You got going to. You got it. You said you gave us a mouthful here. You got to talk really slow for those of us who just finished first grade. Case manager where do we even find the case manager? How do we get to him? Who do we ask?

Timothy Poore:

Yeah, there is a magical person.

J Smiles:

Yeah, there is a magical person Do we go and get this case manager person.

Timothy Poore:

In the ER. Right, they are in the ER and that person is actually, is really is the decision maker on whether or not you get admitted into the hospital or not. It is the case manager. The physicians can have input. The physicians can say, yeah, we're going to or is therapy for this individual, but it's really is the case manager. That's the person you need on your side more than anyone and you need and you need to work with that person. So that person is like the movie producer Everybody else, of course, your loved one is the star of the movie, but the doctors are the different directors, the nurses are the writers and that sort of stuff, but the producer of the film that's going to be your case manager and that's going to change from position in the hospital to position in the hospital. So the ER case manager is going to be different than the ICU or the med surge case manager and so forth. Those are all different case managers, but those are the people Generally. Those are different people, but that's the person you need to know. You know, and that's the person you need to be on the same page with.

Timothy Poore:

You know, it's usually a very stressed out individual. They're usually hiding in a corner around the nurses station, shrouded in darkness. They're stressed out. They've usually had about six people yell at them just before they've spoken to you. They just took turns like all yelling at them. The reality is, though, without case management and central services, the hospital does not operate. It doesn't. There's no reason. It's just a big building. They organize all this panemonium and get your loved one out, and that person has, like, the final say. And really, in what? What type of care they're going to get outside the hospital? At least they have the final say on the hospital side. So that's your best friend. Yeah, bring that person. You know alcohol. They're usually good with chocolate, usually good with pens, all those types of things. Right, you know you don't want to talk to the 20 year old nurse who just broke up with their boyfriend. They've been dating for 10 minutes. That person's not going to tell you what's going on with your mom.

Timothy Poore:

They don't know. They're really smart, though they are wicked smart. They know everything.

J Smiles:

They have a lot of energy. They have a lot of energy, but it doesn't mean that they're going to get what you need, so that is a, that is a man, stay, go ahead.

Timothy Poore:

Yeah, even the physician, the physician he has, he has, he or she has their patients they need to see. And then they got to move on right, because they got to either go visit you know patients somewhere else, you know back at their office, or whatever. They got too much, this isn't their job. They're like, yeah, okay, I can order those meds. Okay, next let's go. It really is. I simply like for them. Case management is the one that's really kind of getting things down to the minute.

J Smiles:

Well, this has been fascinating and informative and funny at times, even though I know it may have been hardships, some serious stuff has been hardships. I'll never forget that lady. It's along the way. But some really silly stuff. I want you to let the parenting up community know the name of your company, how they can get in touch with you if they're in your service area, and or how they find a company like yours, depending on what state or what country they may be in, how they make sure that they're covered.

Timothy Poore:

Yeah, so we are national. Our company is ATP Healthcare. We work with a lot of health systems already, primarily in Florida, georgia, california, texas right now. But you can ask your case manager if they have placement specialists and what we're actually. There are placement companies that do this and they receive a fee from an assisted living company for referring your loved one to their community. That's not how we operate, because we essentially those individuals. We're seeing them as being sold to the highest bidder. We are actually hired by either the hospital, the insurance company or the family and we work with them for six month period blocks on the transition for their loved one, and so we stay with that family for six months.

Timothy Poore:

But what I explained earlier about making sure that the power of attorney, that sort of stuff is in place, that we've looked into, that we looked into Medicaid, a trust those things are really key. You need to get those set up and you don't need somebody like me to do that. And once you do that, then you're halfway there. If you have a clinical issue or a criminal background or something like that, that's more the type of individual we work with privately, so that's not a problem either.

Timothy Poore:

But yeah, the best way is just contact us through atphalthcarecom on our website and you just fill out a form. It keeps you pretty private and you can share information with us that way on how you want to be contacted, or you can reach out to us directly on our phone. It's also on the website too. We are working on a chatbot for the website which you will just be able to. Hopefully in the next few months it'll be up and where you'll just be able to ask the questions and it's going to have a nice little conversation with you. We're still working on some bugs on it, but I should be able to help individuals out.

J Smiles:

Well, this is what I want to say. You are welcome back anytime. Thank you so much for the work that you do, not only as a caregiver because we are all connected by a soul and spirit and elbows in this thing, this journey of being a family caregiver but even, by extension, what you do professionally to make sure that individuals are placed somewhere if, for some reason, they don't have a home where they can return, the fact that you do all you can to get them placed somewhere that is adequate and safe and sound, that's amazing.

Timothy Poore:

So thank you very much. No problem, if somebody called you and they ask you for help, you're supposed to help, right? Yes, right, that's what it is right. So, and someone needs help, so you just help them. Fantastic Well you take care.

J Smiles:

You take care.

Timothy Poore:

I know you did the same.

J Smiles:

Alright, hun, bye, bye, let's nuggle up. Number one Tight. Two diabetes can push you into dementia. Damn it. Listen, what the hell is this dementia doing? To us Looks like everything and everywhere all around is just ending up at dementia land Pass. Go, get $200 and get dementia. Is that the new game we playing now?

J Smiles:

I remember when Zeddy had the catastrophic event of my daddy's death that pushed her and over into it. I didn't know that a sudden calamity could cause it. They were like, oh yeah, jace man, take care. And now Timothy has let us know that his mom's type 2 diabetes absolutely led to her dementia and that it's not just her, that this is a known thing. They just hadn't let us known it. So if you have type 2 diabetes, or if you know some with it, someone with it, blah, blah, blah, please get them to keep it in check. Right, like it doesn't have to run a buck. Your type 2 diabetes can be managed. Please manage it, because you don't need to go from diabetes into dementia.

J Smiles:

Number two Everyone isn't wanted. That's so hard and ugly to say, but everybody doesn't have a family or a loved one or a neighbor or a community who cares. Therefore, as a family caregiver, you're listening, you're watching it. Watch your name. That's hilarious. You're listening and we're going to keep all this in here, because that's what we do with the Parenting Up podcast, right? This is the point. We are human and shit happens, just like that. Blah, blah, blah, blah that Jace Miles just happened to do. You're a part of this village, so you're listening or you're watching, so you do care for someone with dementia or some other debilitating disease.

J Smiles:

Man, everybody that is suffering doesn't have a. You Give yourself credit for that. Give yourself credit for caring, even on a bad day, even when you get the doctor's appointments incorrect or maybe you are. I mean, I forgot mom and dad's shoes. I bought the slippers instead of the sneakers, whatever. I forgot the name of the doctor. Whatever, I forgot to give mom her favorite juice. I gave her water instead, and now she won't drink anything. Whatever, I forgot to call back the insurance company. You guessed it. Let me hear it Right.

J Smiles:

Whatever, you at least are showing up and you care, because that's timid to let us know. There are some people who are left in the hospital and nobody even shows up to discharge them. But, truth be told, that could happen to any of us at any moment in time Because, as my grandmother, zeddy's mom, told me over and over again, nobody owes you anything. No one, not your mama, not your daddy. Anything that is ever done for you, it is a choice that someone decided in that moment in time to care for you. So, listen, the fact that you choose to care is a big, freaking deal. And if no one told you recently, thank you, but day in and day out, choosing to care for your LO, even when you don't want to, you do it any day away.

J Smiles:

Number three what have you done for yourself today, not yesterday, not last week, not last year, today, this day, I don't care if it was 30 seconds or 30 minutes. What have you done for yourself? I'm a pause for five seconds. I want you to say it out loud, wherever you are Now, if you didn't say anything, boo. And I want you to do something for yourself before you go to sleep tonight. It could be five minutes of a crossword puzzle Watch, five minutes of a television show or something streaming that you like, a music video, sing a song that you like. Pull the song up and sing along. Take a bath, massage your own feet with lotion. Something for yourself, hell, maybe actually go to bed. If you don't care, give it. Just going to bed is a big freaking deal. Okay, don't let me down. I'm depending on you to take care of you, all right.