WEBVTT NOTE This file was generated by Descript 00:00:07.070 --> 00:00:09.730 Candace Dellacona (2): Welcome to the Sandwich Generation Survival Guide. 00:00:09.740 --> 00:00:16.380 I am your host, Candace Dellacona, and I am so glad to welcome our guest today, 00:00:16.390 --> 00:00:19.169 the founder of My MD Advisor , Dr. 00:00:19.189 --> 00:00:20.319 Gerda Maissel. 00:00:20.849 --> 00:00:21.829 Welcome, Dr. 00:00:21.829 --> 00:00:22.269 Gerda. 00:00:22.979 --> 00:00:22.980 Dr. Gerda Maissel: 00:00:22.979 --> 00:00:23.279 Thank you. 00:00:23.449 --> 00:00:24.439 It was great to be here. 00:00:24.889 --> 00:00:26.019 Candace Dellacona (2): Should I call you Gerda? 00:00:26.019 --> 00:00:27.179 Should I call you Dr. 00:00:27.179 --> 00:00:27.939 Maissel? 00:00:28.369 --> 00:00:28.370 Dr. Gerda Maissel: 00:00:28.369 --> 00:00:29.259 Gerda, please. 00:00:29.419 --> 00:00:30.439 Candace Dellacona (2): Okay, you got it. 00:00:30.489 --> 00:00:35.529 Well, for our listeners I would love to fill them in a bit on your 00:00:35.539 --> 00:00:41.429 background and explain a little bit of who you are and how you got here, 00:00:41.489 --> 00:00:44.009 how you came to find My MD Advisor. 00:00:44.009 --> 00:00:48.009 So, you are a duly board certified physician. 00:00:48.649 --> 00:00:54.449 I understand that you're board certified as a patient advocate as well as through 00:00:54.449 --> 00:00:56.799 the board of physical medicine and rehab 00:00:57.619 --> 00:00:57.620 Dr. Gerda Maissel: 00:00:57.619 --> 00:00:58.049 That's right. 00:00:58.359 --> 00:01:03.299 Candace Dellacona (2): And you came to find My MD Advisor through a personal 00:01:03.299 --> 00:01:05.019 experience of yours as an advocate. 00:01:05.019 --> 00:01:05.669 Is that right? 00:01:06.499 --> 00:01:06.500 Dr. Gerda Maissel: 00:01:06.499 --> 00:01:07.059 Yeah. 00:01:07.109 --> 00:01:12.189 It was the summer of 2020. 00:01:12.219 --> 00:01:16.449 The pandemic had started and I had been working as a president 00:01:16.449 --> 00:01:17.979 of a medical group in Florida. 00:01:18.359 --> 00:01:21.209 And I was up here working remotely a little bit up here, 00:01:21.209 --> 00:01:22.439 meaning I live in New York. 00:01:23.019 --> 00:01:25.829 And my mom was lonely. 00:01:26.069 --> 00:01:31.684 And I got a call from a friend, whose friend's, aunt and uncle, 00:01:32.044 --> 00:01:33.364 had been in a car accident. 00:01:33.374 --> 00:01:39.024 They were driving over the GW Bridge in a heavy rainstorm and drove into the bridge. 00:01:39.324 --> 00:01:42.164 And he walked away and she became a quadriplegic. 00:01:42.744 --> 00:01:46.879 And my friend's friend said, Can you help? 00:01:46.919 --> 00:01:49.699 Is there, Can you just talk to him? 00:01:49.699 --> 00:01:50.369 To the uncle? 00:01:50.369 --> 00:01:52.139 So, I talked to him. 00:01:52.489 --> 00:01:57.459 And here was this wonderful grown man on the phone trying not to cry. 00:01:57.909 --> 00:02:01.039 And he said to me, They're killing my wife. 00:02:01.309 --> 00:02:03.809 And I thought, okay, well let me see. 00:02:03.809 --> 00:02:05.299 I know a lot about spinal cord injury. 00:02:05.299 --> 00:02:07.069 I know a lot about how the system works. 00:02:07.454 --> 00:02:08.904 Perhaps I can help him. 00:02:09.434 --> 00:02:11.644 And I got involved, and you know what? 00:02:11.654 --> 00:02:12.624 He was right. 00:02:13.191 --> 00:02:16.881 She was in a facility where they were not treating her infections, and if 00:02:16.891 --> 00:02:20.621 she had stayed there much longer, she probably wouldn't have survived. 00:02:21.131 --> 00:02:25.701 I helped get her out, and over time we actually got her home where she had many 00:02:25.701 --> 00:02:28.831 months of a much better quality of life. 00:02:29.681 --> 00:02:34.831 And I realized that so many people get lost in the system, so many people 00:02:34.831 --> 00:02:40.731 struggle and they don't know where to turn when the care is not what it should be. 00:02:42.061 --> 00:02:47.891 By the fall of 2020, I decided to get out of corporate America and 00:02:48.221 --> 00:02:52.971 founded My MD Advisor in January 2021. 00:02:53.846 --> 00:02:55.906 Candace Dellacona (2): Which is really remarkable because you know for our 00:02:55.906 --> 00:03:00.866 listeners if we think back about what was going on in our society at the time, we 00:03:00.866 --> 00:03:02.756 were in the midst of a global pandemic. 00:03:02.776 --> 00:03:04.866 There was a tremendous amount of fear. 00:03:05.181 --> 00:03:08.461 There were patients that were being treated in facilities completely 00:03:08.461 --> 00:03:11.521 alone without access to their families and their advocates. 00:03:12.091 --> 00:03:17.441 And here you were as a physician, and you really saw the need for this role that 00:03:17.741 --> 00:03:23.101 candidly didn't really exist before then, or not in a way that was so formalized. 00:03:23.661 --> 00:03:27.511 But your passion for helping others began much before that. 00:03:27.511 --> 00:03:33.121 I remember talking with you the first time we met and you shared with me that you 00:03:33.131 --> 00:03:41.101 had a family member who was in a situation in a care facility and you felt that the 00:03:41.101 --> 00:03:43.401 care he was receiving was really subpar. 00:03:44.961 --> 00:03:44.962 Dr. Gerda Maissel: 00:03:44.961 --> 00:03:48.471 Well, that was really my mother because I was a child at the time, 00:03:48.501 --> 00:03:51.941 so this goes way back to the 1960s. 00:03:52.406 --> 00:03:57.286 My mother had had German measles when my brother was born in 1958. 00:03:57.946 --> 00:04:02.166 And back then when a child was born with the effects of German measles, they 00:04:02.166 --> 00:04:04.746 didn't even quite realize what it was. 00:04:05.236 --> 00:04:07.236 And they always blamed the mother, right? 00:04:07.266 --> 00:04:09.376 Oh, you know, there's a child's not developing, right. 00:04:09.376 --> 00:04:11.096 The mother must be doing something wrong. 00:04:11.476 --> 00:04:13.276 Well, my mother was alone in the country. 00:04:13.276 --> 00:04:16.056 My parents were immigrants, but they figured out there was 00:04:16.056 --> 00:04:17.926 something not right about the baby. 00:04:17.956 --> 00:04:22.956 And eventually over the years, when my younger brother came along, they decided 00:04:22.966 --> 00:04:28.286 he couldn't stay at home, and so he was placed in a facility to care for him. 00:04:28.826 --> 00:04:30.566 But the care he got wasn't good. 00:04:30.566 --> 00:04:35.586 This was back in the days where, they had certain drugs that they were hitting 00:04:35.596 --> 00:04:40.356 everybody with, and I remember going and we'd find him just drooling in the corner. 00:04:40.936 --> 00:04:47.946 And I think watching my mother advocate for my brother to have him treated with 00:04:47.956 --> 00:04:53.466 dignity and respect and not just be drugged into submission had a huge impact 00:04:53.476 --> 00:04:57.646 and was probably a big piece of why I became a physician in the first place. 00:04:58.026 --> 00:05:01.346 And then eventually I guess all things come full circle and I 00:05:01.346 --> 00:05:03.061 ended up helping other families. 00:05:03.331 --> 00:05:05.361 Advocate for the needs of their loved ones. 00:05:05.561 --> 00:05:09.351 Candace Dellacona (2): Yeah, it's really a remarkable story of coming full circle. 00:05:09.681 --> 00:05:15.041 And I think one of the things that we connected on is relating to our clients 00:05:15.041 --> 00:05:19.771 and how we can help them advocate and find systems that are within their 00:05:19.771 --> 00:05:24.661 family or within their community so that as they age and they become more 00:05:24.671 --> 00:05:29.431 vulnerable, they have others that can help advocate for them, perhaps when 00:05:29.431 --> 00:05:30.871 they can't advocate for themselves. 00:05:30.871 --> 00:05:35.061 And through that topic and that discussion that we had, we talked about the 00:05:35.071 --> 00:05:39.001 concept of something called solo aging. 00:05:39.781 --> 00:05:42.901 Do you want to talk a little bit about what solo aging is? 00:05:44.341 --> 00:05:44.342 Dr. Gerda Maissel: 00:05:44.341 --> 00:05:44.901 Sure. 00:05:44.951 --> 00:05:50.661 Solo aging is when a person is, and they're usually living alone and I'll come 00:05:50.661 --> 00:05:56.831 back to why it's not always, but they're usually living alone and they're, in their 00:05:56.861 --> 00:06:03.386 world they don't have the traditional supports provided by family and what that 00:06:03.506 --> 00:06:08.766 by that what I mean is, family typically takes you to the doctor's appointment. 00:06:09.216 --> 00:06:13.026 Family typically shows up when you're ill and takes care of you. 00:06:13.516 --> 00:06:19.616 But these days there is a huge growing population of people who are solo agers. 00:06:20.196 --> 00:06:23.906 And I do include in the solo ager definition people that are 00:06:23.906 --> 00:06:28.106 living with a spouse or a partner who can't take care of them. 00:06:28.376 --> 00:06:32.766 For example, if your spouse has dementia and you're the caretaker, 00:06:33.116 --> 00:06:37.956 in many ways you have become a solo ager if you don't have family nearby. 00:06:38.396 --> 00:06:41.146 Candace Dellacona (2): In my practice and in yours, I think 00:06:41.146 --> 00:06:45.926 we've seen a trend of increased solo agers for a number of reasons. 00:06:46.501 --> 00:06:50.921 One of the things that you and I have spoken about is the fact that, I 00:06:51.031 --> 00:06:55.601 think there was a cultural revolution where the quote unquote traditional 00:06:55.611 --> 00:07:00.401 family requirements of being married and having children fell by the 00:07:00.401 --> 00:07:02.051 wayside in the sixties and seventies. 00:07:02.071 --> 00:07:06.311 And I think that people were provided an opportunity for choice and some 00:07:06.311 --> 00:07:10.541 folks decided that they did not want to pair up and perhaps they 00:07:10.541 --> 00:07:11.841 did not want to have children. 00:07:12.221 --> 00:07:17.891 And so we're seeing a trend in solo agers for that reason, and also because 00:07:18.071 --> 00:07:21.881 the traditional family unit of staying together at least geographically 00:07:21.881 --> 00:07:24.831 close by is not as common in the U. 00:07:24.831 --> 00:07:25.061 S. 00:07:25.061 --> 00:07:27.021 as it perhaps is in other cultures. 00:07:27.021 --> 00:07:27.691 Is that right? 00:07:28.106 --> 00:07:28.107 Dr. Gerda Maissel: 00:07:28.106 --> 00:07:29.696 That's 100 percent right. 00:07:30.136 --> 00:07:34.486 It really started in the fifties with our societal emphasis becoming more 00:07:34.486 --> 00:07:39.446 about the nuclear family than about the extended family, and then we've 00:07:39.446 --> 00:07:44.846 become a geographically mobile society as people move for education or work 00:07:44.846 --> 00:07:46.926 opportunities or for whatever reason. 00:07:47.286 --> 00:07:50.031 So families don't physically live as close together. 00:07:50.136 --> 00:07:54.416 And then you combine that with the fact that boomers are aging, and 00:07:54.416 --> 00:07:56.686 we have this big population bump. 00:07:57.006 --> 00:08:01.116 You simply have more people over 65 now. 00:08:01.146 --> 00:08:02.856 They call it the silver tsunami. 00:08:03.156 --> 00:08:08.796 More people over 65, and then within that, more of those people don't have 00:08:08.796 --> 00:08:11.506 children, or have children at a distance. 00:08:12.086 --> 00:08:14.646 And we also see gray divorce. 00:08:15.101 --> 00:08:20.371 So, gray divorce is when people get divorced over age 65. 00:08:20.381 --> 00:08:25.131 In past generations, that was not considered an acceptable thing to do. 00:08:25.131 --> 00:08:29.071 If you made it into your 50s and 60s, you stayed with your partner. 00:08:29.134 --> 00:08:32.784 And now the stigma has come off and people are making 00:08:32.784 --> 00:08:34.904 decisions to split later in life. 00:08:35.031 --> 00:08:37.671 Candace Dellacona (2): Really, where MD Advisor comes in is 00:08:37.681 --> 00:08:39.771 where you have the solo agers. 00:08:40.261 --> 00:08:44.311 Who are in their apartments, say in New York City, or in their 00:08:44.311 --> 00:08:48.431 homes in the suburbs of New York, elsewhere in the country, and 00:08:48.441 --> 00:08:50.611 they have no relatives close by. 00:08:50.926 --> 00:08:57.066 And so they are trying to think about what's next and so as a physician or 00:08:57.066 --> 00:09:04.506 through your work as your MD Advisor, what are you hearing from the solo agers 00:09:04.516 --> 00:09:09.186 themselves, or from the distant family members about what they're afraid of and, 00:09:09.286 --> 00:09:14.506 what they're trying to think about as they move forward in their aging process? 00:09:14.691 --> 00:09:14.692 Dr. Gerda Maissel: 00:09:14.691 --> 00:09:16.849 I think there's a couple of key fears. 00:09:17.354 --> 00:09:21.504 One is there's a stigma and I just want to call that out. 00:09:21.864 --> 00:09:27.764 I think people are almost embarrassed to find themselves in a situation where 00:09:27.764 --> 00:09:29.894 they don't have close family nearby. 00:09:29.904 --> 00:09:33.364 And it takes a bit of support and encouragement for people to 00:09:33.364 --> 00:09:35.374 realize that it's not their fault. 00:09:35.794 --> 00:09:38.134 And it's very, very common. 00:09:38.454 --> 00:09:43.874 But I think the boomer generation grew up with negative stereotypes 00:09:43.874 --> 00:09:47.534 about the spinster aunt, in the rocking chair up in the attic. 00:09:47.564 --> 00:09:51.344 And, that's just not the reality for today's solo agers. 00:09:51.774 --> 00:09:56.264 When I first heard about solo agers, the term was elder 00:09:56.334 --> 00:09:59.084 orphan, which is just awful. 00:09:59.729 --> 00:10:03.669 And so I have, I've switched now to solo agers. 00:10:03.843 --> 00:10:09.453 So what they, but what people experience is that we know, and I'm speaking from 00:10:09.453 --> 00:10:16.603 the medical point of view, that people have a 23 percent higher chance, I'm 00:10:16.603 --> 00:10:23.323 sorry, 23 percent increase in all cause mortality if you're a solo ager. 00:10:24.348 --> 00:10:28.548 You don't have to know that statistic to feel vulnerable. 00:10:28.888 --> 00:10:34.408 So people who are solo agers are aware that they have vulnerability 00:10:34.408 --> 00:10:35.588 around their medical care. 00:10:35.883 --> 00:10:40.753 And they have other fears, like many people, especially women, are afraid 00:10:40.753 --> 00:10:42.203 they're going to run out of money. 00:10:43.038 --> 00:10:46.728 And another common fear is they don't, and they don't want to be a burden. 00:10:47.068 --> 00:10:51.348 Nobody wants, you might have some distant nephew somewhere who might 00:10:51.358 --> 00:10:55.418 help you, or maybe even it's a kid, but your kid's got a busy life, 00:10:56.148 --> 00:10:57.368 and you don't want to be a burden. 00:10:57.378 --> 00:11:02.848 You want to be a person with dignity who can take care of themselves. 00:11:03.278 --> 00:11:04.588 Candace Dellacona (2): You just said a lot, right? 00:11:04.638 --> 00:11:05.908 Let's break it down a little bit. 00:11:05.918 --> 00:11:11.608 We're talking about this generation of our silver tsunami as I think 00:11:11.848 --> 00:11:13.638 the New York Times perhaps coined. 00:11:14.068 --> 00:11:18.438 Which is this huge group of the population that is aging. 00:11:18.478 --> 00:11:24.618 And the group of population is the offspring of what you know, the generation 00:11:24.618 --> 00:11:26.268 known as the greatest generation, right? 00:11:26.268 --> 00:11:32.438 So you have these people who are self sufficient, proud people that have never 00:11:32.468 --> 00:11:37.938 asked for help and now they're in a position where at the end of their lives, 00:11:38.685 --> 00:11:41.255 after never having to ask for help. 00:11:41.255 --> 00:11:44.621 They're in a position to ask for help and often of people 00:11:44.631 --> 00:11:49.296 that don't have the traditional obligation to help Is that right? 00:11:49.846 --> 00:11:49.847 Dr. Gerda Maissel: 00:11:49.846 --> 00:11:50.456 All true. 00:11:50.456 --> 00:11:50.926 Absolutely. 00:11:50.926 --> 00:11:51.066 Candace Dellacona (2): More. 00:11:51.406 --> 00:11:51.806 Yeah. 00:11:52.196 --> 00:11:56.726 When you think about the stigma and how difficult it is to ask for that 00:11:56.756 --> 00:12:01.276 assistance you even get into the weeds in thinking about the people that literally 00:12:01.276 --> 00:12:04.506 don't have anyone to ask for the help. 00:12:05.256 --> 00:12:08.926 There are people that certainly there's family estrangement and there are 00:12:08.926 --> 00:12:13.036 people that live more solitary lives and they perhaps don't have the same 00:12:13.036 --> 00:12:15.186 number of ties that others may have. 00:12:15.686 --> 00:12:17.636 I think that's combined with the fact. 00:12:17.851 --> 00:12:22.261 As we've talked about on this podcast before, it's the cost of care, even 00:12:22.261 --> 00:12:24.481 companion care is really expensive. 00:12:24.481 --> 00:12:29.301 So you get into really thinking about running out of money and the fear of that. 00:12:29.301 --> 00:12:33.611 I think there was a, there's a term called bad lady syndrome which to me feels a 00:12:33.611 --> 00:12:38.861 little sexist and I'm sure to you too, Gerda, but it's this feeling because we 00:12:38.861 --> 00:12:41.361 as women tend to outlive our counterparts. 00:12:41.926 --> 00:12:44.996 And we're worried about simultaneously running out of our 00:12:45.006 --> 00:12:46.556 money at the end of our lives. 00:12:46.866 --> 00:12:52.403 And so, you really have answered the call of all of that, which is being 00:12:52.433 --> 00:12:57.423 there as a professional who's not just a daughter, but a trained physician 00:12:57.433 --> 00:13:00.113 to advocate with My MD Advisor. 00:13:00.113 --> 00:13:04.803 So can you talk a little bit about, perhaps an example of someone that you've 00:13:05.043 --> 00:13:10.023 been able to help in such a way where they didn't have the family highest connection 00:13:10.023 --> 00:13:11.963 to our expertise to advocate for them? 00:13:13.123 --> 00:13:13.124 Dr. Gerda Maissel: 00:13:13.123 --> 00:13:13.753 Oh sure. 00:13:13.753 --> 00:13:16.273 I have several clients who are solo agers. 00:13:16.703 --> 00:13:22.603 One of my earlier solo ager clients, wonderful wonderful lady, who was 00:13:22.603 --> 00:13:28.513 facing an operation and was hospitalized and was told she needed an operation, 00:13:28.513 --> 00:13:31.843 but she wasn't going to be able to have it for like four months. 00:13:32.313 --> 00:13:36.733 And so she had a specific focus problem at that time, which is she wanted me 00:13:36.733 --> 00:13:38.523 to help her get her surgery sooner. 00:13:39.043 --> 00:13:44.613 But as I started getting involved with her, there were other medical issues 00:13:44.623 --> 00:13:50.943 going on and a bit of misunderstanding as to why the surgery was so delayed. 00:13:51.443 --> 00:13:56.253 And then she had a couple of really negative interactions with her surgeon. 00:13:56.263 --> 00:14:01.183 And we worked through a lot of those pieces so that ultimately when she 00:14:01.183 --> 00:14:03.633 had surgery, it was successful. 00:14:04.573 --> 00:14:08.523 I have another client who's a current client who's a solo ager 00:14:08.523 --> 00:14:10.113 in an apartment in Manhattan. 00:14:10.533 --> 00:14:11.913 And she never had children. 00:14:12.323 --> 00:14:15.043 And she does have a sister, but they're estranged. 00:14:15.633 --> 00:14:23.463 And her closest friend just passed away and she, in her late 70s, is having a 00:14:23.463 --> 00:14:28.093 number of medical conditions and she was feeling really overwhelmed by them. 00:14:28.683 --> 00:14:31.233 And I she hired me, I got involved. 00:14:31.803 --> 00:14:36.583 And we've been peeling them back one at a time, one at a time, because when you feel 00:14:36.583 --> 00:14:38.833 overwhelmed, everything seems important. 00:14:39.523 --> 00:14:42.213 And some of the issues, she's like, okay, we're going to wait. 00:14:42.253 --> 00:14:44.663 I got, we're going to not deal with that one to the summer. 00:14:44.713 --> 00:14:48.253 Okay, we're going to deal with this one now, because this is more important. 00:14:49.053 --> 00:14:52.383 She found herself being what I call dismissed by doctors. 00:14:52.673 --> 00:14:54.703 She had a weird condition. 00:14:55.148 --> 00:14:58.468 She went to see the specialist and he was like, Hey, I don't know what caused it. 00:14:58.468 --> 00:14:59.218 Don't worry about it. 00:14:59.688 --> 00:15:04.438 And this was a condition that caused her a disability that went on for months. 00:15:04.498 --> 00:15:06.918 And if it comes back, it could be life threatening. 00:15:07.398 --> 00:15:10.978 And so I'm helping her find another physician. 00:15:11.488 --> 00:15:17.058 And we're going to bring the information that physician needs to know to help her 00:15:17.308 --> 00:15:21.358 have a better understanding of how to prevent her condition from coming back. 00:15:22.098 --> 00:15:26.278 Candace Dellacona (2): So in, in all of that, you're talking about someone that 00:15:26.338 --> 00:15:33.468 is in need of a quarterback to advocate for her and coordinate information that 00:15:33.538 --> 00:15:39.578 would essentially assist her in finding a path to restore her health and also 00:15:39.598 --> 00:15:45.138 ensuring that the physician who's treating her is actually listening to her so that 00:15:45.298 --> 00:15:47.318 her condition can be properly treated. 00:15:47.328 --> 00:15:51.453 I mean, it's really sort of a sad state of affairs when you have doctors that 00:15:51.643 --> 00:15:57.923 are in a position where they dismiss a patient's concern or perhaps discount 00:15:58.043 --> 00:16:03.063 those concerns as not being material to what their diagnosis may be. 00:16:03.488 --> 00:16:07.698 You coming in as a physician is even better in some ways than a family member. 00:16:07.748 --> 00:16:12.428 It's fantastic as a solo ager, but I really do think that, someone like you, 00:16:12.428 --> 00:16:19.138 Gerda, is an incredible resource to a family that does have advocates within 00:16:19.148 --> 00:16:21.468 its circle from a medical perspective. 00:16:21.518 --> 00:16:21.519 Dr. Gerda Maissel: 00:16:21.518 --> 00:16:27.038 Yeah I help, I've often, I've helped physicians because even when you're a 00:16:27.178 --> 00:16:32.838 physician recently had an injury but she was a pathologist and she doesn't 00:16:32.838 --> 00:16:36.428 know her way around the rehabilitation system and she was feeling like 00:16:36.428 --> 00:16:40.158 she was getting jerked around and she didn't quite know who to trust. 00:16:40.838 --> 00:16:45.288 And I helped her understand how the system worked and then we went through, 00:16:45.338 --> 00:16:49.098 there's a lot of data online when she had to pick a rehabilitation facility. 00:16:49.388 --> 00:16:52.408 And I helped her go through that because even though it's out 00:16:52.408 --> 00:16:55.738 there, you gotta go through a lot of clicks to look at the data. 00:16:56.208 --> 00:17:00.598 And when the care manager in the hospital said to her, Oh, I applied 00:17:00.598 --> 00:17:04.858 to a few extra rehabs for you just in case I said, no, no, no, no, no, no. 00:17:05.298 --> 00:17:08.248 And we looked and the ones she'd applied to were awful. 00:17:08.748 --> 00:17:10.568 And they said, you refuse those. 00:17:11.188 --> 00:17:14.858 And what I call Joe's sub basement rehab took her right away. 00:17:14.888 --> 00:17:16.988 I'm like, no, you didn't request that one. 00:17:16.998 --> 00:17:18.318 You're not going to Joe's. 00:17:18.873 --> 00:17:22.983 And she held out a few more hours and then one of the ones that she wanted did 00:17:22.983 --> 00:17:25.673 take her and, it worked out just fine. 00:17:25.858 --> 00:17:27.738 Candace Dellacona (2): Yeah, which is remarkable that you point 00:17:27.758 --> 00:17:29.228 out, that is a physician, right? 00:17:29.238 --> 00:17:33.758 Someone who is trained the same way that you were and a medical doctor herself. 00:17:34.108 --> 00:17:40.988 But this world of rehab and discharge and Medicare are really difficult worlds 00:17:40.988 --> 00:17:46.388 to be in all the while, especially if you're a solo ager, you're alone and 00:17:46.388 --> 00:17:48.418 trying to process that information. 00:17:49.093 --> 00:17:49.094 Dr. Gerda Maissel: 00:17:49.093 --> 00:17:51.253 Yeah, well, now that I think about it, that physician is 00:17:51.253 --> 00:17:53.113 a solo ager, as it happens. 00:17:53.213 --> 00:17:54.413 She lost her husband. 00:17:54.943 --> 00:17:58.923 Yeah, it's whether you're on your own or whether you have family. 00:17:59.418 --> 00:18:04.158 I'm thinking of a client where there were three very involved children. 00:18:04.758 --> 00:18:11.638 But mom, at the time that I was hired, had probably a dozen different doctors, 00:18:11.638 --> 00:18:14.518 and she was on nearly 30 medications. 00:18:15.288 --> 00:18:16.868 And she wasn't feeling very good. 00:18:16.888 --> 00:18:19.928 And the kids were running around constantly. 00:18:21.118 --> 00:18:25.668 And fortunately was able to get involved, bring the temperature 00:18:25.668 --> 00:18:27.798 down, help them focus. 00:18:28.393 --> 00:18:33.163 Help them understand more of mom's wishes because sometimes the adult children 00:18:33.163 --> 00:18:37.803 can, in their attempt to be helpful, can say this is what you should do, mom. 00:18:38.313 --> 00:18:41.943 And created some space for mom to say what mattered to her. 00:18:42.613 --> 00:18:46.303 And now things are many times better. 00:18:46.303 --> 00:18:50.763 And when something doesn't go well, we have a whole system in place. 00:18:50.763 --> 00:18:52.173 And when she's in the hospital. 00:18:52.688 --> 00:18:57.678 It's much, much calmer than it was before, and the children, the 00:18:57.678 --> 00:19:01.718 involved children are suffering much less than they suffered before. 00:19:02.083 --> 00:19:06.113 And when I say suffered, they didn't feel like they were, they didn't think 00:19:06.113 --> 00:19:10.613 of themselves as suffering, but they were taking enormous amounts of time out 00:19:10.613 --> 00:19:17.293 of work and a lot of angst and a lot of worry that was able to just calm down. 00:19:18.013 --> 00:19:20.143 Candace Dellacona (2): I think also, you bring up an important point with 00:19:20.153 --> 00:19:25.243 the family dynamics and everyone plays a role within a family unit. 00:19:25.503 --> 00:19:29.603 The role has been likely been played for decades, so it's really hard 00:19:29.613 --> 00:19:35.653 to step outside of that role when there is an acute sort of scary issue 00:19:35.663 --> 00:19:38.813 that everyone is dealing with and doing the absolute best they can. 00:19:38.813 --> 00:19:41.883 But, I would imagine most would admit not their best selves. 00:19:42.433 --> 00:19:49.263 So having a voice of reason come in like you, just order, organize and set a plan 00:19:49.263 --> 00:19:56.543 in place and find a role for everyone and take some of the weight of caretaking, 00:19:56.543 --> 00:20:02.408 the advocating off of the family members and you as a professional taking that 00:20:02.428 --> 00:20:05.438 on to be the quarterback for a family. 00:20:05.488 --> 00:20:10.408 So your role really can straddle between whether the family has a lot 00:20:10.408 --> 00:20:13.928 of family members who are ready to step in and advocate and for those 00:20:13.978 --> 00:20:20.988 who don't, but as far as solo agers go, what were the top, I would say 00:20:21.368 --> 00:20:27.948 conditions that you think, as a solo ager, should really trigger your thought 00:20:27.988 --> 00:20:31.978 about your long term plan as you age. 00:20:32.148 --> 00:20:35.218 Are there particular conditions that you should say, you know 00:20:35.218 --> 00:20:38.798 what, for my mother, my father, my neighbor, who I'm thinking about? 00:20:39.098 --> 00:20:42.748 These are the issues that I can see becoming problematic as a solo ager. 00:20:44.213 --> 00:20:44.214 Dr. Gerda Maissel: 00:20:44.213 --> 00:20:45.463 It's a great question. 00:20:45.463 --> 00:20:51.433 We could spend an entire podcast on that one, but I'll point out one particular 00:20:51.433 --> 00:20:54.303 thing that many people aren't aware of. 00:20:54.708 --> 00:20:57.718 That I think is important and it's easy to correct, whether it's 00:20:57.718 --> 00:21:00.098 yourself or whether it's a parent. 00:21:00.788 --> 00:21:06.858 Which is, there is a very strong link between hearing loss and dementia. 00:21:06.956 --> 00:21:10.956 And when solo agers think about their future, one of the most terrifying 00:21:10.956 --> 00:21:12.906 things is, what if I get dementia? 00:21:13.401 --> 00:21:16.171 And I can't run my life. 00:21:16.181 --> 00:21:18.171 I can't make my decisions. 00:21:18.471 --> 00:21:22.481 Who's going to make sure that my values are respected? 00:21:22.781 --> 00:21:27.321 So people are often very frightened, for good reason, about getting dementia. 00:21:28.031 --> 00:21:33.891 And correcting hearing loss is a very, very good way to reduce 00:21:33.891 --> 00:21:35.601 your chances of having dementia. 00:21:36.241 --> 00:21:38.591 And one of the things that people also don't realize about 00:21:38.591 --> 00:21:43.981 hearing loss is that if you wait too long, you can't correct it. 00:21:44.461 --> 00:21:47.141 So you think of all those people who are going, uh, what'd you say? 00:21:47.141 --> 00:21:47.701 What'd you say? 00:21:48.561 --> 00:21:54.611 After they got their hearing aids, it's because they waited too long and they lost 00:21:54.611 --> 00:21:57.701 the neural ability to understand words. 00:21:57.771 --> 00:22:01.901 And so all hearing aids do is it turns into just this amplified noise. 00:22:02.231 --> 00:22:04.511 Candace Dellacona (2): Yeah, I mean, that's a great tip. 00:22:04.561 --> 00:22:09.741 And, you forget that hearing and sound and being able to engage with the people 00:22:09.741 --> 00:22:14.751 around you is something that, really adds to the beauty of one's life to 00:22:14.761 --> 00:22:19.441 being able to participate in life to be able to have conversations, certainly 00:22:19.441 --> 00:22:23.471 those conversations and being able to be involved in life can stave off. 00:22:23.491 --> 00:22:32.261 Um, and when you think about the strategies of what solo agers can 00:22:32.271 --> 00:22:35.981 do in anticipation of this, because, on the Sandwich Generation Survival 00:22:35.981 --> 00:22:40.161 Guide, we want to talk about, okay, we recognize that there's a problem, or we 00:22:40.171 --> 00:22:44.121 recognize that this could be an issue for someone that you know, or you love, 00:22:44.121 --> 00:22:48.381 or even for yourself, if you're a solo ager, but what are the strategies that 00:22:48.391 --> 00:22:53.391 we can impart to our listeners when trying to advocate for a solo ager, 00:22:53.401 --> 00:22:55.341 or if you're a solo ager yourself. 00:22:56.461 --> 00:22:56.462 Dr. Gerda Maissel: 00:22:56.461 --> 00:23:00.896 So one of the key things is deliberately building community. 00:23:01.416 --> 00:23:03.726 And there's lots of different ways to build community. 00:23:04.106 --> 00:23:07.916 You don't have to suddenly become an extrovert and be out there at parties, 00:23:08.346 --> 00:23:12.476 but instead, friend of mine, who's a solo ager, she calls it her circles 00:23:12.886 --> 00:23:15.886 and she has her Bible study circle. 00:23:15.886 --> 00:23:18.516 She has her swim aerobic circle. 00:23:18.516 --> 00:23:21.736 She has her neighbor's circle and she has these. 00:23:22.046 --> 00:23:26.616 Sometimes overlapping circles of friends, and she was very 00:23:26.616 --> 00:23:28.896 deliberate about building circles. 00:23:29.191 --> 00:23:32.511 Every time I go to visit her, she's making chicken salad for somebody who's sick. 00:23:33.081 --> 00:23:36.491 But what she tells me, because she's now in her early 90s, is that she 00:23:36.491 --> 00:23:42.511 has to intermittently assess who's in her circles and look for other people 00:23:42.511 --> 00:23:46.471 either to join a circle or she has to go and look for other circles because 00:23:46.511 --> 00:23:48.851 people move away, people get sick. 00:23:49.391 --> 00:23:53.441 But when she needs something, because she's, for 20 years, been so 00:23:53.441 --> 00:23:57.451 deliberate about her circles, there's inevitably somebody who will give her 00:23:57.451 --> 00:24:01.721 a ride, who will help her, who, she needs something done in her house. 00:24:02.021 --> 00:24:04.301 Even if she's ill, people bring her food. 00:24:04.301 --> 00:24:10.691 She has, by building her circles, created a very deliberate support network. 00:24:11.531 --> 00:24:16.051 For other people, It may be something as simple as reciprocation. 00:24:16.571 --> 00:24:19.961 I'll walk your dog if you give me a ride. 00:24:19.971 --> 00:24:23.711 Or, I'll bring in your mail if you do X for me. 00:24:24.731 --> 00:24:29.051 What people need are often different from each other and what people 00:24:29.051 --> 00:24:32.381 can give are often different and complementary and so some people feel 00:24:32.381 --> 00:24:34.441 more comfortable with reciprocation. 00:24:35.521 --> 00:24:40.931 Other people need to change where they live in order to find people 00:24:41.261 --> 00:24:43.441 that are in similar circumstances. 00:24:43.861 --> 00:24:47.721 That's why adult communities, and I'm not talking going to assisted 00:24:47.721 --> 00:24:49.711 living, I mean, that's a strategy, too. 00:24:50.101 --> 00:24:55.061 But when you're still independent, certain adult communities that have independent 00:24:55.071 --> 00:25:01.491 living can be a really nice way of meeting other people in similar circumstances. 00:25:01.971 --> 00:25:07.681 And some of those independent communities have on site pharmacy and hairdressing 00:25:07.691 --> 00:25:12.121 and they'll give you transportation so they can, depending on what community 00:25:12.121 --> 00:25:17.101 you choose, you can often replace some of those traditional things provided by 00:25:17.121 --> 00:25:22.841 society, or by your family you can replace those things provided by your family with 00:25:24.226 --> 00:25:26.246 a community that you choose to live in. 00:25:26.806 --> 00:25:30.076 Candace Dellacona (2): Yeah, and so all of these are strategies and, to your point 00:25:30.096 --> 00:25:35.881 earlier with the stigma and the feeling of discomfort and asking for help creating 00:25:35.881 --> 00:25:39.691 these communities where there's maybe reciprocity whether it's your neighbor 00:25:39.691 --> 00:25:45.221 down the street or moving yourself physically to a community in which 00:25:45.301 --> 00:25:49.611 you pull the assistance that everyone needs and make sure that your needs 00:25:49.611 --> 00:25:52.271 are met that way thinking ahead is key. 00:25:52.281 --> 00:25:57.091 I mean in my practice as an attorney as an estate planning attorney, we 00:25:57.091 --> 00:26:02.611 also put documents in place, and we, ahead of time, sign documents called 00:26:02.641 --> 00:26:08.761 advanced directives, in which I, as a client, would appoint someone else to 00:26:08.761 --> 00:26:12.721 make healthcare decisions for me, or financial decisions for me, so I'm setting 00:26:12.721 --> 00:26:16.975 the table and laying the groundwork of building that community that you talk 00:26:16.975 --> 00:26:18.791 about in a more official capacity. 00:26:20.061 --> 00:26:24.886 But all of these strategies are things that solo agers, and any ager should 00:26:24.886 --> 00:26:26.446 really think about in this day and age. 00:26:26.446 --> 00:26:27.226 Isn't that right? 00:26:27.896 --> 00:26:27.897 Dr. Gerda Maissel: 00:26:27.896 --> 00:26:29.166 Oh, absolutely. 00:26:29.226 --> 00:26:32.796 And there are certain key documents from my point of view that are 00:26:32.796 --> 00:26:35.036 really important to put in place. 00:26:35.096 --> 00:26:36.066 Candace Dellacona (2): And what are those? 00:26:36.586 --> 00:26:36.587 Dr. Gerda Maissel: 00:26:36.586 --> 00:26:41.846 Well, it includes making sure that you have a healthcare proxy. 00:26:42.306 --> 00:26:46.056 And it doesn't just mean, well, hey, Joe, would you do this for me? 00:26:46.096 --> 00:26:52.116 It means having conversations with that person about your values, not so that they 00:26:52.116 --> 00:26:58.671 decide for you, but so they can speak as if they were you in certain circumstances 00:26:58.671 --> 00:27:00.391 when you can't speak for yourself. 00:27:00.981 --> 00:27:04.111 And also having somebody, whether it's the same person or not, being 00:27:04.121 --> 00:27:09.051 a financial power of attorney so that your bills can still be paid. 00:27:09.801 --> 00:27:14.411 And the last one that from a medical point of view, and not everybody knows about, 00:27:14.411 --> 00:27:18.761 but is an important form, is especially if you have strong feelings about being 00:27:18.761 --> 00:27:21.776 resuscitated is a POLST or a MOLST. 00:27:21.796 --> 00:27:23.656 It's called different things in different states. 00:27:24.566 --> 00:27:28.296 It is a form that's like bright orange or bright pink. 00:27:28.636 --> 00:27:30.416 And it goes on your fridge. 00:27:30.836 --> 00:27:36.726 And it covers you for what you might or might not want if God forbid 00:27:36.991 --> 00:27:41.281 you go down and you can't speak for yourself and the EMTs come to your 00:27:41.281 --> 00:27:43.331 home to take you to, to the hospital. 00:27:43.771 --> 00:27:48.851 Because the EMTs the folks that show up on the ambulance are obligated to 00:27:48.851 --> 00:27:53.671 resuscitate you unless you have an order, unless they have an order that 00:27:53.671 --> 00:27:55.621 says, no, this isn't what I want. 00:27:56.691 --> 00:27:59.471 And this medical order of life sustaining treatment or 00:27:59.741 --> 00:28:02.651 physician order of life sustaining treatment, again, depends on state. 00:28:03.231 --> 00:28:07.561 is right there and it's orders signed by your doctor and it gives some 00:28:07.571 --> 00:28:12.801 specifics like do not resuscitate, do not intubate, don't give antibiotics. 00:28:13.041 --> 00:28:17.261 There's different things you can put on there if you have specific wishes 00:28:17.711 --> 00:28:19.731 to not have certain things done to you. 00:28:20.166 --> 00:28:23.446 Candace Dellacona (2): And this is a great point and part of the framework of 00:28:23.446 --> 00:28:27.796 what solo agers should really think about putting into place before they get to the 00:28:27.796 --> 00:28:31.856 point where they're in a position where they can't make decisions independently. 00:28:31.856 --> 00:28:35.146 And I want to make sure that the listeners understand the distinction 00:28:35.146 --> 00:28:38.016 between a health care proxy and a MOLST form or POLST form. 00:28:38.316 --> 00:28:42.316 So a health care proxy is a document that an attorney can draft or you can 00:28:42.316 --> 00:28:45.686 even sign in a hospital and you're appointing a person and as you pointed 00:28:45.686 --> 00:28:51.231 out Gerda, you are appointing a person so that your words move through them. 00:28:51.541 --> 00:28:53.951 And that's why the conversation is so important. 00:28:53.961 --> 00:28:57.931 Because it could be a layperson that understands your ideas about living 00:28:57.931 --> 00:29:01.531 and dying and the treatment you would want or not want, your religious 00:29:01.531 --> 00:29:04.771 beliefs, your spiritual beliefs, and to make sure that they are 00:29:04.771 --> 00:29:06.581 your voice with treating physician. 00:29:06.651 --> 00:29:11.891 Whereas a MOLST or a POLST is a document that you create with your physician. 00:29:12.311 --> 00:29:15.881 And you get into the nitty gritty about the type of care you would 00:29:15.881 --> 00:29:18.981 want or not want specific to whatever condition you have. 00:29:19.921 --> 00:29:22.771 I think that's a really important distinction to make. 00:29:23.231 --> 00:29:28.171 And you should have both if you have any sort of long term condition or 00:29:28.181 --> 00:29:33.191 illness, and definitely speak with your physician about whether or not getting 00:29:33.191 --> 00:29:37.641 a MOLST in place or POLST in place is something that you should institute now. 00:29:38.111 --> 00:29:44.231 And so what would you say then, Gerda, when it comes to people taking the 00:29:44.231 --> 00:29:50.466 first step in finding someone like you, would it be appropriate for them 00:29:50.466 --> 00:29:56.316 to start now as these issues occur to get the right people in place? 00:29:56.616 --> 00:30:01.326 How would they go about contacting someone like you and in what circumstance 00:30:01.326 --> 00:30:02.886 do most people reach out to you? 00:30:04.231 --> 00:30:04.232 Dr. Gerda Maissel: 00:30:04.231 --> 00:30:09.311 So for the kind of work that I do, I am unusual in the work that I do, so there's 00:30:09.311 --> 00:30:12.581 not a lot of physician advocates yet. 00:30:12.851 --> 00:30:13.331 There will be. 00:30:13.551 --> 00:30:14.161 There are more. 00:30:14.161 --> 00:30:18.551 I get calls, not quite weekly, but at least monthly with doctors considering 00:30:18.551 --> 00:30:20.951 doing this work, and I think you're going to see a lot more of us. 00:30:21.481 --> 00:30:24.701 People tend to hire me when they're having a crisis. 00:30:25.151 --> 00:30:30.301 You don't necessarily need an advocate by your side when things are going fine. 00:30:30.881 --> 00:30:34.661 We can help with all kinds of things, but it's really when somebody is 00:30:34.661 --> 00:30:42.081 feeling overwhelmed or really angry or really frustrated or really worried. 00:30:42.091 --> 00:30:47.081 It's an emotion I've found about either themselves or their loved one. 00:30:47.411 --> 00:30:49.801 I've had a few people who have hired me proactively. 00:30:50.666 --> 00:30:54.866 When they just want to make sure that they understand everything about how the system 00:30:54.866 --> 00:30:57.786 works and, any of that is fine with me. 00:30:58.316 --> 00:31:03.816 But, people, when to hire a professional, and it's not just 00:31:03.856 --> 00:31:08.446 advocates, there are also geriatric care managers who can be very helpful. 00:31:09.026 --> 00:31:16.706 It depends on time and circumstance and how much you need it 00:31:16.716 --> 00:31:17.956 from your own point of view. 00:31:17.956 --> 00:31:21.266 And it never hurts to ask the questions, to talk to a few people. 00:31:21.626 --> 00:31:25.916 And to see what they might offer to decide if that's a service you might need. 00:31:26.421 --> 00:31:29.261 Candace Dellacona (2): I think it's really important too for someone who 00:31:29.271 --> 00:31:32.671 knows they'll be in that position one day to make contact with someone like 00:31:32.671 --> 00:31:34.651 you, so that there is a level of comfort. 00:31:35.051 --> 00:31:39.591 So perhaps even before the crisis happens, they can go to Gerda, and 00:31:39.591 --> 00:31:42.701 Gerda is going to be the person that will advocate for them, and maybe 00:31:42.701 --> 00:31:45.101 even the go to person for the family. 00:31:45.386 --> 00:31:50.306 If they're not entirely a solo ager, I can't tell you how helpful this 00:31:50.326 --> 00:31:54.466 conversation has been for me, and I'm sure for our listeners, and I know 00:31:54.966 --> 00:31:59.306 sharing clients together, how helpful you have been to other people, and I 00:31:59.326 --> 00:32:03.716 think what we do here on the Sandwich Generation Survival Guide is we inform 00:32:03.716 --> 00:32:08.666 people about the resources and the people that are in our orbit that can 00:32:08.666 --> 00:32:13.986 make things like surviving the sandwich generation or solo aging easier and 00:32:13.986 --> 00:32:18.896 you are one of those people So I can't thank you enough for joining us today 00:32:18.916 --> 00:32:23.086 and we will have for our listeners all of your contact information so people 00:32:23.086 --> 00:32:24.626 know how to get in touch with you. 00:32:25.066 --> 00:32:29.276 But I just wanted to say thank you so much for all that you do for your clients your 00:32:29.276 --> 00:32:33.696 patients and for their families because I think and I know actually that people 00:32:33.696 --> 00:32:35.366 are better off having you in the corner. 00:32:36.276 --> 00:32:36.277 Dr. Gerda Maissel: 00:32:36.276 --> 00:32:36.876 Thank you. 00:32:36.916 --> 00:32:37.765 It's a real pleasure.