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What’s up? Welcome. It’s Gerry. Thank you for listening. Thank you for subscribing to the Art of Wellness podcast.

I have a lot of things I wanna get off my chest today. There’s three things I wanna accomplish with this solo podcast. It’s just me today. No no buddies, no friends. So the three things I wanna talk about is, first, I wanna introduce myself a little bit more, my background in physical therapy, my journey to the profession, all that stuff.

Secondly, I wanna talk about the podcast itself, my goals, my objectives with this podcast, and my overall vision for it. And then third, since it’s my favorite thing to talk about is is back pain. And last episode with Danny, we kinda talked about it a little bit. And I wanna get more in-depth on more statistics for back pain, some treatments for back pain, and some pretty big misconceptions that I still hear about back pain, in health care in terms of structural things and and pain and how they relate to each other, all that stuff. So introduce myself, talk about the podcast, and then we’ll get into some back pain, research and misconceptions.

So let’s have some fun. So a little bit about me is I have my bachelor’s in exercise science, and I have my doctorate degree in physical therapy from the University of Iowa, which you can see back here. I have my bachelor’s from North Central College in Naperville, Illinois. And I wanna kinda tell you guys my story about working in corporate health care and then transitioning into having my own practice. It’s a long story, but I’ll do my best to kinda keep it succinct for you guys.

So after I took the board’s exam after physical therapy school, I worked in, let’s say, the usual corporate outpatient physical therapy clinic or the mill clinic as we call it. It’s kind of a joke within physical therapists. And, you know, it was fine for a first job. I remember working there and, you know, it was great. You learn super fast.

You see all these different diagnoses really quickly, and you learn to think on your feet. And that was great. That was awesome. But along with that is all the corporate structure and insurance, pardon my French, bullshit that comes along with it. So that’s where I kind of started to not like it as much.

And I was there for about three or four years, and it started to wear on me a little bit. The first year was fine. Second year was fine. Third and fourth year, I was like, okay. This is getting a little ridiculous when it comes to how insurance plays a big part in health care.

And, you know, I remember how stressed I was, how how much of a burden it became working in an environment where I have to treat three or four patients at a time, where I have to play the insurance game with these big companies that all they care about is money. And eventually, I was like, okay. Like, I left. I quit. And it was the best decision I ever made.

So I started doing my own thing. I left that that job, and the whole clinic was fine. I remember, like, you know, working with the people there was fine. They’re all great therapists. But, again, the corporate hierarchy was what I was not cool with.

And also the insurance games that we played. So I decided to disconnect from that, and I did. So I remember I started treating people out of my garage. I remember I would also do mobile visits to people’s houses. So I did that for about a year, I would say.

I did combination of the two. So people would come to my garage. I had my treatment table set up. I had a little bit of exercise equipment. And then also, I would drive to their houses with my treatment table and my exercise equipment and my backpack.

And I also started working at the hospital by me and as a PRN physical therapist. So, like, an as needed physical therapist. I would go there on weekends whenever they needed me. And to me, that gave me much more freedom to kinda treat the way I wanted to treat patients. So I did that for a year, a year and a half, and then eventually got my own space that I’m renting out now in Naperville.

And, you know, a a big part of this podcast I wanna talk about or kind of share with you guys is a different side of health care, a more individualized personal style of health care, which I think people appreciate more. And I think they overall want that more out of our health care system because, you know, people one of the big gripes I see in health care or when, you know, patients are talking about the current health care system is they don’t get enough time with their provider, whether it’s their primary care doctor, their physical therapist, anybody really. All I hear is I was I saw him for ten minutes and then they left, and that was it. So and I hated that. And I know people hate that.

And I know the PTs that I used to work with are burnt out. They don’t like working in those clinics. Nobody does. I’ve never seen anybody really say I love working for this company, this physical therapy company. Excuse me.

And, you know, I wanna I wanna change that. At least give you guys a different perspective when it comes to to physical therapy and health care. So my practice is called Art of PT Sports Physical Therapy. It’s it’s all private. It’s all one on one.

It’s all cash based. No insurance. None of that stuff that, you know, we all hate about health care, and it helped me a lot. I remember I, you know, I would hate seeing multiple patients at a time. Now I just see one person at a time.

You know, I just the way I’m talking to you right now is how the usual treatment session goes is I would just or right now, all I do is we talk and we get to work, and it’s for an hour, hour fifteen minutes. I’m not seeing people for twenty, thirty minutes and then seeing somebody else turning my back to them because, you know, I didn’t like that. That wasn’t cool to them, and it wasn’t cool to me. So, you know, I’m trying to make a give you guys a different perspective when it comes to physical therapy. Health care in general, really, because, again, it should be personalized.

It should be individualized to the patient, and I think people appreciate that. I could see it in their faces when I’m with them, helping them that, you know, I get to know them more. I get to build more trust with them. They get to know me more. I get to know them more, and it’s a reciprocal relationship that benefits both parties.

So, and it’s honestly one of my, you know, primary goals with my practices again to show people that this is how health care should be. So that’s why I chose to disconnect from the, you know, the usual physical therapy clinic and start my own. And it’s the best decision I ever made. So, that’s why I went from insurance based to cash based, to more personalized therapy and health care. So, but yeah.

Enough about me. The podcast itself is called Art of Wellness, which is a play off of obviously my practice called Art of PT. You know, wellness is a very broad term. Right? It’s, you know, a lot of people in the podcast spaces, it’s there’s wellness, there’s longevity, there’s biohacking.

There’s so many different ways to talk about health and wellness. But, you know, my objectives with this podcast is to talk about wellness and more so different professions within the wellness industry. You know, I’m physical therapy. That’s a big section of wellness. We get people out of pain without surgeries and pills and injections.

We’re the more conservative pain management. Right? But I wanna have conversations with people who are, you know, that do other that are in if different areas of wellness. So people in wellness and fitness, you know, my love is also fitness. So people that are, you know, within the mental health space, within strength and conditioning, fitness spaces, pharmacists, other physical therapists, more specialized physical therapists, people that can that we could have conversations with that’ll help hopefully benefit you guys when it comes to your health and wellness.

And I think it’s, you know, it’s how I operate my practice is I wanna have a team aspect to help the patient or the client. I have people that I trust that I can text if I need something else from them. Right? Or I need to saw a different set of eyes to look at them. You know?

Surgeons, trainers that I trust, people in different health care fields that I I trust to take another look at this person that I’m trying to help. Or maybe they have a different scope that they could provide to this patient to help them along their wellness journey. So, yeah, I mean, wellness, again, I know it’s it’s a very broad term, but I’m gonna do my best to stay within my lane of physical therapy when it comes to talking to different people and, you know, do my best to inject physical therapy within the conversation in terms of, you know, pain management and rehab, sports therapy, things like that. So it’s gonna be fun talking to different people. So stay tuned to different conversations that I have with these, you know, different professionals.

So and, again, you know, this is my lane. It’s just physical therapy. I’m not trying to be an expert in everything. I’m an expert in rehab, pain, and and injury. So I’ll do my best to stay within just the physical therapy realm.

And, again, if you don’t know, like, us physical therapists, we’re on the front lines of pain. If somebody has pain and they don’t need surgery, injections, or pills, you know, where do they go? What do they do? They come see us. We’re the ones prescribing exercises.

We’re the literal exercises, medicine, health care profession. We prescribe I prescribe exercises and rehab movements to people in pain. That’s our pill to them is to help them get better through movement and exercises. So, you know, a big tagline again in health care is movement is medicine, exercise is medicine. Well, we’re the ones actually doing that.

I’m with people every day showing them exercises, progressions to exercises, rehab movements. I’m doing it with them every day to help them get better and get better, you know, with back pain, knee pain, ankle pain, neck pain. You know, I don’t care what it is. If there’s nothing really crazy serious going on that requires surgery or an injection or some sort of medication, you know, that’s that’s our wheelhouse as PTs. So that’s my mission overall with the podcast is to, again, have conversations with people and to, you know, obviously, inject my own physical therapy perspectives into each each conversation that I have.

So, anyways, that’s the podcast, and that’s a little bit about myself. If you have any questions on any of that stuff, how I how I left my job, how I operate my clinic, my my practice, you know, if you’re a PT student kind of trying to navigate your way through the the health care system or, prospective jobs that you may have. You guys can all just DM me on Instagram at a p t doctor g. Just send me a a message. I’ll I’ll get back to you.

I’m fairly active on there, so you guys can just, you know, message me with any questions you have. Or if you have any pain or injury and you don’t know where to go, I could hopefully give you an online consult or point you in the right direction. So but, yeah, those are the two main things from in the beginning I wanna talk about. And then I wanna talk about more more about back pain because the last podcast with Danny was research heavy on back pain. And back pain, pie by far, is the one thing I see the most.

I mean, everybody gets back pain. It’s it’s crazy the the range of people I’ve seen with back pain. I’ve seen 12 year olds with back pain. I’ve seen, obviously, the middle aged person with back pain and then up to 60, 70 year olds with with crazy back pain. It’s so prominent in today’s health care system.

It’s it’s everywhere. And I don’t think it gets discussed enough when it comes to these health and wellness podcasts. I’ve had back pain, and I see people every day with back pain. So it’s it’s near and dear to my heart in a way, talking about back pain and misconceptions and myths and stats. So, the important thing to remember when it comes to pain in general is it’s all subjective.

Right? Pain is is not just structural. Pain is the definition of it is it’s a subjective experience that anybody can have. Right? It’s not just tissue damage.

It’s stress can amplify it. It’s your sleep can amplify it. It’s your diet amplifies it. So remember, you know, these treatment options that I’ll give later in the podcast, you know, the main thing to remember is to get a a thorough assessment by your physical therapist first before trying anything you see online and in these social media posts that, you know, that say top three things to do with back pain or top five exercises for back pain, you know, you can’t just paint pain with broad strokes like that. It takes a thorough assessment and teamwork with your physical therapist to to get out of pain.

You know, getting out of pain is a process. I don’t care what kind of pain it is. If it’s, you know, mental trauma or physical trauma, your body needs time to process and heal. And it’s the same thing when it comes to pain, chronic pain, any pain, really. So keep that in mind.

It’s subjective. And remember to talk to your physical therapist and get an assessment first before anything because it’s all individual. I mean, I see it every day. What works for somebody with crazy back pain will not work for this person with crazy back pain or or maybe they have minimal back pain and, you know, trying this exercise that I thought was really light just irritates the heck out of them. So it depends is the answer in health care.

There’s no one size fit all fits all protocols that, you know, people like to throw out there in in in social media posts or in, Instagram reels, TikToks. You know? Do this for your back pain. Do this for your knee pain. Sometimes if you try that, it might just irritate it more because, you know, you don’t know what’s the best for your pain yet.

You know, you need an assessment first, a thorough assessment. So be sure to do that first. You know, also if you know, with with back pain, as PTs, we look for what’s called, like, red flag signs of back pain. So, you know, signs of tumors, fractures, serious neurological deficits, things like that. If you don’t have any of those red flags and I don’t wanna just list them out here.

I’ll you know, it’ll take a while, but, you know, we’re we’re trained to spot those out. If you have no red flags when it comes to back pain, your pain can be rehabbed. In other words, you don’t need crazy intervention. You don’t need a surgery. You don’t need a a pill.

You don’t need a injection. So your provider should send you to a physical therapist, and hopefully, they do. I still know some people, primary cares people, other health care people that don’t send people to physical therapy, and the patient has no idea what to do. They have back pain. They get an MRI or something, and the specialist is like, oh, you don’t need surgery.

You don’t need an injection, really. If you wanna try it, we can. And that’s it. And then the patient leaves, and they don’t even say, hey. Try physical therapy.

Obviously, the good specialists I know do send them to PT, and those are the ones that I talk to because, again, if you don’t need those crazy interventions, you need physical therapy. No red flags. Nothing crazy going on. Well, everything’s in our hands now, us and the patient. So keep that in mind.

No red flags. It can be rehabbed. So alright. Some misconceptions that I love hearing when it comes to back pain. Alright.

These are these are fun. So I have I wrote down four kinda stats and misconceptions about back pain. The first one is there’s no realignment when it comes to your spine. If someone says it can move your bones back into place or realign your pelvis, spine, whatever, they’re lying to you. There’s no real research that backs that up.

In other words, it’s just marketing. And my issue with that is you know, I do that. We do as PTs, we do spinal manipulations that could crack your back. Whatever. People love it.

I get it. It feels good. But that’s the point. It just feels good. It’s just like cracking your knuckles.

I could crack them right now. Crack my wrist. It feels good. The joint in the in the the gas in the joint is just released. There’s a neurophysiological effect in the joint that relaxes the muscles around the area.

There’s local pain relief chemicals that get released in the area. Same thing in your spine. That’s it. Someone pops your back, it feels good. It’s short term relief.

That’s it. No one’s moving no one’s moving your vertebrae. If it’s over here, they can’t just move it back into place. It’s you know, give the human body a little bit more credit than that. You know?

There’s you need much more force than someone just popping your back to put your vertebrae back into alignment. So keep that in mind. And, again, it’s more so the explanation of it that is what I have issues with. You can’t just say, I’m gonna put your spine back into place. You can say, and this is what is how I explain it to pay to patients, is it’s short term relief.

It feels good for a little bit for a short amount of time. Let’s use that window of pain relief to exercise, to strengthen it, to load your spine, to get better. That’s the long term relief is getting stronger and more durable and re reinforcing your spine. Cracking your back or someone massaging your back is not gonna make your back stronger. So keep that in mind.

Going along with that is don’t don’t be so worried about your, again, your alignment or how symmetrical your body is. We’re all asymmetrical in a way. You know, everything’s a little bit off. Your pelvis can be a little bit elevated. Your spine can be a little bit, you know, contorted this way.

There’s not good evidence showing that those things affect your pain as much as you think. So don’t be so into those things is what I’m trying to say. Like, if somebody says, well, you’re kind of out of alignment, is that the cause of your pain? Probably not. Pain, again, is so multifactorial.

It’s not just one thing that’s giving you massive pain, unless it’s a physical trauma thing. So, so keep that in mind. Also, more stats on back pain is some of my favorite stats on back pain, they just blow my mind, is over eighty percent of people will experience low back pain in their lifetime. That’s a huge amount of the population. Eighty percent of people will experience back pain within their lifetime.

And, again, you know, I’ve had back pain. I remember working at my old job and, you know, knowing what I know now, it’s it’s kinda funny thinking back on it. But I remember I I maybe you can relate to this, but I remember I twisted and I felt my back just give out. And then for a week or two, I couldn’t even bend over, and that was it. Like, I was done.

And, you know, again, thinking about pain now is I remember during that time in my life, there were so many other things going on. I was so stressed. I was underslept. I wasn’t working out as much as I could be. If anything, that was just kind of the straw that broke the camel’s back.

It was just me twisting. In other words, that was my body telling me to, hey. Stop. You’re burning the candle at both ends. So but, you know, that pain trigger started everything.

I had back pain for about a year, and I was so young. I was 28, 20 nine, and I had sciatica going down to my foot. It was crazy. And I was like, all of this just from twisting? Like, that’s nuts.

And I remember I went to go get an MRI, and the specialist that I knew, he was like, yeah. I mean, there’s a disc bulge there. You know? Again, disc bulge is not as scary as you think. Most people live with disc bulges with no pain, so keep that in mind too.

And he was like, yeah. I mean, you have a bulge there, but I don’t wanna operate on it. Like, I don’t wanna, you know, give you an injection. You’re too young for that. And I agreed as a PT.

Like, I knew that. In my mind, I was like, there’s probably nothing crazy going on, but let me just, you know, get an image just to see if I have a crazy herniation or something. And the funny thing is even if I did, there’s research showing that those bigger herniation actually resorb and get better faster than the littler ones. So it’s it’s weird how the human body works. But, yeah, so I had that pain for about a year.

And I remember, you know, obviously, I would be diligent with my exercises, getting my core stronger, you know, working out, all that stuff, my PT exercises that I gave myself. And, you know, it took a while. It was against a process to get out of pain. So, again, it took me about a year to get out of that. And I remember when I quit my job, the pain got even better.

Like, I wasn’t stressed anymore. It was like all that that burden of working in a crazy health care environment just went away. And along with that, my pain dissipated even more, and I haven’t had it in six years. I wonder why. Maybe because I’m less stressed, maybe because I’m sleeping better, maybe because I’m back to working out more, maybe because I’m doing what I love in a in a better way.

And I love physical therapy. I love doing it, like I said, in a more private way. So, back pain is not as scary as you think is what I’m trying to say. So and the next that I have written down here is over eighty percent of people with back pain, that back pain will go away on its own without with minimal treatment. So what this stat shows to me is that back pain, again, isn’t as scary as you think.

It may seem scary. Like, I remember when I did twist and my back just locked up and I had sciatica going down my leg, which is pins and needles, nerve pain shooting down my leg. There wasn’t really craze anything crazy going on. Again, they even MRI’d my back. There’s nothing horrible going on, but it feels like it.

And I get it. You know? I was afraid to bend over for, like, a few months. And but remember then again, it’s not as scary as you think. Even if you know, I’ve had people walk in with you know, they get an MRI first, and there’s nothing really there just like me.

And the pain is intense. And they walk in, you know, crying. The pain is so bad, and, you know, they’re limping. They can’t walk right. And then they’re like, hey, Jerry.

Like, why why is my pain so intense? There is nothing really in the MRI. Also, vice versa happens as well. You know? Maybe somebody has minimal back pain, just annoying two out of 10 back pain.

And then they’re like, you know what? Let me go get an MRI. They get an MRI and it’s a crazy disc herniation. It goes both ways. You know, pain is very all over the place.

So you can’t really trust an image on it too much. So keep that in mind. Again, I’m trying to say that back pain isn’t as scary as you think. So and going along with that is the the last that I have written down here is over eighty five to ninety percent of people with back pain, which is a insane number, we classify it as nonspecific back pain. Nonspecific low back pain.

And what does nonspecific mean? Nonspecific means there’s no real clear structural cause. Right? It’s nonspecific. There’s nothing there’s no tumor here.

There’s no crazy herniation. You just have crazy pain with no real structural cause. You know, there’s no fracture, no infection, no tumors, nothing like that. And people have this. You know?

Is there’s nothing real that you could point to that’s like, oh, this is the cause of your pain. Because, again, pain is multifactorial. It’s biopsychosocial. There’s so many things that that can amplify your pain or bring on pain. So it’s very weird how that works, but I see it all the time.

You know? Back pain is is everywhere. So remember just that back back pain isn’t always as structural. Back pain is a whole host of things that I’ll get into here in a second. But, don’t be so sure that, you know, you get an MRI.

You have really bad back pain. There’s nothing there. You know? It happens a lot. I see it all the time.

So just keep that in mind. It’s very common, and eighty five to ninety percent of the time, there’s no real clear structural cause. I know. Weird to think about, but that’s stats for you. Okay.

The last section I wanna talk about here is how we treat back pain as physical therapists. Again, you don’t need surgery. Let’s say you don’t need surgery, which I would argue a lot of times you don’t. You don’t need surgery. They don’t wanna give you medications.

They don’t wanna give you an injection, which, again, research is all over the place on injections anyway. What do you do now? Well, hopefully, they send you the physical therapy, and this is the more modern approach to treating back pain. You know, as PTs, our best way to treat back pain is to graded exposure, let’s put it that way, is to desensitize the area, give you movements that’ll desensitize the pain. And then after the pain desensitizes, we continue to load the spine.

We strengthen the spine. So in in other words, again, exercise really is medicine. That’s the long term relief when it comes to back pain is getting stronger, getting more resilient in certain positions, and getting more confident to bend over and pick something up, to arch back and reach for something back here, to twist, to side bend, to not be afraid, and to be strong in those positions. And how do you do that? Through exercise.

You know? Nobody has magic hands to make your your spine and your your muscles stronger. That’s not how the human body works. And, you know, again, I’m trained in all that stuff. I can crack your back.

I could dry needle you. I could cup you, tape, all that stuff. It’s fine. I get it. People like it.

But, again, that’s more the short term relief stuff. I can do that to give you some relief in order to do the exercises afterwards. So let’s say you come in, you know, a a very basic back pain treatment session with me as you come in, We warm up a little bit through some movements, maybe some walking if you can tolerate it. I’ll do some hands on stuff. All that takes fifteen minutes, maybe twenty minutes.

The rest of the forty minutes, forty five minutes is us exercising, is me showing you movements to desensitize your pain and to get stronger in your spine and in your back. And that’s how you treat back pain is, again, to build resilience in your spine. Three kind of key takeaways with physical therapy in terms of treating back pain is number one, don’t rest it. Resting is very outdated. Avoiding movement is not something you wanna do.

You would just be super afraid to move again. The pain will just amplify. There’s no circulation to the area. So remember to actually, again, find a physical therapist to help you move again. Don’t just lay in bed all day.

Your back’s just gonna keep bugging you. I promise. And I work at the hospital too. So, like, I see people in a hospital bed not moving. They have to move.

People were meant to move, get up, and to exercise. And, you know, one of my professors told me that it sticks with me to this day is inactivity is accelerated death. The less you move, the less your body just, like, degrades. So, you know, I’ve seen people fresh out of surgery at the hospital and giving them physical therapy. I I mean, people need to move and they need it quickly.

So, again, don’t rest it if you have back pain. Maybe if it’s super irritable, you can chill a bit, of course. I’m not gonna make you deadlift or anything if your back pain is 10 out of 10, but you should be moving. And, again, that’s our job as PTs is to prescribe movements to help you kinda get the blood moving, get your joints moving. You’d be surprised how much exercise is a natural pain reliever because it is, and there’s research on it.

So, it’s a very strong pain reliever. It buys endorphins and natural pain chemicals get released through exercise and movement. So it’s a very strong drug. I you know, it’s my favorite drug. So so don’t rest it, number one.

Number two is to be aware of the biopsychosocial nature of of pain and back pain. Meaning, there’s so many things that can amplify your pain. Like I said, there’s your sleep patterns, stress levels. You know, I don’t care if it’s a relationship, if it’s family drama, whatever it is. Your body’s gonna be put on high alert.

Your nervous system gets ramped up when, you know, you’re stressed. And if you have back pain, it’s gonna tense up all your muscles, and you’re gonna have even more back pain. And then it’s a vicious cycle that I see with people. So, you know, I try to talk to them about looking at other areas of their life. You know?

How’s your sleep? How’s your stress? You know, I’m not the mental health guy, but I’m like, you know, find ways to find strategies to reduce your stress. Even social factors, environmental factors, all that can amplify your back pain. So just be conscious of those things.

And so I try to, again, tell that to everybody that, you know, stop being so fixated on structural things and try to get these other things fixed as well is, again, your sleep, your stress, nutrition, hydration levels, all that stuff play a part in your back pain. So keep that in mind. A lot of research on that. So please, I mean, look it up. It’s it’s all over the place.

The the modern approach to pain, it’s not just structural. And I keep saying it, but it’s the truth. The third key point that I have here is, again, to remember to distinguish between short term relief and long term relief. Again, all the fancy stuff we do as physical therapists, you know, I could crack your back. I could dry needle it, tape it, cup it.

People love it. It looks cool. I get it. But, again, that’s more short term benefit. The long term benefit is what we want.

And, again, we do that through movement and exercise. You have to get stronger in in certain positions. You have to get more confident in your movement. So don’t, you know, don’t just go to somebody. If someone’s just if you’re laying on the table and they’re just cracking your back or they’re just dry needling you or e stimming you, God forbid, you know, it’s it’s gonna feel better for, like, I don’t know, a day or two, and it just comes right back.

And if they’re not coupling that with exercise and movement, please see somebody else. Get out of there. That’s not gonna help. It’s gonna help in the moment maybe, but, again, it’s not reinforcing your spine the way exercise and movement will. So that’s the long term benefit.

Like I said, the long term relief is getting stronger, reinforcing the area, building resilience in your spine, being confident in your movement and exercise. And, again, the pain dissipates. It goes away. You get stronger. You get more confident.

There you go. It’s a it’s a it’s a beautiful process. I love seeing it. I see it all the time. I see it every day.

And, yeah, you know, again, getting out of pain is a process. There’s always, you know, up and down days, up and down weeks sometimes. But, you know, the path to getting out of pain is never just a linear progression. It kind of it’s kind of a zigzag. As long as it’s going up, we’re good.

Progress is progress. You know? There’s little goals that we give people or they give us their goals, and I, you know, I give them little check marks to hit along the way. If we hit that check mark, it’s progress. You know?

It could be as simple as bending down, tying your shoe again. You know? That’s progress. So remember to be positive and to when those things happen, to be happy about it, to be confident in it, to build confidence, and don’t just fall for the short term relief stuff, please. Okay?

Exercise really is medicine, and we’re the ones providing that to you guys. So and we love doing it. I like to think as physical therapists, we’re you know, we love to work out. We love to to move and to be animated with you guys. Like, I’m very active with my my patients and clients.

Like, I’m doing the exercises with them. I’m showing them progressions to it. And, of course, we modify along the way. If something feels weird or it’s irritated or, you know, you don’t like this, we modify some stuff. You know, that’s our job is to, give you more exercises tailored to you.

And, again, everybody’s different. So, thankfully, I have a library of exercises in my head that I could prescribe to somebody if they’re not feeling this one or, you know, let’s try something else or let’s let’s kinda go back to this one or let’s advance to this one depending on how you’re progressing. So, again, exercise is medicine. That’s the long term relief. Keep that in mind, please.

Just to summarize, again, the the three key takeaways is don’t rest it. Resting is very outdated. Bed rest for back pain. Yeah. I don’t even know who hopefully, nobody still says that.

But health care is weird, so maybe somebody still says just don’t do anything. Also be aware number two is to be aware of all the factors that actually impact your pain, like your sleep, you know, social factors, stress levels, things like that. So be aware of those things. And then number three is to focus more on long term relief, which is relief through exercise, relief through building resilience, relief through getting stronger. And that’s, you know, our main job as PTs is to give you guys exercises, home exercise a home exercise program to build resilience in your spine and to not be afraid to to bend over and pick something up or to, you know, reach back, like I said before.

So, don’t rest it. Be aware of different things that impact pain. And, again, focus on long term relief, which is exercise and getting stronger. So, again, do your best to stay active. There’s not a one size fits all when it comes to treating back pain.

Find a good physical therapist that can tailor it to you, that actually pays attention to you, that isn’t just seeing you for ten minutes and then they go see somebody else. Because I remember doing that, and I hated doing that. Thankfully, now I could be with somebody for an hour, an hour ten minutes, and we could, you know, work things out, game plan to get your back pain under control. So, hopefully, that all makes sense. There’s a lot of stats and misconceptions and treatment approaches to back pain, but I I try to con condense as much as I could.

So, if you have questions, like I said, you could just find me on Instagram at a p t doctor g. You could DM me about what you’re feeling with your back pain or any pain you’re having really. Like, I love treating back pain. I mean, knee pain, neck pain, ankle pain, you name it. You know?

So if you have questions, just find me on there. If you haven’t subscribed to the YouTube, please subscribe on YouTube. I know we’re at, like, I don’t know, one thirty four or something subscribers, so, I’d greatly appreciate it if you keep subscribing. And, also, I have in the description is my newsletter called the PT Handbook. It’s a free newsletter that I send out every other week, and it’s about, you know, basic easy physical therapy tips that you could implement throughout your daily life and also, research based, discussions that I maybe I link an article and I talk about it for a few paragraphs to help, you know, help you guys better understand it.

So, it’s a great read. So subscribe to that if you haven’t. It should be linked in the YouTube. And so the newsletter, please subscribe to, like I said. I’m also on Spotify and Apple and all those other podcast places.

That’s all I got. So I appreciate you guys listening to me ramble about back pain and talking about myself, but, thanks for listening. Thanks for watching, if you’re watching on YouTube, and we’ll talk to you guys soon. Peace.

Speaker 1:
0:11

Welcome to Patti's Place, a place where you can find comfort and understanding about grief, dementia and caregiving. So pour yourself a cup of tea, coffee or, if it's been a really bad day, grab a glass of wine and let's sit and hopefully you find some comfort. So today I thought we would talk about how we can keep our loved ones close even when they're gone. I think it's important to stay close to our loved ones even when we learn, even when we are learning to adjust to life without them, and sometimes it's really hard to stay connected to them. Some days they feel so far away and the hurt is just unbearable and all we can feel is how much we miss them. Some days they feel so far away and the hurt is just unbearable and all we can feel is how much we miss them, and that's okay. Sometimes for me, when I want to feel close to my mom, I'll wear some of her clothing or I like to tell stories about her with her friends or people who knew her and loved her. For me, I find comfort in talking about her. She was here, she lived, she made a difference and I want her memory to continue. I know sometimes some people have a hard time talking about their loved ones because it hurts too much For me. Like I said, I find great comfort in being able to talk about my mom, share some of her funny stories or things she used to say or things she used to do. I find comfort in remembering those things with her, the things we did together or just little things. An example my dad and I went. We were out to eat the one day and you know we got to-go boxes and we both laughed because my mom always had a hard time with the to-go boxes. She could never figure out which was the top and which one was the bottom and the place that we were at they had their name on the top. So we were like this would have made it really easy for her because this was the top. And it was always funny because she always got it wrong with the boxes. She always struggled with that. But it made us both laugh because we were like that was her with the to-go boxes. She always had a hard time with it. You know, I also sometimes like to wear some of her clothing. I have a couple of her T-shirts or her sweaters that sometimes I like to wear because I just feel comforted, knowing that she's close. You know, there were things that she always wore and it just makes me feel close. I also have a blanket on my bed that that was the blanket that was on her when she passed. And sometimes, when I can't, I have a hard time falling asleep. Sometimes I just pull that blanket close and I just think about her and I feel close to her. Then you know, and I've also learned, that we can do rituals that we can do for ourself. Maybe we say a prayer or we do a meditation or we do something that they like to do For my mom's birthday this year.

Speaker 1:
2:53

It was her first. It wasn't technically her first birthday without her, but it was the first one that we celebrated without her, because she passed on January 6th of last year and her birthday was January 16th, but we actually ended up having her service on her birthday. Now some people might thought that might have been a little weird, but we decided that we would celebrate her life that day and we actually even had a birthday cake for her. So this year was the first like real birthday without her. So I went to a tea room with her friend and friends of the family and we my mom loved anything about tea and she loved to learn about the tea rooms and it was something she would have liked to do and we had the best time because we had tea with her and we had a little some of the little cakes and stuff the tea cakes because my mom always loved all that and I felt really close to her. We felt like she was there with us as we were celebrating her birthday in a tea room. So maybe you do something that they always like to do or go to a place that they always like to go to.

Speaker 1:
4:00

For me, sometimes, too, when I want to feel close to them, I will watch movies or shows about grief. And it might sound funny. You might be like, why do I want to watch something about that? But for me, I find comfort in seeing others experience the same thing as me. I don't feel so alone. I feel sometimes I even learn something. I find that I find this comfort, this peace. Sometimes I cry, sometimes I laugh.

Speaker 1:
4:32

Some of my favorite movies about grief there was one. It's a I think it's a 2014 movie. It's called this Is when I Leave you. It starts. It stars Jason Bateman and Jane Fonda and Tina Fey and it's about a family whose father has died and the father's last wish is for them to sit for Shiva. I just love this movie.

Speaker 1:
4:54

I have watched this movie I don't know how many times, because I think, the more I think about it. I think it's because they show grief in so many different ways. I think about it. I think it's because they show grief in so many different ways and it shows how everyone deals with grief in a different way. With it there's laughter, there's tears, and it also, I think too, it shows how it addresses how life goes on even in the middle of your grief, like you can't control it. There are things that happen in the movie that they have to deal with. They're major things and but they're still grieving, and it talks about how how sometimes you you feel like you just can't cry. It addresses that or you laugh or you think about what life could have been or what should have been, and and then it also addresses your family relationships and things like that. So for me that one is a big one. I love that movie. I find great comfort in it with it because it's not a heavy. I guess in a way it's a heavy movie, but they address it in such a way where you find for me like I said, I find a lot of peace, a way where you find for me, like I said, I find a lot of peace.

Speaker 1:
6:07

Another really good movie about grief is called the Starling. It stars Melissa McCarthy and Chris O'Dowd which, when you think of that, they're both comedians. So you think, oh, this is a funny movie. It's not a funny movie at all. I mean, there are some comedic aspects to it, but it's not. It's a very serious movie. I think why I like this movie too is that it addresses anger and grief, because a lot of times we don't like to talk about that. You know, some days you just feel angry about that your loved one is gone. So this movie does address that. It also addresses the helplessness and despair you feel, especially if your loved one had died suddenly. It really goes into a lot of details with that and how you feel and how you cope. It has a lot to do with coping, this particular movie and what you can do and different ways that come up and that, and so I've seen that movie several times as well and I always feel good at the end about it. And they get the name from, because the starling is about a bird and the bird plays a role in the movie.

Speaker 1:
7:16

There's another one that Dan Levy did called Good Grief. That one's a good one too as well For it. I've seen that one, I think, at least once. There's also another movie about loss. It's called Love Again. That one it's a little bit different because it shows different types of loss. It is about a death, but it's also about breakup and heartache and stuff, and it's more on the romantic side. But it also shows you all the different ways you go through with grief and loss and how it is such a roller coaster ride up and down with it. And it's got really good music in it too as well. So sometimes I find that I'll watch these things and I might feel bad, but then at the end I'm like I feel better.

Speaker 1:
8:04

If you're looking for a really good documentary about grief, there's one. They did it all about Christopher Reeves. It's his three kids that did it and it's such a powerful documentary. I did cry at the very end because one of the statements that they make is that they talk about how they just felt alone from that day forward. And it was so powerful to me because my mom was my person. She was the one I went to. She was the one that knew how to comfort me. She knew how to talk to me. She knew how to make me feel better. She knew me better than I knew me and I miss that. I miss that connection and I do feel alone. So I think when I watch movies or shows, I don't feel quite as alone because I see other people going through the same thing, the other one. If you're looking for a good TV show that was on for six months, six seasons, this Is Us. It's definitely an excellent show, in my opinion, about grief and loss. It also depicts dementia very accurately. It really shows dementia and what you go through and what caregivers go through, and about the denial and about how hard it is. In her particular case, in that one, she knew she had it, but it really shows what you go through and the decisions you have to make with that and with any caregiving it is. So I mean, it is six seasons, but it's definitely a good one, as they talk about a lot of heartache, a lot of loss with it.

Speaker 1:
9:41

Another way that I find comfort or I feel close to my mom is through music. My mother gave me the love of music. No matter what genre of music you like, there's always a song that can match how you feel. I think that's why I love music so much, because it expresses what you can't sometimes. Some days I put on the same song over and over and over again and I just listen to it and it makes me feel better. There's a song by an artist called Will Dempsey. It's a song that's called Beat you there, and some days that's what I listen to over and over again. Sometimes I listen to her favorite artist. She loved Barry Manilow. She used to always say that Barry knows pain, and so some days I listen to that. My mom even so much, as she picked out all the songs that she wanted at her service long before she ever got sick, and so I have those songs on a playlist. Some days I listen to that. Some days it's just too hard to listen to those songs. But sometimes, when I'm having really bad days, a song that I know she would love boom, it'll pop up on the radio. So it's like I know she's there. I think too.

Speaker 1:
10:53

Music and TV give me that place to cry and laugh and feel connection when I can't talk to anyone in that moment, because there are days isn't there, where you're just like I, just I can't talk. It's not that I don't have anybody to talk to, I just don't know what I want to say. I just maybe you feel angry, maybe you feel hurt, maybe you just feel despair or, too, that I feel comforted by watching TV and movies and music, because I used to do that with my mom all the time. We used to sit and watch TV all the time and all different shows and that, and, like I said, she gave me the love of music. I remember listening to music when I was little. You know she'd said she gave me the love of music. I remember listening to music when I was little. You know she'd put the vinyl records on and we would listen, and so I feel close to her when I do those things, because those were things that we used to do all the time.

Speaker 1:
12:03

I know sometimes it's hard, maybe with music, to listen to the music that they used to love, because it hurts. You think about how much they loved it and you just can't quite do it. And that's okay, because maybe there's gonna come a day when you can listen to it or you can watch their favorite movie or their favorite TV show. You know, it might sound silly. Like you know, I just can't watch it right now. It hurts. That's okay. Acknowledge that, because maybe there's going to be another day that you can listen to that song or you can watch that show and you find comfort, you find peace that they're there with you with it.

Speaker 1:
12:46

I think that the point today is that you have to find what makes you feel good about your loved one, find the thing that honors them. Maybe you love taking pictures, so maybe you make a collage of all your favorite pictures with it, or you finish a project they were working on or one that they always wanted to do. That's another way where you can feel close to your loved one with it. You know, maybe there were things that they love to do. Or maybe your loved one loved to bake.

Speaker 1:
13:16

You know, sometimes I have found in this past year or so like all of a sudden, I just wanted to make one of my mom's favorite recipes she used to do. You know, she left me all her recipes long before she got sick. She handed me this book that she put together. Of it was some were handwritten recipes. My mom also used to love the little cookbooks and everything. So she would cut out recipes and then she'd put them in the little plastic sleeve and she had it in this book. So I had this book. So sometimes I go through it and I'm like I'm just going to make this because it makes me think of her and I know what she used to make and she taught me how to bake too.

Speaker 1:
13:53

So sometimes I find comfort doing those types of things. So maybe that's what you do for it, or maybe your person loved to, they were crafty, and that's what you want to do. And if you can't do it right now, that's okay too. Just you can find ways where you find comfort and peace while you're experiencing your grief. You know you don't have to be sad all the time and if you feel that way, that's okay too. And then I know sometimes you feel guilty if you're having a good day because you think I shouldn't feel this way. But it's okay if you have that. Think I shouldn't feel this way, but it's okay if you have that, because what I'm learning on this journey because grief is a journey is that grief is a feeling which will never go away In the long run, I think it's better to make friends with your grief than push it away and run away from it, because you can't run away from it.

Speaker 1:
14:50

It'll come back up in all different ways. So I have found and as I talk with grief counselors, and that you need to make peace with your, you need to make friends with your grief and I know that sounds really crazy, but it's like being with your friend. It might not you might not always agree with your friend on that day, and sometimes grief might take over. Where you're like I can't face the world today, I just can't. Maybe it's an anniversary or maybe it's a holiday coming up and you're like I just I can't, I can't acknowledge it. That's okay. And it's hard because there's a lot of people in this world where they'll tell you no, you have to do it, you just have to, but you don't. If that's not what you can do today, that's okay, because maybe next time you can, maybe if you give yourself that grace to say I can't do it this time, maybe you can't celebrate Easter, or you can't celebrate the 4th of July this year, maybe you can't celebrate Mother's Day, that's okay.

Speaker 1:
15:56

You do what you have to do, because if you acknowledge it and you make friends with it and maybe you just need to ignore it or whatever it is, if you make friends with your grief and you say, I'm really sad today, I'm just sad because what I've found is that when you're able to say that maybe it only lasts for a little while, maybe it will last all day, but maybe it only lasts an hour or two, and then you start to feel a little better. Maybe that's the day you binge, watch all your favorite sad movies, you know. Or maybe you say you know what? I'm going to just watch all comedies today, because that's what I need. I need to laugh today. That's okay too. Or you play all the sad music. Or maybe you say today's the day I'm going to listen to all their favorite music and maybe you cry all day. Now someone might say why did you do that? But I bet you felt a lot better if you did with it.

Speaker 1:
16:53

So the point being is that if you make peace with your grief, you make friends with your grief, because I don't know that you ever really. I think at some point you make peace with it, but it takes a long time to admit that grief's always going to be a part of your life, because your loved one was a part of your life. And just because they're physically not here anymore, it doesn't mean they're still not a part of your life. They're part of who you are and that's where I think that honoring them is a way to make you happy as well For me. I do this podcast to honor my mom, because she was always that person that people came and talked to. She was always that one, especially when people were sick or they were going through a rough time. She would listen and she just kind of had that gift.

Speaker 1:
17:42

And it's hard at times if you're doing something that you want to honor your loved one or other people might not understand, but you just have to. Don't worry about what someone else says. If it brings you peace and it makes you feel close to your loved one, that's what's important. And it might change after a while. You know like, maybe you know, maybe you put up all these pictures and then after a few months or a few years, you, while you know like maybe you know, maybe you put up all these pictures and then after a few months or a few years, you go. You know what. I want to change it up. This is what I want to do.

Speaker 1:
18:13

Or maybe you took that trip that they always wanted to take and then you're. You feel different now and maybe you want to do something else. That's okay too, because what I'm learning with all of this is that grief is a living, breathing, ever-changing emotion. It's never the same. It's the roller coaster ride. You're up and down and all around, and some days you handle the grief easier than others. Some days grief wins, and that's okay too. That's why I think it's important when you're able to find rituals or you're able to find different things that make you feel at peace. In that, and maybe it's too, maybe you do go to a support group and you find other people that you can talk to, because, as you find on this journey, not everyone will understand what you're going through.

Speaker 1:
19:06

A lot of people think you know there's these steps to grief and you just boom, you should be over it by now. They don't want to talk about it, and it's hard because maybe you still need to talk about it. I mean, I know for me, I don't never want to stop talking about my mom, I just don't. You know, it doesn't mean I, she was alive. Like I said, she lived, she breathed, she made a difference. You know, I always want to talk about her or joke about the things that she did and stuff. It makes me feel good and I know a lot of people have a hard time talking about that person, but that's on them.

Speaker 1:
19:43

So sometimes you do have to seek out others that are going through what you're going through, because they understand and you can easily talk to them and you need that. You need to be able to say, yes, I understand, I know what you're going through, I have a really good idea and that's a bond that never really goes away when you find other people that feel and have gone through what you go through. You know, and it's always hard, you know, because we honor our loved ones right after they pass. But then people are like you need to go right, go right back to how it was and it isn't so. That's why it's okay to find some private rituals that you may need to help them, you know, or maybe it's something. You light a candle in memory of them, maybe that's what makes you feel good in that moment to honor them and it's okay to.

Speaker 1:
20:36

I talk to my mom all the time, you know, and that's okay. I mean, I know she's not here, but I still talk to her. I feel like she's still watching over me. She still, she still give me signs, with those types of things. So I think, as you're, as we're traveling on this ever-changing rollercoaster ride of grief, we need to just know that, like I said, it's a living breathing ever-changing emotion and we need to find different ways that make us find comfort, make us find ways to honor our loved ones and ways to stay connected to them on the days that we really feel like we need to with it. And it's okay, it's really okay.

Speaker 1:
21:20

If others don't understand. You have to do what makes you feel good in that moment, because it's hard, it's, it's just hard. Grief is hard because it changes. One day, you, you, you may wake up and feel really good and then, boom, there might be that song that you and you hear, that song that they loved, and you're like, oh, that's it your whole day. You know you're crying in your car and you know what. Your whole day, you know you're crying in your car and you know what. That's okay, and I know not everyone will understand that, but hopefully you can find some, somebody that does, or hopefully, just listening to this will make you feel like you know what. It's okay that I cried my eyes out in the car. It's okay Because crying is cathartic or angry or that.

Speaker 1:
22:05

So you know, maybe check out some of the movies that I shows that I told you about, or music, if that's what you want, or, hey, send me. You can always send me an email on my website. I'd love to hear from you if there's other movies or music that you like to listen to. That helps people. That's a great way to, like I said, to find different ways to honor.

Speaker 1:
22:27

It just made me think about it these days because you know we have Easter and stuff like that coming up and Mother's Day, and those are just hard days sometimes. But I think we're going to talk some more about that as we come up in the next few weeks here. So I hope you found some peace today. I hope you enjoyed your cup of tea or cup of coffee or, if it was a really bad day, a glass of wine, and I hope you find some comfort and know that you're not alone with this grief and your whole journey for that, and definitely send me an email if you have comments or things you want to learn about as well. So again, thank you for joining me here at Patty's Place.

Speaker 1:
0:05

Okay, so our guest today here on Patty's Place is Debbie Miller, a certified senior advisor, an aging in place specialist and author of Doing the Right Thing Simple Solutions, essential Tips and Helpful Resources for Assisting Aging Loved Ones. So, debbie, I'd like to welcome you to Patty's Place. How are you today?

Speaker 2:
0:25

aging loved ones. So, debbie, I'd like to welcome you to Patty's Place. How are you today? Thank you, I'm doing great and I appreciate being invited to come on your show. Thank, you.

Speaker 2:
0:35

So I read your book. So what made you want to write this book? Well, it all started back in 1995, which sounds like eons ago but I was responsible personally, as an adult child, for the care of my parents, my in-laws and two sets of aunts and uncles who didn't have any children. And it was over a period of about two years and I had to do everything you know run to the grocery store, fill out Medicare forms, take them wherever they had to go with health issues, take them wherever they had to go with health issues.

Speaker 2:
1:03

And once they had all passed away, I just kind of said you know what? I'll bet you there's going to be other baby boomers, adult children like me, who are not going to know what to do and don't have time to figure it out. So I'm going to write this book to help them, you know, educate and empower them to make better decisions for their loved one. And so over the years I was already in real estate, but I'd always wanted to be a social worker. So this was kind of a good fit and I've helped hundreds of adult children and their parents make the move to another facility or age in place safely. And the book is a compilation of not everything I've learned, but the basics to help you get started and learn things before it's too late.

Speaker 1:
1:58

And it is very overwhelming as an adult child having to take. You know my mom had dementia and trying to figure it out and navigate. It's a lot. So what type of advice would you give someone who's struggling with a parent who maybe can no longer live alone?

Speaker 2:
2:18

Well, I think there's a few things that you can do. The problem is, many people think, oh well, mom's doing fine, I'll worry about that when the time comes. Well, you need to do the research before it's too late, because once she falls or there's an emergency, you won't know who to call, you won't know what questions to ask and you don't know where to look. So do some homework beforehand and at least you'll be prepared, because a lot of times, let's say, she fell and now can no longer live in her own home. You have to find a place. Well, a lot of the better places have wait lists, and so waiting till the last minute is not good. And I realized that people say, oh well, mom's doing just great. Well, that's wonderful, but and so you need to at least research, because there are lots of options out there for her depending on what the issues are with her health Exactly.

Speaker 1:
3:22

So what type of questions do you think someone should ask themselves to determine?

Speaker 2:
3:26

if their loved one can stay at home or they may need additional care. Yeah, we refer to it as the ADLs activities of daily living. And when you visit, if you live far away, it's harder to ascertain what might be the problem. But if you visit her, can she cook for herself easily, can she get herself dressed, do housework, even simple things like changing the sheets on the mattress can become a challenge. So if you notice that she's having a bit of problems, or maybe she forgets something that she did or she can't find her car keys take note, find her car keys, take note. It helps to talk to her doctor and see what the doctor thinks, because they have testing they can do to ascertain where she is in the scheme of things. And the other thing I love is having an aging life care manager to come in. They will do an assessment of the situation, of her living situation, and make recommendations and help her get placed, if that's what has to happen or how to fix the home so that it can be lived in more safely.

Speaker 1:
4:37

And how would somebody go about even finding an aging life care manager?

Speaker 2:
4:42

They have a website. They're all all over the country, so, regardless of where you live, uh, you come on to the uh website and it is aging life care.

Speaker 1:
4:58

Uh, let's see because I know aging life care association aginglifecareorg org okay, because I know that's partly too. I you know I have a lot of friends right now too. They're taking care of their, their, their parents, and it's so overwhelming to even know where to start to get your parents some help. So what would an aging life care manager? What would they do for somebody?

Speaker 2:
5:32

Okay, well, when you come on their website, you can come up on their they have a section called what is Aging Life Care and come in there and find an aging life care expert. They have a lot of information that's a big help on their website so you can put in your zip code and they will give you a list of people. They can come in and do an evaluation. They can substitute for you.

Speaker 2:
5:58

If you live far away, they can come in, make sure she takes her medicine, make sure she gets to the doctors things like that as well as help you if she has to be placed in some other facility, help you know what that facility should be and how to go about filling out the paperwork to get in. They do a myriad of things for the adult child. It's a wonderful resource and I've used them many times over the years to help not only with my situation, but also just recommending them to adult children that I work with, because they really it's like a substitute person to be there in your place and also they work with the adult child. You know they don't leave you out, but it's an encouraging situation. They help you with resources and lots of ways to deal with issues that come up.

Speaker 1:
6:57

Do you happen to know is this service free or is there a charge?

Speaker 2:
7:02

Well, when you first talk to them, they're not going to charge you because it may not be the right fit, and then they usually will have like a retainer fee or charge an hourly rate, but each one is different. When you come up on the website and find all the different ones, you're going to want to definitely talk to more than just one, because you're going to click with somebody, right?

Speaker 2:
7:26

away personality-wise, and that's what you're looking for, because this person is going to be a part of your life care for a long time and they will tell you what they charge for different things, like they'll take your mom to the doctor or they'll make sure she gets her medication. It depends on how serious and how detailed the work is that they have to do, but they will explain to you. So it's a good idea to talk to two or three of them just to see you know who makes sense for you in your situation and also the care that they provide and how much it costs, Because a lot of times the adult child if they're close by, they can do some of the things, but if they need help, they're a great resource to help out.

Speaker 1:
8:12

So what type of advice would you give someone if their parent isn't ready to accept the help? You know, because a lot of times you know my mom was very independent. She would be like I'm fine, I'm fine, I don't want anyone want anyone. You know she would have resisted someone coming in. So what? What can you do?

Speaker 2:
8:31

because it's a hard battle oh yeah, it's one of the hardest parts of the whole process in my opinion. But, um, you have what I did once uh, I've done this more than once actually but I invite the person the life care manager ahead of time and I explain the situation about mom or dad or whatever the situation might be, give them a little bit of background and then have them come with you on a visit and just kind of introduce mom to them gently, because they're trained social workers and nurses. They know how to deal with people in dire situations, so they're used to this and they have a lot of different techniques to help you. And mom may not want it, but if you wait until it's too late, then it's too late, and I've never met a parent yet who thought, oh yeah, sure, let's have them come in and take over.

Speaker 1:
9:27

no, it doesn't happen that way, trust me on that and you will know from experience right they. They tell you they're like I don't need your help. When did my adult child become my parent? You know they get. They get very upset. You know which I understand, which I understand as of today.

Speaker 2:
9:43

Mom, I became your parent, exactly, exactly, but both my mother-in-law and my mother both said no, nobody's going to take care of me. You're not putting me into assisted living. Exactly, I know that feeling. I know that feeling. Yeah, one of the hardest parts is when the adult child becomes a parent to their parent, because it's a totally different mindset. Yes, it is.

Speaker 1:
10:14

You're reminding mom, did you take your medicine Of?

Speaker 2:
10:16

course I took my medicine. What's the matter with you. You don't think I can do that, oh yeah. And then you get over there and you found out that they haven't taken it in three days. So you know. Then you just have to put your foot down sometimes and just say you know, mom, this is what we're going to have to do, because I can't bear the thought of having something happen to you because we didn't take action.

Speaker 1:
10:34

Exactly. So what should somebody look for when they're visiting, say, an assisted living community, because that's overwhelming too when you go into those places, community, because that's overwhelming too when you go into those places.

Speaker 2:
10:52

I have oh yeah, I put down I I learned so much from this uh exercise. Um, as far as what to ask, and I I think I have like three or four pages in my book, but I want you to. When you go in, you make an appointment and a marketing person is most likely the first person you're going to meet up with and they're only going to tell you what they want you to know. What you need to know is what you don't know and how to find out.

Speaker 2:
11:24

So what you want to find out? Well, what happens if mom falls and has to go into your rehab center for a while? What happens to dad? And do you have to pay rent or extra fees for both services? In other words, you're paying a monthly fee to live in the apartment as an independent, but then one of you has an issue and then you have to move into rehab for a while. It may be 20, 30 days, but how much extra does that cost? And then, if the other big one that I learned was, let's say, the facility has 20 beds in rehab, but you're the 21st person and they don't have a bed for you, when do you go?

Speaker 2:
12:10

Well, then you want to find out. Well, where would you take my mom if she had to have rehab for a while and there's no bed available in the facility? Where will she go and how will you let me know about where she is? And do they have to have renter's insurance for the personal items in their apartment? Every state requires a resident bill of rights and it has to be posted somewhere obvious so that you can read it. But you want to also talk with other residents about how they live there. Do they like it and other things to do, or is it all just kind of sitting around watching TV all day? Do the residents socialize with one another? Are they happy? Does it smell funny when you walk in the door? You know there's nothing worse than a urine odor when you walk in.

Speaker 1:
13:00

That's true.

Speaker 2:
13:00

Yes. Is there a staff person available to coordinate home health care visits from a nurse, a physical therapist or whatever, if needed? What is the procedure that they use to respond to a resident's medical emergency? If there's an evacuation required, like California with the fires or Florida with flooding, what is their evacuation plan and is it something that you think is realistic? And how many people do they have on staff to help with that? And what are the training requirements for staff? Are they really capable people on staff? Do they have to pass a criminal background check? What training is provided for the staff on elder abuse and neglect? What is the policy for reporting suspected abuse? Do they allow hospice care? Some communities you know they can take you in and have assisted living facilities, but then if they have memory care for a dementia, do they?

Speaker 2:
14:07

have that or do you have to move again? For example, a life care community with a life plan community is you walk in as an independent and as long as you can walk in by yourself, they will take care of you through all phases of your life, regardless, until you pass away and you know you're only in one apartment and then when you need to have memory care, you'll move to another floor and then when you need hospice, you'll move to yet another floor so that they keep you. It's quiet for you when you're there. You don't need to be involved in all the hustle bustle of the independent people. Is there a staff person available to coordinate home health care visits from a nurse, a physical therapist? You want to check the residency agreement before you move in. That's very important. You want to know what plan they have available. How much does it cost? Are there varying levels of plans? Some places will have plan A, plan B, plan C, and it depends on how much you pay as to how much you get as far as services. There's so many other different things, but those are just a few. But can you go in and spend the night? Or can you take your grandchildren in to spend the night and, if they can, how much does that cost?

Speaker 2:
15:32

And what's the reason that a resident might be told to move out of a community? Is it because the community itself doesn't have the care that is needed? For example, if they're in assisted living but the community does not provide dementia or Alzheimer's care, that means they have to move. And will that staff help them find a facility that is agreeable and amenable to your parents or your loved ones to care for them?

Speaker 2:
16:01

Or I had one woman she was so difficult to work with. We got her in and all she did was call me. She said, well, they're just yelling at me all the time. So I talked to the staff and they said, well, all she does is cause trouble, so we can't keep her, because the other people, they have a right to a quiet environment. So she had to move out and she didn't like that. But that was the way it was, and there's a lot of different things that you have to think about, but the marketing people are not necessarily going to ask you, they're not going to tell you and you need to know what to ask.

Speaker 1:
16:40

Definitely, because it is overwhelming, because when you, especially you know sometimes when you go to those places you don't have a choice and so you feel overwhelmed about the whole thing anyway. Oh yeah, you know. So if you have a resource like your book to kind of prepare, that's helpful too to kind of prepare.

Speaker 2:
17:06

That's helpful too. So you mentioned Remember too, lisa, the ones that are for-profit. I call them facilities. They have what I call a heads-in-the-bed mentality, whereas faith-based or church-based, religious-based groups are not quite as aggressive about that. But those marketing people have to fill the empty spaces and as people pass away they have an empty bed. So it's a heads-in-the-bed mentality and they like to put pressure. They'll come back and I mean I've had clients be told oh well, we'll pay this and this and this for you and you can come in right now, and otherwise they would have been told oh well, it's going to be at least a year before we can get you in. So as soon as you balk at it, they're going to come after you.

Speaker 2:
17:47

So be careful about the aggressive tactics that some communities use to get your loved one in their facility. It's just you need to be careful about that and look at more than one facility before you make a decision and find out. I like to tell people move in to move up. In other words, they might not have the exact floor plan that you're looking for initially, but they may have something a little smaller. That's not quite perfect, but it's available sooner and that's important. You need to get the care provided as quickly as possible and then, once you're inside, on the inside track, so to speak, oh wow, well, we put you on the list ahead of everybody on the outside. So you stand a better chance of getting in if you move in to move up and you get the one you really want.

Speaker 1:
18:37

So those are all very good, because it is a very overwhelming situation Very much so.

Speaker 2:
18:44

And you've got a job, you've got kids and you don't even know what to look for. You don't even know if there are any places near you and if your parent doesn't live close by. Do you keep them in a facility where they live now or do you move them in with you for a while until you look for something? There's a lot of choices and they can't be made and quickly. You have to take your time and have time to evaluate.

Speaker 1:
19:08

Oh, definitely, and you know if the if your parent is still living alone or if they've moved in with you. You mentioned about creating a safe space in a person's home. Yes, like you suggested, like maybe improving lighting through the interior, exterior of the home. What are some other ways? You know? Like I know, with my mom. She lived with me for a short time before we, before she went into mammary care. Like for her situation, we had to take all the knobs off the stove, you know, and different things like that.

Speaker 2:
19:55

I remember hearing that I listened to your podcast on that subject and, yeah, you don't know what can go wrong. But one thing that's very important, or two things actually, that I would like to stress. There are a number of things to do, but one is to make sure, if they live in a single-family home, make sure the exterior house number is easily readable from the street, because when the ambulance comes, even though they're using GPS, that light on the house number is a big help to them to act quickly and it just makes a big difference.

Speaker 2:
20:34

And then I've worked with a lot of hoarders and accumulators over the years, and I find that if a fireman cannot get in to the house through a window or the door because there's so much trash and stuff blocking the way, that's going to be a problem, because they need to be able to get in and they're carrying a backpack of health supplies on their back and they have to get in, and they're using an axe or whatever. So make sure that the areas there's a clear path to move around inside the property, and if you have to put the magazines up and away, then so do it. Or have one room set aside for stuff that your loved one doesn't want to part with at all, because it's just the most wonderful thing they've ever had, even though they don't remember where they got it or what's in it. Just be sure it's safe and you can.

Speaker 2:
21:32

The well-lit entrance, though, and getting rid of a throw rug. Make sure the path that they have to walk, because if they're on a walker or a cane, it's helpful to have the hallways wide enough to be able to walk, because if they're on a walker or a cane, it's helpful to have the hallways wide enough to be able to walk next to them instead of behind them. But the way houses were constructed back in the day, a lot of hallways are not wide enough and bathrooms are not large enough to accommodate either a wheelchair or even a walker. So there's different things that you can do, but the safety is important.

Speaker 1:
22:05

Oh, definitely Like that was our always our biggest concern. We just wanted to make sure she was safe, right.

Speaker 2:
22:11

And that, to me, is paramount. Yeah, so, and remember one other thing. One other thing, lisa. I'll just mention it quickly. A lot of people are saying, well, medicare will pay for me to have this tub, a walk-in tub. Just be aware, first of all, before you do it, you need to find out how far away the fire department is, because when the paramedics come, time is of the essence. And if that tub takes seven minutes to fill and seven minutes to drain, that could be the difference between life and death, because they cannot get her out of the tub until the water's drained. People don't think about that.

Speaker 1:
22:51

But that's a big concern.

Speaker 2:
22:53

That's a big concern, I think, and you know it's wonderful to be able to take a bath, but if you're going to and if you have a care provider with her helping her bathe, they can't lift her out. She's too heavy. So the paramedics, when they get there, or the fire guys get there, they have to be able to get her out quickly, and every minute counts, and so if the fire department is further away than how long it's going to take for the water to drain, you really need to rethink that.

Speaker 1:
23:23

Yeah, I didn't even think about that. And then too, if you do those walk-in tubs, those are very expensive too.

Speaker 2:
23:29

Well, and they say oh, Medicare will pay.

Speaker 2:
23:31

Well, these guys are making money hand over fist and I don't mean to speak disparagingly of them, because I've remodeled a lot of bathrooms myself over the years. But you want to just be careful because sometimes they will forget or not tell you that there's supposed to be a barrier, a waterproof barrier, behind the wall and behind the tiles that they put in. And if you don't have that, then you can have mold grow easily and just things like that that you don't know about construction. That can make all the difference in the world. And those tubs it's wonderful to see them in the picture, you know, and relaxing and taking a bath, but if they have a heart attack while they're in the tub, it's going to be extremely difficult to get them out in time to be able to get them to emergency care.

Speaker 1:
24:22

And that's the most important If you have to call the paramedics, you want to make sure they can help them as soon as possible. Exactly.

Speaker 2:
24:28

Exactly, exactly. And it takes time for the tub to drain and people think, oh, I can just get in and out like a regular tub, but you can't. That door is locked and it won't unlock until the water is drained out.

Speaker 1:
24:39

Oh, ok, see, I did not know that. Yeah, an adult child should obtain from their parents. I know it's a long list. I'm lucky in the sense that before my mom got sick, my mom and dad had done the wills and the powers of attorneys, and all that at a time, and even now my dad always makes sure I know where everything is.

Speaker 2:
25:07

Oh, that's wonderful.

Speaker 1:
25:10

Yeah, so how would an adult child even go about trying to talk to their parent about this, getting information that you need, Because sometimes you don't know you need the information, until you're standing in the hospital and you're like I don't know where this is you know, right, and that's that's very important.

Speaker 2:
25:25

And just starting a conversation with your parent about you know what, what their future might be as far as housing and health care is important, and starting the conversation on you know, mom, where would I find your life insurance policy? Or do you have your will in a safe, or is it and you don't want to put it in a bank safe because the bank will freeze the safe and you can't access it. So you want to have it in a fireproof area in the home is the ideal place, unless she's in a facility, and then it would be in your home. But getting that information is tricky. But if you don't act combative, act like well you know, I'd really like to know have you made a will? Is it up to date? You know who is your attorney? And just check you know, casually, check with it, because a lot of times the parent doesn't even know how to begin the conversation and they want to tell you but they don't know how to start. So, and it might not be that you'll get everything in one conversation, you'll have to go back again. But start a master list and you want things like the death certificate and you need to have an original death certificate and you want to have a. You know if they have a birth certificate available. You want their driver's license, keys to the house and their social security number, the will, the original will and any codicils or a trust if they have their things in a trust who has power of attorney to act on their behalf while they're alive. You want insurance policies, as I said. You want also who should I contact for you, mom, if you get sick and you want to tell your friends. Wouldn't you want them to know too? So you get their emails or their phone numbers or whatever information you can glean and you add it to that list that you're collecting. You need to know who their doctors are. I mean, who should you call if there's a real emergency? The doctor won't necessarily know that she's fallen. I mean, the ambulance will take her to the hospital, but her doctor needs to know that she's there. And if they had a business boy, you have to know well who's the CPA for the business, who prepares the taxes, who does this, who does that? Do they have employees? And how do you tell the employees and what do you do with that? And any clergy or religious organizations that they're affiliated with if they're Catholic or Protestant or other and their friends their friends can help step in and help out with care, perhaps, and visiting after they come home from the hospital.

Speaker 2:
28:14

If they were in the military, there's a procedure for being buried at Arlington National Cemetery. You need their Medicare and Medicaid numbers and identification cards. You need to know who their health insurance is with. If they own a property, you need to know what's the address and the tax record for the property. Is it tenant, occupied? You need to have the title. If they've paid off their automobile or whatever it might be, you need to know where the title is for that, because you're going to have to sell it and you want to make sure. If they have online accounts, you need to know the passwords and the PIN numbers, for example, if their bank account is online. Find out that information you want to know. Well, where do you keep your previous tax returns, mom? Is it in a safe or is it in whatever? And that will tell you an awful lot about how organized they are. Your parent is either going to be a planner or a procrastinator.

Speaker 1:
29:16

That's very true, and you did a really good job outlining all this in your book. So I'm going to give you a plug for your book again, because people can get it right on Amazon and all those places. Yes, okay, so it's called Debbie Miller. Yes, okay, so it's called Debbie Miller. It's Doing the Right Thing Simple Solutions, essential Tips and Helpful Resources for Assisting Aging Loved Ones. And I like it because you have a lot of bullet lists and stuff so people can kind of check things off and go along. It makes it easier. It doesn't feel so overwhelming with it, it's true.

Speaker 2:
29:51

You don't have time to think about this, oh gosh. And then they ask you, well, where's the yada yada? And you say, oh, I don't know, was I supposed to have that? And this is why I like to tell people to try to do this before it's too late, because there is no do over in dementia or death. No, they're they once that, and you know this from your mom. There is no do over. Once they're gone, they're gone and you cannot.

Speaker 2:
30:16

Then it's going to take you hours to go through the house and if they have accumulated a lot of stuff you have to sort through that To find the important information. At least tell them, hey, show me where you keep it so that I know in case of emergency. We don't think an emergency is going to happen, mom, but you know it's good to know just in case. And if they're not organized, that will tell you. You know it'll be. Well, I think the life insurance policy is here. Well, is the life insurance beneficiary up to date, or is it 20 years old and they haven't updated it? How long has it been since their will was updated? If it's in a trust, it's a whole lot easier. But just ask and just say you know, mom, do you keep all your things all together? In other words, are you a planner or are you a procrastinator? Exactly, and that will help you. Well, you just be gentle, don't go in acting. All you know military and stand and salute and stuff. But just say you know military and stand and salute and stuff. But just say you know, mom.

Speaker 2:
31:17

I was thinking the other day what would happen if we needed to access your records. For example, if you go to the hospital and you wind up too ill to speak for yourself, someone's going to be there. Who did you appoint to be there for you and where would they find that information? And you know your parents are not going to say that anything's going to happen to them. They don't believe that for one minute. But it's going to happen and you need to be prepared. So it's not like you're coming in and being the boss. You're just coming in and just saying you know, I'd really like to help in case of emergency, but I need to know where some of these things are case of emergency, but I need to know where some of these things are.

Speaker 1:
31:59

Yes, definitely.

Speaker 2:
32:00

Well, this has been very, very helpful today. Well, I'm glad it is a lot to understand. Lisa, I absolutely agree.

Speaker 1:
32:05

So I appreciate you taking some time to talk with us here and again. This was very insightful, so definitely you should check out Debbie's book and thank you again for joining us on. Patty's Place. Thank you All right, bye-bye, bye.