transcript

Speaker 1:
[00:02] Kathy, don't forget to tell your mom, to tell your dad, that Jan's mother-in-law and Dr. Gail's mother already won the Publishers Clearing House sweepstakes. Somebody gonna cue me or do I cue myself?

Speaker 2:
[00:15] Cue yourself.

Speaker 1:
[00:16] Okay. Wait, wait a second, are we live again? We're live again. Again. Back by popular demand. We are back with another live episode of Let's Talk Off Camera, so let's get talking. We're doing something, listeners, that we have never done before. We are doing a follow-up show because we usually just hit them and quit them, Jan.

Speaker 2:
[00:42] That's right. Move on.

Speaker 1:
[00:43] But during the last time we did this episode, we did an episode on being in the club sandwich generation, where if you are, like many of us, where you have children, you may have young children. Many of you have young adult children. You're working full-time and you're caring for aging parents. It is something we are all navigating our way through. Ashley's still too young to be navigating this. Good for you, Ash. May you never grow up. But it struck a nerve, Jan, I would say like no show we've ever done before.

Speaker 2:
[01:25] The lines were full and we've since gotten so many questions that were sent to us, which we'll get to today because I just like thought we talked about it afterwards and we're like we should answer some more people's questions.

Speaker 1:
[01:37] That's right. We have to. It was the one, what was so funny was the episode of this past podcast that we did on caring for aging parents was requested by so many people I know like send me that episode. And I wanted to say like you or you could just subscribe and download it like a good friend and person. But it was the number like I've never been asked to I've never been asked to for that an episode like that episode. So joining us back again is the only person who can handle this with us. She's the Clinical Associate Professor of Psychiatry at Weill-Cornell and the host of the How Can I Help podcast. She's the best. She really is. She's brilliant. She's wonderful. She's just our dream guest. Dr. Gail Saltz is back. And remember we are opening the phone lines. So call in with your questions or stories. We're going to get to as many as possible. But before we get to Gail, let's do a quick check-in, mental health check. Jan, what's going on?

Speaker 2:
[02:46] Well, I do want to bring up the fact that now we've all seen Mark on Broadway.

Speaker 1:
[02:50] Yes, we've all seen Mark on Broadway. In previews, he opens. Opening night is Sunday night.

Speaker 2:
[02:55] I know. Yes. And it was thrilling. It was so fun. It was it's like they talk about him the entire time.

Speaker 1:
[03:02] It's a big build up.

Speaker 2:
[03:03] It's a big build up. And when he comes on, it does not disappoint. It's it's fantastic.

Speaker 3:
[03:07] It's really exciting. And then Kelly O'Hara and Rose Byrne are just like comedic assassins.

Speaker 1:
[03:13] And the whole cast and Scott Ellis is the director.

Speaker 3:
[03:17] Amazing.

Speaker 1:
[03:17] He's just amazing. I said it's like watching 90 minutes of sheer joy and laughter.

Speaker 2:
[03:23] Yeah.

Speaker 1:
[03:24] And just I said to Mark, because when I when I saw his entrance and what happens and the ovation he gets, I said to him, I feel bad that Lena and I just sort of, you know, he walks in and I'm like, are you hungry? That's what he gets. Now I feel like I need to do more of a bigger welcome home.

Speaker 2:
[03:45] How has he felt about, because it's a grind, it's definitely a lot of work on top of the talk show. So how has he felt with the schedule?

Speaker 1:
[03:52] Well, he's, you know, like he said, he's very lucky because he is, it's a 90 minute play, there's no intermission. It's a comedy. The material is fun and frothy and great. And he, without a spoiler alert, he is like sort of the cherry on the Sunday to the whole thing. So he does not feel, he doesn't feel stressed out. Wednesdays are hard because we do two shows, you know, at live, we do two shows on Wednesday and then he's got a matinee and then he's got an evening performance. So that's a big day for him. But the rest, he's been really managing it.

Speaker 3:
[04:27] I mean, he's so disciplined in general, like of anybody that should be able to do that with him. I mean, the guy.

Speaker 1:
[04:33] I mean, he used to work at a soap opera and go do theater at night. So he is not like, he used to work 12 hours and go do the theater.

Speaker 3:
[04:42] So he's like, he's so good in it.

Speaker 1:
[04:44] I don't want to give a lot away, but he's just so good in it.

Speaker 3:
[04:48] His arrival, everything from his arrival is...

Speaker 1:
[04:50] The play, ladies and gentlemen, is called Fallen Angels at the Todd Haynes Theater. And it's really, it's a limited run. It's great.

Speaker 2:
[04:58] And now I want to talk about the proud mama moment. I mean, I was like, so happy for you. Like, just like the mom in me was like, oh my God, I can't even imagine what that must have felt like.

Speaker 1:
[05:12] Well, you've been there since his college performances. I know.

Speaker 2:
[05:14] But Kelly, that must have been so thrilling for you.

Speaker 1:
[05:17] It was thrilling. We keep using the word surreal because it was surreal. We were blown away.

Speaker 2:
[05:25] We're talking about Joaquin.

Speaker 1:
[05:26] We're talking about our son, Joaquin Consuelos made his Broadway debut opening night was Thursday night and in Death of a Salesman, Joe Mantello brilliantly directed, critically acclaimed the reviews. I've never seen reviews like that.

Speaker 3:
[05:44] Reviews like that don't exist.

Speaker 1:
[05:46] They don't exist. But interestingly, and Joaquin by the is fabulous in it, but the entire cast is fabulous. There is no weak link in that cast. It is excellent.

Speaker 3:
[06:00] So cinematic.

Speaker 1:
[06:01] Yes. It's like watching a movie.

Speaker 3:
[06:02] I said to Joe, I said, it's like going to the old Ziegfeld movie theater, but watching the whole thing come to life and you're on this stage. It's just, it's unbelievable.

Speaker 1:
[06:11] But the reason I am turning this around and bringing it back to our topic at hand, I don't know if you read the New York Times review, but the theater critic says that Willie Loman is sundowning. And that's how she describes his behavior in Death of a Salesman. And that is what is happening. That is what we are watching unfold before our eyes.

Speaker 3:
[06:38] And Nathan Lane, by the way, is incredible.

Speaker 1:
[06:39] Nathan Lane is, I mean, I think he and Laurie and Ben and Chris will certainly be nominated for Tony's and I suspect in my opinion, they should win.

Speaker 2:
[06:51] Has Joaquin, like, has he had that pinch me moment? Is he like, Oh my God, I can't believe this is happening or what's happening?

Speaker 1:
[06:58] I think here's what Joaquin is so like, he's ignorance is bliss. So he doesn't know how improbable, impossible it, like he just, like he auditioned and he got a call back and then he auditioned again and he got the play. And Mark was like, I've been auditioning for 30 years, you know, for Broadway shows. And so, but here's the thing. He is so blown away by the people he works with. And he said he has learned so much and they've been so good to him and the young cast. Like, they have, they've really learned so much. Because one of his, one of his castmates is still in college.

Speaker 2:
[07:51] It's crazy.

Speaker 1:
[07:51] Like, he's taking a sabbatical from college, from drama school to be in this play. So it's like, it's really sort of a remarkable group of people helmed by Laurie Metcalf and Nathan Lane. And they're really teaching them a lot.

Speaker 2:
[08:07] Have either Mark or Joaquin had a moment yet where they got tripped up for a second or anything? I don't think I've heard of any of them. We need to have Joaquin on this podcast. I'm putting that out there now.

Speaker 1:
[08:19] I mean, if you can get him on, that would be amazing. I'm dying to know what's in his head. If we could get inside his head, I would love to know that. But he's very even keeled.

Speaker 2:
[08:30] Well, we'll talk to him.

Speaker 1:
[08:32] Every night he comes home from the show and I say, how was the show? And he's like, it was good. That's the most I get out of him. And even opening night, I was like, how was it? How was opening night? Because we were like over the moon and he's like, it was good.

Speaker 2:
[08:48] The girls are going to start coming to see him.

Speaker 3:
[08:50] 24 years that I've known you, I've never seen that Kelly before in a theater, watching her son make his Broadway debut. You were beside yourself.

Speaker 1:
[08:59] I said, I'm the only person sitting through Arthur Miller's Death of a Salesman smiling.

Speaker 2:
[09:04] Smiling.

Speaker 3:
[09:05] Huge smile. Huge.

Speaker 1:
[09:07] I'm the smiling one.

Speaker 3:
[09:09] People coming up to you and congratulating you on it. It was just all of it was really unbelievable to see.

Speaker 1:
[09:16] What was funny was Albert and I both know that they made a directorial. There was a director's note. There's a portion where Joaquin is in a football uniform and he climbs on top of the car and he stands on the car and they moved him to the back of the car. And when he stands on the front of the car, it's very stable and the back of the car, he's like on a slope and it's very unstable.

Speaker 3:
[09:41] Like it's almost an uphill he's gonna stand on.

Speaker 1:
[09:43] And he sort of says to me sort of casually, he's like, I hope I don't fall off the car. And then I was like, Oh no. And so he gets, he jumps up on the car and Albert and I clutch each other like two elderly women in church. Like it was like, stand up, stand up, it was that moment. But it was, it was really great. Anyway.

Speaker 4:
[10:07] Yes.

Speaker 1:
[10:07] Anyway, what's going on? I want to know what's going on with your mom.

Speaker 4:
[10:14] Yeah.

Speaker 1:
[10:14] Cause you've been talking last time we spoke, you were talking about your mom. She's talking.

Speaker 3:
[10:19] Yeah. So we, we ended up having to take her to the hospital because as most people who I'm sure we'll hear from today, like UTIs are like the biggest thing with parents. And she of course doesn't drink enough water. So it's that same issue. So she's back in the hospital and she, you know, during the day with where she is right now in her Alzheimer's, she doesn't really speak very much. It's a few words here and there and she recognizes people, but it's not very articulate. Well, she fell asleep midday because as you know hospitals, you're sleeping during the day and at night you're wide awake. Right. And full stories were coming out of her mouth, like speaking as if it was her 10 years ago. And my sister and I were like, what the hell? And it was wild.

Speaker 1:
[11:02] Are you recording it?

Speaker 3:
[11:03] She did. My sister recorded it because we were like, this is unreal. Like she was telling us a fully articulate story in her spoken. Everything was just very articulate and like a story that she probably would have told us however many years ago or if she were awake. And then I looked it up after and it's so interesting to know that there's still a part of her that is processing things and that in that disease, Alzheimer's only affects the cognitive part of the brain where you're awake during the day and you can't articulate things. But this was her subconscious who's clearly from this story is experiencing the world along with all of us and is able to tell a story in her sleep. It was really mind-blowing and it kind of gave me a moment of, wow, so she does have an, there's obviously an awareness of what's happening in her life.

Speaker 1:
[11:49] Yeah, no, she's in there.

Speaker 3:
[11:49] She just can't put the words to it and connect with people during the day. So it was just a different facet of the whole thing.

Speaker 1:
[11:58] Yes.

Speaker 3:
[11:58] Yeah, it was pretty wild.

Speaker 1:
[11:59] I mean, it's so tough. It's like you just wish you could unlock that all.

Speaker 3:
[12:03] Right, and then I'm like, you know, I wanna be, I wanna figure out how to meet her in the sleeping realm so we could have a conversation together. Like, there were those thoughts, like, how do you?

Speaker 1:
[12:12] Well, there's a movie about that called Inception starring Leonardo Sarkis.

Speaker 2:
[12:17] Are you saying his name properly, Kelly?

Speaker 1:
[12:19] I mispronouncing his name as apparently I've done, as I have always done in my life.

Speaker 3:
[12:24] Yes. Anyway, it's very interesting.

Speaker 2:
[12:26] Yeah, we should ask Gail about it.

Speaker 1:
[12:28] Okay. Should we bring Gail in? Yes. Okay. Let's bring her in now because Gail Saltz, Dr. Gail Saltz is back. She was so helpful in our last Aging Parents episode. Dr. Gail, welcome back to the podcast.

Speaker 5:
[12:45] Thanks for being here. Thank you so much. You guys are so generous with your appreciation. I love being with you all and I have to say, I got a lot of feedback which doesn't usually happen. I was very aware that how many people are struggling with this. I was thinking about it. It touches a nerve with so many people because everybody has parents, and if things go well, they've aged and they're here. So that affects everybody. But also, I think part of it is it's really scary. It's you feel in some way whether you register or not, you're looking at your future, and that's terrifying. I think that creates an additional layer of how do I handle this because this could be me one day. And so that adds in a lot of emotional layers of fear and guilt and even anger that I think make this that much more difficult for everybody.

Speaker 1:
[14:00] It's really true. It's made this time in our lives as sort of like, Mark and I have always been really prepared. Like we've always established like a will and a DNR, and we're very clear with our intentions with one and other. But this has made it, make it so that the line of communication is very open, so that there is no confusion because it seems when it comes, push comes to shove, end of life situations, there can be a lot of confusion. Well, I thought he wanted to be buried. I thought he wanted to be cremated. I thought like there's a lot of, and it's better to have the conversations now, don't you believe, while everybody is cognizant and able to communicate their wishes?

Speaker 2:
[14:49] Absolutely.

Speaker 5:
[14:49] But it really is this fear and discomfort with the topic that keeps us from talking about one of the most important things to talk about. So yes, but you have to surmount your discomfort in doing that and facing it emotionally, like peering at all of this that is nobody really wants to peer at, right? We all defensively want to say, this makes me anxious, so like I'll look away. But it is super, super important because of exactly what you're talking about.

Speaker 2:
[15:25] Yeah. So I'm the prime example of this. So last time we did this podcast, okay, I have never broached this conversation with my dad because I just don't ever want to acknowledge that he's, I've already lost my mom. I don't ever want to acknowledge that he's getting older. Like I don't want it to ever be a thing. But I grew up a little bit after our podcast. And you said the number one thing was to have a conversation and do exactly what you're talking about. So I called him up as soon as we were done the next day. And I said, hey, like, let's meet for lunch. And he's like, okay, great. Then he canceled our lunch for the following week. So I get a text from my dad, a text to me and my brother saying the following week before we meet, he goes, Jan, I think this is what you wanted to meet about. But I just listened to the podcast, Kelly Ripa's podcast with Dr. Schultz. And I think I know what your conversation is about. So I'd like for you and your brother to agree upon everything. But if not, I'm telling you now that your brother will be in charge of financial and you will be in charge of medical and social, which I still haven't figured out what social means, medical and social. Okay. And then we wrote, this is not legal, dad. He wrote that back and he says, I will make it legal. So he doesn't want to talk to us about it. He told us where there's a list of all passwords. And he told us the person he wrote his will with his living and not living well. But he, I don't get the sense that he really wants to talk about it.

Speaker 5:
[16:51] Well, the fear comes from both sides. It's not just, you know, right? It's not just you, it's them too, of being afraid of what the future looks like and what it's going to be like ahead. Just having to talk about, like, you'll take care of means he doesn't have the independence to do that anymore. So that's not shocking. But hey, if you have to do it by text, you can do it by text.

Speaker 4:
[17:13] I was going to get a text from him after this.

Speaker 1:
[17:16] Yeah, no, I mean, I understand your reticence to talk to your dad about this, because when I look at your dad, your dad seems like one of our peers. Like your dad does not present like a dad. He presents like a dad's much younger friend. Does that make sense?

Speaker 2:
[17:33] Yes.

Speaker 1:
[17:33] Yeah. But what are some of the checklist people should sort of put together? I think we went over it last time, but let's remind everyone, like, what do we need to have an order for our parents? And better to have it done while everybody is sort of healthy and not going into rapid decline.

Speaker 5:
[17:54] Correct. So basically, right, you want a power of attorney. So like, should I be incapacitated? This is the person who has the legal right to do. And then your dad may have the desire to, for example, have it be the financial and the banking will be this person, maybe the, and this is where another document comes in. It's called a healthcare proxy. If I'm incapacitated, this person will make health decisions for me. Another good piece of paper to have them do is called a living will. That basically they want or don't want various kinds of medical care should that come to pass. So maybe there are a lot of people, for example, like I never want to be intubated. I don't want to live potentially on a respirator. So that's off the table for me. I might be, do not resuscitate. I might be, it depends on the individual and what they feel while they can still feel it, which is better than putting it completely in your hands. And ideally a will, because dying and testate is not a great thing to do for what you care about, but also for your family. Next, it would be great if you could have a basic list of like accounts, as you mentioned, passwords, car titles or access to where is that, what monthly bills do they pay? What insurance do they have? Because if something happens or they become less capable, you need to know where to find these things so that, for example, they don't stop having insurance because nobody paid for it, or they didn't pay these monthly bills, or you don't know where their banking is done and you can't intercede on their behalf. So the basic really big important things like that, just the information that you just keep. I suggest you document all these, like keep in a safe place a document that has listed all of these things. Next would be a list of the medications they take. So for example, should they have to suddenly be brought to the hospital and they can't list their own medications, you know what the meds are. That's really important in medical care. Who are their doctors? What are their care preferences? And as we sort of alluded to earlier, like their end of life wishes. But you know, you might even get to their after life wishes. Do they want to be buried? Do they want to be cremated? They want to be put in a specific place? All this information can be a one time conversation. And then you've just got it documented, you've got it there. And when or if something happens, you are prepared to be able to handle whatever needs to be handled.

Speaker 1:
[20:50] And if there are multiple siblings, it should be all of the siblings together when all of this is happening, as best as possible.

Speaker 5:
[20:59] Ideally, that is best, mostly because you know, it's the one who tends to not be there, who ends up having a problem along the way, right? Because they had the more, let's say, ambivalent or a strange relationship, or they don't want to take part. And then their guilt is super amped up, and they come in like they're a white knight and disagree with everybody and, and, and, you know, do all the things. So yes, ideally, if you can get together and hear it out of the horse's mouth, so to speak, that's really the best because everybody is saying, we're following their wishes, some, you know, wish I'd be out of business if all families operated that well.

Speaker 1:
[21:44] That's so true. So true.

Speaker 2:
[21:46] Hey, dad, text all that information to Ed and I.

Speaker 3:
[21:51] The DNR thing came up with my mom and you didn't even realize that in the hospital, they started asking you, does she have this? Does she have that? And my sister had to get the document like I didn't have it. So it should be with everybody.

Speaker 1:
[22:01] I have all the documents. I'm the only person that has the documents.

Speaker 3:
[22:05] Because you don't realize in those moments, I don't have the paperwork with me to say, And they're legally obligated.

Speaker 5:
[22:10] They are legally obligated. If EMS comes to their house, and you know they don't want to be resuscitated because they've told you that. If that pink paper isn't there, they're obligated and you're not there. They're obligated.

Speaker 1:
[22:28] I know. I keep saying to my parents, I'm like, you should have copies of all of this. And they're like, no, we'll just lose it. So I have everything. But I live in fear of, you know, I'm always like, what if something happens to me? Then what? So it's one of those things.

Speaker 5:
[22:53] Share with siblings, but also as you said, if it's the most important thing, like what you want to happen, literally put this on their refrigerator.

Speaker 1:
[23:01] Right.

Speaker 5:
[23:02] You know, because EMS knows to look around.

Speaker 1:
[23:06] Right.

Speaker 2:
[23:07] Well, we have a ton of callers. We're going to get to after the break.

Speaker 1:
[23:09] Yeah. Go ahead.

Speaker 2:
[23:12] We have a ton of callers. There is, we also got a bunch of people who wrote in with questions as well.

Speaker 1:
[23:17] I know we have so many. Yeah. We have so many. All right. So what we're going to do is we're going to take a commercial break. We're going to come right back with Dr. Gail Saltz. Stick around, everybody. We're back with Dr. Gail Saltz, and the phone lines have already lit up here, Jan. Yeah. I say lit up, although I have not seen a phone line at all. I just get little, I get little post-its slid to me. But we've got Kathy from North Carolina. Hi, Kathy, you're on with Dr. Gail Saltz.

Speaker 6:
[23:54] Hi, thanks for taking my call.

Speaker 1:
[23:56] Of course.

Speaker 6:
[23:57] Podcasts have been very helpful. My question is, my mom is really together, and I would say she's done everything on your checklist. My dad, however, we see a lot of signs of dementia. So I've actually sat her down and suggested, we need to go to someone and find out what the next steps are, because I can see him kind of wearing her down. And she told me they went to a neurologist, and the neurologist was like, oh, we'll worry about that later. So my concern and my question is, how do I get them to the right kind of doctor who can diagnose that and give us tips?

Speaker 5:
[24:40] Yeah, so diagnosis is by a neurologist to, you know, a neurologist can be sub-specialized. So it is somebody who deals with dementia. But the reality is that Alzheimer's is a bit a diagnosis of exclusion, meaning they look, they look at the symptom collection and they do a neurological exam and maybe they do a scan. And they just rule out that it isn't something else that could be treated. Because the true diagnosis of Alzheimer's is, is basically neurofibrillary tangles in the brain and plaques in the brain. And that can't be looked at while someone's alive, right? So it's a diagnosis of exclusion. But it is good to see a doctor and get a diagnosis because some things can look like dementia, but be something else that could be treated and should be treated, which is why it's worth going to the doctor. Once you've done that, there are medications that can be considered. They have limited use in sometimes maybe slowing down an earlier state of dementia, again, something to talk about. But also, you'll get guidance and she'll get guidance on what the course looks like in terms of at what juncture you might need help, you might need assistance. For example, if it starts to become the person is wandering, or the person is falling, or the person is getting into trouble because they pick up the phone, and they don't understand, then you can address those things, which is really, really important for, even though your mother is living with him, to think about because of course, this will be very, very wearing and difficult on her. And when a person's memory becomes such that they really need memory care, that's what it's called, right? Then it may or may not be safe for them to be at home. Now, it sounds like he's far from that, which is why the neurologist is, the doctor is saying this, but it's helpful to have a neurologist way in about the kind of timeline so that people can think about this well in advance and know the signs where they might need to bring in someone for some care or consider memory care.

Speaker 6:
[27:06] Okay, thank you. I just, I really feel bad for her because it's like her day is like groundhog day because every morning he gets up and they have the same conversations and the same things on his phone and he's going to win the Publishers Clearing House too, all that kind of stuff over and over and over. So I just worry it's going to wear her out to the end that she'll start showing. Well, it is wearing.

Speaker 5:
[27:30] It is wearing. She is the caretaker and you can, you siblings can all spell her a bit here and there. So she has a little respite where there's something else in the mix, so to speak. But basically, empowering her that she doesn't have to be alone with it. I think that's really important, yeah.

Speaker 1:
[27:53] Kathy, don't forget to tell your mom, to tell your dad that Jan's mother-in-law and Dr. Gail's mother already won the Publishers Clearing the Sweepstakes. So he doesn't have to keep you.

Speaker 5:
[28:08] That's right.

Speaker 1:
[28:09] Yeah, if you recall.

Speaker 2:
[28:10] Yes.

Speaker 5:
[28:12] And help your mom put some safeguards in place.

Speaker 1:
[28:17] Yeah, for sure.

Speaker 5:
[28:18] So that he doesn't keep winning, because money can be lost and she won't want to say anything. But that's a whole important topic, which is, what does he have access to? And who has access to him such that money can be lost. And those things step in now with safeguards.

Speaker 3:
[28:41] Kathy, you can block all numbers to their phone, except for people that know them. You put in the numbers that are the okay numbers, and then no one else can get through.

Speaker 6:
[28:52] I'll say, my brother and I have both had it out with him over it. And it's like a hobby. So now all he really has is a stamp. And my mom looks at it as it gets him up out of his seat to walk to get the stamp, to send it in. So he's not, he did send money at first, but he's been stopped. He has really no access anymore. So we let that happen. But yeah, the phone is a big issue every day. Like he, you know, I won't get into political things, but they talk to him every day too. They send him to him. Yeah. Yeah, I just need to make sure she protects herself from getting totally worn out, and we can help her too.

Speaker 1:
[29:33] They also have, I don't know if you've seen this, Cathy, but I saw it recently. They have sort of, for people who may or may not be battling dementia or neurological disorders, they have like activity mats, like there's zippers, there's buttons. I mean, it's sort of like toys that you would almost, you know, remember when you had like small kids and they would like learn how to tie a tie or zip up a zipper, but they have them now for adults dealing with memory care issues. And that could be something that may occupy his time in a way that's sort of constructive, like a little weird, you know, if he doesn't mind like licking a stamp and going to the mailbox, this will be less weird than that. And it's more active, I think, maybe.

Speaker 6:
[30:24] So mad at me if I suggest it.

Speaker 1:
[30:26] I know, I know. Just like act like you got one, you know, you got one and all the people in your neighborhood have one. You know, it's like, oh my God, where everybody's doing it, everybody's playing with this thing.

Speaker 5:
[30:38] Also, like, did he have any old hobbies? Because I, so this is something you see a lot. Somebody who, for example, used to play music, you know, played a musical instrument, or or was artistically creative in some way or was big on, or liked to garden, you know, bringing back something that was pleasurable in their youth, you'd be surprised. I have literally seen patients who used to be a drummer and haven't been for decades, and you get them that indoor, you know, they wear headphones, so it's not driving you insane, but they, you know, and he could play anything because their old memory is accessible for them.

Speaker 1:
[31:22] It's still there.

Speaker 6:
[31:23] Yeah, he was a college basketball coach, so he can tell stories forever. And I sometimes want to like put out something to all his old players and say, just send him a text and or tell him a story or something, but I'm not sure that might be okay.

Speaker 5:
[31:40] Or mock up plays, mock up some coaching plays.

Speaker 6:
[31:44] Yeah.

Speaker 1:
[31:45] I was thinking maybe you get him like an old school, like, you know, the old school tape recorder.

Speaker 2:
[31:51] Yeah.

Speaker 1:
[31:51] Or you just use, you know, the, the, on the phone, the memo records on the voice memo on the phone. And you put it in front of him and say, dad, tell me some stories from the basketball days and just like let him go.

Speaker 6:
[32:07] Yeah. I think that's a good idea.

Speaker 2:
[32:11] Or if he's watching some basketball games, he can, he can talk into the recorder about the plays that they're making.

Speaker 1:
[32:15] Yeah.

Speaker 2:
[32:16] And some of the things they're doing. He can give the play by plays.

Speaker 6:
[32:20] Yeah. Yeah, these are all good suggestions. But he often resorts to, I'm crazy.

Speaker 1:
[32:27] No, I mean, listen, we, we, you know, we're all in it together, Kathy. We wish you the best, best to your family and good luck to you. Thanks for calling in.

Speaker 6:
[32:37] Thank you. Bye bye.

Speaker 1:
[32:39] Bye.

Speaker 2:
[32:39] Okay. Before we get to our next phoner, I just wanted, we had some people who mailed in. Stephanie from Maryland wants to know, Dr. Gail, if you don't have a close relationship with your parent, how much involvement is expected of you to help them in their old age?

Speaker 5:
[32:55] Well, there isn't a guide on this. And so there isn't a rule. You know, I can't say like this many hours is expected. And so I think what's hard is right, that everybody has to sort of look internally to their own moral compass about what they're going to feel okay enough with, so to speak, in dealing with this situation, right? And so you might not have been close, as I alluded to earlier, sometimes that's because there's a pretty ambivalent relationship with that parent, and that can stoke a lot of guilt. And you may therefore do one of two things, charge in and be like, I'm doing everything and I have to do everything, or your fear is you have to do everything and then you do nothing, because you defensively sort of just don't want in, you know? And so I would advise you to think about ways that you can do something, right? Look at the situation very logically, who's covering what? Who's covering what personally? Who's covering what financially? Where do you feel you can contribute without making yourself insanely miserable? It may not be the same. Maybe you're in a position to provide some financial caregiving, and you're not going to be the one in person if like it's extraordinarily painful for you to be with that parent. Or maybe you're going to say, I'm going to do some of that even though it's hard for me, but that will be a lot for me. So it's trying to find that it is hard. It will be hard. There's no way to make this great. But I also want to say this to everybody, to everybody. If your parent cannot be alone for 24 to 48 hours, meaning not alone, but without your help for 24 to 48 hours, then this is no longer a, what am I doing as a kid situation to help? This is where some other caregiver is either, you're going to bring them in financially to try to keep them at home a little longer, or they're going to need to be in a place where they, for example, if they need memory care. So the idea that despite your minimal or more minimal relationship, how much do I have to do? Nobody should be doing everything. That's just not a reasonable, giving up your life, giving up your relationships, giving up your work. Does nobody any favors and in your parents better days? It's not what they would want you to do, to ruin your life. So I do want to say that. But I think it's harder for the person who's been more minimally involved. I suggest you do get somewhat involved and just think about logistically. What's the best way to do that?

Speaker 1:
[36:10] My question is, you struck on something like if a parent can't be alone for 24 or 48 hours without assistance, there needs to be a caregiver in the home or there needs to be an alternate, whether it's going into a care facility or what have you. What if the parent is fully resistant and refuses having outside help in and refuses going somewhere else? Right.

Speaker 5:
[36:40] So this is probably one of the most common and the most difficult aspects of all of this. And what I would say to you is this, there's going to be a certain amount of risk taking that you might not agree with because they feel how they feel about their quality of life and not just their quantity of life. And so you may not see eye to eye on it. And to a certain degree, my feeling is as long as they have agency, in other words, they don't have dementia, real, you know, more than minimal dementia. There's a certain amount of respecting that, right? But once you get to the point where either dementia is, is really what's keeping them making that same decision that is very illogical and they're falling down, they're mixing up their medications, they're doing things that basically can be lethal. And they don't have agency, that unfortunately is when you may have to just do it for them, whether they like that or not. And, you know, now we can be talking about anything from taking legal guardianship, which, you know, if you have not gotten power of attorney, maybe what you have to do, you need to involve a lawyer. And, you know, if they've been diagnosed with, you know, significant dementia, you will obtain legal guardianship and you'll do what you have to do. But I always think before you're at that extreme point, they may take some risks that you don't want them to. And you can be very clear, I don't want, this is, in my opinion, wrong. And I think it's a mistake. And it pains me because I see the risk here. But, you know, it's still their life.

Speaker 1:
[38:38] Jan, it's still their life.

Speaker 2:
[38:42] I mean, I feel like everybody I know is dealing with this right now. It's really wild.

Speaker 1:
[38:48] Listeners at home, you would be amazed if you could understand how similar every story is that we are hearing both at the office, in our own families, with our callers. It's all sort of the same story over and over again. We have to take a commercial break. I know that we have a caller waiting who has been so patiently. Don't forget, we're going to get to you caller as soon as we get back. We're going to take a break. We'll come right back with Dr. Gail Saltz. We're back with Dr. Gail Saltz. We're going to get to Julie and Charlotte. Hi, Julie, you're on with Dr. Gail Saltz.

Speaker 4:
[39:35] Hi, Kelly. Thank you so much for talking about this. My mother has been in independent living since 2020. She has light dementia. She is single mom, worked for the government her entire career, and has a pension. I'm terrified. I'm terrified if she needs memory care because right now, we supplement her living. I don't know what we're going to do. I guess I live day to day as her caregiver, and we got through that day. We're getting through this day. She tells me she's going to live to 100, which, you know. You know, but I'm scared to death. I don't know. Are there programs for seniors? I mean, we have not done a good job for care for our seniors. And if you don't have a trust fund or lots of money, how do you take care of yourself?

Speaker 5:
[40:39] Yeah. Well, this is, you're bringing up the financial piece, which is very real and is a huge problem. And first of all, when it comes to facilities and when are they ready for a facility? That is not, as you said, independent living. Often in independent living, there are people around who assess those things, you know, and we'll be looking at them and see. And probably there's even time. Years, I'll say, where somebody could just come in for a couple of hours and, you know, make sure her meds are in order and, you know, her laundry is done and things like that, even while she's in independent living. But at some point, if, you know, as I said, meds are getting mixed up, she's having falls, she's leaving the stove on, you know, she's wandering out, she's getting lost, like more significant dementia, real significant, which could be years before that, you know, really. But at that point, that's when you really do have to think about moving. And in terms of financially, I will be, first of all, there's a wonderful book out there for everybody who is like, how in the world do I think about nursing homes? And it's just like terrifying to me and all of that, called Being Mortal, which I really would, we just highly recommend. It's sort of about the dilemma this country is in, in terms of healthspan versus lifespan, quality of life versus quantity of life. And the fact that we have a not a good system for dealing with older people in this country, unlike some other countries. But I will tell you this. If there is no money, then the reality is, and you need to get with a lawyer on this, your mother would probably qualify for Medicaid, and Medicaid will pay for skilled nursing. Okay? But it's something you want to look at, you know, not too far in the distant future, because I don't advise that families totally go bankrupt for generations so that they can put their mother in a needed skilled nursing facility, okay? When the reality is Medicaid will pay for that. So that is something to look into. And then, of course, in most people minds, nursing homes are like horrible, horrible, scary, and all of that. And that is not universally the case, okay? So I think that one thing when you feel like you're approaching that time is you want to go look at a lot of places. And you want to look at, you want to question them. What is the ratio of, of aids and nurses and doctor to patients on the floor? What does the facility look like? What activities do you have in this facility? What supplies are really provided? Spend some time on a floor and get a vibe, get a vibe check, right? So you're even if you're hanging out in the lobby area, you're hanging out, you will get a feeling state of the, you know, vibe of this place. And whether it's something you can feel good about because different places feel differently, have different ratios, have different kinds of medical care, have different kinds of nursing care, allow different kinds of things to be in, and pick a place that is not far from you. It doesn't matter if your parent lives in a different state right now, pick a place where you will have access.

Speaker 4:
[44:31] No, I mean, we're together. We talk every day. I do her meds. I do have a caregiver that comes in, but we signed an appointment May, early May, and for memory. And, you know, I'm just so, I'm just worried and it's scary. And it's so great to hear someone such as yourself talk to us because we are in it together, we really are.

Speaker 1:
[44:53] And it's, you know, what's crazy is in this big wealthy country of ours, that we don't have an abundance of memory care, independent living facilities. There, I mean, there's a lot, but they're hard to find. We're lucky in New York City, there are many, but you go outside of New York City and you can have a really hard time finding an adequate place with skilled nursing. And forget affordability, like you said, is sometimes you have to really jump through hoops. And I just think it's outrageous. I mean, don't get me started. Now I'm going to get into health care. In this big, rich country of ours, with so many billionaires running around, running everywhere. It's like, I feel like sort of the tariff on that ought to be, well, you have to contribute to the least amongst us. There needs to be some sort of contribution to building memory care facilities, building neonatal units, building facilities for people who are unhoused. I mean, you name it. But anyway, now I'm going on a rant. Look at me ranting.

Speaker 5:
[46:05] I mean, it's hard.

Speaker 1:
[46:06] It's really sad.

Speaker 5:
[46:07] Medicare will not generally pay for a school nursing facility. And most of these people, like they made a living. They provided, they grew their children. They did all the things right. And they saved money for retirement. They did everything right. But the cost of these things is unbelievable. So it doesn't, you know, it can bankrupt families.

Speaker 1:
[46:37] Julie, are you still on the phone?

Speaker 4:
[46:40] I am. I am.

Speaker 1:
[46:43] You said that your mom wants to live, she's going to live until 100?

Speaker 4:
[46:48] Yes, that's her goal.

Speaker 1:
[46:51] So where is she right now? Like give me her age right now.

Speaker 4:
[46:56] Yeah, she's 89. Scorpio lives in assisted living, determined person and what this dementia has done is she made her mean. So my one sibling said, I'm out and my two brothers are in other states. So it's on me and I'm 58. My daughters are grown, I'm saving for my own retirement. My second husband, bless his heart, bless him, because he's more of a son. And I just, you know, she'll call me tonight and, you know, we'll see, we'll see how it goes. But, you know, this weekend, she was mad at me because she could not find anything cool to wear. And it was hot. And literally, and you've got clothes in your closet, mom, you've got clothes in your closet. I just need to come and move them around.

Speaker 5:
[47:57] You know what? When that happens, when that happens, take a break, take a timeout, okay? Because she is not going to necessarily 30 minutes later, remember how mad she was. So when things heat up like that, it's always good to just take a break out of the room or take a break at the set. I'm going to call you back in 30 minutes. I have to do XYZ, call you back. Just shut it down. Try to depersonalize it. Realize it's not your mom, mom. It's this illness has taken on some of your mom, and you're kind of talking to an illness, if you will. I do want to say this to you. It is more than okay. You are a wonderful daughter. To keep your life, to keep enough money, to keep your marriage, to keep your children, to grow them. You need to have all those things for you. It does not in any way detract from you are a wonderful person who is helping your mom. Don't give that up. Don't give those up.

Speaker 1:
[49:11] I mean, I agree. I echo everything Dr. Gail said. And Julie, I'm just I'm just letting you know your mom's a Scorpio. She is going to get to 100. I know. I know. Thank you.

Speaker 4:
[49:31] Thank you so much. I really appreciate you.

Speaker 5:
[49:34] Thank you.

Speaker 1:
[49:35] Thanks for calling in, Julie. Oh, my gosh.

Speaker 5:
[49:37] Wow.

Speaker 1:
[49:38] God bless, Julie. That was great advice, Dr. Gail.

Speaker 3:
[49:41] So good.

Speaker 1:
[49:41] I mean, like, OK, I'm just going to say it again. We got to a fraction of what we need to get to.

Speaker 2:
[49:46] There's like pages of questions.

Speaker 3:
[49:48] So many more questions.

Speaker 1:
[49:50] Make sure you join us for part three of Dr. Gail. We're going to do you know what? That's going to be our new podcast Club Sandwich. Club Sandwich generation sandwich. That's it. Dr. Gail, thank you for joining us always. Don't forget to follow Dr. Gail. Download her podcast, How Can I Help? And of course, thank you all for listening in and for calling in. Albert, do you have anything to add?

Speaker 3:
[50:13] No, Dr. Gail, I'm blown away. And thank you. We need you in our life.

Speaker 1:
[50:17] We really do. We need you on every episode. I know you have your own podcast.

Speaker 5:
[50:22] It's always good to be with you. Thank you.

Speaker 2:
[50:24] Albert, are you down with Club Sandwich? It's food.

Speaker 3:
[50:26] I know. I want to know what's in the Club Sandwich. Is there bacon in the Club Sandwich?

Speaker 1:
[50:30] I can't wait to talk with you all off camera next week.

Speaker 4:
[50:33] Thanks, everybody.

Speaker 1:
[50:34] Bye-bye. Let's Talk Off Camera with Kelly Ripa is a production of Milojo Productions. From Milojo, our team is Kelly Ripa, Mark and Swalos, Albert Bianchini, Jan Chalet, Seth Bronquist, Ross Therrien, Devin Schneider, Michael Halpern, Julia Desch and team radio Andy, Lisa Mantineo, Michael White, Shakira Perez.