Parenting UP! Caregiving adventures with comedian J Smiles

White Coat Wisdom: Best Practices for Care Partners

• J Smiles • Season 6 • Episode 2

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Do you ever feel dismissed or intimidated when advocating for your loved one in medical settings? That ends today.

In Episode 2 of our 'Detroit Cares About Caregivers' series, medical providers share the importance of caregivers in the healthcare process. 

"I may know textbook, but you know your loved one," explains Dr. McNeill, Principal Investigator of the AGREED GWEP Program and the one who invited our team to create this insightful series!

Dr. McNeill and her colleagues shared game-changing insights in this powerful exploration of the caregiver-provider relationship. From Detroit's innovative Rosa Parks Geriatric Center, medical professionals reveal what they wish every family caregiver understood about being true healthcare partners.

The candid conversations unpack why the caregivers' perspective is invaluable in medical settings - not just welcomed, but essential. Dr. McNeill boldly repositions caregivers as "leaders of the healthcare team," pushing back against outdated hierarchies that diminish caregiver input. Meanwhile, geriatric specialists showcase thoughtful facility designs demonstrating how environments can better serve elderly patients and their caregivers.

Whether you're a seasoned caregiver or new to supporting an aging loved one, these conversations offer a roadmap for confidently navigating medical partnerships. Stop feeling like an outsider in your loved one's care and start embracing your rightful position as an essential healthcare ally with the expert guidance in this episode.

What conversation will you initiate with your loved one's healthcare provider after hearing these insights? Your voice matters more than you know.

For more information about the AGREED grant and resources for caregivers in Detroit, visit agreed.wayne.edu. 

Host: J Smiles Comedy

Producer: Mia Hall 

Editor: Annelise Udoye

This episode was filmed at Evry Media Studios in Detroit.  

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Speaker 1:

I think that it's very important as a provider to listen to the caregiver, the husband or the wife or the child, whoever is the main person involved, Because I may know textbook right, but you know your loved one.

Speaker 3:

What do you think caregivers can do, can learn, can assist in this whole process of medicine management when it comes to the elderly, Cattekers also need to look after themselves, especially if they are caring for their loved ones who have dementia, then really there is a lot involved. You know they can get wound up.

Speaker 2:

This sounds like a real relationship, doc. Oh yes, it sounds like you are open to, or at least suggesting that, there is open communication, honest communication, and that we we meaning caregivers are giving their provider a chance to say, okay, this didn't go so well. But before I just quit you, I'm going to let you know, let's work it out.

Speaker 1:

Give me a chance. I think I got to look into the camera when I say this, so listen here.

Speaker 2:

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 this shit is heavy. That's why I started doing comedy. So be ready for the jokes. Caregiver newbies, ogs and village members just willing to prop up a caregiver. You are in the right place. Hi, this is Zeddy. I hope you enjoy my daughter's podcast, is that okay? Today's supporter shout out is also from Detroit. You know what we're doing this whole series. We are Detroit ready. Baby.

Speaker 2:

It's Dr Faith Hopp, associate Professor, wayne State University School of Social Work, agreed GWEP program. Guess who is the principal investigator? Dr McNeil, I told y'all she was dope. This is the shout out. This is an amazing and inspiring podcast. Double exclamation point OK. One, two. The caregivers, as Dr McNeil says so eloquently, should be a critical piece of the health care team team. Our caregivers have shown us their passion, dedication and commitment to their role and are an inspiration to all of us in Detroit and beyond, and beyond. Ow, I love it. Thank you so much, dr Hopper. If you would like to receive a supportive shout out. You know what to do. Leave a review on Apple Podcasts, ig or YouTube.

Speaker 2:

Parenting up we, the same everywhere, thank you. We in Detroit, detroit, this is our first tour and it's happening in Detroit. Okay, you just get ready, baby. You know how they do it up here. What up, though. What up, though. And this is the day that we are bringing you that fire, that Detroit fire. So, wherever you listening, wherever you watching, just get ready, baby, sit down, drink something, sip on something, eat on something, but be safe.

Speaker 2:

Today's episode White Coat, wisdom, best Practices for Care Partners what's up? Parenting Up, family we still in Detroit, y'all. So you better be happy that I'm even awake and smiling enough to talk to y'all, because you know Detroit is a party. What up, though? What up though? So this is episode two. We are talking with medical professionals getting their point of view around caregivers, how caregivers can help more, how caregivers can get help more.

Speaker 2:

Let's dig in and find out from the other side, right here, who I got with me the one and only Dr McNeil. I call her Dr Detroit, though. You know what I'm saying Because I got it like that. But y'all, if you see her in the street. Don't do what I do. You call her DrNeil, okay, what up, doc? What up, though? You see what I'm saying. You see what I'm saying. Listen, you got a lot of fancy things, but look at this y'all, look at all them things. Can y'all zoom in and see all these letters? That's a. That is everything in the alphabet. She has the alphabet behind her name. What that really means is she went to school a lot, a whole lot. So can you tell us what? You went to school? A lot, a whole lot. So can you tell us what you went to school to? Learn how to do which degree? See what I'm saying. See what I'm saying. Okay, the ones, the degrees that have to do with that white coat, okay.

Speaker 1:

So I have my doctorate from Wayne State University. I have a doctorate in Pause.

Speaker 2:

Doctorate, that's what you call a terminal degree. Okay, yes, pause, doctorate, that's what you call a terminal degree. Ok, I mean, you can't get nothing higher. Than that Means you can't get further, further with an A on it or head or her in that there thing.

Speaker 1:

Go ahead. I have a doctorate in nursing practice, which means I'm a nurse practitioner with a doctorate degree. Before that, I was a nurse for many years, working in health care doctorate degree.

Speaker 2:

Before that I was a nurse for many years working in health care. I can hand you a band-aid. If you need more than a band-aid, go to Dr McNeil. Please let everyone know about your passion in even getting in nursing, because nursing might be getting all the shine now, especially post pandemic. Nurses finally got what I've thought for years should have been. A lot of accolades and thank yous came during the COVID pandemic and it was so obvious that nurses were holding us down. But you were nursing way before that. Way before it was like the sex it was brought back. What made you so excited about that?

Speaker 1:

field. I mean, it's just my desire to serve, my desire to be a vessel. You know, when you have individuals, that's at their most weakest, vulnerable state and they are relying on you, as stranger, essentially to care for them, and that's a big responsibility. And so that's something I do not take lightly and that is something that I feel I do well, but one of the reasons why nursing is one of the trusted professions and I take that to heart. Then, being able to be home in Detroit and being able to address health disparities, using this talent, using this skill, using what God gave me, it's kind of my calling, a calling.

Speaker 2:

So I like to how you can be called to do something other than preach. So people listen. If you've been called to preach, by all means do that. But I just want you to know you can be called to do something other than play basketball or preach. Look at that. There's a third thing Well, I was called a comedy, so that's at least four. Ok, that's four things that you have learned today that you can be called to do. And nursing yes, I'm so grateful for nurses. I know how well nurses made so much difference in my mom's journey Well, I guess our journey in in her caregiving. Wow, I love doctors and they may have been the ones who did the surgery and all the good things, but the nurses, what they do and how they convey what I see back to the doctors to then change and or manage the care, makes such a big difference.

Speaker 1:

Yes, and I think that it's very important to know that you have different levels of professionals, right? So before I got my doctorate, I was a bedside nurse. I was the one that was by your side 12 hours while you were sleeping. I was the one that was monitoring you, I was the one making sure that whatever orders came in for you were for you, that were appropriate for you, and I was protecting you when I went back to get my terminal degree, that put me in a position of a provider. So not only am I having to think about what the nurses are doing at the bedside, now I'm in responsible. I'm the person that's writing the orders, creating the care plans for the patients, and again, it's another layer of responsibility because you have to know what you're doing and then be able to execute this. You have to know what you're doing and then be able to execute this, not just for that family member, but for the whole care team, the whole family, to be able to get the best outcomes.

Speaker 2:

You talk about care team, oh, yes, oh, you're making my heart pitter patter, doc. You're making my heart pitter patter because when you say care team, I consider me a part of my mom's care team. Absolutely. I'm her daughter, yes, but I am her caregiver, her care partner. I've learned that term recently and I like it a lot because I still consider my mother a partner in this. Even though, cognitively, she is not included in any of the decisions, her spirit is still with me and it guides me because I can tell when she don't like something. And if I can tell she don't like it, I'm not going to do that again. So therefore, we are still partners in this. When you talk about care team, do you consider the family caregiver as a part of the team?

Speaker 1:

Not only do I consider that part of the team, they're leading the team Like they're the ones that really are telling the other members of the team what their goals are. You know, because you're with me for 15, 20 minutes, whatever the visit is, but you have to go home. So whatever plan we create has to be done collectively and together and you have to have buy-in so that when you go home. So whatever plan we create has to be done collectively and together and you have to have buy-in so that when you go home, we can make sure that those things are occurring. If you tell me this, we're not doing this, I would rather you tell me we're not doing it than me to come back two months later, me thinking okay, we were going along with the plan, and you said, no, I'm not, we're not doing that. So to have a great relationship with the health care provider and the family, it has to be honesty, it has to be accountability, and I think that those things are what make the whole team work Fantastic.

Speaker 1:

What are some things that you have noticed from the family members, from the care partners, the caregivers, that have worked well? I think that it's very important as a provider to listen to the caregiver, the husband or the wife or the child, whoever is the main person involved, because I may know textbook right, but you know your loved one and it really should be a compromise we should be talking about. We both have a mutual goal of getting to, whatever the health outcome is. It should never be a situation where you feel like, oh, whatever they said, you know they're the professionals. No, in that moment you're the professional, especially if your loved one can't advocate for themselves.

Speaker 1:

And so I really want to empower caregivers to kind of own that, to own that when you're there and don't let anyone make you feel down or feel less than because maybe you don't have a white coat or you may not have letters behind your name. If you're caring for that loved one, you have information I need. I need to know are they eating? What are they eating? What's going on with them? I'm asking them, but I'm asking you because maybe they're not able to participate in the conversation, so you are integral in kind of helping me understand what's going on when we're not together.

Speaker 2:

Y'all heard it first here Dr McNeil just gave me a white coat. I don't know if she should have done that, and I don't know if the rest of the world is ready for all the trash. I'm about to talk because I just it sounds to me like you have emboldened me and empowered me to go and give a whole lot of people some orders. I'm going to say what Dr McNeil said, to tell you that my mama said that right now, I mean.

Speaker 1:

But you do, you have to, you have to advocate. Everybody's bringing something to the table, so what you're bringing is not less than what I'm bringing to the table. I may be bringing some knowledge, I may be bringing some textbook or some evidence-based practice, but you're bringing lived experience, you're bringing the real. So we need to have a conversation, honestly, to come up with a plan that's unique for your loved one, unique for your situation.

Speaker 2:

That is so powerful, doc, and I champion you for taking that approach. Not everyone in a white coat is as progressive as you are. I'm doing my best to enunciate and say this politically correct. They just haven't had that change of heart, or perhaps they actually do have some better than thou God type complex. I'm the doctor, I know more. I went to school for this. I can write prescriptions, whatever the case may be. And then you have the factor of just pure intimidation. There are a lot of caregivers or just family members who are intimidated the moment they went into, walk into a hospital or a clinic or a doctor's office. It's just like, oh like, banks, jails and hospitals just scared the shit out of people you don't even even want to go into. The. You know, keep, keep asking the questions or go ahead and share your thoughts or your concerns, even if you might naturally feel a little intimidated you what closed mouths don't get fed?

Speaker 1:

is that the same?

Speaker 2:

you know so that is one of them. I'm about to tell you now. I'm from, from Alabama originally. Honey, that definitely is one of them.

Speaker 1:

You. You can't be intimidated to where you would jeopardize the best outcome for your loved one, or yourself for that matter. You need to be empowered to ask questions. You should understand what the plan of care is. You should understand what is going on. What should you anticipate next? You should have that understanding Now. On the other end, you can't go to Dr Google and come into the office and tell me some things. You pulled off TikTok Now just to be fair, right, so again we can Wait.

Speaker 2:

Doc, now you're meddling. Now, on behalf of the umpteen caregivers I know my grandfather would say now you're meddling, now you're calling me out, now you're not as a hit dog or holler, now you're going to say can't go to Dr Google or TikTok. Now you know. Now you know, we go, listen, we are Googling while we in the office with you. As soon as you say it now, we might misspell it. Now that could also be a problem. Half the stuff that we are researching, we might be researching the wrong damn disease, because you spell it with a P-H and we spelling it with a F and we going I'm over here in cancer and you trying to tell me about dementia. I got it all screwed up. But what are we supposed to do though?

Speaker 1:

if we don't understand, okay, screwed up. But what are we supposed to do, though, if we don't understand? Okay. So now that's why you have to. You have to have a provider that you have open conversations with, that you have an open relationship with. I have no problems with patients coming to me and saying, okay, I heard about this medication. What do you, what do you think? Or we can, I can, point you to some reliable sources, right, because everything on Google and everything on TikTok we know is not real.

Speaker 1:

Okay, and so no, yeah, girl, you will be surprised. That is not real, okay. And so, again, don't feel as though you can't come with some research, but we all have to be on the same page, right? Because you may hear something that you think works well for somebody else, but as a healthcare provider, I know your whole past medical history and, because of your heart condition, this is not going to work for us, right. And so being open to kind of hearing that kind of feedback and having that exchange, the same works in reverse.

Speaker 1:

If I'm suggesting some evidence based approaches to you that you don't necessarily agree with or you don't agree with your loved one, let's have a conversation about that. Because, again, what I don't want you to do is walk out of my office and you say okay, and then don't have no intentions of following through. We'll never get anywhere. You know we'll be kind of at this holding space, so honesty is what I expect and then be able to tell us you don't have to use big words, big fancy words Tell us what's going on, so that we can provide you with the necessary resources.

Speaker 2:

This sounds like a real relationship, doc. Oh yes, it sounds like you are open to, or at least suggesting that, there is open communication, honest communication, and that we, meaning caregivers, are giving their provider a chance to say OK, this didn't go so well, but before I just quit you, I'm going to let you know, let's work it out.

Speaker 1:

Give me a chance. I think I got to look into the camera when I say this, so listen here. It is very, very, very, very important that we have open communication, and so what I'm going to tell you is that you have to have a primary care provider. Now I don't know what's wrong with our people that think they don't need a relationship with a primary care provider. They can use the urgent care. They're going to use the emergency room. This is my plea when you have a primary care provider, and primary care is my specialty. So this is my plug.

Speaker 1:

I have a longstanding relationship with you. I have a longstanding relationship with your developments over the years. I know you. I've known you from the beginning, developments over the years. I know you. I've known you from the beginning, and so now it's one of those things where, if you just go to the urgent care, they don't know you. It's true, they just know that one symptom that you told them about. The same thing with the emergency department If you're using the emergency department for primary care, you're not really getting the care that you deserve or the care that you really need, and I see a lot of people come to the emergency room and say, oh, I'm having this issue, do you have a primary care provider?

Speaker 1:

No, I don't. And so, again, emergency rooms are Band-Aids, right, they're going to try to fix whatever and send you back out to a primary care provider. Having that relationship even when you're feeling well right, because we don't want to always see you when you're not feeling well. The relationship is long lasting, long standing, right. So I see you in your good days, I see you in your bad days and we kind of working through that relationship.

Speaker 1:

But that person is supposed to know you. So if you don't have that relationship, if you don't have that relationship with your love for your loved one, a provider that knows them, that can see changes over a period of time, that can further advocate oh, I've known this person for five years, this is not their baseline, this is not who they are Then that kind of adds difficulty when you're trying to get things done. So, again, just have that established relationships with your provider before things start to go bad. Every year, annual physicals, every year, annual checkups, so that when things start to go right, we then have an opportunity to say, okay, now I see slight changes and we can jump in and intervene early.

Speaker 2:

I mean, when you say it, it makes so much sense, yes, it sounds so. One plus one, yes, but when you're out there in that world, doc, that thing sounds like rocket science math, chinese math, sprinkled on top of oodles and noodles. You know what I'm saying, but I'm going to do better though. Okay, you know what I'm saying, but I'm, I'm, I'm, I'm a do better though. Ok, I'm going to do better, and I'm going to encourage everyone, in the sound of my voice or in the view of my face, yes, to do the same, because it does make a difference. And I've seen it with, very recently, where there are caregivers whose LO's will not go to the doctor. And let me tell you the ploy I've been seeing, okay, and you let me know if you've seen this recently Okay, lots of appointments for elderly individuals are in the morning, because initially, when they're making them, they say, yeah, give me the eight o'clock, nine o'clock appointment, I want to go ahead and start my day.

Speaker 2:

So I want to get on home because they want to be in the bed at 6 PM, okay, but come that morning they don't feel like it. Oh, I'm just not really up to getting dressed. It's just a checkup. Nothing's really wrong with me. Can you reschedule? Okay, when you go to reschedule, the reschedule is 90 days, 60 days, a hundred days, whatever. It's not the next week or the next day because there's no emergency. And family doctors, your primary care physicians, they are booked out and out and out. And so these seniors are really playing hooky. I think they are playing hooky from the regular doctor for checkups because they're like ain't nothing wrong with me and I don't really want to go. And then they end up in the ER because they start feeling poorly. A family member freaks out. This old person is in my house panicking.

Speaker 1:

What am I going to do with him? Yeah, it's a loop, yeah, it is a vicious cycle, but again you have to understand that people, for whatever reason, we think hospital, I'm going to get the best care if I go through the emergency. Now there's instances where emergency room is necessary. That's right, emergencies. But there are things that we can do preventatively to kind of like the blood pressure, right. So what I've learned from our people is that if I feel good, I'm good, right. And then when you don't feel well, that's when that emergency occurs.

Speaker 1:

But it's like, okay, I've been feeling well all of this time. I have no relationship with a primary care provider. I didn't know I was diagnosed with high blood pressure because I felt fine, so I never went to go get checked and so now I'm in the emergency room with 200, over 100 blood pressure, right. So I think just some of this, the mentality of even if you don't feel like going, you feel fine, that's that maintenance, even if it's a 15 minute check here, right. So all changes for your car right now you know you don't get an oil change for your car, you could potentially be on the bus and that and that potentially be on the bus will get you to sit in that line, pay 60 bucks or more every you know every amount of time to get your oil change and you will pay that money. You'll sit in that line. You'll do that because you don't want to be stranded.

Speaker 2:

No, I don't want my engine to lock up.

Speaker 1:

Okay.

Speaker 2:

I don't want a $30, $40 oil change to cost me $20,000.

Speaker 1:

So why you don't think about your health care in that same kind of?

Speaker 2:

way. Well, I told you you meddling. Now you know what I mean. You know what I mean. Doc is taking this personally. We were supposed to be having a conversation about other people. Now how come I feel like she over here grilling me? It's a hit dog, holler, that's what my grandfather always said, and I would be like we don't even have a dog. It took me so long to figure out that. Figure out that phrase. You're right. You're right. We know everybody out there. We're going to do better, right, I know y'all are somewhere shaking your head, clapping your fingers, finger snapping. We're going to do better, doc. And for caregivers Listen, how exciting is it to know that there are providers that actually want us around, are appreciative of our involvement and are open to greater conversation, honesty, feedback, partnership.

Speaker 2:

I could cry. Well, I ain't going to cry because it'll mess up my beat face, but anyway, we go. They got beaters in Detroit. Y'all DM me and I'll tell you who did my face, but that's for later. Dr Detroit, thank you so very much. Thank you, thank you so very much. You have given us a wealth of knowledge and and if anybody is trying to figure out any of the stuff that you said and talked about here right now, on this couch, I'm gonna just tell y'all this you can google her now. Don't google your disease, but you can google her. She is all over everywhere Billboards, telephone poles. But we got even more for y'all. We're about to go to the Rosa Parks Geriatric Center and chat it up with even more medical providers about what we as caregivers can do. That makes it a little bit easier for them and even sweeter for our LOs.

Speaker 1:

So this is the team that really makes this happen.

Speaker 1:

So doing a geriatric grant of this size, really advocating for change in how we provide care for geriatrics in the state of Michigan, cannot be done without clinicians that are here on nine-to-five doing this type of work and telling us and advising us on kind of what we need to do to improve the care and then hopefully being a model so that other clinics can be able to follow their lead. So this is the Rosa Parks clinic team and this is a team that are also part of the grant as faculty and advisors to kind of make sure that we're using these resources appropriately, and they are also integral in many parts of the grant. They work with our students in educating and training our students that come to the clinic. Actually quality improvement at the site, at the primary care and the long-term care facilities, ensuring that we are providing age-friendly health care to everyone that encounters our system. And so I couldn't do this without them and I want to just take this opportunity to thank them so much for what they do and you will get to know them very shortly.

Speaker 2:

Okay, dr Lisa. Dr Lisa Benz-Emerick, did I get that right? Listen, I'm a comedian first and then I'm a caregiver, but we are here at the Rosa Parks Geriatric Center. I can't thank you enough for even being a part of a mission and a clinic that provides care for a population like this. How did you even become involved with this facility?

Speaker 4:

30 years ago, I became involved with this facility. I had lovely grandparents, and that's what taught me the love of the older adult, and so, after I got my master's degree, this job became available and I came here, and I've been here ever since. So 30 years, 30 years, yeah, taking care of older people and their caregivers.

Speaker 2:

Yeah, yeah, and I have a real passion for the elderly population too. It started for me with my grandparents, so I understand what you mean. Now tell us real well in your words the difference between a nurse practitioner which I think y'all can do just about everything as the MD, because you can prescribe medicine and you can see me and tell me if I have the flu. Correct Sounds pretty good to me, right. So what can't you?

Speaker 4:

do Really nothing. I can really pretty much do everything.

Speaker 2:

See there, I tell y'all. So listen, when you go in your MyChart and your doctor's not available, go ahead to that NP. I'm just trying to tell you, I've had such good experiences with my.

Speaker 4:

NP. I think the patient benefits from both. I mean, the physician has their perspective and I bring a nursing perspective to things a little bit more holistic perspective.

Speaker 2:

She's being kind, go to the nurse practitioner. No shine or no hate on the doctors, but I can say it, she doesn't have to. So we are in one of the rooms within the Rosa Park Geriatric Center and you're going to show us a little bit of the difference of what a patient can get here that you wouldn't necessarily get in a standard doctor's office or facility. That's correct. I'm excited to see.

Speaker 4:

Here we have hip high chairs. They're the higher for the older adult. Oftentimes they have arthritis in their hips or their knees, so it's easier for them to get up from a higher position than sitting down low. So this is one of the things we created when we brought the clinic to inter-fruition is to have hip high chairs for patients. They're also heavy so they don't tip over, because older adults don't get up as readily as a younger person and so they're heavier chairs.

Speaker 4:

Behind you there is a wheelchair scale. Oftentimes, if you go to a regular doctor's office, they have the little tittery scale that people get on, and this allows us to put an individual in a wheelchair there and weigh them and then bring them over here and then weigh the wheelchair so you can really see what the individual's weight is doing. So that's another thing we have for the older adult. Other things when the individuals come out to check in, our counters are lower because oftentimes they're in wheelchairs and so they're able to then converse with the individual receptionist without having to have the counter there in their eyesight.

Speaker 2:

That is so powerful? Did you all think that through in advance? And being designed for it? Yeah, absolutely, absolutely. That's magical. My mom is still battling dementia. She has Alzheimer's. We're currently in year 13. And let me say, even though she currently is a part of a dementia clinic All right, I'm going to pause for everybody to digest that they don't have everything you just named in terms of seating or a scale that would be easy for her to get on, to get on while she's not currently using a wheelchair. The fact that the scale you just showed us is so low to the ground and has that little like, I guess, a little small ramp that would just be easier for her to even walk onto, let alone a, I guess, just a lower height um check-in area for a reception, these things sound real doable. Not high technology, no, and it sounds like, I'm sorry, caring. It sounds like caring. Well, thank you. Thank you so much. So now we're going to go to some other parts of the clinic and see you guys in a second.

Speaker 4:

Oftentimes, when an older adult goes to a regular doctor's office, they have difficulty getting on the exam table, and so oftentimes they're examined in a wheelchair or in the chair, and that's not really a good examination to do for the older adult. So this goes up and down. It's low to the ground, so the older adult can get on it without having to. It's low to the ground so the older adult can get on it without having to um, you know be precarious.

Speaker 4:

And then this uh is able to you're able to move it. However you need up. If again, if they have arthritis and they have hard times sitting in low chairs, then we bring it up. So it's, it's really for the older adult, it's comfortable, it has a you know, soft.

Speaker 2:

So because a lot of times they're bony, yeah, absolutely, I could take a good nap in this thing too. I mean, I know it's not for me, but they want to take it home with them.

Speaker 4:

I appreciate it and then again we have the lower things for the older adults, so the lower counter space and stuff.

Speaker 2:

Thank you so much Lisa I appreciate it. All right, we'll be back in a sec. Dr Patel, thank you for talking with us.

Speaker 3:

Well, thank you for taking time to come and see our clinic. This is one of a kind clinic. It's a one-stop shop kind of a thing for older adults, because we not only provide primary care here for the older adults but also some of the subspecialties like cardiology, gastroenterology, sleep medicine. We have pharmacy, social work, nephrology all in this one clinic. So the older adult doesn't have to really go out of this clinic to another place to see a different provider, because you know oftentimes, if they do, that their care is kind of fragmented. They get confused of where they have to go. Instead, everything is done here in one place. So all their medical specialists and diagnosis and everything is in one chart here. Yes, makes it easy for them.

Speaker 2:

That would be a lot easier, I think, for any of us, definitely for their family, caregivers, for them to manage.

Speaker 3:

Absolutely.

Speaker 2:

Have you found that many family caregivers bring the patients?

Speaker 3:

here. Yes, yes, most of our older adults are accompanied by their families son or daughter, grandchildren and it's nice to see them involved in the care of older adults, because often the older adults, for them, this technology and all can be a bit too much, and so having the caretakers involved in their care is not only supportive but it kind of creates that healthy environment for them. It's very good to see that the next of kin are involved at an early stage of any disease, illness, and they are learning and encouraging the older adults to follow the medications, take those medications on time and improve their overall well-being.

Speaker 2:

Yes, sounds amazing. As a family caregiver, I am happy to hear that coming from you, from a physician. Do you have any advice or tips? Is there something that you would like the family caregivers to do more? If you're like, yeah, you know, maybe it would help if the family caregivers could add this or do this a little bit more, as you are, as we are trying to help our mothers or our grandparents.

Speaker 3:

I think the one thing, as I mentioned, they can do, is get involved early on, especially for some disease process like dementia, because they start to have these memory issues and it doesn't happen all of a sudden.

Speaker 3:

It's like slowly builds up over years.

Speaker 3:

Initially they may have subtle memory lapses but then they start having, you know, more issues with recalling past events and ultimately in the advanced stages they just completely forget of what's happening.

Speaker 3:

But when they get involved the caretakers, once they're involved in early stages, then they also get to know what the older adults really likes, how they like the physician to provide care to them. So in the later aspect of those diseases where they don't have the ability to make the decision, the caretaker getting involved early on knows what the loved ones would have preferred if they would have wanted certain things done certain way, if they don't want these procedures or aggressive management and they just want to live their life out more comfortable, you know, enjoy the remaining aspect of their life. So I think the key is for the caretaker to get involved early on and then not to get anxious if they learn about some disease process like dementia and get, you know, really worried about it, because now there are a lot of resources. Caretakers also need to look after themselves, especially if they are caring for their loved ones who have dementia, then really there is a lot involved. You know they can get burned out.

Speaker 2:

Doc, I have to ask you now now you're saying something that makes me want to, uh, almost start tap dancing in the room caregivers taking care of themselves. It is. It's hard. We don't always know where to start and how to do it. Do you have any suggestions on how a care taker could actually do better with caring for themselves?

Speaker 3:

yeah, I think. Um, so the caretaker, especially as we talk about, let's say, disease like dementia if it's a solo caretaker, then it's overwhelming for that person and if the families involved brothers, sisters, aunts, uncles or grandchildren are involved, it makes it easy for that one person because then everybody can share in the workload. But the important thing is that caretakers should also look after their health, Because what we see is that oftentimes a solo caretaker often, you know, forget to take care of their health. They forget to look after their medical issues or go to doctor, see them for preventive care and then ultimately can lead to them having medical issues. So there are resources available and if there is a larger family involved in the care, it makes it easier for them to share the workload while they still stay active with their daily life, you know, exercise, meditation, healthy lifestyle so they are not overwhelmed with one aspect, yes.

Speaker 2:

I'm only going to admit this because you have been so calming and specific with your advice. I found out just last week, Doc, and I didn't know this. I thought I was doing pretty good. My primary care physician contacted me and said it's been two years since my physical. I had no idea I'm in year 13 with my mom, but I to the point you were making. I thought if you had asked me I would have said no, I went last year, but last year was two years ago, and so I received the message you're giving us and thank you so much for sharing your advice, sharing your passion, your understanding, your expertise, and I know it's going to be very helpful.

Speaker 3:

Thank you. I think it's very important that caretakers get this message across that they got to look after themselves in the process of taking care of their loved ones. Otherwise, they are neglecting their care and they may put themselves at more risk than benefit.

Speaker 2:

Listen, he has the white coat on with the thing with the comma and the MD behind him. So if you don't believe me, believe Dr Patel. All right, we'll be back with some more information about caregivers and what you can do, pharmacy and geriatrics and old people. That sounds way confusing and complicated. How do you make sure the medicines don't get messed up? Candice, tell the truth.

Speaker 5:

You know, there's so many ways that medicines can get messed up. First of all, we want to make sure that the patient is getting the right medications. So it's what is the right dose, what is the indication? What do they need this for? Also, there's the patient's end of it, right Like are they taking it right? So we problem solve through it.

Speaker 2:

Are they taking it right as a caregiver? Mom is in year 13 Alzheimer's. I know for a fact she's depending on me for how she takes it. Where do caregivers come into play from your perspective as a geriatric pharmacist? Into play from your perspective as a geriatric pharmacist? Well, I know you do more than geriatrics, but that's your specialty here at the Rosa Parks Geriatric Institute. What do you think caregivers can do, can learn, can assist in this whole process of medicine management? When it comes to the elderly, you know a couple things.

Speaker 5:

I think they can ask questions. So asking questions of the doctor, but asking the questions of the pharmacist, you know, to make sure that they're taking it right. The other thing, I think, is having a list being organized. Some of our best caregivers will keep a notebook and a schedule and a calendar, and a lot of times what I do in my role here in the clinic is we come up with a final medication list and then I write it all out on a calendar. I'll include the brand names, the generic names and what time of day to take the medication, and I try to simplify the schedule for the patients. Like a lot of people think that you can't take two meds together, so they'll schedule their medications out through the whole day, which is complicated. So a lot of times I'll just try to simplify their regimen so that they can take the least medications to get the most effect out of them and tell them what time of day they can take it and write it all down, because really, who can remember all of that? No one.

Speaker 2:

You, you, the pharmacist, can remember it all and I know this happens to me and you tell me if you've come across this with other caregivers. You get all the medicines, you call the pharmacy. The pharmacy says hey, the way the doctor told you to take that is wrong. What am I supposed to do as a caregiver if the pharmacist that's feeling it says the way the doctor is telling you to take this just doesn't match with that medicine?

Speaker 5:

Oh man, what am I supposed to do? Yeah, you're kind of in the middle of it, right, yeah? So I think the first thing is to ask questions how should it be taken properly? Then verifying back with the doctor's office. You know, I'm told that I should be giving it this way. Is that correct? So that it's reconciled? So that's our big buzzword medication reconciliation is it needs to be reconciled, but it's coming from this source, coming from that source, another source. How do we reconcile that so that there's one accurate list? So taking that list of medicines to every point of healthcare is a really key way that caregivers can help.

Speaker 2:

That list. You keep bringing up that list. I guess it really matters to caregivers that we have this list and it's not permanent, right? It seems to be changing it is evolving. It is changing, much like many of us. Uh, we're changing and evolving too. What have you learned from conscientious caregivers that you're like, wow, I hadn't thought about that they're doing this activity, or I hadn't thought about that they're doing this activity, or they have this habit. That seems to be really useful.

Speaker 5:

We have some great caregivers. I mean a lot of them are just trying to like get at like the most effective, least problematic approach to administering the medications to their patient, to their you know loved one, and so sometimes they'll use like strategies of like trying to distract them or like giving it to them at their best time of day. Sometimes they'll put it into their food, you know, if it's a medication that you can do that with. Sometimes injections are helpful when you know a patient doesn't want to take oral medications because it's kind of like one and done. You know, right, yeah, so there's all kinds of different strategies and approaches that I've seen people do, but a lot of it's kind of going at it with like let's get this way possible, yeah, okay.

Speaker 2:

I have a final question for you. Is there anything you can suggest that a caregiver probably should not do in their approach to a pharmacist? Let's say we're a little frustrated and we're not trying to take it out on the pharmacist Like, hey, the doctor screwed up. What is like a no-no in your industry?

Speaker 5:

Oh man, pharmacists hate being yelled at. Okay, they hate being yelled at by their patients and their patients' caregivers. You know, I think that we just want to help right and so being able to, like, have a conversation, a dialogue, a back and forth. Everybody's frustrated when things aren't going the way that you want for them to. You're like not getting the medication that you need. Seeking to understand, don't yell at your pharmacist.

Speaker 2:

Okay, y'all got it here, okay. So listen, go out in the car, scream to your favorite song and then walk into the drugstore in a calm place. All right, thank you so very much. Thank you so very much.

Speaker 2:

It's been a pleasure, the Snuggle Up. This time we had the pleasure of being in two places for one episode the Rosa Parks geriatric center, and then actually in studio. We had medical professionals in a clinic and somebody telling us about an academic perspective, a personal perspective. How could you get any more? You know what I'm saying. What really struck me and what I know I'm going to take away from all that is these providers want a real, honest and open relationship with the caregivers. They want us to be involved.

Speaker 2:

Now maybe you over there saying Jay Smiles, but you don't know my mama's doctor, or you don't know my granddaddy's dialysis giverer Okay, well then maybe you need to change that person that ain't the only dialysis giver in your granddaddy's town, because apparently there are some providers who want to have an open dialogue with us. They realize that we are the boots on the ground, that we are the person who is around their patient 24-7. And without us they cannot give adequate care to their patient. So while you BSing, they can't even really for real, for real, fulfill that oath they took either to be a pharmacist, to be a nurse practitioner, to be a general physician, to be a neurologist. They can't do none of that right and well, to the best of their ability, if they don't get information from us. So what we got to do, we heard from them. We got to ask more questions and maybe be a little pushy when we say, no doc, no nursing pool. I said this what's happening at the house? You ain't got to be ugly with it, but go ahead and send that second or third email in my chart or whatever version of email in digital communication you have with your family member's provider.

Speaker 2:

If you got to pull up on the doctor's office when they keep telling you they don't have no space for an appointment, but you see your LO is walking around the house talking to spiders, pull up on that thing, pull up on that office. Listen, not with violence, with care and concern. We just heard from and saw multiple providers, multiple genders, multiple ethnicities and religions. They all said the same thing they need us, and so do our LOs. We got it and we gonna give it. What up, though. Thank you for tuning in. I mean really, really, really. Thank you so very much for tuning in, whether you're watching this on YouTube or if you're listening on your favorite podcast audio platform. Either way, wherever you are, subscribe, come back. That's the way you're going to know when we do something next. Y'all know how it is. I'm Jay Smiles. I might just drop something hot in the middle of the night.