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Welcome to Healthcare Redefined: Advocating for Aging Adults and Their Families, where we empower families to navigate the complexities of aging and healthcare. Presented by Your Nurse Advocate Consulting, we share real stories, expert advice, and practical tools to help you and your loved ones confidently navigate aging with dignity.
We explore topics like creating collaborative care plans, demystifying Medicare, handling healthcare crises, and preparing for the future. Join us as we transform uncertainty into understanding.
Pam Dunwald: [00:00:00] Welcome to Healthcare Redefined: Advocating for Aging Adults and Their Families. Hi, I'm Pam Dunwald.
Linda Kritikos: [00:00:05] And I'm Linda Kritikos. We're registered nurses and board-certified patient advocates, and we're the co-owners of Your Nurse Advocate Consulting.
Pam Dunwald: [00:00:13] Today you're listening to episode nine. And what we're talking about is the new caregiver roadmap. What to do in your first 30 days. I know some of you maybe just started this year, you've been a caregiver for a while, but we thought it was really important to start this year fresh with information that we can share for new caregivers.
Linda Kritikos: [00:00:34] So if you've just stepped into the caregiver role and it is truly a labor of love, it is truly a very awesome and big role. But it is very self-fulfilling, and it is very compassionate and empathetic in the type of care that you're providing. So maybe you're starting this because there was a fall, or someone in the family or yourself has had a new diagnosis or a hospital stay. The episode that we're doing today is for you. Our goal is to help you feel less overwhelmed and more confident with this caregiving role, one step at a time.
Pam Dunwald: [00:01:07] You know, we're going to walk you through what to do first, what can wait, and give you some simple systems. We'll walk through what to do first, what can wait, and the simple systems that keep you from having to hold everything in your head, so we're going to give you lots of tools.
Linda Kritikos: [00:01:23] And a quick reminder, this podcast is truly educational, and it does not provide medical advice. So always talk with your healthcare provider about your specific situation, about any of the recommendations that we're providing here.
Pam Dunwald: [00:01:38] And you know, before we jump in, if you want a printable version of today's roadmap, we're going to have a tool for you in the show notes. And that will be our free new caregiver starter kit. And so that will have a lot of the information that we're sharing with you today, as well as some many cheat sheets to go with it.
Linda Kritikos: [00:01:58] So you can find it all at YourNurseAdvocateConsulting.com.
Pam Dunwald: [00:02:03] Okay, let's go ahead and let's get into your first 30 days. So who is this for? This is for adult children who've realized they're now in the caregiving role. As Linda said, maybe after a fall or diagnosis or a gradual decline. But, you know, it's also for those long-distance family members and caregivers, maybe you're a busy professional. Maybe you've got your own family things going on. You're in that sandwich generation, and you're looking for a simple plan.
Linda Kritikos: [00:02:29] So our episode promise today is to provide you with a calm, step-by-step roadmap for the first 30 days so that you're not guessing, reacting, or missing something important. So that you can be the daughter, the son, the spouse, the significant other, because you have a roadmap to guide you.
Pam Dunwald: [00:02:48] The big mindset shift. You know, we're not trying to solve everything. That's not what this podcast is all about. We're trying to get you to kind of take a step back, stabilize, organize, take a breath. And so your goal in the first 30 days is to reduce the risk, reduce the confusion, and create a simple system.
Linda Kritikos: [00:03:09] And so here let's start with our 30-day roadmap. There's three phases to this. And phase one is days 1 to 3. It could be a little longer. That's just kind of an average. But it's to stabilize. Which means you need to confirm immediate safety risks like fall risks. Are there throw rugs on the floor? Is there appropriate lighting in the home? Is the individual that you're providing care for driving, or should they be driving? Are they wandering? Is there confusion? Are they able to use the stove or appliances appropriately? Are they taking their meds appropriately or not? Are there any infections and red flags in regards to any and all of this? Identify the right medical priority. So even as you assess all of these components, you need to prioritize them. So what is the right now? What is the immediate priority? What problem is most likely to cause an emergency department or an emergency room visit this week, or within the next 72, 48 hours, or even within the next two weeks? So get the basics in one place. So even if it's messy, you're going to need to kind of look at what's going on, what is their diagnoses, what types of meds do they have? So you may have to call the physician and get a current med list. Sometimes they're not always updated as they should be, because individuals are poor historians sometimes and don't necessarily provide whether a medication has been continued or disconnected, discontinued, and/or whether they're seeing multiple physicians. And a lot of times there's no communication with that. So med lists sometimes are duplicated. So looking through those meds, which is really a tough task, along with allergies, and what pharmacies are they using. I recently had a client that had not one pharmacy but three different pharmacies that she was getting medication from. So looking at all of those things and finding out the providers that are providing this type of care and writing those prescriptions is really important. But again, it's prioritizing that medical necessity of what could cause an ER visit. Is it the fact that they have medication issues, that they're not taking their medication, they're inappropriately taking it, they've had a few falls in the last few weeks, they're confused, they're not sure of where they are, time or place? So you need to just kind of identify, and you as the individual who knows this person the best is going to be able to pick up on this stuff more quickly than a stranger.
Pam Dunwald: [00:05:50] And you know, that's that's a a great really phase one. Because mainly you want to stop the bleeding, so to speak, put the bandaid on, you know, figure out what you're dealing with. And then we're ready to move into phase two. And that could be days 4 through 14. Again, give or take. This is again a roadmap. It's not, you know, it's not an exact science.
Linda Kritikos: [00:06:11] It's not set in stone.
Pam Dunwald: [00:06:12] No, no. And it's fluid. So it's based on what's going on. But anyway, this phase two is to organize. And as an aging adult myself, I'm telling you, I'm still a paper person. So I love my notebooks, whether it's a spiral notebook or, you know, whatever composition notebook. I like my paper. And so whatever method, whether you're using digital methods, you're keeping notes, Google Docs or a Word document, or whatever you're using, you know, we want to start organizing a few things. So the first thing is, is build your care team list. Look at your circle. Look at your aging loved ones' circle. Are there, who's the immediate family? Extended family? What about neighbors? If they are, you know, attend a faith-based organization? What about, you know, those family members? And then we got to get into the health care. I mean, who do they see? Who's their primary care provider? Do they see any specialists? Are they getting any home health services? And we want to make a list of these contacts complete with email and phone number. So and you're going to use that later on to help, you know, put this plan in place. So the second thing is, is just to create a simple communication plan. And you know, one point person, someone's in charge, one sharable update method. And this is really important: in looking at all the players, what's going to be the best method? Is it a text message? Is it an email? Is it a shared document? Can you, are they tech savvy enough that you can use a shared calendar? What types of communications? Or a Zoom or a Skype or FaceTime? You know, choose one method and be consistent with that method of communication. The next thing is, is, you know, set up the appointment and meds tracking. So again, one calendar, one tracker, one place for questions, so nothing gets confused. And then lastly, you know, start the questions list for the next doctor visits. You know, and sometimes, you know, I, again, being a paper person sometimes that's not all appropriate. If you've got your phone and you're out somewhere and you think, oh gosh, this is a question, maybe you can jot it in the notes section of your phone. You can even phone, even can record a message to yourself, and then you can update it on your favorite communication tool later on. But it's important as you come up with things that you want to ask any of the healthcare providers, you know, to make that list. So those are some of the types of things to do to get organized.
Linda Kritikos: [00:08:48] Well then in phase three, which is pretty much days 15 to 30, as I said, it's, you know, Pam and I both said this is a working, you know, fluid tool. So those days may vary, but it's to support and sustain some of these things. So we want to really clarify what that care plan is. So what are we treating? What does better look like? So for mom or dad or significant other, what does better look like? Would that be to have someone else in the home to help them with basic functioning tools such as housekeeping or cooking or shopping? Or would it be to transport them back and forth to the doctor's office? Would it be to have some type of video conferencing? So what does better look like for them? And that's based on the diagnoses, the medication lists and your assessment of everything that's gone on and all your organization, of all the tools and the things that you need by having everything in one place. So what is the next step if something happens? So if mom falls, what happens? What happens next? Or if Mom and dad can't stay here or my significant other is no longer able to care for themselves, and I really physically am not able to care for them, what is the plan B? And it's not only necessarily having plan B, but also having plan C, because a lot of times this is very dynamic, it's very fluid, it's constantly changing. Just as we all as individuals constantly change, so do some of our plans. So they're kind of what we call working tools. So you need to kind of look at that, of what's changing. Go ahead, Pam.
Pam Dunwald: [00:10:30] Absolutely. And I just was going to just mention in there, and it's important to involve them in the process. What are they willing to do and what are they not willing to do?
Linda Kritikos: [00:10:38] Oh yeah. Oh, I can tell you that. Some of the individuals that I have cared for. It's like, nope, you can't make me go there. Nope. I'm not going there. Nope. I'm staying in my home. You're removing me in a body bag. Nope. I'm not doing this.
Pam Dunwald: [00:10:53] And that's a whole nother podcast.
Linda Kritikos: [00:10:55] I know it is. It's a whole nother podcast. But, you know, people, you know, if you think about it, individuals have had their routines and their processes and their own way of doing things for many years. So as a family member or as an individual that's providing these caregiving services, you know, trying to get in there, you really need to understand where they're coming from. You need to seek to understand first before you start going in and making these recommendations, saying, well, you're going to do this or we need to do that, or we need to do this. Find out what they want.
Pam Dunwald: [00:11:24] Yeah, that's the quickest. Yeah, that's the quickest way for them to say no way, Jose. You know, no way I'm not doing it. If you start telling them, well this is what we're going to do. That's going to put a wrench in the whole situation. Right.
Linda Kritikos: [00:11:36] That'll be that deer in the headlight look from them. Yeah. Not going to work.
Pam Dunwald: [00:11:40] They're going to protect their independence with everything they've got, so.
Linda Kritikos: [00:11:44] Exactly as we would, as we all would. So then make sure that you're going to confirm any legal decisions in regards to the basics, such as, you know, is there a release for medical information so that you can talk for them in case there is issues in regards to getting information, or receiving information, or providing information? HIPAA has gotten very, very structured and very rigid in regards to who and how information is communicated. So you need to make sure that you have all those proper releases in place so that you can share that information appropriately, making sure that there's a POA or a healthcare proxy in place, and that you have all the emergency contacts in one place, and that everybody knows what their role is in regards to this. Are they emergency contact number one or number two or number three? And then how do they want to be contacted, and make sure everybody has this list that needs this list.
Pam Dunwald: [00:12:42] I was going to say before we move on, I was going to say, could you just talk about the importance and how beneficial it would be if they could get on their MyChart?
Linda Kritikos: [00:12:51] Oh, yeah. They, a lot of the, as we all know, a lot of our hospitals now have gone to MyCharts or e-charts, and they're sharing a lot of the information with us as consumers as they should. So a lot of our test results, x rays, visit summaries, and prescriptions are all on these charts. And it would be, it's really beneficial that if you are able to have access to this for your loved one, that'll give you kind of a step up. You don't have to worry about mom or dad or the individual that you're caring for, giving you the update on what that visit looked like, or the new meds that the doctor prescribed, because you'll get it right from the horse's mouth, right from that e-chart, because it'll be transcribed as it happened in that visit, so that you can have the information you need. And it's also a really valuable tool if you have questions, because you can go in there and say, look, I'm looking at this CAT scan result, and it's showing that there's some calcification here. What does that mean in regards to my mom's function or in regards to a hip replacement for my mom? So it gives you the information so that you can ask very intelligent, informed questions about your caregiving role and about what it's going to take to provide care for the individual you're caring for.
Pam Dunwald: [00:14:06] Again, oftentimes it's just like emailing the doctor or messaging the doctor right within the MyChart.
Linda Kritikos: [00:14:12] So yeah. And it's it's actually very convenient and it's an easy way to get ahold of them instead of trying to go through their service or call them at 9:00 in the morning and then be told, well, they'll get back to you because they're with patients now and then maybe by 5:00 or the next day you'll get a phone call. So they respond a lot better through that email system. So the other thing you want to do is look at and support needs and gaps, such as do they need transportation? So do they need transportation to get to and from doctor's offices? If they still like going to the grocery store to shop, because I can tell you just from my own personal family, we ordered groceries for my parents, but they said, yeah, that's all fine and good, but I really want to choose the fruit myself. The fruit that's coming here isn't the right way, the way I want it to be ripened, or isn't the right brand. So a lot of individuals still are like going to the grocery store themselves, because that's what they're used to. They're not used to a DoorDash or, you know, a grocery delivery service. So do they need transportation for this? Is there someone that can take them so it helps them? Remember, we want to maintain independence and quality of life for as long as we can because it's really important for them as individuals for that. We also want to make sure that they have meals. And what do those meals look like? Can someone prepare the meals? Can they be pre-prepared and put into the refrigerator or freezer? Can you, as family members, can each of you take a day and prepare a week's worth of meals for them, and put it in ma and dad's freezer and label it for Monday, Tuesday, Wednesday? And all they have to do is put it in the microwave and heat it up, or in the oven? What does that look like? And do they need special meals because they're diabetic, or because they need softer meals because of a GI problem or because of a swallowing issue? All those things need to be looked at. And bathing. Oh my goodness, the safety around bathing. What does that bathroom look like? Can they get in and out of a tub safely or in and out of a shower safely? Do they need some assistance to do that? Has there been recent falls regarding those types of things? Did they fall in the bathroom recently? Those things are red flags to identify that there needs to be some assistance with that whole activity of daily living, such as bathing and washing up, because falls in the bathroom can be very, very, as anywhere else, can be very deadly for an individual. So looking at how they're bathing, how often they're bathing, and can they get in and out of a tub or a shower safely? And do they need something just as simple as a grab bar installed so that they can get in and out safely? A lot of times bathtubs are not set up for grab bars and/or fall mats or anything in there to help prevent you from slipping. So maybe sometimes just some minor adjustments to the bathtub or to the shower around the toilet can help with that, maintaining that independence.
Pam Dunwald: [00:17:07] Yeah. And I just wanted to just throw in a quick example here. Linda and I had a client that was working on walking, using a walker in the house, and things like that. But, you know, when you get in the shower, you know, you don't often have that walker with, you don't have that stability. And she had just finished physical therapy. She was feeling really confident, and she slipped in the shower, fractured her ankle, and that led, she had complication after complication, led to a 30-day stay in the hospital, a week stay in intensive care. She was intubated. So, you know, we want to do everything that we can to prevent falls because we never know what that fall is going to lead to.
Linda Kritikos: [00:17:47] Right. And we understand that nothing is 100% foolproof. So, but if we can put as many measures in place as possible, it will decrease the either the severity of the fall or the fall itself. So the other thing we want to look at is supervision. What type of supervision do they need? Do they need someone to live in the house with them? Do they need someone just to do check-ins? Do they need a private caregiver that comes in to help with these bathing and dressing or grocery shopping? What type of supervision do they need, or do they need none at all? So those things are part of that sustaining those plans and then respite. Respite is really important for the caregiver and for the individual. And there are facilities such as assisted living facilities that will provide a 30-day respite for the individual that you are caregiving for at a specific cost per day for up to 30 days. And this is great if you have, if you've got a trip that you're planning or a wedding or out of town, or you're going on a cruise and you need to know that mom, dad, or the individual you're caring for is well cared for and safe. And a lot of times these opportunities or these types of respite situations work really well because there's caregiving staff on place. They'll provide the medications, they'll get their meals there. They'll be in an environment that's safe, and that's staffed. So looking at respite and respite opportunities within certain outside or external living environments, are actually very, very good for both the caregiver and for the individual because it allows them to also to socialize in other situations. Now, I've had a few clients that have gone into respite and didn't want to do anything but sit in their room and watch TV. And that was fine too. But the family knew they were safe and they knew they were well cared for. And in fact, one of them actually said, you know what? I think I want to stay here. Afterwards. They didn't even want to go back to their house because they really liked the bingo, and they really like the music, and they really like the dog therapy, and they liked all the things that were going on there. They said they were more active there than they were living in their own home. So sometimes it's kind of like a blessing in disguise.
Pam Dunwald: [00:20:05] It is. We had another client that, you know, she contacted us because she was kind of in a panic mode. She was gifted a trip to New York and some Broadway shows with her granddaughter and things like that. But her husband, you know, needed so much care. She didn't know what she was going to do, and we were able to set up respite for him. He needed a level of care, like a nursing home level of care, to have nursing. So we got a respite stay set up. She was gone for a week. He enjoyed, he had a good time. She had the peace of mind knowing that he was being looked after 24/7, and it ended up being a win-win for both the client and her spouse and his, you know, her spouse as well. So it can really be a godsend.
Linda Kritikos: [00:20:45] And I think one of the last things I want to add in here is about boundaries. You really need to set boundaries for yourself and for the individual you're caring for, and also with other family members or other people that are maybe sharing some parts of this caregiving role with you. You really don't want to burn out, because if you can't take care of yourself, you're not going to be able to take care of anyone else. And burnout is real, and it affects people in a lot of different ways. So understanding what causes you stress and understanding what relieves your stress is going to be really important because caregiving can take a lot out of you. Pam and I both know this, as we've both been, or I'm still in that role, and Pam is too, in regards to caring for our elder parents. And it is, it can be a lot. So you need to make sure that you understand what your limits are and what things you're able to do and willing to do, and what things can be delegated to others. Just because some family member or a sibling or someone lives out of state, does not mean that they can't provide some level of care to that loved one, or to the individual that you're providing care to. They can send out meals. They can talk to them on the phone. They can help pay for certain things. There's things that they can do, but know your boundaries and know the word no and use it and use your voice.
Pam Dunwald: [00:22:11] Yes. And you know, and you just really, like Linda said, you really just need to get clear on your non-negotiables, you know, and you have to stick to those. And like Linda said, there's so many things that a caregiver can do. I'm a long-distance caregiver to my mom. And, you know, I deal with all her insurance. I can manage things with her MyChart, I manage her equipment. And so there's lots of things, you could pay their bills. There's so many things that you could do as a long-distance caregiver. So, yeah, don't let that stop you. So the next thing is, is the don't do this sections. So, and this would be just we're going to go over a couple common early mistakes. And I think Linda will agree that, you know, in our advocacy experience as well as, you know, our experience as nurses and caring for families and aging loved ones, the biggest concern or the biggest challenge that we wish we could explain to people is that you don't know what you don't know, and that's what oftentimes gets families in trouble because, you know, I wish I had a nickel for every time someone said, oh my goodness, I didn't know that. Oh, I would have done things different had I known that. But you don't know what you don't know. So this section is just to talk about a few common early mistakes. And the first one is trying to manage everything in your head. You know, that's next to impossible. I mean, in the nursing world, if it's not documented, it's not done.
Linda Kritikos: [00:23:50] Not done.
Pam Dunwald: [00:23:51] Yes. And in the real world, if it's not written down, it probably won't get done.
Linda Kritikos: [00:23:55] So that's true, especially as we age.
Pam Dunwald: [00:23:58] Yes, yes. So, and if you've got a lot going on, that's really the only way humanly possible you can do is to get it on some form of reminder, whether that's digital or pen and paper. And the second one is not bringing a written med list to appointments. I wished, you know, I don't know how many times we've had clients, and a lot of times what we'll do is we'll be reviewing their medications with them, you know, during a check-in or a doctor visit. And I wish I had a nickel for every time they had a medication on their list that should have been taken off a month or two months ago. And they go, and they ask to have it taken off, and it's still not taken off. So you want to make sure that you have the most current list with you of what they are taking, not the most current list oftentimes of what the clinic has given you, because that might not match, but you need to have a list of what are they actually taking so that you can compare notes, make sure that they're taking what the doctor wants to say, and making sure that they get the medications off the clinic list, that that's not supposed to be there. So that's really, really important. Linda, did you want to say something?
Linda Kritikos: [00:25:08] Yeah, just, you know, a lot of times people will say, well, mom or dad, let me see your med box. Your pill box. That's not the way we want to look at things. You need to ask them, where are the pill bottles for the pills that you're actually taking every single day, or before you go to bed, and actually have them show you the prescription bottles. Because on there will be a lot of information in regards to when they were prescribed, how many refills they have, who is the doctor that prescribed them, and then you can, if you also know that you can count the number of pills or capsules or tablets that are in there to see whether they're actually been taking them, because if it was prescribed on the first of the month and now it's now the 22nd and there's still 30 pills in there, you can tell that they haven't taken any. So it's a real good eye-opening exercise for you to look at this. And Pam and I both know that we've done it in our careers, both with home health and hospice, to take a look at what actually they're taking, because a lot of times they don't know, or they're taking so many they don't remember what to take. So by looking at those bottles will give you a real good exercise in understanding what they're actually taking. And then you can write that down and take that to the doctor's office. Sometimes some people actually say, I'm not going to write all 35 bottles down. I'm just going to take all the bottles with me and let the doctor go through them. So do whatever you feel comfortable with. But I'm telling you, the pill bottles are the way to go.
Pam Dunwald: [00:26:33] Yeah, absolutely. That's a great point, Linda, because, you know, you look at the expiration date, I mean, are they getting them refilled? And the other thing, one other thing I wanted to mention on that is sometimes, depending on where you get the medicine, or that one bottle may have the generic name, one bottle may have the trade name, and so they think they're two different medications, but actually it's the same one. So you got to be really, really careful with those medications.
Linda Kritikos: [00:26:59] Um, yeah. I had a client that actually said to me they had a full pill bottle, and I said, you haven't taken any of this medication. Oh, well, it's not the medication I'm used to taking. Well, they changed distributors of the pill, so the pill used to be a little white pill. Now it's a little pink pill. They thought it was different. So instead of calling the pharmacy or looking at the bottle, saying that this is now the type of pill it is and the description of it, they just decided not to take it. And then they wondered why they didn't feel good. Well, the pill was supposed to help you with that.
Pam Dunwald: [00:27:33] No, that's a really good point. And I can't tell you how many times that changes. I mean, you could get for three months in a row, you could get a different-looking pill because, you know, the pharmacies are trying to get their best deal. So they may, you know, look different. So Linda, I'm glad you brought that up because that really happens quite frequently. So the next thing in the don't do this section is waiting until a crisis to ask for help. Linda and I, I think, I think we can honestly say as nurse advocates, that's the biggest challenge for us, and a point of us not feeling that we've provided good care is when we're brought into a situation in a crisis mode. They need 5 or 10 things done yesterday, and we're trying to get as much done as we can as quickly as possible. And sometimes, you know, that's just not the best way of handling it. But you have no choice. So it's always, you know, an ounce of prevention is worth a pound of cure. And so it's really, really important to get ahead of the game and not wait for a crisis to ask for help. You know, asking for help is not a weakness. It actually is a strength. And Linda and I feel very, very strongly about that. So. The next thing is assuming siblings will just know what to do. I'll give you an example. And this is a real-life example. My mom is scheduled to have some hip surgery. And so when she had her hip surgery appointment, her appointment with orthopedics to schedule her surgery, it was at the end of December. It was like, well, the middle of December. And my brother, he's, you know, is a project manager for a construction company. Bless his heart, he says, I'll take mom. So he took mom to, you know, to the doctor appointment, and they set her surgery for, like, January, like the beginning of it was going to be like next week already. And so when I heard this, and even my sister's a nurse practitioner, she lives with my other sister who's in accounting, and nobody thought about, well, gosh, we know that she's going to be changing insurances in January. How in the world are we going to get prior auth by the first week of January when we don't even know her new insurance number until the first of the month? And so then everybody's in a panic. Well, do we need to cancel the surgery or what are we going to do? And make a long story short, for clinical, for health reasons, it had to be done at a different facility, and it's now bumped until, you know, the middle of February. So we'll have no problems with them getting their prior authorization. But these are the kind of things that if you don't know what you don't know, you don't think to ask. So, it's always, always a good idea to stay ahead of the game.
Linda Kritikos: [00:30:28] And clear expectations of like, who's doing what, and what people are able to do, and looking at caregiver strength. I mean, not everybody can handle certain things, but somebody may be better at keeping the calendars up to date or the appointments up to date. Another sibling might be better at making meals or sitting with ma or dad reading to them in the evening. Somebody else may feel comfortable, so just pull off of each other's strengths and kind of work together to get the best care for your individuals, because you don't know what you don't know. And you know, assuming that all your siblings know what's going on and understand everything, it doesn't work. It doesn't work. I know in my family there's six of us and I can tell you we all come from different career paths with different educational backgrounds, and two of them are out of state. And so expectations and understanding about what's going on on a day-to-day basis with my dad is, it's not an easy task. Even when you communicate, and you think you're communicating appropriately, somebody will always take it out of context and always perceive it very differently. So it's a constant, it's a constant kind of educational component, making sure everybody understands what's going on and has a clear understanding of what their role is.
Pam Dunwald: [00:31:49] Yeah. And one thing I'm going to add to that, too, is, again, if you've got brothers or sisters, you know, and taking care of maybe a mom or a dad, think about whether or not they'd be comfortable, you know, doing helping with a bath or taking him to the bathroom. Some guys might be comfortable with doing that with their mom, I know my husband would be, but others may not. So just, you know, see what their comfort level is. And again, just making sure that everybody's roles are clear. You know, who's doing what. And the other thing is, is you don't want to make the mistake of not knowing who the decision maker is, who is the one that is making the decisions. Do they have those documentations? Do they have that in writing? Because, you know, not everybody, everybody's going to have their own opinion. And sometimes, you know, your opinion may not coincide with your aging loved one's opinion. But the bottom line is, is if they have their wishes in writing, nobody needs to argue about what's the best thing to do? All you have to do is agree on this is what mom or dad wants, and this is what we need to do. We need to follow their wishes.
Linda Kritikos: [00:33:01] And sometimes that's difficult because I think a lot of individuals don't... I think sometimes family members have a difficult time with their own processing that ma and dad are declining or that, you know, their loved one is dying, and they may want to go against what those wishes are, especially if they're the power of attorney, you know, for healthcare, a lot of times you're chosen as that power of attorney for a reason by that competent individual that chose you. They chose you because they were, they are confident in their decision-making that you will follow their wishes.
Pam Dunwald: [00:33:41] Right.
Linda Kritikos: [00:33:41] And so when you take on that role as a healthcare POA or as a financial POA, you are to act in their best interest, and follow their decisions that they've put in writing, and to go against that is really disrespecting that role and their wishes. So a lot of times that will cause a lot of strife within a family, because even though mom and dad have been very clear, or the individual that you're caring for has been very clear on their wishes, there are a lot of times there's someone that may want to challenge that, but that is why it's so important to have these things in writing and documented, and everybody understands and has copies of them as needed, so that everybody understands what that individual wanted, so that there is no confusion about it. And there still may be. But those documents, those legal documents, keep that decision-making where it needs to be.
Pam Dunwald: [00:34:40] And, Linda, didn't we recently have an inquiry about a client that was deemed incompetent? So the health care power of attorney was going to take over, and they thought it was within their power to change everything. You know, this 90-something-year-old, all of a sudden they wanted to make sure that everything, you know, they wanted everything to be done. And that's not the role of the healthcare power of attorney.
Linda Kritikos: [00:35:06] That's absolutely correct. Yeah, we did. We had an inquiry in regards to that. And the individual was having a hard time processing the death of their loved one. So they, as the power of attorney, actually, they were the durable power of attorney, decided that, you know, well, what would it take to, you know, to go against this and the individual--
Pam Dunwald: [00:35:30] -- it was a hospice situation, wasn't it?
Linda Kritikos: [00:35:32] Yeah, yeah. It was, you know, they had everything in writing very, very clearly of what they wanted, you know, that they only wanted to be comfortable. They did not want a lot of extraordinary measures done. And the durable power of attorney said, no, I want to revoke that. I want to have everything done. And you can't really do that. You'd have to go to court. There's a whole lot of legal things that go around it, and I'm not even clear on all of it. But I do know that when someone signs up with a healthcare power of attorney or durable power of attorney and puts these things in writing, they want those wishes followed. And that's why they've chosen you, because they felt that you would be able to follow those directives that they're giving you. And that's what they are. They're directives. They're telling you what they want. So as that power of attorney, it's a privilege to be someone's power of attorney for their care when they can no longer make those decisions. So you need to really make sure that if, that you can follow through on those directives that they have put in place in writing and had notarized and want to be in place when they can't make those decisions. So and sometimes, as I said, it does. We had that inquiry. I mean, eventually it got worked out. Hospice and I were able to kind of work through that with them. And it was, it ended up okay, but it took longer than necessary. And I think that we could have probably done things a little, if things would have been done a little quicker, we would have met the advanced directives a lot sooner.
Pam Dunwald: [00:37:11] Yeah. And, you know, you got to remember, as the healthcare power of attorney, you are the voice for them regarding their healthcare needs when they can no longer speak. And so it is serious. So Linda, let's go ahead, and we're getting close to wrapping up here. Why don't we go ahead and you can share some of the practical tools.
Linda Kritikos: [00:37:29] Okay. So, one page who to call sheets, such as with the name, and this is great because you can put it on a refrigerator, people can have it in their phone, in their contact list, but a who to call sheet with the primary care provider, the pharmacy. You know, what's the closest urgent care? What's the facility name of where they're at? Or facilities that you may want to look at. What's the closest hospital number? You know, what are the family contact numbers? And this can all be on a one-page sheet that people can access. It can be on a spreadsheet, however you want to do it. But it's really important to have that one-page sheet, not 15 pages, one page. Having a sheet, a, you know, a current med list and an appointment tracker. So knowing when their next appointments are, with who the appointments are with, and current meds are important, and then a running list of questions for the next appointment that you can share with the healthcare provider that are concerns to you or for your loved one. You know, do they have any concerns? They may not remember it when they hit the doctor's office or the practitioner's office. So having those lists written, those questions written down before the next appointment is really important. And then we're going to include our new caregiver first ten checklist. So please make sure that you check that out because that will give you a lot of these tools. We're also going to include in the show notes, our extended version of the new Caregiver Starter Guide. For those who want a more detailed guide. In the new Caregiver Starter Guide, we have a lot of other checklists and videos that will pertain to each of the four sections of the guide. Excuse me. And lastly, we will also include the link to the accompanying blog post for further information. So okay, just a quick recap. I know that was kind of a lot of information we've given you, but you know, in your first 30 days as a caregiver, your job isn't to do everything. You cannot do everything, and you cannot keep everything in your head. So please use your resources. So it's all about in the first 30 days to stabilize, organize, and build a good support team for you and the individual you're caring for.
Pam Dunwald: [00:39:42] You know and we want to start with safety. So medications is huge. So you want to get your medication and your appointment information in one place. And then create that simple who-to-call list so you're not scrambling in a crisis.
Linda Kritikos: [00:39:55] You know. And if you're thinking, oh, I wish I had somebody or someone could just tell me what matters most this week. Well, that's exactly what Pam and I do. And we can help you with that. So just give us a call.
Pam Dunwald: [00:40:09] And, you know, you can download the free new caregiver starter kit. We're going to have that in the show notes. It includes the first ten checklist, medication tracker, appointment tracker, and a who to call sheet. So we've got some templates in there for you or some descriptors of how to create your own template or worksheet.
Linda Kritikos: [00:40:29] And if you want ongoing guidance, check out our paid tier program. The Your Nurse Advocate Now monthly program allows you to have an RN in your back pocket. Isn't that great? Kind of like a concierge nurse. You'll get Tuesday tip videos, how to videos, and of course, our live open Q&A sessions so you can bring your real-life questions and get nurse-led answers. There are four tiers of service, so you can choose the tier that best meets your needs. We will include information on this as well in our show notes.
Pam Dunwald: [00:41:02] You know, and if this episode helped you, please share it with a friend who's stepping into caregiving and leave us a review. It really helps other families find us.
Linda Kritikos: [00:41:12] So thanks for listening to Healthcare Redefined: Advocating for Aging Adults and Their Families.
Pam Dunwald: [00:41:20] And, you know, we'll see you next time. And remember, you don't have to do this perfectly. You just need a plan for the next right step. We'll see you soon. Take care. Bye-bye.