Elder Care Options in Akron

Nick:
Hello and welcome to the Ascent Health Show. I’m your host, Nick Angelis. I’m a nurse anesthetist and one of the owners of Ascent Health Center and I’m here with Tiffany Adjei. How are you today?
Tiffany:
Hi, how are you?
Nick:
I am great And I think our show counter is counting the wrong way, so maybe this won’t air, but that’s fine. It’ll make it more casual for us. Yes, I did have a question because you’re so integrated into senior care here in the greater Akron area. I’ve always wanted someone on the show to talk about this. When we first started Ascent Health Center, we went into all the skilled nursing facilities and there’s just such a great need both for their mental health and their physical health. So my first question is and then we’ll talk more about who you are and what you do, but more importantly, what’s wrong with elder treatment in the US compared to other places? What do we do wrong?
Tiffany:
I think with that being said, I think with it it’s more of I think we kind of lack empathy for them. I think, you know, we use we you know, with elderly, they usually, you know, when they’re when they’re home and they don’t really have, you know, a lot of people come in and assist them with specific things. I think instead of looking at them as a job or a number, you know, we just start looking at them as a human and just knowing, you know, these people have taken care of us, you know, throughout our lives. We have to treat them as such, right?
Nick:
So it’s more of a respect thing where instead of honoring our elderly, it’s more of like, okay, now you’re in this population that’s no longer required is useful. Like I read somewhere, one of the unique things about American culture is how once you turn 70 we feel like you’re fit to run the government, but nothing else. You know, we’re perfectly fine with presidents and justices and senators being 70, 80, 90. But if you want to do anything else, it’s there’s this huge ageism issue.
Tiffany:
Yes, for sure.
Nick:
Okay. Well, why don’t you tell us like how you started with health care and because I know you at one point you were trying to be a nurse and then you realized that, no, actually, I’m better served to help the elderly population by going a different path. So can you tell us a little bit about that?
Tiffany:
Yes, of course. I started off as a candy striper, so my mom, she had me volunteer as a candy striper. And I think once I you know, I’ve gotten that just feeling of experience of helping someone. I just fell in love with it, you know, I’m like, I’m going to go in here and just, you know, just work with these people and, you know, But then once I got in there, I’m like, I actually like this, you know, I love helping them. And then, you know, just getting older, going into nursing as a registered nurse, I transfer my degree over to Public Health and Health Services Administration because I already was into the home care industry at that time. So. Okay.
Nick:
And then walk us through what the different stages are because again, in this country now with my Greek heritage, which somehow I bring that up into every single show, it’s kind of embarrassing actually. But that’s also part of Greek heritage is talking about being Greek whenever possible. But both of my grandmothers, we took care of them until they died in our home. That’s part of the culture of that. You don’t send the elderly off into some home and visit them on Easter and Christmas. It’s like, Nope, they took care of you. Now it’s your turn to take care of them. Even if every night at 3 a.m. they start screaming about the donkeys and the fields as if they’re still in the village, yelling from the rooftops so that everyone in the village can hear them. That’s just what you do? Yes. So what’s the appropriate amount of this is a terrible question, but that’s fine. What’s the appropriate amount of sacrifice for like, okay, I can help you in my home or I can do this for you, mom. And when is it like, okay, I’m going to need some expert help.
Tiffany:
Yes. I think, you know, because there’s a lot of cultures that that do that, you know, they want to keep the parents or their grandparents home with them to take care of them. Like that’s what we’re supposed to do. You know, it’s like our job and specific cultures. But I think too is having the right team on board with you, the right doctors, the nurses, the, you know, having a good staff and planning for that I think is really helpful because you can’t do all of that alone. You know, it’s very emotionally draining. Sometimes when you’re working, you’re taking care of kids, you’re busy, you know, and then you have to take care of your loved one as well. So it’s like, no, you have to, you know, bring that team on to assist you with your loved one.
Nick:
So you’re saying it’s not appropriate to realize, oops, I’m overwhelmed, I can’t do this because a lot of times that moment happens when there’s a fall or an incident. You’re saying like, well, let’s if it seems like a little bit much, let’s get this whole team together and let’s start planning. So that way we can slowly introduce because obviously a lot of seniors also aren’t that excited about having somebody help them. It’s true. They value their independence. No one wants to end up. Dependent on people for every single daily need.
Tiffany:
Yes, it’s very true. And I think just, you know, having the right people in your in your in the guardian’s corner to assist them with, you know, the the different experience and things that they’ll be going through is having specialists come in to help with that. You know, because sometimes we’re not equipped, as you know, loving our loved one a specific kind of way. We’re just equipped to love them, you know, But we’re not we don’t have the the I would say the tools that we need to take care of them the proper way.
Nick:
You’re saying it’s also of objectivity that sometimes we can’t. Yeah, that makes sense.
Tiffany:
Yeah. So I just think, you know, just having the right people to come in and to help them to to guide the guardian with specific things so that they can have the right, you know, information that they need to help the loved one at the time.
Nick:
And the opposite could be a problem too, like being too objective. I mean, being a nurse anesthetist. I’ve done anesthesia for my brother. I don’t think you’re supposed to do that. Yeah, but also I was like, No, I’ll treat him like every other patient. But that’s not necessarily a skill either. Like the ability to be objective when it’s your own family members and you’re saying, okay, here’s the health problem. Here’s how we have to fix it. Yes, it can cause a lot of discord and it’s not a position where you want to put yourself in, correct?
Tiffany:
Correct. I definitely agree with that 100%. You know, it’s different with your loved one. It’s different with, you know, your your your grandmother or your parents. It’s just different, you know, because you have a certain kind of love for them, you know, and you want to make sure that, you know, we’re doing everything the proper way. But it’s also, you know, it’s your loved one. So it’s like, you know, just get the specialist to do the things that they need to do just to assist them with those specific things. Yeah.
Nick:
So what kind of specialist are we talking about? Because for one thing, you mentioned guardianship and a few other terms that not everyone might be familiar with. Yeah. So does it start with having power of attorney and deciding who’s helping mom and dad figure this out? Or what’s what’s the first step?
Tiffany:
I would definitely say, you know what the future planning having a definitely having a lawyer and things of that such, you know, involved. There’s a whole team of it. There’s the doctors, there’s the lawyers, there’s the like you said, the estate planner. These are the people that can give you the information that you need to help plan with that. You know, different the insurance information, the, you know, the doctors that can help with that. It’s just basically the therapy, you know, therapist that has to come into the home. So just having that whole layout of that core team to assist with, okay, Mom’s going to go into the home or Mom’s going to go here, she’s going to a nursing home, Is she going to stay home? You know, and just having those conversations early, you know, on when you’re in your in their, you know, 30s and 40s and things of that such is very important to start having those planning conversations to find out okay you know because a lot of times we just we only start planning when it happens right You know and it’s like we have to start planning before things happen. And I think just, you know, getting that that team of nurses and therapists and estate planners and things early on will definitely help with the issues that will come later.
Nick:
That makes sense. The show that we just did was all about families at holiday gatherings and how do you get along with them. And the message was you might get triggered, you might have your sympathetic nervous system start getting really anxious as you’re trying to deal with the family. So what you’re saying is like, why don’t we start this planning before it’s an issue, before we’re all distraught about Mom’s failing health and that way we can do so in a reasonable, drawn out manner that gets things done as opposed to, Oh, we’re also worried since the stroke and here we are as a family bickering and trying to find a solution. And a lot of we need to do something but not really understanding of what the next step is.
Tiffany:
Correct. And I think by just, you know, sitting down with the family and starting to have those meetings and those conversations is going to help with that process. You know, it’ll lessen the arguments for, you know, with that being said. So I think just like future planning is very important when it comes to the care of, you know, the loved one as well. Right.
Nick:
But isn’t there a danger and again, this is unfortunately part of my personality, isn’t there a danger of too much help? Like I’m trying not to make this morbid. It’s okay. It’s community TV. Yeah. So so when someone dies, usually there’s one family member who is the most distraught and the most Let’s do everything for mom. She meant so much to us. And then the funeral director might point out, okay, this is a family member we need to talk to. This is the one that’s going to get the platinum package. Yeah, I mean, that’s just the way it is. So, you know, there’ll be one member of the family that’s you know what Walmart.com sells caskets could really save. The money and then there’s somebody else like, No, it’s 40 dozen. Flowers are not enough. We really need 80 dozen. Don’t you care about Mother and what she meant to us? Yes. So how do we take good care of our parents but at the same time be reasonable about it? We’re okay. This is what we need right now and this is what we can afford. And this is what makes sense because unfortunately in this country, most of those discussions don’t happen. No, they don’t. I mean, I’ve I have them all the time with patients and they find it super awkward. Yeah, because I’m super awkward, but also because health care just understood as this thing where like it’s almost offensive to talk about the financial aspect of it. That’s true. I mean that’s not true in all cultures. Like I’ll just reading how in China now they have these COVID outbreaks. A lot of the elderly don’t want to get treated because they’re like, No, I don’t want my savings to go to treating me when it’s supposed to go to the next generation. Yeah. And in our country we kind of have the opposite feeling. Well, it’s like, Hey, let me spend all of my life savings on these last 90 days of my life in the ICU. So what’s a smart way to for family to talk about this awkward part of almost end of life planning? Yeah.
Tiffany:
I think too sometimes is having someone come in with the meetings and I would definitely say, you know, it could be like maybe a nurse or, you know, a therapist or someone that can, you know, really sit down with the family or also, you know, the estate planner, someone that’s actually, you know, going to plan majority of everything with them to help them make those decisions. You know, just having someone just be there as a support system as well because the arguments can start and also just making sure that there’s a will or you know, that who is the person that is over everything. Just like you said, sometimes they can be too much or too less. But you know, just having that that specialist come in and just assist them with the planning part of it all, I think they should be, you know, just through the whole planning process of that.
Nick:
So how does one find one of these estate planners that you’re talking about?
Tiffany:
Oh, yeah. They actually there’s there’s a website there’s a lot of websites as well that if you do have like a family lawyer, sometimes if you don’t, there’s there’s a, you know, a couple of websites that you can go to that can assist with finding an estate planner, you know, someone that will probably fit within the company. I mean, I’m sorry in the family you do have to do a lot of, you know, little research, but ask around. You know, I would ask, do you know a good estate planner or do you know someone that can, you know, assist with these specific things that we’re looking for? You know, I think just opening up and talking to people about that can So.
Nick:
Is it fine if our viewers just ask you?
Tiffany:
Oh yeah, yeah of course they need ask for everybody. Of course I do have a lot of resources as well that can assist with majority of that. I do have, you know, a list of estate planners, a list of lawyers and a list of doctors that I, you know, communicate with on a regular basis. So if they ever needed to do that, I can assist them with that. Okay.
Nick:
And since we haven’t gotten to this yet in the 13.5 minutes that we’ve been on the show, how what exactly is that you do now and how do people reach you?
Tiffany:
Yeah, I am the executive director for a senior staffing I have the company has been around since 2018. And Teresa, she is the owner of the organization. She actually is a ball of sunshine. So that’s why it’s called Sunshine Staffing. She really cares about the the elderly community when it comes to them. She cares about the care of elderly. And I think, you know, with that being said, they can find us at info staffing info at staffing a senior staffing.com. The phone number is also listed below that can assist with any care needed for.
Nick:
And I think that’s something that I found remarkable about the elder care community that if you’re searching for help, you don’t necessarily need to find the right person right away, that there are a lot of very accommodating organizations where. Yes, because I’m sure some of our viewers would be like, I don’t need senior staffing. I don’t understand what that has to do with my particular issue. But they can still contact you and you can point them at the next step.
Tiffany:
Yeah, for sure. We can definitely assist them with any information that they may need. I do have a, you know, have contact list, any information through the State Alzheimer’s Association. I’m also accommodated with as well. So so yeah, if they need any assistance I can definitely assist them with that.
Nick:
Now is there anything that they should avoid? I mean, this might be a more personal question for you, but there’s so many little niches in elder care and I’m sure some of them are a dumb idea. Is there any in particular that like, let’s say, assisted living is. Really expensive in this particular case or this one’s too much or this really isn’t doing because I mean, again, I’ve been a nurse since 2004, so I know all the stories where the state comes to inspect the nursing home and all of a sudden everybody’s brother who’s unemployed shows up to show the state like, Oh yeah, we’ve got tons of employees. And then as soon as the state leaves, it’s one LPN passing meds to 60 patients and you know, they’re not getting anywhere near the care that they need.
Tiffany:
It’s the truth. I think just having, you know, making sure that there is enough staff but also trying to find that quality staff sometimes can be very hard as well. And you know, the processes that we go through when we are bringing our clients I mean, I’m sorry, bringing our nursing assistants on, they go through like three different interviews, you know, and it’s like with the it’s almost like a matchmaking service, you know, just trying to find that perfect, you know, quality aide that can assist with, you know, with the client’s care. Sometimes that can be really tough to do, you know, But just making sure that, you know, you’re matching the matching the nursing assistant up with the you know, with the client, making sure their personalities and things match, you know, as well is very important. But I would definitely say because I have assisted living friends that are directors, come on, just tell us. What I don’t want to, you know, just to I don’t want to, but I can say that assisted living is a little more expensive than home care. Okay. You know, because they do have to you know, there’s activities they may sometimes go on different trips and things, you know, that they have to pay for their meals. And so there’s a lot of different things that’s included with that. But, you know, if a if a if a client is home, you know, the A prepares their food, the food is already in the home. So you do save a lot of cost, you know, working just them living in the home and nobody wants to really leave their home, you know, So it’s just we try to keep them in their home as much as we can and just bring them that, you know, that trust and safety to the home so they can feel comfortable as well with, you know, a stranger being inside of the home.
Nick:
So so what you’re saying, though, is that if of your thinks that their parents need to be going to a nursing home or skilled nursing facility or even assisted living, it sounds like it’s not that much different from selecting a college like, oh, this one has a rock wall and they have a buffet await Look at the tuition. Like you have to really think is this a need to have or a nice to have? Because a lot of times it’s just guilt based where you know, I haven’t really seen mom and dad a lot in the last few years. So let me get them a really nice nursing home and that’s irrelevant to what they really need. Yeah.
Tiffany:
Okay. It’s the truth. I agree. Sometimes I think going off of the need of the client is very important. You know, just really paying attention to, okay, where would mom be comfortable or where would that be comfortable? Where do we you know, and also asking them where would they want to go? Sometimes, you know, we don’t actually ask them, talk to them and speak to them. Okay, Mom, where would you want to go or what would you like to go? You know, how are you Where are you feeling? Of course they’re going to stay home, you know, But sometimes it is you know, you have to make the best decisions for the client. And I understand that sometimes they can’t keep them home. But, you know, just adopting that system is just, you know, that core team system. Right? It’s just very important to to start off with. And again.
Nick:
Specifically what you do now is it’s home health with nurses aides. So if someone can no longer be by themselves 24 hours a day if they need help bathing and washing, that’s the sort of care that you’re talking about. Yes.
Tiffany:
If someone being there, you know, with them majority of the time to assist them with their, you know, the shopping, the errands, the bathing, the you know, also the medication reminders, you know, we have now where the the nurses will be doing the medication, reminders, the lpns. If so, if they need their medicine, we can have a nurse come to the home and actually, you know, provide them with that service if they you know, also if we need any anesthesia or anything and I wouldn’t say anesthesia, but any pain management, we can call you Nick that you can so you know you know and moving towards more into the telehealth as well is kind of important. You know, instead of them going out into, you know, the doctor’s office and in the winter time, they can do that online, you know, which also makes it more easier. So just trying to also make it convenient for them because I think what we’re really trying to.
Nick:
Do and there’s different options where you can have somebody come in once a day just to check on you or somebody who’s there for hours every single day. That’s what you’re talking about. Yes. And again, the whole goal here is to keep them in the home. Correct. At. That point Is home health care not an option anymore? How sick does someone have to be?
Tiffany:
No, I would definitely say if they’re close to, you know, basically the end of life. You know, if it’s you know, has something to do with them, basically just, you know, hospice, I would say they do have hospice nurses that comes into the home for that. But you know, if it gets too bad, I would say that probably would be like the worst case scenario where they would have to go to a hospital or to stay in a nursing home if, you know, they can’t really do too much. I mean, they can still stay home with a broken leg and things of that such. But I would definitely say if it was close to just the end of life, you know? Yeah.
Nick:
Because that is another awkward thing about our health care system here in America is that poll after poll shows that nobody wants to die in a hospital. And the reality is that almost everybody dies in a hospital. Yeah. So finding that balance of like, okay, here’s the care that you need and the realization of like, well, what’s the end game here? Like what will we be able to do by moving you out of your home? Is it just okay, you may live a few weeks longer, but then you have that separation from your house, from your friends, from your family. And that’s where which was probably originally going to be the purpose of this show. But this is all really important information. Yeah, the mental health of seniors is obviously a passion of mine. Me too. And we see that all the time at Ascent Health Center where they’ll tell their kids one thing and then when they come in to see our psychologist or a psychiatrist, it’s a different story. So what’s the best way to help the mental health of seniors? Like what have you seen in your work with them?
Tiffany:
Oh yeah. I’ve actually I’ve had a client as well because I also serve clients myself because I have like, you know, I’ll I’ll meet the client first and then they fall in love with me and I have to care for them myself. So I go back into the nursing role as well from time to time. But I did. I have this client of mine during COVID, you know, there was a lot of isolation and loneliness for the elderly community and during that time we did like grocery shopping for them, you know, dropping their groceries off for them during that time. What I did personally is with a lot of the clients, I actually delivered cards and flowers to their houses and the family that, you know, that I spoke with. They always used to like really thank me for that because I think during that time, you know, with the mental health, it was really bad for them. You know, they were alone. There wasn’t they couldn’t a lot of people couldn’t go see them. Their families couldn’t see them even inside of the nursing homes, You know, you couldn’t see your family members. So there’s just the loneliness and the isolation that they had at the time was just very I was saddened by it. So I’m like, what could I do? You know? And so I would just personally write them cards to let them know, you know, I’m here, we’re here, you know, write us a letter, do video chat, you know, things of that such just to get them to understand, you know, they do have someone here and you’re not alone. So I think just trying to, you know, just be there for them and not just, you know, just leave them alone and not think about them. I think we need to start being more, you know, empathetic when it comes to things of that such when it comes to the elderly community.
Nick:
So you’re also saying if someone’s like, well, my father is getting sicker, I don’t know what to do. I don’t have health care background myself. I can’t really take care of him. Well, at least you can do is visit him. The least you can do is be there, strengthen the relationship very much because in our practice what we see a lot is this diagnostic differential, is this dementia or is this depression. And a lot of times it’s interwoven in such a complex way that know what they really need is a strong relationship with those who are important to them. I agree. I mean, we’ve seen almost miracles where it was thought, okay, this is end stage dementia. And I was like, Nope, they need to talk to a therapist to work through some things even at their age. Because you’re right, these these are the generations where if they’re suffering with physical pain or emotional pain, they’re not going to go make a tick tock about it. Yeah.
Tiffany:
We go to social media, Facebook and things of that such they you know, when it comes to technology, you know they’re not too good with that. So, you know, it’s just, you know, just making sure that we’re giving them that contact and they love when you come to see them, you know, it really helps them with their mental health is just, you know, and dogs, dogs as well. They love dogs. Dogs can always make you you know, even us as people, we just we love dogs, you know, And elderly community loves animals. They love people to come in and just see them and just to know that they’re here, they’re alive. They’re, you know, still thriving and moving. And, you know, I think just. As you know, tapping into that with them is really helped them out mentally. Right.
Nick:
And I think that’s a better way to approach it, too, because, you know, we do some cases where we’ll do tests to see what kind of cognitive impairment is going on. And a lot of times that’s hard for the elderly too. Like, what are you trying to figure out? Why am I here? But a lot of times I’ll tell family members like, Well, why don’t you have your mother come and talk to one of our therapists or see our psychiatrist? And it’s not to establish a patient who will have to see us over and over again. It is just a healthy checkup to see where are we, what might we want to do in the future. Let’s get a baseline before the health deteriorates so we can sort of see, okay, here’s a path whether it’s for pain management with a Ketamine infusions or some of the other interventions, because I think that’s really important for the elderly too. Very important. They have so many medical interventions where it’s like, all right, here’s this pill. Take it till the day you die. So I think we need in this country, we need to be conscious of what interventions can we do that are still limited, that are still here’s what we need to do for today or for the next few weeks, and then we can lay off of this and continue to focus on the quality of life instead of just necessarily the numbers of days that you have left.
Tiffany:
Yes, I definitely agree with that. And just taking them out from time to time, you know, like sometimes I guess with people, we think just because they’re in nursing homes or they’re in the house that they can’t move or get up and go, we can take them to lunch. You know, you’re allowed to take them places and, you know, take them to like their favorite just, you know, specific things. Like I used to have a client that used to love baseball and he loved baseball so much. And I’m like, when was the last time you’ve been to a game? Like he could walk in everything, right? You know? And so what I did was I set him up with, you know, one of his I think it was his brother or his nephew. It was his nephew, I’m sorry. And his nephew. I talked to his nephew. I said, why don’t you take your your you know, your uncle to a game with you one day and, you know, just a suggestion, You know, I’m like, he can still walk and move around. He can do these things. And I spoke with him. He got them some tickets to go see the Indians and it was just awesome. You know, he and because I wanted to talk to him and converse with him, I’m like, So how was the game? He’s like, Tiffany It was and it was just the liveliness and him lighting up and just talking about those things. So it’s like that helps with mental health as well. It’s just doing things with them, you know, taking them places. They’re not glued to the couch, they’re not glued to those things. So I think just, you know, keeping them active as well if they can be, is very, very, you know, relevant to them as well.
Nick:
Well, that’s all the time we have for today. But thanks for coming on the show, Tiffany.
Tiffany:
Thank you very much for having me.
Nick:
Absolutely.
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