Ep. 21 - Caregiving: Fact vs. Fiction

Attorney Bob Mannor speaks with Pamela Wilson, SA, MS, BS/BA,CG, who is an expert in the field of caregiving. Pamela has personally helped thousands of families since the year 2000 through her advocacy, educational speaking engagements, appointed guardian positions, and support channels via her Facebook group, published book, and her own podcast.

Through her work, Pamela intends to help caregivers and people in the field come together to fill in the gaps. Her overall goal is to help people take more control over their situations in order to feel less overwhelmed and stressed by the daily challenges that caregiving presents.

In this episode, Pamela speaks with Bob about her past history being a court-appointed guardian from the years of 2007-2018 for hundreds of individuals in the state of Colorado. What she learned during that time could make a difference in the lives of both caregivers and they love. Listen now. 

Transcript

0:09

Welcome back to advice from your advocates. I'm Bob Mannor. I'm a certified elder law attorney in Michigan. And we have this podcast where we talk to very interesting people about things related to the long term care industry, to seniors, to anything that we find that would be interesting to our audience. And today, I'm really excited that we have today Pamela Wilson, who is really a thought leader and an advocate for caregiving. So welcome, Pamela. Thank you. I'm happy to be here. So Pamela has really a great audience, and she's got lots of topics that she covers and her audience. She's got an excellent website that's called pameladwilson.com, but then lots of resources on YouTube. She's got a Facebook page for caregivers called The Caregiving Trap, which we'll ask her about in a little bit. And she's also got her own podcast called Caring Generation. So I'm excited to talk to you, Pamela. We're both kind of in the same field and advocates for better care. So just tell us a little bit about what your work is and how you are an advocate and thought leader. Well, I've been involved in what I call the aging field, the caregiving field, for over 20 years. And mostly what I do today is help caregivers. And people in the healthcare industry kind of come together to understand what I call gaps, things that people normally don't understand or maybe struggling to find information. And so I do this through online caregiving support groups. I talk to people. I answer caregivers questions, I speak to groups. And really, the goal is to help people take more control over their health and their caregiving situation and their life and feel a lot less stressed. Yeah, that's really great. And so one of the things I know that you've had an opportunity to do in the past, which I find very interesting, is to be an appointed guardian or conservator through the court process. Is that right? Yes, I did that in the state of Colorado. Tell us a little bit more about that experience. It sounds like a very both important but also challenging opportunity to help folks. It's a great experience. From the fact that I was a court appointed guardian, I would call myself someone's guardian angel. So there are a lot of people out there who really don't have anybody, whether they're male or female or maybe they're a married couple. And one of these people becomes cognitively impaired through a car accident or a brain injury or Alzheimer's or dementia or something else. And they need someone who has medical experience or financial experience to really manage their medical care and their financial care. And then sometimes there are unfortunate situations where family members didn't get along. The children and I was appointed, or even one spouse didn't want to choose a child to be the guardian for the other spouse, and I was appointed. Now, are you still doing that, or is that something that you just is sort of your historical background. Are you still doing some of the guardianship work? No, that is my historical background. Today I mostly do education and speaking and groups. I was a guardian from 2007 to 2018 for hundreds of people. Okay, thanks. I thought that was the case. I'm just curious. I'm going to your take on it. I didn't prepare you for this, but have you experienced or have you gotten any criticism when you were a guardian? You've seen the movie, I'm sure. Oh yes, evil guardian. And so I get it and it's Hollywood and whatever. There have been some terrible cases and I'm just wondering if you've ever experienced that or been received unfairly that criticism or if you've actually seen some sort of bad guardianship situations, not necessarily family. We'll come back to that in a minute because that's important to address when the family are the bad actors. But when it was sort of the professional care, the professional guardians, have you come across that or you pretty much experienced professional guardians in their best role? No, I have experienced all of that. And so my opinion as being a guardian is you have to be willing to be 100% transparent, have your life laid out in the newspaper and be able to answer any question. So there were plenty of times where I testified in court and I actually enjoyed doing that. And I was questioned for why do you want to move this person from their home? Why should this person have more support from the estate? And even to the point of supervised guardianships, I had to do restraining orders. I actually had to divorce a client from a caregiver he married one time. So I was in court a lot in very, what I call crazy situations. But if you're a professional, you expect that. Yeah. And you're going to take the slings and arrows when you're dealing with family issues and things like that. But yeah, in Michigan, they're really looking to try to reform some of the guardianship rules. The state of Michigan, the governor and the attorney general formed this task force, and its primary goal of the task force was to reform the guardianship system in that there were abuses in it. There were some guardianship situations where it really felt like the guardian was benefiting inappropriately in some circumstances. And it was the rarity, it wasn't every case, but those were the ones that made the news. And so I think that's a shame because what's happened now, there's been a chilling effect and nobody wants to be a guardian in Michigan now because of that chilling effect. And everybody worried about that scrutiny that you seem to have understood. There are good people and bad people everywhere in all walks of life, including guardianship. Anybody who accepts this appointment, whether it's professional or family member, you have to be willing to explain why you're doing things and to your point in what Michigan is probably trying to do is least restrictive alternatives. You can't put somebody in a home if they really can live at home, or they can afford to live at home and they're doing well. Unlike that movie that you mentioned where she pulled the lady out of her home and put her in this very restrictive situation. Yeah. In the worst case that got the most attention in Michigan, there was a family member. It was a blended family, and so it was either a mother and stepfather or a father and stepmother. And the daughter petitioned for guardianship over both of them. And instead the court appointed a professional guardian, which first of all, in the law, there's a preference for the family if they're competent and capable. But the next thing we know, in that particular case, the guardian paid their husband lawyer a lot of money in legal fees, like a really substantial legal fee. Conflict of interest. Oh, my gosh. Hired their own. The guardian also owned a caregiving company and hired 24 hour caregivers and spent about 400,000 in a period of about ten months. And most of the money went to related entities to this guardian. And unfortunately, there wasn't anything particularly illegal about what she had done, but it was just that's the type of reforms that they were trying to say, okay, if you're going to be appointed a guardian, there's got to be some scrutiny as to how the money is spent and particularly if it's spent on any related entities. Well, and here in Colorado, that would be seen as a total conflict of interest. And I'll give an example. So years ago I did a live radio show and I had sponsors, right? So one time I was going to a court case and the attorney said, hey, I'm embarrassed to even have to ask you this, but you're recommending that this person goes to this assisted living community. I know you had sponsors of your radio show years ago. Was this one of them? Did they give you any money? And I said this was not a sponsor and they didn't give me any money. And that was one of the things that I was very clear about. I didn't accept referral fees. We didn't take money from people. Nobody could take us to lunch. There were no gifts. There was none of that allowed in my company. Not that other people don't do it, but we did not. Yeah, I think that's that sort of appearance of propriety there is what you're always going for. So tell me more about some of the misconceptions. Let's kind of shift over to family as being sort of the appointed person, whether it be through legal documents or through a court. What are the misconceptions that you see in the unsigned roles that family members might have, either being appointed by a court or through a power of attorney or those types of things? There's two sides to this. There's one side where family members are appointed, whether it's power of attorney or guardian, and they believe that they have total control over the situation. Now, legally, obviously they do. But in the perfect world, you're supposed to work in the best interest of the person that you are appointed for. So, no, you can't spend their money, you can't go on vacation, you can't put them in a nursing home if they really shouldn't be there. So sometimes people think that because they have legal authority. They can do anything they want. And then very much on the opposite side, people don't understand the authority that they have. So an example is advocating with a doctor for treatment. Sometimes the power of attorney or the guardian won't advocate. So the doctor may say, well, no, I don't think your loved one should have this treatment. I was very much an advocate and I couldn't can share a quick story. So, this lady had lung cancer and her primary care doctor is like, oh no, put her in a hospice, let her die. Her time is up. She wanted treatment and the oncologist said, this treatment is going to really work. So I had to battle between the primary care doctor and the oncologist to get this woman treatment. She lived another two years. She was able to reconcile the fact that she was dying with her family. It was a great situation. But family members in my situation may have just agreed with the primary care doctor against the woman's wishes and said, no, you're not going to get treatment. We're just going to let you die. Interesting, that kind of brings up where sort of family misconceptions of what their authority really is. They actually, I believe, passed a statute in Michigan a couple of years ago. Do you remember the Casey Kasem situation? Yes. His daughter has been going around the country trying to get laws passed because the situation, and I've seen this many times where the person that's been put in charge, the daughter, son, sometimes spouse refuses access to the family, to the loved ones. They're not allowed to see their mom, they're not allowed to see their dad or sometimes even their spouse, which is crazy. And so the Casey case, his daughter, she's been trying to get laws passed to say, okay, there's got to be some protections for family. The person, just because they're put in charge as guardian or power of attorney or those types of things, they can't isolate the person that needs care. They can't isolate them and deny them access to family without good reason. And making sure in Michigan what they did is they came up with a process that the probate court can review it and even appoint sort of a third party to analyze it to determine whether or not they can refuse family member from visiting and those types of things. There was another celebrity experience like that too. It was Peter Fox. Peter Fox daughter. There's actually a Peter Fox law that's been enacted in a lot of states. But I was in those situations too, where I had to supervise visitation in some cases because maybe a spouse or a son or daughter would want to see the person that I was guardian for. And they would come and they would upset the person. So people with cognitive impairment, they can't reason, they can't understand a lot of information. And so these people would come in and try to try to talk to my clients, and my clients couldn't understand, so they would get upset. So in some cases, I had to do supervised visits, right? No, and that makes sense. Sometimes we call it the seagulls is sometimes what we refer to family members. And I believe that most of the time they're well intentioned, but they're out of state family members that haven't seen what's been going on. They don't understand the situation. They're probably in a bit of denial about it. And the seagull comment is they fly in, they poop all over everything, and then they fly away. Yes, there is an element of that where there's a court case in Michigan from a few years ago where this woman had been living alone She clearly shouldn't have been living alone. She needed some help. She had severe dementia. They found her on her floor, and then someone got her to the hospital. And then after the hospital, they got her to rehab to get her a little bit stronger. And the seagulls, meaning the relatives, flew in from out of town saying, my grandma's not going to be in a nursing home. You should go home right now. And so they got her all riled up, and so she started telling the people at the nursing home, I'm going home right now. And they said, well, it's not safe, dear. There's nobody home to take care of you, and it's not safe there. And there was this big whole court case about it, and it was basically out of state relatives getting a person with dementia that's easily influenced and them well intentioned, but not understanding the gravity of the situation. Unfortunately, it happens too often. Absolutely. Let's shift gears. What I really want to do is kind of shift gears into your current role. I really appreciate what you do, just raising awareness. I think that a lot of the public, a lot of what I probably believed before I really lived this area of dealing with helping with families that need long term care, have a family member with dementia, was informed by culture, was informed by movies, was informed by Morgan Freeman, really, he's just fine. He's perfectly capable of doing everything on his own, and the kids are just overprotective. And that's where I think a lot of us get our ideas when it comes to this long term care concept, is from the movies, where in reality, it's always a very capable person in the movie and just wants to live the remaining years as free as they can. And the reality is that doesn't work very well when you have a bed sore that doesn't work very well when you can get confused going around the corner or get confused where you are in your own house. That's not real life. And yet much of the public. So I really appreciate the efforts that you have in supporting caregivers, educating caregivers, and even just going out into the community and educating the world about the reality of caregiving is. You know it's hard, There's even differences between caregivers. So a caregiver on my YouTube channel this morning said, well, you know, I cared for my mom for one year until she died, and I just don't understand how people can get burned out. And I said, well, if you had done this for five or ten years, maybe you'd have an inside of a caregiver who's been twenty four, seven and got isolated and couldn't leave the home. So there are so many misperceptions and you don't really realize what it's like until you are that person and then you are much more empathetic and understanding. Now, Pamela, we had an opportunity to speak earlier, and one of the things I know that you do is you sometimes talk to business groups and things like that. So I'd like to hear more about that. It's really interesting how this is a business issue. This is an issue for businesses about how do we make sure that our employees are going to be able to show up to work and do their work and be focused on their work. And it's not going to influence, it's not going to have the impact on making sure that we make payroll that week or whatever it is. So talk to us a little bit about the work you've done with different business organizations and things like that. Caregiving in the workplace is a huge issue. It's receiving more attention. So some companies are creating what they call employee resource groups. And so it could be a group of caregivers for elderly people, it could be a group of caregivers for their children. But what I do is I speak to those groups, they approach me, and normally it's about caregiving. Maybe they've done an internal survey with their caregivers, and their caregivers have a list of questions, or they want to know specifically about Medicare or guardianship or some topics. So I speak to those groups, and the company's premise is that we realize that our caregivers are stressed. Stress causes absenteeism. It causes caregivers. I think there's a statistic out there from a John Hancock study or a similar study that says about 30% of caregivers actually leave the workplace. So they quit their jobs to be a full time caregiver because they feel they can't do a good job at work, or that the caregiving is affecting their ability to show up consistently because they have to take time off work to take a parent to a doctor appointment, or they're inattentive, or they're just not feeling well. So there's a huge effect on the workplace from caregivers, taking care of elderly or spouses or even raising children. It's a huge issue for companies from a number of aspects. And I think it's so important that you're able to get out there and talk to groups and help them sort of get their perspective on some of these issues because for those that are going through it, it's hard to have perspective. But what's important, I think not just that you're helping those that are going through that and providing them with education and content and resources, but you're also out there kind of warning those that aren't going through it yet about, okay, you might need to start looking at preparing for this. And I think that's just such a valuable aspect of what you do. Well, it's hard to see what is six months or twelve months or two years ahead when you've never had that experience before. So I do try to talk to caregivers about. Here's a list of things you might want to think about. This is what can happen. And have these discussions early on before you're in the situation and you're burned out and you're exhausted. Earlier we were talking before we started the podcast, we talked about some of the work that you do in educating with regards to you had a specific term of art that you used when it comes to the doctors and how they interact with their patients. And some of the things kind of looking beneath the surface tell us a little bit more of it. So there's a term called social determinants of health. A similar term is health related social needs. Now, these are terms that clinical people and doctors, social workers use So the general public probably is not going to understand what those mean, but basically it's the 80% of everyone's life that impacts health. So for an example with a doctor, a doctor may think, well, you know My patient who has diabetes, they just don't want to take their medications. They're not listening to me. Doctors call this non compliant, but really what's happening on the patient side is the patient may not know how to take their blood sugar. They may not be able to afford insulin. So there's this disconnect between the doctor looking at this as a disease versus a doctor using what's called a social determinants of health screening that says, do you have trouble paying for prescriptions? Are you having trouble keeping a job? Do you have enough money to buy groceries? Can you pay your rent? It's all of those things that affect a patient's ability to care for themselves and to do what the doctors would like them to do. But we don't talk about it well. And it's so important that we do talk about it and that you're bringing some of these things to light and helping in that process. We have sort of a mentor that he's starting to get closer to retirement. He's out of Tennessee. His name is Tim Takacs as a lawyer down there and kind of innovated the care planning concept for lawyers. So we offer, in addition to the legal services, we offer care advocacy or care planning. And this is something that Tim had kind of come up with and really created probably 20 years ago now, maybe not that long, but he talks about how there is built in the law a lot of very helpful things that if you had a well educated knowledgeable, knew exactly what they could ask for. Patient there are some great resources within medicare, within the insurance system that are mandated that if you were thoroughly knew all of the details and were the expert, you could actually get really good health care services throughout and have that sort of continuation of care. But who's like that? I'm not even like. Thank you for bringing that up. That's an important topic. And the social workers who listen to your program won't know this, but medicare provides an annual wellness visit. Medicare provides an appointment for care planning. It's paid for through medicare. Pharmacists can do annual medication reviews that medicare pays for. And a lot of the social workers who listen will follow your line on talking about care planning because they do a lot of care coordination. They may be trying to coordinate social services in the community, maybe like meals on wheels or things like that with clinical care. So the social workers understand this very well and they're very passionate about it. Absolutely. And I think that was Tim's point, that there is no such perfect patient I've been working within the medicare and insurance system for 20 some years. And when I was a patient in the hospital several years ago, I felt just as lost as I know my clients do. And I know the law, I know the ins and outs. I know what we can ask for. I know what Medicare calls for and what is allowed and the procedures and the appeals that you can do and the demands that you can make. One of the things that most people don't realize from a discharge from a hospital, medicare calls for a clear, detailed discharge plan when you're discharged from the hospital. How many people feel like they regularly get a clear, detailed discharge plan when they leave the hospital? I'm not sure that that is something that most families feel that they have, but they also don't know that they can demand that or that that is actually required under the Medicare rule. But I can tell you, even when I was a patient I felt just as lost. Even though I'm knowledgeable about the intricacies of the law and the regulations and the statutes, once you're the patient, it's a whole different ballgame. It's a whole different deal. Well, and it is for the caregivers because they are so overwhelmed.

I can't tell you how many calls I would get Friday at 04: 24:03

00 from caregivers saying, pamela, my parents are being discharged from the nursing home and they didn't tell me. And I said, well, you know, they have this thing called three day notice. And I'm guessing that they had your mom or dad signed the paperwork and nobody told you. So it's the stress of the situation that impacts the caregivers. And when you think about it, doctors talking to patients, they don't speak the same language. Patients have no idea what the doctors are talking about, so they don't even know what questions to ask, which then causes all of these problems. We have for years now we've had what we call elder care coordinators or care planners in our office. Currently we have two social workers, but previously I had a registered nurse. She was in the sort of the waning years of her career and she just wanted sort of a final job that she could really make an influence and impact on people's lives. And one of the stories I love to tell is that she went to a doctor's appointment to the family. So the family had come in to see me and married couple and their kids and wonderful beautiful family and we were getting ready to set things up. They were talking about getting a ramp in the house and they had already contacted a contractor to get the ramp. We were talking about getting a hospital bed and maybe doing a little remodeling to make it so that this is going to be easier. They were working with us on how to rearrange the assets in order to qualify for Medicaid. And we had all of these things going and I sent my care planner, who in that case was a registered nurse, to the meeting, to the doctor's meeting. And so she sat with them and the doctor came in and did the doctor thing and then left. And she turned to them and said, do you understand what the doctor is telling you? And they said, no, not really. She said, Your dad's dying, and that's what we should be preparing for. That's what the doctor just told us. Dad's dying. Now, the doctor, I'm sure, thought he was very articulate in expressing that, but nobody likes to say those words. It's one of the things that people accuse me of being too blunt about life and death. And I do use dying. I don't use pass away. I don't use the nicer words. I'm going to be very direct with people because I think communication is too hard already. You've got to be direct. And so I'm sure the doctor very well intentioned thought that he had conveyed this. But the family would have come home. They would have paid for the ramp. They would have started to pay for the construction. They would have paid me for my services, to rearrange their assets and qualify for Medicaid. And none of that was necessary. What was necessary was to be there as a family, realize this was Dad's last days, and take care of dad and take care of each other. And they never would have had that had my nurse not been there to say, this is what's happening, because the family didn't understand what the doctor thought that he was clearly saying, well, but there is indefense of the doctor. So you'll find this interesting. There is a premise that doctors have to say something like, would you like to know more? Or they almost have to ask permission to talk about death and planning for death and all of that. Now, some doctors will just be more blunt and put it out there. But because doctors are not real comfortable giving bad news, sometimes they feel like they have to ask permission. And if the family doesn't catch that, like this family probably didn't they have no idea what's about to happen. And I think that that's true, and I even think that once the family is trying to ask more specific questions, it's a very difficult thing to say. It took me years to get to that point where I can look at somebody And from what I'm hearing from you, you're going to die soon. And we need to prepare for that. And to say it that bluntly, but that's what needs to be said. Because too many times I've seen, even with lawyers, where they're preparing an estate plan as if that this is something that, okay, we need to have this estate plan last over the next 40 years. Well, if we know that's not the case, we should plan differently. The circumstances should be differently. It should not be that generic plan of somebody that, for all we know, they're going to be here 40 years from now. And it's so hard for people to face this so directly. It took me a long time. I used to say, avoid the word saying you're going to die or death or anything like that. And I'd use those nicer terms like, well, when you pass away. And what I realized was I'm not doing anybody any favors by that. They're coming to me for a very specific reason in the same thing as avoiding the word like dementia. Oh, well, what if you have dementia? So when I have somebody that is in my office has dementia, we have to address that directly and say, okay, so I understand you've gotten a diagnosis of dementia. Here's the planning. We need to start thinking about what that means for you and how that's going to affect your life. And it's hard to look at somebody in the eye that's gotten this dreaded diagnosis and start telling them, oh, and by the way, it's going to get worse, I can guarantee you. And that's one of the things I always say is, well, if this diagnosis is correct, it will not get better, it will only get worse. And it takes a lot. And I think doctors and lawyers and most people really have a hard time being that direct, but often I feel like that's what's called for in these situations. No, it's very much needed, and I think it takes time in the industry, like for you and me, because I like you, I'm very blunt, and I'll share a quick story. So I had a client, I was her guardian, and we were doing wellness care, so we went and did a mammogram and the Doctor's like, well, you know, she's got a spot. You should go have it investigated. So we did, and the radiologist called me back there and he's like, oh, look at all these spots and blah, blah, blah, blah. I'm like, okay, what are they? He's like calcifications. I'm like, well, what does that mean? He's like, well, you know, in ten years they're going to be cancer. And I'm like, I'm not putting her through any more tests. She has Alzheimer's. She's going to be dead in two years. So walking out of this clinic, the nurse said, oh my gosh, thank you so much for saying no, for not putting her through that. These radiologists like to make money for the hospital, and they don't understand the effect on the patient, especially people who have Alzheimer's. So, again, that's something that most family members probably would have went along with because they because nobody said your loved one is going to be dead in two years. Why put them through all these treatments if there's going to be no different outcome? Absolutely, yeah, no, that's a very good and meaningful story. I want to tell the audience more about some of the resources. I was able to look through a lot of your resources and have an excellent website at pameldawilson.com, but I particularly liked your YouTube channel. So tell us a little bit about some of the content and information that you're providing on your YouTube channel. So, the YouTube channel is probably one of the most fun things that I get to do. So caregivers in my support groups and people will fill out surveys on my website and say, Pamela, answer this question, talk about this. And so on average, I release two videos on YouTube a week. I think there's about 600 there. But there are also so I have a very extensive course on my website called Caring for Aging Parents. It's about 60 hours. It's no cost, the only cost of the caregiver's time. There are six segments, one specifically on Alzheimer's, one talking about family relationships. And these are kind of all the foundations of the videos that are on my YouTube channel.

Some caregivers will find my channel at 03: 31:46

00 a.m. And say, oh my gosh, I couldn't sleep. And here's the answer to my question, and thank you so much for doing this. So there's a lot of good content on that YouTube channel and that's great that it's accessible. Whenever I call, those the worry hours.

If somebody's up at 03: 32:01

00 a .m., I know if I get some we have online on our website, people can contact us and send us a message anytime.

And I know if I got a message from someone at 02: 32:09

00 a.m., they're in the worry hours. They've got something serious going on. And yeah, I was able to watch a number of your YouTube videos and thought they were all very interesting and easy to watch. And so I wanted to repeat the name of the series that you have on your website. pameladwilson.com. You have a series called Caring for Aging Parents? Yes, and so I just wanted to repeat that in case people are looking for that. And then you have two other things I thought are really helpful and fascinating. I wanted to give you an opportunity to talk about you have a Facebook page for caregivers, and I'm going to have you tell them the name of that. And you're also doing a podcast, which is pretty cool. Yes. So the Facebook group is called The Caregiving Trap. It's a private group, so you do have to request to join because I don't want service providers in there. So it's mainly family caregivers all the way from 20 to spousal caregivers who are in their eighties And nineties, caregivers are very understanding. There's no controversy, and they're very supportive. And it's a place for caregivers to say, I'm trying to get a Medicaid application through, or, I don't know anything about hospice, or, I'm burned out. Can you guys empathize with me because I'm having a bad day? It's just a great group. There's about going on almost 900 caregivers in there. And then my podcast is called The Caring Generation. I'm probably, I'm guessing on about 160 episodes. And again, those episodes respond to questions that mostly caregivers ask. So all the content comes from caregivers that I talk to. Well, that's really great. I want to repeat those just for anybody that was listening and didn't quite catch it. The Facebook page, you have to ask permission to join it because she wants to make sure you're legitimate and not trying to sell something. And that is Caregiving Trap on Facebook. So that sounds like a really great community, and I'm glad it's out there. And then your podcast is called Caring Generation? Yes. And you can find it if you Google it on Apple, Spreaker, Spotify. It's on about 15 different podcast sites worldwide. Excellent. Well, Pamela, I appreciate your time. You're doing great work, and I appreciate all that you do. Is there anything else that you'd want to leave our audience with, tell them about you or anything else that you want to conve. For the caregivers I think if I can emphasize anything and I know caregivers hate to hear this, they want to feel like they can do everything, and they don't want to ask for help. Nobody does. Right. But the earlier that you ask for help, the more resources that you can have, like finding you Bob, an attorney. Right. The more resources you have, the easier caregiving is to manage over the long term. And just like your parents who you complain about because they don't want to accept help, do not be like that. Find help. Accept help. Find a support group, online courses. Please do search for information. It will make your journey so much easier. Absolutely. And that's such great advice. I've said that many times that people will ask me my active seniors that I work with will ask me, okay, well, what is the best advice for staying out of a nursing home? For never having to go to a nursing home? And my advice is accept help before you think you need it. Definitely long before you need it. Another way of saying it is, don't break your hip. Don't fall on ice. Don't fall off the chair when you were trying to reach for the top cabinet and get the plate out. Don't fall on the stairs bringing up your laundry from downstairs. Accept help. Get the help you need before you think it's necessary. And you have a much better chance of staying out of the nursing home, because when one of those bad things happen way too often, everything spirals out of control. And then there are times where people are going to spend the rest of their life in a nursing home, and sometimes it's because it started with something simple like a fall or a break or those types of things. Well, and on that subject, just one quick story, too, for your caregivers. So I call this the chair, right? You know those chairs that stand people up? So this is in my own family, right? My husband's like, I got to get my mom a lift chair. And I'm like, Why? And he's like, well, her balance is bad. She's going to fall. I'm like, no, you don't need a lift chair. She needs physical therapy. She needs to get stronger. She needs to fix her balance. She needs to walk. If she does that, she's not going to fall, and she's not going to need the lift chair. But a lot of caregivers think that the lift chair is the answer. They're actually harming their parent instead of helping their parents stay independent. Excellent point. Very good. Well, thank you again, Pamela Wilson from pameladwilson.com Thank you for listening to advice from your advocates. If you found this interesting and want to hear about some of our other topics, you can subscribe and you'll get notice of the future editions of this podcast, Advice From Your Advocates, and look at our catalog of all of the really great and interesting people we've been talking to over the last year or so. So thanks again for listening and don't forget to subscribe.