>>> TONIGHT, A WOSU PUBLIC MEDIA SPECIAL.

"INSIDE CAREGIVING. "

YOU'RE NOT ALONE.

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>> WELCOME TO WOSU PUBLIC MEDIA'S ROSS COMMUNITY STUDIO FOR "INSIDE CAREGIVING," A LOOK AT THE CHALLENGES OF CARING FOR AGING LOVED ONES.

I'M YOUR HOST, ANN FISHER.

THE NUMBERS ARE STARTLING.

BABY-BOOMERS ARE RETIRING AT A RATE OF 10,000 PER DAY.

MORE TO THE POINT, THEY'RE ALSO AGING.

WHILE THE NUMBER OF PEOPLE OLDER THAN 80 WILL NEARLY DOUBLE IN THE NEXT FIVE YEARS THE NUMBER OF THOSE ELIGIBLE TO BE THEIR CARE CAREGIVES WILL GENERALLY STAGNATE, AND AS BOOMERS REQUIRE MORE HEALTH CARE AND SPECIALIZED HOUSING ARRANGEMENTS ALONG THE WAY, THE RACE TO MEET THOSE NEEDS WILL CHALLENGE EVERYONE AROUND THEM, THEIR FAMILIES, AND SOCIETY AT LARGE.

IN THIS HOUR WE HOPE TO HELP YOU NAVIGATE THIS COMPLEX WORLD OF AGING CARE.

WE HAVE A WONDERFUL PANEL OF EXPERTS, CHANDO WINGO, DIRECTOR OF THE FRANKLIN COUNTY KOSOVO ON AGING, DR. TANYA GURE, A GERIATRIC PHYSICIAN AT THE WEXNER MEDICAL CENTER, AND MICHELLE MESSER, A FAMILY CAREGIVER WHO HAS TAKEN CARE OF HER DAD AND MOM.

WE WILL HEAR FROM THEM, AND WE WANT TO HEAR FROM YOU.

WE'LL TAKE QUESTIONS HERE AT WOSU AND FROM VIEWERS WATCHING ON YOUTUBE OR FACEBOOK.

JUST TYPE YOUR QUESTIONS INTO THE COMMENTS SECTIONS.

LET'S START WITH BASIC AGING, AS WE GET OLDER WE NEED MORE.

WE NEED MORE HEALTH CARE, WE NEED MORE HELP, AND SOMETIMES THAT HELP HAS TO COME FROM OTHERS OUTSIDE THE FAMILY CIRCLE.

KAREN HENSLEY RAYBURN HAS A FAMILIAR STORY.

HER ELDERLY MOM STARTED HAVING MEMORY ISSUES AT AGE 71.

NOT ENTIRELY UNUSUAL, BUT THE ISSUE BECAME MORE ACUTE.

>> SO IS IT THE AGING OR DEMENTIA, YOU KNOW?

AND SO WITH NOT HAVING THE ROUTINE ANYMORE, SHE JUST --CRUMBLED IS THE BEST WAY TO DESCRIBE IT.

SHE WAS A SHELL OF HERSELF.

SHE HAD NO MORE PURPOSE.

AND THAT WAS THE DISCONNECT.

>> KAREN'S MOM WAS DIAGNOSED WITH ALZHEIMER'S WHICH LAUNCHED SEVERAL YEARS OF INCREASINGLY INTENSIVE CAREGIVING.

MICHELLE MESSER, YOUR FATHER HAD CANCER, YOUR MOM HAS BEEN DIAGNOSED WITH DEMENTIA.

HOW DID YOU FIND YOUR FOOTING IN ALL OF THIS WHEN IT CAME TO DECISIONS ABOUT GETTING THEM MORE HELP?

>> YEAH, SO I THINK WITH MY FATHER, I THINK LIKE WE KIND OF TALKED BEFORE, IT REALLY HELPED THAT I WORKED IN HEALTH CARE, AND THE SAME CONDITIONS HE IRONICALLY HAD.

SO I DID WORK AT THE JAMES.

AND CANCER TRIALS, THE LAST ONE BEING HEAD AND NECK.

AND THEN IRONICALLY WHEN I LEFT, I WORKED IN GASTROENTEROLOGY FOR A WHILE AND WAS ON FEEDING FUB STUDIES, MY FATHER HAD A NECK CANCER AND REQUIRED A FEETING TUBE.

FOR ME --FEEDING TUBE.

FOR ME, WORKING IN THE FIELD HELPED WITH WHO TO CONTACT, DEAL WITH THE CONDITION, AND TAKE CARE OF HIM WHEN HE WAS LIVING WITH ME.

AS FAR AS MY MOM GOES WITH DEMENTIA, I DIDN'T KNOW WHERE TO GO.

SO I WAS JUST REACHING OUT TO WHOEVER I COULD, GRASP AT STRAWS.

ONE NIGHT I FOUND GOLDEN BUCKEYE, AT OHIO STATE.

THEY OFFER FREE CLASSES IN THE EVENING AND ALSO DURING THE DAY FOR ANYBODY WHO'S GOT AN AGING PARENT THAT DEALS WITH LIKE DEMENTIA AND ALZHEIMER'S.

AND THEY CAN CONNECT WITH A LOT OF RESOURCES.

THAT KIND OF GOT ME THROUGH.

>> IT'S KIND OF A PATCHWORK QUILT IN A WAY.

I'M WONDERING, DR. GURE, HOW FAMILIES KNOW WHEN AND WHERE AND WHAT AND HOW AND WHY TO GO AND DO WHAT AND THEN MAYBE EVEN DON'T UNDERSTAND WHAT THE ILLNESS IS IN THE FIRST PLACE.

HOW --WHAT ARE THE SIGNS THEY SHOULD LOOK FOR?

ARE THERE ANY -- ANY CLASSICS?

>> THOSE ARE EXCELLENT QUESTIONS, AND I THINK YOU'RE ABSOLUTELY RIGHT, IT'S A SERIES OF QUESTIONS, WHO, WHAT, WHEN, WHERE, HOW, THAT ENDS UP BEING ADDRESSED ED ED IN SOME OF THE INITIAL CONSULTATIONS WE DO WITH PATIENTS AND THEIR LOVED ONES.

IT DEPENDS ON WHAT THE CONDITION IS AND WHAT THE CONCERNS ARE AT PRESENT.

OBVIOUSLY CAREGIVING IS FOR ALL TYPES OF MEDICAL NEEDS THAT CAN COME UP.

BUT SPECIFICALLY FOR DEMENTIA, THERE MAY BE SIGNS OF MEMORY AND THINKING TROUBLE THAT SEEMS TO MAKE IT DIFFICULT TO SUSTAIN OR MAINTAIN USUAL ACTIVITIES OF DAILY LIVING.

IT TYPICALLY REQUIRES A TESTING THAT'S VALIDATED FOR EVALUATING THAT PERSON TO REALLY BE ABLE TO CHARACTERIZE IT.

BUT WHERE WE REALLY AS PROVIDERS RELY ON FAMILY TO PROVIDE THAT ADDITIONAL INSIGHT, IT'S SO CRITICAL BECAUSE SOMETIMES PART AND PARCEL TO THE CONDITION PATIENTS DON'T ALWAYS HAVE CLEAR INSIGHT.

I REALLY PRIDE MYSELF ON HAVING LONGITUDINAL, REALLY STRONG RELATIONSHIP WITH MY PATIENTS AND SOMETIMES I CAN DISCERN WHEN THERE ARE CHANGES THAT ARE STARTING TO HAPPEN, MEDICATIONS AREN'T RIGHT, IF THERE IS SOME MORE DIFFICULTY THAT'S COMING UP WITH VARIOUS ASPECTS OF THEIR CARE, MORE HOSPITALIZATIONS, ER VISITS, THAT CAN TRIGGER THINGS FOR ME.

THE CAREGIVER IS SO CRITICAL.

WE VIEW THE CAREGIVER AS A VITAL PART OF THE SUPPORT NETWORK.

I THINK OF PEOPLE LIKE MICHELLE AS OUR HELPERS.

THEY'RE OUR HELPERS, AS MR. ROGERS SO BEAUTIFULLY SAID.

AND SO YOU WANT TO FIND THOSE HELPERS, THE PEOPLE WHO HAVE REALLY ALLOW THAT OLDER PERSON TO THRIVE AND DO THE BEST THEY --AS THEY CAN.

>> CAN SOMETIMES FAMILY MEMBERS, THOUGH, OR CAREGIVES WHO ARE CLOSE BY -- CAREGIVERS WHO ARE CLOSE BY BE TOO CLOSE AND NOT SEE IT?

COVER ME HERE.

THAT WAS MY PROBLEM.

I DIDN'T REALLY KNOW WHEN MY MOM WAS FADING.

>> I THINK THAT EVERYONE'S GOING TO HAVE A DIFFERENT STORY ON THAT.

I MEAN, IN GENERAL MY ASSUMPTION IS THAT IF YOU'RE COMING TO THE APPOINTMENTS, IF YOU'RE CALL BEING YOUR LOVED ONE, THEN THAT MEANS THAT YOU JUST WANT TO DO THE BEST THAT YOU POSSIBLY CAN.

AND I OFTEN FIND THAT, YOU KNOW, ONE VISIT TO THE NEXT THERE'S MORE PEOPLE IN THE ROOM, MORE CHAIRS IN THE ROOM.

AND I'M SAYING, OKAY, WE NEED TO GET A SUITE BECAUSE IT'S GROWING WITH THE NUMBER OF FOLKS THAT ARE PRESENT.

I TRY TO TELL FAMILIES THAT WE START OFF IN THESE DIACTIC RELATIONSHIPS, YOU KNOW, PATIENT WITH PROVIDER.

BUT AS CAREGIVERS ARE IDENTIFIED AND THOSE ARE REALLY, YOU KNOW, THERE'S NO STRICT DEFINITION ON THAT.

YOU KNOW, THOSE RELATIONSHIPS ARE REALLY NT ON WHAT'S MEANINGFUL FOR THAT OLDER ADULT.

WE WORK WITH WHOEVER THAT PERSON FEELS SAFE WITH AND COMFORTABLE WITH.

AND I SEE THOSE PEOPLE AS PEOPLE WHO ARE GOING TO BE A PART OF THE TEAM AND HOW WE WILL MOVE FORWARD WORKING TOGETHER.

SO THE TRIAD BECOMES WORKING WITH NOT TWO BUT THREE, AND THAT GENERALLY IS MORE IDEAL THAN A --AS WE GO OUT.

NEVERTHELESS, THE MORE THE MERRIER AS FAR AS I'M CONCERNED.

>> CHANDO WINGO, MICHELLE MENTIONED EARLIER GOLDEN BUCKEYE IS ONE RESOURCE.

CAN YOU GIVE US A THUMBNAIL ON WHAT ELSE IS OUT THERE IN GENERAL?

>> ABSOLUTELY.

>> GREAT.

>> ONE OF THE THINGS THAT I'VE LEARNED IN MY SHORT TENURE IN THIS ROLE IS THAT A LOT OF AGING SERVICES ARE NOT COMMONLY KNOWN.

SO IN FRANKLIN COUNTY WE ARE RESOURCE RICH.

I WORK FOR THE FRANKLIN COUNTY OFFICE ON AGING AS THEIR DIRECTOR -- >> BECAUSE IT'S A BIG COUNTY.

THAT'S A BIG PART OF IT.

>> YES.

WE ALSO HAVE ONE OF THE ONLY LEVY FUNDED SENIOR SERVICES PROGRAMS IN THE STATE OF OHIO.

IN ADDITION WE ALSO HAVE OUR PARTNER AGENCIES, THE CENTRAL AREA OHIO AREA ON AGING.

AND AT OSU YOU HAVE AGE FRIENDLY, A PART OF THE WORLD HEALTH ORGANIZATION NETWORK IN PREPARING CITIES AND, YOU KNOW, WHAT IS ON THE HORIZON FOR AGING.

BUT SPECIFICALLY AT THE OFFICE ON AGING, WE OFFER A HOST OF PROGRAMS TO SUPPORT SENIORS AGING IN PLACE SAFELY AND SECURELY.

BUT OVER THE YEARS WE'VE ALSO REALIZED THAT CAREGIVERS ARE A LARGE PART OF THAT, AND WHAT WE KNOW IS AGING IN PLACE IS VERY IMPORTANT TO OUR SENIORS IN FRANKLIN COUNTY.

AND THAT ALSO MEANS AGING IS PLACE THE WAY THAT THEY WANT TO.

SO THROUGH OUR OFFICE, WE DO HAVE A SPECIFIC PROGRAM THAT SUPPORTS CAREGIVERS BECAUSE, YOU KNOW, THE GOAL IS TO KEEP OUR CAREGIVERS WHOLE TO CONTINUE TO PROVIDE CARE F FOR THEIR LOVED ANYONE.

THAT CAN INCLUDE PROVIDING ASSISTANCE FOR RENT OR UTILITIES.

WE COULD PURCHASE INCONTINENT SUPPLIES, DURABLE MEDICAL, BUT ALSO CONNECTING THE CAREGIVER THEMSELVES TO MENTAL HEALTH RESOURCES, AS WELL.

SO WE ARE VERY, VERY, VERY FORTUNATE HERE IN FRANKLIN COUNTY TO HAVE THE LEVEL OF AGING SERVICES THAT SUPPORT CAREGIVERS.

>> IF I REACH OUT, IS IT LIKELY I'M GOING TO GET THAT PANOPOLY OF RESOURCES BROUGHT TO MY ATTENTION, OR DO YOU HAVE TO GO FROM STEP TO STEP TO STEP ON YOUR OWN?

>> SO IF YOU REACH OUT TO THE FRANKLIN COUNTY OFFICE ON AGING, ONE OF THE THINGS THAT WE SPECIALIZE IN IS INFORMATION AND REFERRAL.

SO WE CAN PROVIDE RESIDENTS WITH --EVEN IF IT'S NOT A SERVICE THAT WE PROVIDE WITHIN OUR OFFICE, WE CAN CONNECT YOU.

CAN'T REALLY SPEAK FOR OTHER OFFICES.

BUT I WILL TELL YOU THAT THE OFFICE IS ALSO RESOURCE RICH.

>> OKAY.

WELL, LET'S GO TO AMY JURAVICH WITH A QUESTION FROM OUR AUDIENCE.

AMI?

>> YES, WE HAVE A QUESTION FROM STEVE DIKES IN OUR AUDIENCE TONIGHT.

AND I THINK HE WANTS CHANDO TO EXPAND MORE.

HE'S ASKING WHAT RESOURCES ARE AVAILABLE IN COLUMBUS TO ASSIST ELDER CAREGIVERS?

HOW DO WE KNOW HOW TO CONTACT, BUT MORE IMPORTANTLY, HOW DO YOU KNOW IF YOU QUALIFI?

>> THROUGH OUR PROGRAM, IT'S NOT AN INCOME-DRIVEN PROGRAM.

IT MERELY IS ARE YOU TAKING CARE OF A SENIOR THAT IS 60.

OUR STAFF WILL DO A COMPLETE ASSESSMENT ON YOUR NEEDS AND CONNECT YOU TO THOSE RESOURCES.

>> OKAY.

AGING IS INEVITABLE AND COSTLY.

FOR MOST OF US EXPENSES INCREASE AS INCOME THINS.

WE WORKED ALL OUR LIVES.

I MEAN, WE CAME FROM PEOPLE THAT WORKED ALL OUR LIVES.

WE MIGHT NOT HAVE PLANNED CORRECTLY FOR OUR RETIREMENT OR DONE WHAT WE COULD HAVE, BUT WE WORKED ALL OUR LIVES, TOO.

SO --THE REASON WHY SENIORS HAVE TO BE SO LEFT OUT, YOU KNOW.

AS THEY GET OLDER.

THE BOTTOM LINE CAN BE SHOCKING.

LOOK AT SOME OF THE AVERAGE COSTS HERE IN OHIO.

ASSISTED LIVING COSTS MORE THAN $5,000 A MONTH, ALZHEIMER'S ASSISTED LIVING NEARLY $7,000 A MONTH, AND A NURSING HOME CAN RUN YOU AS MUCH AS $10,000 A MONTH FOR A PRIVATE ROOM.

CHANDO WINGO, I IMAGINE HUMAN RESOURCES IS A PART OF THE --BIGGEST PART OF THE EXPENSE, BUT CAN YOU TALK ABOUT HOW OUR PRESENT SYSTEM EVOLVED AND WHY IT IS SO EXPENSIVE?

>> FOR CAREGIVING?

>> YEAH.

>> WELL, CAREGIVING I THINK THE AARP REPORT, REPORTS THAT CAREGIVING IS A $21 BILLION INDUSTRY.

YOU HAVE VARIOUS PROGRAMS, WHETHER IT'S THROUGH MEDICARE OR MEDICAID, AND THEY JUST DON'T QUITE COVER ALL OF THE NEED THAT IS OUT IN.

SO SOMETIMES OUR SENIORS ARE NOT CONNECTED TO ADDITIONAL RESOURCES THAT --YOU KNOW, BECAUSE MEDICAID OR MEDICARE DOESN'T COVER EVERYTHING.

YOU HAVE A LOT OF OUT-OF-POCKET EXPENSE.

I MEAN, MEDICINE HAS SIGNIFICANTLY INCREASED IN COST.

HOUSING, WE ARE IN THE MIDDLE OF A HOUSING CRISIS.

AND SO WHEN YOU THINK ABOUT HAVING TO RELOCATE AND MOVE A SENIOR FROM MAYBE THE HOME THAT THEY'VE LIVED IN BECAUSE MAYBE THEY CAN'T AFFORD THE INCREASE IN PROPERTY TAXES, IT'S - - IT CAN BE COSTLY FOR VARYING REASONS.

>> DR. GURE, WHAT ABOUT THE COST?

I MEAN, PART OF IT IS A FUNCTION OF THE ADVANCES IN MEDICINE, RIGHT?

>> I WAS JUST THINKING THAT.

I THOUGHT, YOU KNOW, THAT WHEN YOU THINK ABOUT THE AMOUNT OF TIME THAT OLDER ADULTS ARE SPENDING AFTER RETIREMENT WITH CHRONIC DISEASE WELL INTO THEIR 70s, 80s, 90 s. THE AVERAGE AGE OF MY CLINICAL PRACTICE IS ABOUT 80.

AND I HAVE SOME --THREE-DIGIT PATIENTS, CENTENARIANS, LIVING WITH CHRONIC DISEASE BECAUSE THAT IS THE --THE WONDER OF OUR HEALTH CARE SYSTEM IN THE U. S. AND GLOBALLY.

THAT WE HAVE SIGNIFICANT ADVANCES IN HOW TO IMPROVE THE QUALITY OF LIFE AND THE OUTCOMES AROUND HEART DISEASE, CANCER, AS MICHELLE WAS BRINGING UP WITH HER PARENTS.

EVEN WITH DEMENTIA CARE THERE ARE SOME TREATMENTS THAT ARE COMING ON THE HORIZON THAT POTENTIALLY CAN BE HELPFUL, IMPROVING THE OPPORTUNITY FOR PEOPLE TO LIVE LONGER WITH THE CONDITION.

THEN THINK ABOUT SOME OF THE -- THE CHRONIC DISEASE THAT'S PEOPLE GET IN MIDDLE AGE OR EVEN IN HIV, FOR EXAMPLE, PEOPLE AGE WITH THAT CONTINUE.

THAT USED TO NOT BE WHEN YOU THOUGHTS ABOUT THIS 15 YEARS AGO, 20 YEARS AGO.

EVEN CHILDREN WITH SPECIAL HEALTH CARE NEEDS ARE AGING WITH THEIR CONGENITAL HEART DISEASE, DEFECTS, AND ALL KINDS OF CONDITIONS.

SO IT IS REALLY I THINK A PHENOMENON RELATED TO THE ADVANCEMENTS AND MEDICAL TECHNOLOGIES AND PRACTICE THAT HAS ALLOWED PATIENTS TO LIVE THIS LONG.

BUT IT ALSO MEANS THEY MAY BE SPENDING MORE OF THEIR LIVES WITH DISABILITY.

IT ALSO MEANS THAT THERE ARE A LOT MORE MEDICAL EXPENSES THAT CHANDO WAS GETTING AT JUST IN THE DAY-TO-DAY CARE.

AND SOME CONDITIONS HAVE HEAVY MEDICAL NEEDS.

AND UNFORTUNATELY THE REALITY IS THAT THERE'S A LOT OF GAPS IN WHAT CAN BE PROVIDED THROUGH OUR HEALTH CARE SYSTEM.

IT'S NOT COMPREHENSIVE, UNFORTUNATELY, IT COVERS THE THINGS THAT ARE REALLY FOCUSED AROUND ACUTE CARE.

I'M SURE YOU ALL KNOW WHAT I MEAN BY THAT.

AND THERE IS A GOOD PRIMARY CARE NETWORK, BUT CARE THAT REALLY HAS WHAT I CALL INTERCURRENT CARE, BETWEEN VISITS, BETWEEN EVALUATIONS WITH PROVIDERS.

THE DAY TO DAY, THE DOINGS, THE THINGS THAT HAVE TO BE DONE TO MAINTAIN THAT MEDICAL CONDITION, DIABETES, HEART DISEASE, HEART FAILURE, YOU KNOW, MANAGING THE MEDICATIONS THAT KEEP THINGS STABLE AND IN CHECK.

THOSE ARE REALLY HEAVY DUTY, TIME- INTENSIVE PRACTICES THAT OFTEN CAN'T BE DONE BY THE INDIVIDUAL ALONE.

AND SO HAVING THAT ADDITIONAL SUPPORT STRUCTURE REALLY HELPS TO GET THE JOB DONE.

BUT IT OFTEN ENDS UP BEING THE --OFTEN ENDS UP NEEDING TO BE A HYBRID OF THINGS THAT GETS TOGETHER.

>> DO YOU FIND YOURSELF HAVING CONVERSATIONS WITH YOUR PATIENTS AND THEIR FAMILIES AND LOVED ONES ABOUT THE FINANCES OF THIS?

>> WELL, WE DEFINITELY DO.

AND YOU KNOW, BETWEEN THE COST OF MEDICATIONS, THE SHORTAGES, THE FORMULARY ISSUES, I'M SURE YOUR LISTENERS WILL, IN THE AUDIENCE HERE, WILL ATTEST TO THE CHALLENGES THAT ARE HAPPENING WITH JUST THE AVAILABILITY OF PHARMACEUTICALS.

WE'VE HAD CONSTRICTIONS IN THE MARKET.

EVEN DURING COVID, THIS BECAME ACUTELY AN ISSUE.

SO YES, WE ARE --I THINK YOU'RE NOT LIVING IN THE CURRENT DAY IF YOU'RE NOT ADDRESSING THINGS WITH YOUR PATIENTS AND THEIR FAMILIES BECAUSE IT'S AN ONGOING CHALLENGE.

ONE OF THE THINGS THAT I CONFRONTED AS A CAREGIVER ALSO WAS THAT I HAD TO SORT OF MEET THE -- MEET UP THE GAP IN WHAT MY PARENTS COULD NOT AFFORD TO TAKE CARE OF WITH THEIR MEDICINE.

SO WHEN THERE ARE ADDITIONAL THINGS, NUTRITIONAL SUPPLEMENTS WHICH ARE VERY EXPENSIVE, YOU KNOW, INCONTINENT SUPPLIES, ANY OF THOSE ADDITIONAL THINGS, SUPPORTING THE ADDITIONAL TIME THAT WAS NEEDED TORR TO HAVE A CARE --NEEDED TO HAVE A CAREGIVER IN THE HOME.

THESE ARE THINGS YOU END UP INSTEAD OF PUTTING THAT TOWARD OUR CHILDREN WHERE IT'S FLOWING UP TO OUR PARENTS.

AND OBVIOUSLY THAT'S SOMETHING I WOULD NEVER TRADE, BUT THAT'S THE CONFLICT.

>> IT KIND OF NICKELS AND DIMES YOU TO DEATH.

>> THAT'S RIGHT.

THAT'S RIGHT.

>> $21 BILLION IS ACCUMULATED --THAT'S IN OHIO.

>> WHEN YOU'RE TALKING ABOUT THAT $21 BILLION INDUSTRY, IT'S EVERYTHING FROM --INCIDENTSALS TO MAJOR SURGERIES.

>> YES.

>> AND NURSING HOMES AND ALL OF THAT STUFF.

I THINK A LOT OF PEOPLE THINK OF IT IN TERMS OF NURSING HOMES.

MICHELLE MESSER, HOW ARE YOU FEELING?

HAAS YOUR POCKETBOOK THESE DAYS?

YOU'RE JUGGLING TWO DIFFERENT PARENTS IN TWO DIFFERENT HOMES.

AND THEN YOUR OWN HOME.

>> YEAH.

FOR ME IT'S MOSTLY ABOUT JUST DRIVING AROUND CONSTANTLY.

BECAUSE MY PARENTS AREN'T TOGETHER.

YEAH, I'M CON SANTLY DRIVING ALL --CONSTANTLY DRIVING ALL DAY CHECKING ON THEM.

THAT'S WHERE IT IS FOR ME FOR THAT.

I DO --OBVIOUSLY USE MY OWN FUNDS SOMETIMES TO HELP THEM WITH THINGS.

BUT YEAH, GAS MONEY.

A LOT OF IT.

>> YOU KNOW, FOR SOME PEOPLE THEY DON'T EVEN HAVE -- OWN A CAR AND THEY'RE TRYING TO TAKE CARE OF A LOVED ONE.

THEN THEY'RE DOING WHO KNOWS WHAT TO GET AROUND.

>> YEAH.

>> WHAT I OFTEN WILL SAY IN THESE CIRCUMSTANCES, TIME IS MONEY, TOO.

SO THAT'S TIME THAT YOU'VE LOST DOING YOUR JOB, DOING -- DOING THE THINGS THAT YOU NEED TO DO TO TAKE CARE OF YOUR FAMILY.

TAKE CARE OF YOUR HOUSEHOLD.

WE DON'T MONETIZE IT THAT WAY WITH PEOPLE WE LOVE.

BUT THAT IS REALLY THE FACT OF THE MATTER, THAT THOSE ARE THE WAYS THAT CAREGIVES ARE MAKING THOSE TRADEOFFS.

AND WE SHOULD ACKNOWLEDGE THAT.

>> SOMETIMES PEOPLE LEAVE THEIR JOBS TO TAKE CARE OF THEIR LOVED ONES.

>> ABSOLUTELY.

>> AND THEN THERE'S NOT --THERE'S NO --THERE'S NOTHING BUILT INTO THE SYSTEM TO SAY, OKAY, YOU'LL GET YOUR JOB WHEN YOU GET BACK.

OR THERE'S GOING TO BE A JOB WAITING FOR YOU.

YOU'VE DEFINITELY TAKEN A HIT FINANCIALLY AND SO ON IN YOUR CAREER.

>> YES.

>> ABSOLUTELY.

>> YES.

>> AND THAT INDUSTRY ALSO SUFFERING.

YOU DON'T HAVE ENOUGH PEOPLE THAT WANT TO WORK AS A CAREGIVER, WHETHER IT BE THROUGH A NURSING HOME OR SOME OTHER TYPE OF AGENCY.

THEY DON'T PAY ENOUGH, AND IT'S VERY DEMANDING WORK.

SO A LOT OF CAREGIVERS ARE FORCED INTO THESE TYPES OF DECISIONS BECAUSE THE INDUSTRY IS ALSO LACKING.

>> AND MICHELLE MESSER, I'M KIND OF INTERESTED --YOU'RE IN THE MIDDLE OF OR ON THE PRECIPICE OF GETTING SOME HOME HEALTH CARE, SOME REGULAR HOME HEALTH CARE FOR YOUR MOTHER.

HOW DID YOU THINK ABOUT THE FINANCES OF THAT AND WHAT IS AFFORDABLE AND DOABLE?

>> WELL, I JUST KIND OF COMPARED A FEW DIFFERENT AGENCIES TO SEE, YOU KNOW, WHAT IT WOULD BE LIKE.

AND TO BE HONEST, I HAVEN'T THOUGHT AS MUCH ABOUT IT AS I SHOULD.

MORE OR LESS I'M TRYING TO GET MY MOM TO GET USED TO THE FACT OF SOMEBODY COMING IN.

SO WE'VE JUST BEEN DOING A LOT OF DIFFERENT TRIALS.

BUT THAT'S DEFINITELY A CONSIDERATION BECAUSE, YOU KNOW, I THINK AT SOME POINT SHE'S PROBABLY GOING TO NEED 24-HOUR CARE, AND I'M READY AND WILLING TO DO THE JOB.

BUT I ALSO REALIZE LIKE I CAN'T DO IT ALL.

I NEED TO BE AVAILABLE FOR OTHER LOVED ONES AND JUST MY LIFE, TOO.

SO THERE'S JUST A LOT TO JUGGLE, AND THE FINANCIAL PART DOES COME IN TO JUST FIGURE OUT HOW AM I GOING TO DO IT ALL WITH ALSO HIRING, YOU KNOW, AIDES.

SO IT IS A BIG PART OF IT.

>> I'M GLAD YOU BROUGHT THAT UP BECAUSE IT MAKES ME THINK ABOUT SOMETHING I WANTED TO ASK EARLIER, TOO.

THE WHOLE ISSUE OF BUY-IN --FROM THE LOVED ONE, FROM THE PATIENT.

THEY'RE BUYING INTO THIS.

THEY WANT TO WORK ON IT AND BE A PARTICIPANT.

IT'S A LITTLE DIFFERENT WHEN THERE IS DEMENTIA INVOLVED, I KNOW.

BUT WHAT IS YOUR EXPERIENCE BEEN?

>> MY EXPERIENCE IS MY MOM DOESN'T WANT ANYBODY TO HELP HER BUT ME.

AND I MEAN WITH EVERYTHING.

AND SHE'S SO CUTE SO I ALWAYS GIVE IN TO HER, BUT YOU KNOW, WHEN WE'VE TRIED AN AIDE FOR MAYBE A WEEK AND A HALF, IT DIDN'T GO SO WELL.

I DON'T THINK WE GOT AS MUCH OUT OF THIS PARTICULAR PERSON THAT WE WANTED.

BUT ALSO MY MOM'S JUST NOT GOING TO WARM UP TO SOMEBODY.

SHE CALLED ME AND SAID SHE WAS SCARED AND WHERE ARE YOU AT, DID YOU FORGET ME?

Y THAT SHE --SHE THOUGHT I ABANDONED HER.

THIS SEEMS LIKE IT COULD BE A GOOD SERVICE FOR SOME IF PATIENTS ARE WILLING.

MY MOM HASN'T BEEN.

SO MY NEXT TRIAL IS GOING TO BE WITH SOMEBODY THAT KIND OF KNOWS MY FAMILY AND HAS CARE-TAKED BEFORE.

THEY AREN'T GOING TO COME IN A UNIFORM.

AND THEY HAVE A COMPLETELY DIFFERENT PERSONALITY.

SO I'M TRYING TO REALLY KIND OF FIND SOMEBODY THAT MIGHT CONNECT WITH HER.

I THINK THAT'S THE MOST IMPORTANT THING.

SO FAR I HAVEN'T BEEN SUCCESSFUL AT THAT.

>> WE'VE BEEN TALKING ABOUT THIS AS IF THERE'S ENOUGH TO GO AROUND ANYWAYS.

>> YEAH.

>> AND CHANDO WINGO, THERE'S JUST ENOUGH PEOPLE OUT THERE TO DO THIS ANYWAY.

>> NO.

THERE ISN'T.

YOU KIND OF TALKED ABOUT EARLY ON WITH THE NUMBERS.

IN FRANKLIN COUNTY, 38 PEOPLE TURN 60 A DAY.

AND I FOCUS ON 60 BECAUSE THAT'S WHERE A LOT OF OUR PROGRAMS START AT MY AGENCY.

AND TO PUT THINGS IN PERSPECTIVE, WE ARE SERVING FOUR GENERATIONS, THE SILENT GENERATION, GREATEST GENERATION, AND LAST YEAR WAS THE LAST YEAR FOR OUR BABY-BOOMERS TO TURN 60.

THIS YEAR'S GENERATION X BEGAN TO TURN 60.

WHEN YOU THINK ABOUT ALL OF THOSE GENERATIONS, AND WE HAVE SOME CENTENARIANS, TOO, IN OUR CASE LOAD.

AT ANY GIVEN TIME REALLY YOU CAN HAVE THE ADULT CHILD AND THE OLDER ADULT ALL IN OUR CASE LOAD AT THE SAME TIME.

WHEN YOU REALLY PUT THAT IN PERSPECTIVE, THERE'S NOT ENOUGH MONEY AND RESOURCES.

CAREGIVERS PLAY A CRITICAL, CRITICAL ROLE TO ALLOWING OUR SENIORS TO AGE IN PLACE.

WE NEED OUR CAREGIVERS.

>> OKAY.

LET'S GO TO AMY JURAVICH WITH A QUESTION FROM OUR AUDIENCE.

AMI?

>> SPEAKING OF NOT ENOUGH, WE HAVE TWO QUESTIONS FROM OUR AUDIENCE THAT ARE SIMILAR.

BETTY GIAMAR WANTS TO KNOW WHAT FINANCIAL SUPPORT IS THERE FOR A HOME CAREGIVER WHO HAS TO LEAVE THEIR PAYING JOB?

IS ANY FINANCIAL HELP AVAILABLE?

AND NATALIE EPO HAS A SIMILAR QUESTION SAYING, CAN YOU PLEASE DISCUSS IF THERE'S ANY COMPENSATION FOR FAMILY CAREGIVERS FOR THEIR SERVICES?

>> I CAN SPEAK TO WHAT WE DO IN THE OFFICE ON AGING.

ONE OF THE SERVICES THAT WE DO PROVIDE IS THAT RESPITE CARE.

SO THROUGH THE CAREGIVER PROGRAM WE DO OFFER ADULT DAY CARE SERVICES WHERE THE CAREGIVER THEMSELVES CAN GET SOME RESPITE.

BUT WE ALSO REALIZE THAT AS I MENTIONED, THERE'S A WORK FORCE SHORTAGE.

BUT THAT DOESN'T STOP OUR FAMILIES FROM CAREGIVING.

SO YOU ARE ABLE TO BECOME A PAID CAREGIVER THROUGH ONE OF OUR AGENCIES THAT WE WORK WITH, AND WE'LL PAY YOU THROUGH THOSEATIONS --THOSE AGENCIES TO DO THAT WORK.

I HAVE HEARD OF OTHER AGENCIES DOING SIMILAR TYPES OF THINGS.

BUT I CAN TELL YOU AT THE OFFICE ON AGING WE ARE COMMITTED TO MAKING SURE THAT IF YOU ARE ALREADY CAREGIVING, WE CAN GET YOU SET UP WITH ONE OF OUR AGENCIES TO GET THAT COMPENSATION.

>> MOST PEOPLE CANNOT NAVIGATE THE COMPLEX WORLD OF CAREGIVING ALONE.

WHETHER THEY ARE THE PATIENT OR THE FAMILY CAREGIVER.

>> THIS IS A TEAM SPORT.

IF YOU'RE TRYING TO DO THIS ALONE, IT'S NOT GOING TO WORK LONG TERM FOR YOU OR THE PERSON YOU'RE PROVIDING CARE TO.

I THINK PEOPLE OFTEN --I'VE GOT TO DO IT ALL AND ACTUALLY YOU CAN'T.

IT'S NOT IN THE PERSON FOR WHOM YOU'RE PROVIDING CARE'S BEST INTEREST.

>> THERE.

YOU NEED A TEAM.

THANKFULLY THERE ARE TEAMMATES OUT THERE.

BUT SOMEONE HAS TO PUT THAT TEAM TOGETHER WITH THE RIGHT PEOPLE AND THE RIGHT AGENCY.

YOU HAVE TO FIND SOMEONE WHO PUTS YOU AND YOUR LOVED ONE'S INTERESTS FIRST.

DR. GURE, IT MAKES SENSE THAT SUCH A TEAM INCLUDES THE PHYSICIAN.

CAN YOU TALK ABOUT WHAT YOU'VE SEEN IN TERMS OF SUCCESSFUL TEAMS LIKE THIS?

YOU MENTIONED IT WAS KIND OF A STAR CHAMBER AT TIMES IN YOUR OFFICE.

AND YOU --MORE THE MERRIER IS THE GENEROUS --HOWEVER, WHAT DOES A GOOD TEAM LOOK LIKE TO YOU?

>> WELL, USUALLY THEY SHARE THAT QUARTERBACK IS DESIGNATED BECAUSE YOU DO NEED TO SORT OF HAVE A CENTRAL PERSON THAT IS A PART OF THE DECISIONMAKING.

AND AS I SAID, THE ASSUMPTION IS ALWAYS THAT PEOPLE WANT TO DO THE BEST JOB.

AND SO I ROUTINELY AND I KNOW A LOT OF MY TEAMMATES WITHIN OUR GERIATRIC SECTION AND ALSO WITHIN THE PRIMARY CARE NETWORK AT OSU SPEND TIME TALKING TO THE PATIENT BUT ALSO GIVING SPACE TO THE CAREGIVER TO TALK ABOUT ANY ISSUES THAT ARE COMING UP.

WE TRY TO REALLY I SAY WHEN I'M TALKING TO THE PATIENT, I'M TALKING TO YOU, BUT I'M ALSO TALKING TO YOUR LOVED ONE.

WE'RE TALKING ABOUT THESE THINGS TOGETHER, TRYING TO UNDERSTAND WHAT THE CONCERNS ARE, HOW TO REALLY EDUCATE, LEVEL UP THE NEEDS THAT MAY BE FOR, YOU KNOW, HANDS- ON CARE, LEARNING MORE ABOUT THE MEDICAL CONDITION, DISCUSSING HOW YOU'RE DOING --YOU KNOW, SPECIFICALLY SOMETIMES IT'S HOW ARE YOU DOING TO MANAGE ALL OF THIS.

BECAUSE WHEN YOU START TO REALLY SORT OF PARSE OUT EVERYTHING THAT THAT ONE PERSON IS DOING, IT CAN BE ASTOUNDING.

I'M OFTEN SPEECHLESS THINKING ABOUT THE AMOUNT OF THINGS THAT INDIVIDUALS HAVE TO DO IN THEIR DAY TO DAY WITH WORK AND CHILDREN.

JUST GIVING SPACE FOR THAT IS SOMETIMES EXTREMELY HELPFUL.

AND THEN THE OTHER PART OF IT, SOMETIMES I WILL OFFER --ESPECIALLY SINCE I AM A GERIATRICIAN AND AS CHANDO WAS SAYING THERE ARE INTERGENERATIONAL FAMILIES THAT ARE 60- PLUS AND STACKING, GRANDMA, GREAT GRANDMA, EVERYBODY IN THE CLINIC WITH YOU, TO TRY TO MAKE SURE THAT THEY'RE BEING SEEN IN THE SAME CLINIC, TO SORT OF MAKE THE VISITS MORE CONVENIENT.

I DON'T ENCOURAGE VISITS TO BE BACK TO BACK BECAUSE EVERYBODY NEEDS THEIR SPACE.

BUT I DO TRY TO ENCOURAGE THAT AND ALLOW FOR THAT OPPORTUNITY FOR A CAREGIVER TO GET CARE IN THE CLINIC SO THAT IT SIMPLIFIES THINGS.

I THINK WE ALSO TRY TO USE TELEMEDICINE TO HAVE FAMILY MEETINGS WHICH CAN BE VERY HELPFUL FOR GETTING EVERYBODY ON THE SAME PAGE, TRYING TO BRING IN ALL THE FAMILY THAT ARE LONG DISTANCE AND CLOSE TO DISCUSS THINGS, HAVE FAMILY DISCUSSIONS.

SOMETIMES THOSE ARE HAPPENING IN PERSON.

YOU KNOW, IT'S TRICKY FOR PHYSICIANS, THOUGH, BECAUSE WE DON'T WANT TO GET INTO FAMILY DYNAMICS.

IT'S COMPLICATED, I UNDERSTAND THAT.

I KNOW MY OWN FAMILY, TONS OF COMPLICATIONS.

SO THERE'S A LOT THAT JUST DON'T WANT TO WADE INTO, BUT YOU TRY TO REALLY PROVIDE THE FACTS, THE INFORMATION.

TRY TO OFFER SOME SUGGESTIONS, WAYS, AVENUES LIKE MICHELLE WAS SAYING, HOW CAN YOU REALLY INITIATE IN-HOME CARE.

I THINK IT'S WONDERFUL THE WAY THAT YOU'RE ING THAT, PROBLEM SOLVING, WE WILL HAVE THOSE DISCUSSIONS TO TRY TO HELP PEOPLE GET INITIATED BECAUSE THE INERTIA, FEELING TOO OVERWHELMED CAN DELAY GETTING THINGS TO REALLY --STARTING SOMEWHERE IS OFTEN THE MESSAGE.

I SAY START SOMEWHERE.

WHATEVER HOURS YOU CAN GET THAT, YOU KNOW, YOUR LOVED ONE IS WILLING TO TAKE, TRY THAT, KEEP IT THERE, EEVALUATE.

KEEP MOVING FORWARD HOWEVER THAT NEEDS TO HAPPEN.

THOSE ARE SOME OF THE THINGS I TRY TO CONVEY ON REPEAT.

>> WE NEED TO START THAT CONVERSATION EARLY.

>> ABSOLUTELY.

>> A LOT OF TIMES IT'S HARD FOR US TO TRANSITION OUT OF THE SPACE OF BEING AN ADULT CHILD.

WE STILL VERY MUCH LOOK AT OUR PARENTS AS OUR PARENTS.

AND WE ALLOW THEM, YOU KNOW, THAT SPACE, RIGHT, AND WE DON'T GET IN THEIR BUSINESS.

A LOT OF TIMES WE'RE APPREHENSIVE TO HAVE THOSE CONVERSATIONS BECAUSE WE DON'T WANT TO UPSET OUR PARENT OR WE DON'T WANT TO MAKE IT SEEM LIKE WE'RE BEING --CROSSING A LINE.

SO YOU KNOW, THE EARLIER THAT YOU CAN START TO HAVE THOSE CONVERSATIONS, LIKE, YOU KNOW, IF YOU WERE TO GET SICK, HOW WOULD YOU WANT YOUR CARE TO BE MANAGED?

YOU KNOW, ARE YOU ADVERSE TO HAVING -- AVERSE TO HAVING SOMEONE IN THE HOME, DO YOU WANT IT TO BE ME, DO YOU WANT NOG A FACILITY?

SOMETIMES THE DYNAMICS YOU DON'T KNOW THEY EXIST UNTIL IT'S TIME TO PROVIDE CARE.

THE EARLIER THAT YOU CAN HAVE THOSE CONVERSATIONS THE BETTER SO THAT YOU HAVE A GAME PLAN.

AND WORST CASE SCENARIO, YOU CAN CHANGE THAT PLAN.

THE BEST CASE SCENARIO, YOU NEVER NEED TO USE IT.

I THINK THE EARLIER THAT WE HAVE THAT CONVERSATION THE BETTER.

>> YOU KNOW, MICHELLE, I THINK OF YOU AS --I'M TERRIBLE AT SPORTS ANALOGIES, BUT YOU'RE KIND OF LIKE THE QUARTERBACK, YOU'RE CALLING THE PLAYS, BUT YOU'RE ALSO THE TACKLE AND WHATEVER ELSE THEY DO OUT THERE.

IT SOUNDS LIKE YOU'RE DOING ALL OF THE STUFF.

>> YEAH.

YEAH.

>> WHAT'S YOUR TEAM LOOK LIKE?

>> MY TEAM?

>> YEAH.

>> WELL, FOR THE LONG TIME IT'S JUST BEEN ME, TO BE HONEST.

BUT I HAVE GOT A LOT OF SUPPORT FROM LOVED ONES.

SO --I THINK JUST REACHING OUT TO FRIENDS AND LOVED ONES AND JUST LETTING THEM KNOW HERE'S WHERE I'M AT, SO JUST EVEN JUST HAVING SOMEBODY TO VENT TO OR SOMEBODY TO DROP OFF SOME FOOD, THAT MEANS THE WORLD TO ME.

LIKE I SAID, I DID TAKE CARE OF MY DAD WHEN HE HAD CANCER, AND I WAS FEEDING HIM THROUGH A TUBE.

THAT WAS DURING THE PANDEMIC.

WE WERE ISOLATED, ME AND MY DAD.

AND HE COULDN'T SPEAK.

I DON'T REALLY KNOW --I THINK THE ONLY WAY I WAS ABLE TO GET THROUGH THAT IS BECAUSE I WORKED IN THE CANCER HOSPITAL WITH PATIENTS.

AND MY DAD WAS ALSO A PARA MEDIC, SO HE JUST --PARAMEDIC, SO I THINK IT HELPED.

BUT FOR THE LONGEST TIME IT HAS BEEN JUST ME.

I THINK IT DOES JUST --IT WEARS ON YOU.

AND YOU LITERALLY CANNOT SUSTAIN IT WITHOUT OTHER THINGS KIND OF BEING AFFECTED IN YOUR LIFE.

SO I'M AT THAT POINT NOW, I HAVE BEEN FOR THE LAST PROBABLY SIX MONTHS OF HAVING AN ACTION PLAN OF GETTING THINGS TO BE A LITTLE BETTER SO I CAN TAKE A LITTLE BIT BETTER CARE OF MYSELF.

BUT IT TOOK ME A LONG TIME TO ACCEPT THAT, TOO.

>> IT PROBABLY ISN'T THAT UNUSUAL A SITUATION LIKE MICHELLE, RIGHT?

THAT SOMEONE -- >> NOT AT ALL.

>> --GOING TO LARGELY ALONE.

>> NOT AT ALL.

>> THAT'S RIGHT.

>> NOT AT ALL.

>> AND I THINK LIKE KNOWING MY DAD'S CONDITION SO WELL, WHAT MEDICINES HE TAKES, HOW TO DEAL WITH HIS PERSONALITY, ALL HIS DIFFERENT --SOMETIMES IT FELT MORE OVERWHELMING TO TRY TO, AS SOMEBODY SAID THEY COULD HELP ME, TRYING TO EXPLAIN IT ALL.

THEN HAVING TO DEAL WITH, YOU KNOW, THEM NOT WANTING TO LET ANYBODY ELSE HELP.

SO THAT'S PART OF IT, TOO.

>> LET ME ASK YOU, HAVE YOU HAD THOSE CONVERSATIONS?

I KNOW YOUR MOM HAS DEMENTIA, AND THAT'S --A DIFFERENT STORY.

WITH YOUR DAD, DO YOU TALK ABOUT WHAT YOUR NEEDS ARE, TOO?

>> YOU KNOW, I THINK HE'S STARTING TO GET THAT.

BUT HE'S GOT A VERY STRONG PERSONALITY, AND --HE'S DOING OKAY RIGHT NOW.

BUT HE'S EITHER REALLY NOT OKAY OR HE'S OKAY.

SO THAT'S THE THING THAT MAKES IT A LITTLE BIT DIFFICULT.

RIGHT NOW HE'S OKAY.

SO I DO GO OVER, DO HIS MEDICINES, TAKE HIM TO A DOCTOR'S VISIT.

WHEN HE'S NOT OKAY IT'S ALMOST LIVING WITH ME OR I HAVE TO BE WITH HIM BECAUSE HE'S IN AND OUT OF THE HOSPITAL.

THAT'S ONE THING THAT MAKES IT DIFFICULT.

HE HAD CANCER, LOTS OF VISITS.

THEN IT WAS HAVING ISSUES FROM THE CANCER THAT HE HAD OR CANCER TREATMENT I SHOULD SAY.

THEN DEALING WITH HEART FAILURE.

NOW HE'S ACCEPTING OF THE RIGHT CPAP MACHINE ARE THE RIGHT MASK AND OXYGEN.

HE'S BEEN STABLE FOR SIX MONTHS.

HE'S FINE AND WANTS ME TO DO MY THING.

I GUESS HE --HE WANTS ME TO DO WHAT I CAN FOR MYSELF NOW.

YEAH.

IT GETS DIFFICULT.

I HAD THAT CONVERSATION.

I SAID, WHEN YOU GO THROUGH AN EPISODE WHERE YOU NEED HELP AGAIN WE'RE GOING TO REACH OUT FOR MORE HELP BECAUSE WHAT IF I'M SICK OR NOT OKAY.

HE DOES AGREE TO IT NOW.

I HOPE HE STICKS TO HIS WORD.

>> IS THERE SOMETHING LIKE A SOCIAL WORKER OR SOMEONE IN YOUR OFFICE THAT IS PAYING ATTENTION TO THESE KIND OF DYNAMICS?

AND I MEAN, IF SOMETHING HAPPENS TO MICHELLE -- >> OH.

GAME OVER.

>> YEAH.

>> FOR US IN TERMS OF HOW WELL WE CAN BE ASSURED THAT, YOU KNOW, THAT OLDER ADULT IS GOING TO BE OKAY AND FIGURING OUT WHAT THE NEXT OPTIONS ARE.

VERY DIFFICULT IN THOSE CIRCUMSTANCES.

THIS IS WHY IT'S SO CRITICAL, AS DR. ROSE WAS SAYING IN THE VIDEO, TO REALLY THINK ABOUT A BROADER TEAM IN TERMS OF HEALTH CARE DECISIONMAKING, HOW YOU WANT TO KIND OF GET TOGETHER YOUR NETWORK.

IT'S VERY HARD.

ONE OF THE MOST IMPORTANT SKILLS THAT I'VE LEARNED AS AN ADULT THAT I THINK REALLY APPLIES WELL TO CAREGIVING IS COMPROMISE.

YOU HAVE TO CONTINUE TO TALK ABOUT IT FROM WHAT YOUR NEEDS ARE, WHAT THEIR NEEDS ARE, AND WHERE IS THE MIDDLE GROUND.

BECAUSE YOU KNOW, IF --IF LOVED ONE DOESN'T WANT ANYBODY IN THE HOME AND IT'S NOT FEASIBLE FOR DEAR, BELOVED CHILD TO BE THERE 24/7, THEN HOW DO YOU MAKE THAT WORK?

IT'S IRRECONCILABLE.

YOU HAVE TO FIND THAT COMPROMISE IN THE MIDDLE AND REALLY WORKING ON THAT IS CRITICAL.

AND I'VE USED THAT ON REPEAT, TOO, IN CLINIC WHEN I'M TALKING TO FAMILIES ABOUT THIS.

JUST ONGOING, IT HAS TO BE A COMPROMISE.

YOU HAVE TO FIND THAT MIDDLE GROUND SO THAT EVERYBODY CAN BE FUNCTIONAL AND HAPPY.

WITH RESPECT TO THE QUESTION ABOUT SOCIAL WORK.

SOCIAL WORK SERVICES ARE MORE SCARCE.

THAT'S BEEN A PROFESSION THAT HAS BEEN REALLY CHALLENGED PARTICULARLY WITH THE PANDEMIC AND EVEN BEFORE THAT.

SO WE DON'T HAVE --WE DON'T HAVE A CLINIC SOCIAL WORKER IN PRESENT, IN HOUSE, IN OUR CLINIC AT PRESENT.

BUT THERE IS A TRIAGE SYSTEM THAT WE USE WITHIN OUR NETWORK.

VERY WONDERFUL SOCIAL WORKERS THAT HELP US WITH SO MUCH.

THEY'RE ANGELS AS FAR AS I'M CONCERNED.

AND THEN ALSO OBVIOUSLY THE CASE MANAGERS, LIKE CHANDO WAS BRINGING UP, IF THERE'S SOME COMMUNITY- BASED AGENCY, THERE'S A CASE WORKER, I UTILIZE THOSE QUITE A BIT.

THOSE TYPES OF PROFESSIONALS FOR THINGS THAT NEED TO BE COORDINATED WHILE THE PERSON IS AT HOME.

JUST TO KIND OF TRY TO DISTRIBUTE SOME OF THE WORK AND - -BECAUSE AS WE TALKED ABOUT THESE MEDICAL CONDITIONS ARE PRESENT, THEY'RE PROGRESSIVE.

SO THINGS DON'T OFTEN LET UP.

IT'S OFTEN JUST A LOT OF THE SAME IN TERMS OF THE INTENSITY OF RESOURCES THAT ARE NEEDED, AND SOMETIMES IT GETS HEAVIER, YOU KNOW.

IT WILL GET HEAVIER OVER TIME.

THAT'S REALLY JUST THE REALITY.

>> AND CAREGIVERS ARE OFTEN --THEY FEEL GUILTY, RIGHT?

ABOUT PUTTING THEMSELVES IN THE EQUATION.

THIS IS MY MOM, THIS IS MY DAD, THIS IS MY BIRTHRIGHT.

I OWE THEM.

SO I'M GLAD THAT YOU'RE TALKING, YOU KNOW, A SERIOUS APPROACH TO YOUR CIVIL CARE AND USE --SELF-CARE AND USING THOSE WORDS.

OFTEN TIMES CAREGIVERS JUST WON'T.

IT'S WHAT I HAVE TO DO.

BUT WE ALSO KNOW THAT OFTENTIMES THE INTENSITY THAT CAREGIVING REQUIRES, IF YOU DON'T TAKE CARE OF YOURSELF THE CAREGIVER FINDS THEMSELVES IN THE POSITION WHERE THEIR HEALTH DECLINES.

>> RIGHT.

>> ALL THE WAY UP TO DEATH.

WE HEAR STORIES ALL THE TIME AND HAVE SEEN WHERE THE CAREGIVER HAS PASSED AWAY BEFORE THE PERSON THAT THEY'RE CARING FROM.

AND IT'S FROM THAT STRESS AND THAT LOAD OF DOING ALL THE THINGS, MANY CAREGIVERS HAVE OTHER THINGS GOING ON.

LIKE EVEN IN MY HOUSEHOLD, IT'S A SANDWICH GENERATION.

BUT I HAVE TO GET UP, GO TO WORK.

MAKE SURE MY KIDS GET TO SCHOOL.

MAKE SURE MY PARENTS HAVE WHAT THEY NEED.

THE END OF THE DAY I PUT MYSELF LAST.

BUT I HAVE --TO ALSO THINK ABOUT THAT, TOO.

BUT THAT SELF-CARE IS VERY IMPORTANT.

AND YOU SHOULDN'T FEEL GUILTY ABOUT GETTING THAT CARE THAT YOU NEED FOR YOURSELF SO THAT YOU CAN CONTINUE THE JOY OF CAREGIVING.

OFTENTIMES OUR CAREGIVERS WILL TALK ABOUT IT.

YOU KNOW, IT'S A PRIVILEGE TO BE IN A POSITION TO BE ABLE TO PROVIDE THAT CARE FOR YOUR LOVED ONE.

BUT WE WANT TO MAKE SURE THAT YOU'RE ABLE TO CONTINUE TO DO THAT IN A HEALTHY WAY.

>> LET'S GO TO AMY JURAVICH FOR A QUICK QUESTION FROM THE AUDIENCE.

LET'S SEE IF WE CAN SQUEEZE ONE IN.

>> WE HAVE A QUESTION FROM CHRIS WEDDINGTON WHO WANTS TO KNOW, IN A FAMILY WITH MULTIPLE CHILDREN, HOW CAN SOMEONE WHO LIVES FURTHER AWAY FROM THEIR PARENTS BEST SUPPORT WITH CARE?

>> A CARE PLAN.

I REFER TO THEM AS CARE JOURNEYS.

YOU KNOW, WHO ALL IN THE FAMILY OR ADJACENT TO THE FAMILY, WHETHER THEY'RE A FRIEND, FAMILY MEMBER, YOU KNOW, EXES BECAUSE THEY CAN CONTRIBUTE, TOO, DON'T LEAVE THEM OUT.

DEVELOP A CARE PLAN.

IDENTIFY WHAT THAT CARE LOOKS LIKE AND WHO CAN DO WHAT, ALMOST LIKE YOU USE THAT FOOTBALL TEAM ANALOGY.

LIKE WHO'S GOING TO BE THE QUARTERBACK.

BUT ALSO, GET CONNECTED TO THE HEALTH CARE PROFESSIONALS AS A PERSON THAT IS ABLE TO SPEAK ON BEHALF OF YOUR SENIOR SO THAT YOU CAN HELP GUIDE THAT CARE.

THERE'S ALSO SOME TECHNOLOGY OUT THERE THAT WILL ALLOW YOU TO MONITOR WHAT'S HAPPENING, WHETHER IT BE MAKING SURE THAT THEY TAKE THEIR MEDICINE ON TIME, LIKE THERE'S TECHNOLOGY THAT WILL TELL YOU, HEY, THAT MEDICINE DISPENSER WASN'T ACTIVATED TODAY, SO THAT YOU CAN, FROM LONG DISTANCE, CHECK IN.

THERE'S ALSO DEPENDING ON WHAT THAT CARE REQUIRES, THERE'S ALSO SOME TECHNOLOGY THAT WILL ALLOW YOU TO TRACK YOUR OLDER ADULT, AND MAKE SURE THAT THEY'RE NOT, YOU KNOW, VEERING OFF TOO FAR FROM HOME OR ANYTHING LIKE THAT.

SO THERE'S --IT'S A CARE PLAN.

THERE ARE AGENCIES THAT WILL SIT DOWN WITH YOU AND HELP YOU DEVELOP WHAT THAT CARE PLAN LOOKS LIKE.

>> SO AS WE INDIVIDUALLY PREPARE FOR THE CAREGIVING PHASES OF OUR LIVES AND THOSE OF OUR LOVED ONES, WE WONDER WHETHER THE SYSTEM, EVEN THE LARGER SOCIETY, IS PREPARED.

AND MANY FEAR IT IS NOT.

>> WE KNOW THAT BY 2050 WE WILL NEED A 225% INCREASE IN OUR HEALTH CARE WORK FORCE IN ORDER TO MEET THE DEMANDS OF DEMENTIA.

AND WE KNOW THAT WON'T HAPPEN.

WE'RE NOT SEEING AN INCREASE IN THE WORK FORCE LIKE WE WILL NEED TO MEET THAT DEMAND.

AND SO WHEN YOU THINK ABOUT THE CURRENT STATE OF CAREGIVING IN OHIO AND THE PRESSURE THAT THAT WILL PLACE ON OUR INFORMAL CAREGIVING INFRASTRUCTURE BY THE TIME 2050 GETS HERE, WE REALLY ARE IN DESPERATE NEED OF THOSE POLICIES AND APPROACHES TO SUPPORT FAMILY CAREGIVERS THAT ARE ALSO WORKING.

>> A SHORTAGE OF CAREGIVERS IS ONE CHALLENGE ALONG WITH RISING COSTS, LARGER TAX BURDENS.

DR. GURE, LET'S TALK ABOUT THE LARGER ATTITUDES THAT SHAPE OUR APPROACH TO POLICY AND MAKING IN THIS REGARD I GUESS.

EARLIER I MENTIONED THAT THE NUMBER OF PEOPLE OLDER THAN 80 WILL DOUBLE BY 2030.

ARE WE EVEN CLOSE TO KEEPING UP WITH THAT AT A POLICY LEVEL?

ARE WE THINKING --ARE THEY THINKING ABOUT THAT SOME WE HEAR HER SAY THAT, IS ANYBODY DOING ANYTHING ABOUT THAT LOOMING SHORTAGE?

>> I WANT TO TRY TO WALK A FINE LINE HERE.

YOU ASKED THE QUESTION, THOUGH, SO I THINK WHAT I WILL SAY IS THAT WE ARE NOT GOING IN THE RIGHT DIRECTION WITH OUR HEALTH CARE POLICY RELATED TO THE ENTITLEMENTS AND CARE THAT OUR OLDER ADULTS WILL NEED.

AND WE HAVE TO MAKE DECISIONS AS INDIVIDUALS IN A SOCIETY ON THE TYPES OF ELECTED OFFICIALS WE WILL CHOOSE TO REPRESENT US AND THAT THEY ALIGN WITH THE POLICIES THAT WE CARE ABOUT AS CAREGIVES, AS HEALTH CARE PROVIDERS, AS PEOPLE WHO WORK IN HEALTH CARE.

SO THAT IS THE CRITICAL QUESTION.

HOW WILL WE MOVE FORWARD IN THE WAY THAT WE MAKE THE CHOICES ABOUT WHO ARE OUR ELECTED OFFICIALS BECAUSE THIS HAS A DIRECT IMPACT ON THIS VERY ISSUE THAT WE'RE TALKING ABOUT TODAY.

YOU -- I THINK EVERYBODY KNOWS WHAT'S HAPPENING IN THE NEWS RIGHT NOW AND WHAT THE POTENTIAL IS FOR MEDICAID CUTS, MEDICARE CUTS POTENTIALLY, EVEN CHANGES IN ENTITLEMENTS WITH SOCIAL SECURITY.

THAT IS A REAL HEAVY BURDEN THAT'S GOING TO BE PUT ON CAREGIVERS AND HEALTH CARE PROFESSIONALS, TRYING TO MANAGE THE GAPS IN CARE THAT EXISTS.

>> IF ALL OF THAT OTHER STUFF WASN'T GOING ON RIGHT NOW AND WE JUST WENT WITH A BASELINE FROM FIVE YEARS AGO, WHAT KINDS OF POLICIES BESIDE SPENDING MORE MONEY AND FULLY FUNDING THINGS, IS THERE A WAY TO APPROACH THESE CHALLENGES, SOMETHING WE COULD DO AT A POLICY LEVEL?

>> IMPROVE SUPPORT FOR IN-HOME CARE.

>> OKAY.

>> WHICH IMPROVES ACCESS TO SERVICES TO HELP PEOPLE STAY IN THEIR HOME.

SO THAT LOOKS LIKE HAVING COMPANION CARE, HAVING NURSING CARE, HAVING ADDITIONAL HOUSEHOLD KINDS OF SUPPORT WHEN NEEDED.

THAT MEANS SUPPORTING TELEMEDICINE SO THAT PEOPLE TONIGHT HAVE TO GET OUT --DON'T HAVE TO GET OUT OF THEIR HOMES AT INOPPORTUNE TIMES OR IF THEY'RE HOMEBOUND, THAT MEANS HAVING POLICY AND PAYMENT SCHEMAS THAT ALLOW FOR PHYSICIAN HEALTH CARE PROVIDERS TO DO HOME-BASED CARE.

THAT MEANS ALSO SUPPORTING QUALITY AND THE RESEARCH THAT'S NEEDED TO SUPPORT OLDER ADULTS AS THEY'RE AGEING WITH DEMENTIA, WITH OTHER MEDICAL CONDITIONS.

>> I WOULD ADD THAT THE WORK FORCE NEEDS TO LIKE TAKE A CLOSE LOOK AT POLICY, AS WELL.

AND BEING --DEVELOPING POLICY THAT ALLOWS YOU TO BE A CAREGIVER BUT ALSO KEEP YOUR JOB.

YOU KNOW, FMLA CAN ONLY GO SO FAR.

>> FAMILY MEDICAL LEAVE.

>> YEAH.

AND SO WHEN YOU THINK ABOUT ALL OF THE NUANCES OF CAREGIVING, YOU MAY JUST NEED TO HAVE THAT MOMENT, BUT IT'S NOT NECESSARILY FMLA RELATED.

LIKE WE REALLY NEED THINK ABOUT HOW OUR FLEXIBLE POLICIES CAN BE IMPLEMENTED TO ALLOW CAREGIVERS TO STAY IN THAT SPACE OF CAREGIVING BUT MAINTAINING THEIR EMPLOYMENT.

>> MICHELLE, WHAT DO YOU THINK?

I MEAN, FROM WHERE YOU SIT, WHAT WOULD YOU LIKE POLICY CHANGES YOU WOULD LIKE TO SEE THAT YOU THINK WOULD HELP?

>> I THINK MORE RECOGNITION BECAUSE I THINK, YOU KNOW, AS WE'RE TALKING TODAY AND TRYING TO MAKE EVERYBODY AWARE OF IT, I THINK A LOT OF WORKPLACES, YOU THINK ABOUT KIDS, BUT I THINK A LOT OF PEOPLE JUST DON'T SEEM TO KNOW HOW TO EVEN SPEAK WHEN I SAY, YOU KNOW, CARING FOR MY 85-YEAR-OLD MOM, TAKING CARE OF MY DAD, I THINK IT'S NOT COMMON THAT'S TALKED ABOUT IN THE WORKPLACE.

I DO THINK IF THERE WERE SOME TYPE OF POLICIES TO SAY, YOU KNOW, LIKE SHE --NOT NECESSARILY FMLA, BUT SOME TYPE OF POLICY LIKE IF YOU'RE CAREGIVING AND SOME X HAPPENS THAT YOU'RE ALLOWED X AMOUNT OF TIME OFF, WITHOUT FEELING LIKE TOILET ABOUT -- GUILTY ABOUT IT OR STRESSED IF IT HAPPENS.

ME.

WANT TO DO A JOB WELL, THEY JUST WANT GUIDANCE AND SUPPORT.

IF YOU SUPPORT PEOPLE IN THE WORKPLACE, THEY'RE GOING TO DO EVEN AN BETTER JOB.

IF THEY FEEL LIKE THEY CAN STILL PROVIDE CARE TO THEIR PARENTS BUT ALSO KEEP THEIR JOB IT WILL MAKE EVERYTHING A LOT BETTER.

>> AND YET I THINK YOU SAID SOMETHING ABOUT GOING IN THE WRONG DIRECTION.

I WAS TALKING TO SOMEBODY TODAY WHO SAID THEIR DAUGHTER-IN-LAW IS PREGNANT, AND THE MATERNITY LEAVE BENEFITS WERE ELIMINATED AT HER WORKPLACE BECAUSE THEY COULDN'T AFFORD TO DO IT ANYMORE.

THAT'S GOING BACKWARDS.

I KNOW IT'S NOT AN AGING ISSUE.

>> RIGHT.

>> BUT IT'S THAT SORT OF THING.

>> THAT'S RIGHT.

I'M INTERESTED, TOO, IN THE --WENT THROUGH THIS PANDEMIC, BUT IT REALLY DID BRING --IT BURNED OUT A LOT OF PEOPLE IN THE BUSINESS OF CAREGIVING.

BUT IT ALSO INTRODUCED SOME TECHNOLOGY.

AND THESE REMOTE, YOU KNOW, BEING ABLE TO SEE PEOPLE REMOTELY, THE TELEMEDICINE HAS GOT TO BE A BIG GAME CHANGER IN SOME WAYS, RIGHT?

>> OH, YEAH.

I MEAN, IT'S AN IMPORTANT COMPLEMENT TO THE WORK THAT WE DO.

I MEAN OBVIOUSLY IT'S NOT A NEW TECHNOLOGY.

IT WAS BEING UTILIZED IN THE VA FOR PEOPLE HERE THAT RECEIVE VA BENEFITS OR GET CARE AT THE VA OR HAVE LOVED ONES THAT GO THERE.

VA USES HAS BEEN USED IN TELEMEDICINE SERVICES FOR A LONG TIME.

AND THERE ARE CERTAIN NICHE KINDS OF CLINICAL PROGRAMS WHERE TELEMEDICINE'S USED PARTICULARLY FOR ACCESS TO IM-- IMPROVING ACCESS TO REMOTE, RURAL AREAS.

SO THAT HAS BEEN AROUND FOR DECADES.

BUT IT REALLY SPEEDED DURING THE PANDEMIC BECAUSE OF THIS CONCERN AROUND ACCESS AND OBVIOUSLY ALL THE, YOU KNOW, REALLY DIFFICULT THINGS THAT WE HAD TO DEAL WITH WITH ISOLATION AND PEOPLE NOT BEING ABLE TO GET OUT AND MAYBE NOT TAKING AS GOOD CARE OF THEMSELVES, GETTING COVID, FOR EXAMPLE, AND GETTING TREATMENT WHILE AT HOME.

THERE WERE REAL THINGS GOING ON.

AND ONE OF THE DELIGHTS HAS BEEN THAT EVEN AS COVID HAS KIND OF RECEDED, THAT THERE'S STILL BEEN A LOT OF ADOPTION TO VIDEO PHONES AND SMARTPHONES AND OTHER KINDS OF TECHNOLOGY.

SO YOU KNOW, I'LL ASK, YOU KNOW, DO YOU HAVE A SMARTPHONE, AND MANY TIMES MY OLDER PATIENTS SAY, YES, I DO.

YOU KNOW, SHOW ME THEIR PHONE OR WHATEVER.

YOU KNOW, I THINK THAT THERE'S --I THINK THAT OPPORTUNITY FOR HAVING MORE OF A DIRECT RELATIONSHIP WITH THE PATIENTS THROUGH VIRTUAL CONNECTIONS IS HELPFUL.

AND LIKE I SAID IT REALLY DOES AUGMENT THE OPPORTUNITIES TO TALK WITH THE FAMILY, COMMUNICATE AS YOUR QUESTIONER ASKED ABOUT HOW TO DEAL WITH THE LONG DISTANCE BIT.

I THINK THAT'S PART OF THE QUESTION THAT WAS COMING UP USING THE TECHNOLOGY FOR THOSE KINDS OF THINGS CAN HELP TO BUILD ALIGNMENT WITHIN CARE.

AND WE ALSO USE A LOT OF CONSULTATIVE BASED PRACTICES FOR OTHER SPECIALTIES.

THERE'S A LOT OF WHAT WE CALL E-CONSULTS AND THINGS THAT CAN BE DONE THAT DON'T REQUIRE A DIRECT CLINIC VISIT.

IT'S REALLY CHANGED THE WAY THAT WE THINK ABOUT AN ENCOUNTER.

>> OKAY.

>> WITH A PATIENT.

>> LET'S GO TO AMY JURAVICH WITH A QUESTION FROM OUR AUDIENCE.

>> AND WE HAVE A QUESTION FROM CHRIS COE.

HE ASKED THIS ON FACEBOOK.

IT'S KIND OF POLICY ADJACENT.

HE SAYS THAT HE DOES NOT LIVE IN FRANKLIN COUNTY, HE LIVES IN MURROW COUNTY, A RURAL COUNTY, AND HE'S SAYING THAT MORE COUNTIES IN OHIO ARE RURAL THAN URBAN.

SO HE IS WONDERING WHAT SERVICES THERE ARE FOR THE MORE RURAL COUNTIES, AND HOW CAN WE HAVE MORE?

>> THE AREA OFFICE ON AGEING IS NATIONWIDE.

THEY'RE DIVIDED INTO REGIONS, SO THERE IS AN OAA THAT SERVICES THAT RURAL COUNTY WHERE HE IS.

I WOULD ENCOURAGE HIM TO LOOK INTO THE OAA.

THEY ARE FEDERALLY FUNDED MOSTLY, AND SO ALL OF THE PROGRAMS THAT I TALK ABOUT, MOST OF THOSE OAAs HAVE THEM, AS WELL.

>> I GUESS I COULD ASK A FOLLOWUP QUESTION.

I CAN ASK A FOLLOWUP QUESTION RELATED TO THAT.

JOE IN OUR AUDIENCE WAS ASKING HOW DO WE PREPARE TO STILL HELP OUR PARENTS IF GOVERNMENT PROGRAMS ARE CUT?

>> IT'S GOING TO BE A CHALLENGE.

>> GOOD QUESTION.

>> YOU MENTIONED THE PANDEMIC, AND ONE OF THE THINGS THAT ALSO HAPPENED DURING THE PANDEMIC IS MORE FAMILIES REALIZED THEY NEEDED TO LIVE TOGETHER.

SO MUCH SO THAT YOU SEE DEVELOPERS BUILDING WHAT THEY'RE CALLING MULTIGENERATIONAL HOMES.

SO I BELIEVE THAT YOU'RE GOING TO SEE A SHIFT WHERE EVERY INDUSTRY REALIZES THAT AGING IS NOT SOMETHING THAT SHOULD BE A LINE ITEM OR A SENTENCE IN A CONVERSATION.

THAT IT REALLY NEEDS TO BE BROUGHT TO THE FOREFRONT BECAUSE AGING TOUCHES EVERY ASPECTS OF OUR LIVES.

AND SO YOU'RE GOING TO SEE MORE OF THESE SHIFTS WHERE PEOPLE ARE GOING BACK TO --THAT OLD SCHOOL WAY OF PUTTING ALL OF THEIR RESOURCES TOGETHER TO MAKE SURE THAT THAT OLDER ADULT CAN AGE IN PLACE, AND THAT THE FAMILY MEMBERS ARE ABLE TO PROVIDE THAT CARE AND, YOU KNOW, NOT BE AS COSTLY AS IT WOULD BE IF EVERYBODY WAS STILL SPREAD OUT IN MULTIPLE PLACES.

>> DO YOU SEE A LOT OF PATIENTS FROM RURAL AREAS?

IS THAT PARTS OF -- PARTS OF YOUR PRACTICE?

HAD.

>> YEAH.

MORROW COUNTY RINGS A BELL.

WE HAVE PEOPLE FURTHER OUT.

GOING BACK TO TELEMEDICINE, I TEND TO USE THAT A LOT WITH MY PATIENTS COMING FROM A FURTHER DISTANCE.

NOT TOO FAR.

IT BECOMES A LITTLE BIT DIFFICULT IF IT'S MORE THAN AN HOUR'S DRIVE IN.

SO I UNDERSTAND THE CHALLENGES THERE.

AS GERIATRICIANS, WE HAVE CARE THAT WE DO.

THERE'S AN OPPORTUNITY FOR COMING FOR AN EVALUATION, AND WE TRY TO PROVIDE THE INFORMATION FOR THEIR PRIMARY PROVIDER TEAM MORE LOCALLY TO DO THE CARE.

SO IT'S FEASIBLE IN SOME INSTANCES, BUT IT'S VERY HARD TO HAVE CONTINUITY.

>> BUT WE'RE IN A PERIOD OF --RUNNING OUT OF TIME --WHERE THERE'S A CONTRACTION OF SERVICES IN RURAL AREAS.

HOSPITALS ARE SHUTTING DOWN AND THAT KIND OF THING.

THERE'S A LOT MORE PRESSURE ON THE URBAN AREAS TO PROVIDE THOSE SERVICES.

YEAH.

>> EXACTLY.

AND IMAGINE WHAT IT'S LIKE BEING HEALTH CARE PROVIDER IN A DESERT LIKE THAT.

GOT TO BE EXTREMELY DIFFICULT.

YOU'RE DOING THE RIGHT THING, BUT YET YOU DON'T HAVE ALL OF THE SUPPORT.

SO YEAH.

>> BEFORE WE CLOSE, LET'S HAVE EACH OF OUR PANELISTS SHARE A QUICK FINAL THOUGHT WITH OUR AUDIENCE.

CHANDO WINGO?

>> YES, MY FINAL THOUGHT, ONE OF THE THINGS THAT I WANT TO ENCOURAGE PEOPLE TO CONSIDER IS OFTENTIMES CAREGIVERS DON'T RECOGNIZE THAT THEY'RE A CAREGIVER.

AND THE FIRST STEP IS IDENTIFYING THAT.

SO IF YOU CALL YOUR PARENT OR OLDER ADULT TO CHECK ON THEM, YOU'RE CAREGIVING.

IF YOU ARE TAKING THEM TO THEIR DOCTOR'S APPOINTMENT OR GROCERY STORE, YOU'RE CAREGIVING.

IF YOU ARE TALKING TO THEM ABOUT THE FUTURE AND FINANCIAL PLANNING AND WHAT THEIR WISHES ARE, THOSE ARE THE EARLY STAGES OF CAREGIVING.

AND THE REASON THAT THAT'S IMPORTANT IS YOU NEED TO IDENTIFY YOURSELF AS A CAREGIVER SO WHEN YOU SEE RESOURCES YOU KNOW THAT WE'RE TALKING TO YOU.

SO THE FOREMOST, IDENTIFY YOURSELF AS A CAREGIVER, AND TAKE ADVANTAGE OF THOSE RESOURCES THAT ARE OUT THERE.

>> AND DR. TANYA GURE?

>> I DIDN'T REALIZE THE TIME WAS UP.

I ENJOYED THE CONVERSATION VERY MUCH.

I THINK THE ONE THING I WILL STRESS IS THAT FOR ANY OF YOU CAREGIVERS OUT THERE, THAT YOU THINK ABOUT YOUR HEALTH CARE PROVIDERS AS BEING PART OF YOUR TEAM.

AND THAT YOU UTILIZE VISITS TO REALLY GET EDUCATED, GET AWARE, DEVELOP A GREATER, DEEPER UNDERSTANDING, AND THAT YOU FEEL A SENSE OF ADVOCACY IN WHAT YOU'RE DOING.

AND WE APPRECIATE YOU, AS I SAY, YOU'RE A VITAL PART OF THE HEALTH CARE TEAM NO MATTER WHERE YOU ARE WITH YOUR LOVED ONE.

SO I WILL LEAVE IT AT THAT.

>> OKAY.

AND MICHELLE MESSER?

>> SO I WOULD JUST SAY THAT DON'T EVER GET SHY ABOUT TALKING TO PEOPLE BECAUSE IT WAS THROUGH TALKING TO EVERYONE AND ANYONE THAT I CAME ACROSS.

EMAILING, CALLING, CHURCH, THE GROCERY STORE, SPEAKING OUT, WHAT YOUR SITUATION IS, WHAT YOU NEED HELP WITH.

BECAUSE YOU NEVER KNOW WHO YOU'RE GOING TO RUN INTO.

AND FRANKLY, I FEEL LIKE SOME PEOPLE I'VE RUN INTO WERE ANGELS.

SO YOU HAVE TO JUST BE TRANSPARENT AND TALK TO AS MANY PEOPLE AS YOU CAN AND DO NOT FORGET TO TAKE CARE OF YOURSELF.

AND EVEN IF THAT'S JUST A TEN-MINUTE WALK, DO IT.

EVEN IF IT'S LIKE 10 OR 15 MINUTES, I RECOMMEND TAKING WHATEVER TIME YOU CAN FOR YOURSELF IN LITTLE INCREMENTS, BABY STEPS ALONG THE WAY.

>> DO ANY OF YOU SEE A CHANCE THAT THERE WILL BE SOME KIND OF SOCIETAL SHIFT, WE'LL COME TOGETHER MORE, WILL BE MORE HELPFUL TO EACH OTHER?

>> OH, WE'RE TRYING TO DO AT THE OFFICE ON AGING THOSE TYPES OF INITIATIVES.

AND THIS YEAR WE'RE GOING TO START A NEW PROJECT WHERE WE'RE NAMING IT THE AGING BLUEPRINT WHERE WE DO THIS LANDSCAPE ASSESSMENT OF EDUCATING AND PUTTING THIS INFORMATION OUT INTO THE COMMUNITY FROM WHATEVER INDUSTRY THAT YOU ARE.

BUT ALSO ENCOURAGING PEOPLE TO DO JUST THAT.

SO ON VALENTINE'S DAY WE DID AN INITIATIVE WITH ACTS OF KINDNESS.

BUT IT WAS OUR FIRST PUSH TO SAY, HEY, WE NEED EVERYBODY IN THE COMMUNITY TO PAY ATTENTION TO OUR AGING RESIDENTS AND DO WHAT YOU CAN FROM WHERE YOU ARE.

>> THAT WILL DO IT FOR "INSIDE CAREGIVING. "

WE KNOW WE HAVE NOT ANSWERED EVERY QUESTION WHEN IT COMES TO THIS VERY COMPLEX TOPIC.

BUT HOPEFULLY WE HAVE GOT YOU THINKING, PROVIDED IMPORTANT INFORMATION, AND POINTED OUT SOME USEFUL RESOURCES.

AND MOST OF ALL, WE HOPE YOU KNOW THAT YOU ARE NOT ALONE.

I THANK OUR PANEL, OUR WOSU CREW, AND OUR AUDIENCE HERE IN THE ROSS COMMUNITY STUDIO.

AND I THANK YOU FOR WATCHING.

I'M ANN FISHER.

GOOD NIGHT.

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> >> FOR MORE INFORMATION AND RESOURCES "INSIDE CAREGIVING" GO TO WOSU.

ORG/INSIGHT.

>> PRODUCTION SUPPORT FOR "INSIDE CAREGIVING" IS POWERED BY THE STORYTELLERS TRUST.

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