Podcast #129 Navigating Modern, Meaningful Caregiving – Allison Applebaum, Ph.D.

Allison Applebaum, Ph.D. sees caregiving through both a personal and professional lens, giving her a unique take on the logistics of individual situations as well as the broad view. She talks about the “three buckets of responsibilities” that are common for carepartners; offers ways to create support both internally (think: breathing) and externally (think: build a team of support); and asks two big questions:

1) “How can our healthcare system better prepare caregivers for the tasks they face?” and

2) “What does it mean to find meaning in caregiving?”

⁠https://allisonapplebaum.com/⁠

⁠https://www.instagram.com/drallisonapplebaum/⁠

⁠https://twitter.com/DocApplebaum⁠

Transcript:

Diane Hullet: Hi, I am Diane, and you’re listening to the Best Life Best Death podcast. And this week I’m talking to Dr. Allison Applebaum. Welcome, Allison. I. Thank you 

Allison Applebaum, Ph.D.: so much for having me. 

Diane Hullet: So I came across Dr. Applebaum’s name in a New York Times article in December of 23, and it was this kind of intriguing article about caregivers and anger.

And I read the article and I was like, I’ve gotta find this woman because she’s writing a book and her new book comes out in February of. 24 and it’s called Stand By Me, A Guide to Navigating, modern Meaningful Caregiving. So welcome Allison. I think we’re gonna have a great conversation. This is a topic that’s really important, and I think so many people are, if they’re not caregivers yet, they’re looking at the future going, oh, I’m gonna be a caregiver or need caregiving.

So, you know, that’s kind of how I came to your book. Tell us. You know, both your, a little bit about your professional experience and then also your very personal experience about caregiving and your dad. 

Allison Applebaum, Ph.D.: Absolutely. And just to start by saying, yes, this is the role that touches us. All right. There are currently fifty-three million American family caregivers.

It’s likely an underestimate, actually the number’s probably a lot higher and all of us step into and out of this role repeatedly throughout our lives. And it’s one that forever changes who we are and the trajectory. Trajectory for our life moving forward. So I’m a clinical psychologist by training and, and how I came to this work.

 Professionally, I am currently just by title. I’m the, the founding director of the Caregivers Clinic at Memorial Sloan Kettering Cancer Center, where I’m also an associate attending psychologist and, and I’m an associate professor of psychology at Weill Cornell Medicine in New York City. When I began my postdoctoral fellowship at Sloan Kettering in psycho-oncology, which is the field that combines oncology and mental health care.

I was providing care primarily to patients at end of life. And what was so striking to me about the conversations that I was having with these patients was that the focus was not so much on how they were doing. I. On the parent or partner or child or sibling or friend who was left in the waiting room or who was at home and who these patients were identifying as the linchpin of their care, the the person who was really holding everything together and the person that they knew would be so very deeply impacted by their eventual death.

And it was so striking to me at the time to realize that there was very little support for these family caregivers. That year I also had an experience where I was asked to review an, an, a new protocol for an outpatient and homebound stem cell transplantation program. This is back in 2010. This is now the norm at this point, but back in 2010, this was very novel.

And what was so striking to me about the protocol is it’s stated that in order for a patient to receive this type of transplant where they get their stem cells and they go home. That they needed to have a caregiver available twenty-four, seven for at least one month and ideally up through the first 100 days.

And I thought to myself, what an incredible ask. We are asking families to shoulder these responsibilities, then we as a healthcare system should be providing training supported education to these very same families. And I realized at that time that there were no targeted support services for family caregivers in any cancer center in the country.

And so a year later, in 2011. I founded the Caregivers Clinic at MSK, whose goal was to provide targeted psychosocial care to family caregivers of patients with all sites and stages of disease across the caregiving trajectory from diagnosis through bereavement. I founded the clinic in 2011 and soon thereafter, my own caregiving journey being my own caregiving journey began. 

My dad had been living completely independently up through his late eighties. And had begun in his late eighties to exhibit some minor part in kidney failure that then progressed and a series of events happened at that time in his early nineties which led to a diagnosis of Lewy body disease.

And at that time, I stepped in to be his primary caregiver. I. 

Diane Hullet: Wow. I mean, what a combination of events. And I think you know what you said about the caregivers. You began to see that not only did they need support mid journey, but education, right? Because here they were being sent home with I, I’m sure, some degree of cursory education.

You know, kind of a, here’s what you’re gonna need to do. Here’s the page of directions, which are often kind of indecipherable. But the ongoing support, the weekly touch-in that, that, that was just really new back then. Is it more commonplace now for hospitals to have this. 

Allison Applebaum, Ph.D.: Here is absolutely moving to the home, right?

We are seeing this. This was pre-pandemic, though certainly the pandemic underscored this shift of care outside of the hospital, but certainly we are seeing families being asked to shoulder more and more responsibilities. You know, I think you point to a piece, which is oftentimes families are, are given very little information and education.

I should acknowledge, you know, for all of us, myself, very much included every time my dad got discharged from the hospital. That was one of the most overwhelming moments for me because it meant a new skill set that I was gonna have to have a new set of responsibilities. I was gonna have to assume, and and very infrequently did I ever receive any formalized training.

Now, things have shifted since the time I stepped into that role back in 2011 and 12, which is that we currently in this country have public policy, which is aimed at addressing this issue for us as family caregivers. It’s called the Caregiver Advice Record Enable Act, care Act. It’s as of today in 2024, passed in 45 states and territories, and it requires hospitals at the point when a patient is discharged to provide caregivers with training and education so that they actually know how, how know, how to take care of their loved one when they go home.

Now the reality is that it’s not as if today consistently implemented. So there is a lot of work to be done to, to help caregivers to take on what, what is. Enormous responsibility and increasing each day. And 

Diane Hullet: so back at the beginning for you, it, it’s interesting, you know, there has to be sort of the top down level of lobbying and advocacy that says this is important.

And then there have to be the model programs like you started that say, and this is what that might look like and this is how we might do it. Right? One of the things you talk about in your book is, is the power of language and the importance of language. Say a little bit about 

Allison Applebaum, Ph.D.: that. I think one of the challenges that comes up in terms of caregivers receiving support and education is that they don’t always identify with the phrase family caregiver or purely the word caregiver.

And so, you know, oftentimes caregivers, I’ll just use that word here, will say to me, Dr. Applebaum, I am just the daughter or the wife, or the child, or the friend. I, I’m not necessarily a caregiver. And so. I think that it’s important to consider a wide array of language we use to describe what we’re talking about here.

There is no gold standard language, and I, I should say that one of the goals that the National Alliance for Caregiving has outlined in 2024 is actually to come to consensus around what is the right language to use. So, you know, we have caregiver, family, caregiver care, partner, partner, and care. We could probably come up with.

Five or six more phrases. What I can say is there are certain phrases that we know are inaccurate. I’m gonna, I’m just gonna give you two because I feel very passionate about these. One of these is the phrase informal caregiver, and this was actually a phrase I’m completely guilty as charged. I, I had seen it used in the scientific literature, in dementia caregiving when I came to this field in 2010.

 And I adopted it early on, but I realized very quickly. There is absolutely nothing informal about the work that we do, the physical, emotional, spiritual, existential, and financial care that we provide. There’s nothing informal about this, so we need to get rid of that word informal. We are superheroes, we are formal caregivers.

We are not informal whatsoever. The other phrase that gets misused and appropriately used is that of caretaker. There’s two reasons why this word bothers me, and one of them has to do with what is at the heart of what it means to be a caregiver. That is us giving of ourselves to someone else. We are giving energy.

We’re not taking it. For sure. Anyone who’s been in the role knows this is all about giving, not taking. So that’s inappropriate. But by definition, a caretaker is someone who oversees land or property or even a funeral home. So that’s really not what we’re doing here. So those words and phrases we know are not right.

I think what’s most important is to understand that individuals may not initially identify as a family caregiver, but it doesn’t necessarily mean they’re not in that role. Yes. 

Diane Hullet: Yes. I think, I mean, one of the things I loved about reading your book, and I feel so fortunate that I got to read it ahead of time, right?

It’s coming out in a couple weeks and in this advanced copy, you know, you do this beautiful job of weaving your personal story as the daughter who’s the primary caretaker, wrong word, caregiver 

Allison Applebaum, Ph.D.: correction, and 

Diane Hullet: you, you talk about your role with that interspersed with both. Observations about what it means and practical what do I wanna say, like practical steps you can take to work with that role because it’s such a difficult role.

So one of the things I think is that, you know, you really say there are three buckets of responsibility for which caregivers are woefully, underprepared, often not always, and, and those are caregivers as healthcare professionals, caregivers as case managers. Caregivers as mediators. And I really was struck by how you broke it out in those buckets, so to speak.

And I wanted to address kind of each one of those. ’cause I just think they’re so different and so important in terms of understanding what does this role take and why does it feel like such a cluster and so complicated sometimes. 

Allison Applebaum, Ph.D.: Absolutely beautifully said. I’m gonna start by, by saying an elephant in the room, labeling an elephant in the room.

Family caregivers are a critical member of the healthcare team. And we as family caregivers form the long-term care system in this country. And we are not paid to do so even though we know our efforts are currently, I think, valued at $600 billion. So these are elements of our role and responsibilities that take many caregivers by surprise, but really form the bread and butter of daily life of caregiving.

So caregivers as healthcare professionals, and, and this goes to what you and I were just talking about, which is that. We are increasingly asked to assume medical and nursing tasks once performed, only by trained medical professionals and too frequently without training and support. So for me, this meant I took my dad’s vital signs.

I administered both oral and injectable medications. I cared for his suprapubic catheter. I did wound care, all sorts of things that always, when he would get outta the hospital would mean another task. And the skills can range from simple, such as, you know, doing. Blood pressure with a digital machine to actually managing a pick line.

It can get very complicated, and I think that we as family caregivers are often unprepared. Now, one suggestion, I’ll, I’ll share that I, that I, that I discussed in the book is that, you know, while we wait for our public policy to really be instituted, you know, we might not always be getting our needs met immediately.

So we need to be educated consumers, and that means before you leave the hospital, I wanna encourage you, if you’re in this role, to ask a nurse. Or other member of the healthcare team to demonstrate for you what it is you’re gonna need to do when you get home. And then I want you to perform that task back for that healthcare professional so that you feel confident and competent to do so when you get home.

And similarly, many patients will be receiving, visiting nurse visits, post a hospital discharge. My dad always had that in New York State through the visiting nurse service of New York. I want you to consider every visiting nurse visit an opportunity not only for your loved one to be evaluated, but for you to be able to brush up on your skills again, have them demonstrate for you tasks you need to do and make sure that you know how to do them.

That’s how I learned to take blood pressure. The old-fashioned way was from a visiting nurse. So, so you’re gonna have a a, a nursing degree and a medical degree, and guess what? You’re also gonna become a case manager. So case managers are by definition, paid employees and hospitals who help to coordinate care, but you’re not gonna be paid to do this.

Your case management responsibilities likely will range from coordinating care, navigating insurance coverage, navigating medications, getting the home safe for your care partner if they have some limitations in mobility. It also means navigating home healthcare and implementing home healthcare, and this actually comes as one of the most enormous responsibilities for me.

It actually was the most prominent of my case management responsibilities and actually. It was very surprising for me and my mother who was alive at the time when my dad was first ill. I should say that my caregiving journey was punctuated by the fact that a year into it, my mother died very suddenly.

And so my journey was, took a, took a significant turn and very much shaped by, by trauma and grief. But when she was alive, when, when my dad was first ill, she and I were both shocked to learn the traditional insurance, blue Cross Aetna and Medicare. Does not cover home healthcare. In fact, there are three routes to implementing home healthcare and those are out-of-pocket pay, which can be exorbitant long-term care insurance.

If you’re lucky enough to be able to take one out, I strongly encourage you do to do so. And if you have in the past, thank God. Then the third is through Medicaid and for for many older adults, they fall into a gray zone where they make too much money to qualify for Medicaid, but they don’t make enough money to pay for, for home care and to live in.

My dad was in that category, so for me, my responsibilities included getting him onto Medicaid and implementing home care. You know, I go into detail in the book about my journey and, and, and share some guidance there, which I’m not gonna share here except to say. That the earlier you can speak with your care partner with other members of the care network of your family about what resources are available to pay for care.

The earlier you can do this the better you’re gonna be able to navigate these case management responsibilities down the line. And I’ll also say that this is where being formally identified as the power of attorney. For your care partner can be very beneficial. It would’ve been impossible for me to navigate the financial side of caregiving had I not been my dad’s power of attorney because he wasn’t unable to do this on his own.

And I just 

Diane Hullet: wanna highlight the piece that you just said, which is activate the resources in your network and you know, translating that really, it’s like, is there another sibling? Is there a cousin? Is there an aunt or uncle? Is there a dear family friend who might. Have some of these skills and could share these responsibilities.

Yeah. With you and for you, because it can just be daunting. How are you managing the physical needs of the person you’re caring for, while also trying to make those insurance phone calls, which by the way, have to be made during, you know, certain first hours. Oh, and you’re employed and so you can’t, you know, it’s just the juggle of trying to keep all the balls in the air and make these.

Inroads with these difficult kind of bureaucracies that you have to navigate within their hours and their restrictions is really it’s, it can be such a maze. So you really have to you know, activate your resources, whatever that looks like, whether it’s financial or 

Allison Applebaum, Ph.D.: social. Yeah, and I think just towards that end to piggyback on what you share, which is that there are likely members of the care network who are better suited to navigate the financial elements or, you know, the legal elements of caregiving versus the hands-on.

And being able to delegate is a beautiful thing. I strongly encourage caregivers to delegate where they can to create more bandwidth for the hours you will spend on hold with your, you know, with Medicaid or God knows who else, or the time that you are. Engaging in more hands-on caregiving, any way you can delegate it is a really, really important thing to do for yourself.

And 

Diane Hullet: this kind of leads right into this third bucket of responsibility of mediators. Say, say what your experiences with 

Allison Applebaum, Ph.D.: that. You know, so we as caregivers don’t necessarily, we don’t ask to become caregivers, most of us, but we emerge from this role with some fine-tuned communication skills. As family caregivers, we are asked to navigate communication between our care partner and between members of the healthcare team and with, with difficult family members potentially, but with family networks.

And we are almost the hub of communication. And so I think this, this often takes many caregivers by surprise. It’s superimposed on all the other things we just talked about. They’re then going to have to field phone calls from family members, navigate how to communicate information, getting on the same page when members of the family are on different pages about mom’s goals of care, or you know, what she wants to do in terms of the last years or months of her life.

For example, this could be very, very difficult. You know, I talk a lot in the book about some communication skills that caregivers can learn rather quickly. I can give you for two of them right now as a take home, but I think that. I, I always like to empower caregivers to take control of conversations and take control of situations in which we feel powerless.

You know, one of these is, is the feeling like you as a caregiver really want to talk with your care partner, the patient, about their goals of care, about advanced care planning, about what they want in the future. But inevitably, this is a conversation that. Invites an elephant into the room and that elephant in the room is deaf, and you as a caregiver might be ready to have that conversation and your care partner might not be at at this point.

And so I encourage you to do what I call setting the agenda, which is basically putting out on the table. Write. Write immediately what it is you wanna talk about and why. And you can practice setting the agenda in advance of the conversation. You can practice multiple times so that you can feel confident in actually saying it.

So for me, with my dad setting the agenda sounded something like, dad, I would really like to talk with you about what type of care you wanna receive in the future. If there comes a time that we can no longer control your Lewy body disease hallucinations. If there’s a time that you can’t communicate on your own behalf, I wanna make sure that I understand what’s important to you so that I can make sure that you get the care that you need.

Can we talk about that having a, you know, setting the agenda at the opening of a conversation? Once you do, you take an exhale. I just took an exhale, reimagining myself, having that conversation. And while maybe your care partner might not be ready to, to respond, at least you’ve opened the conversation.

You know, it’s also gonna be, you are likely gonna be asked to navigate difficult, difficult relationships with family members and others in the care network. And, and I think what can be so important is to realize that in a family, I’m using family as both blood, family and chosen family and a family network.

A lot comes up in this, in, in this setting of caregiving, old traumas, legacies of hurt, legacies of loss come up. And to realize that we as family and caregivers. A lot is getting projected onto us. We are a logical target. And so in those moments, it’s funny, I’m gonna call this a communication skill, but one of the best things that we can do is take a, take a really deep diaphragmatic breath.

You know, if it’s difficult conversations or if we feeling like everybody needs our attention, it’s taking a deep breath in through your nose, holding for a few seconds, exhaling through your mouth. When we do that, we bring oxygen to our brain. We lower our stress hormone cortisol, and when we exhale, we are then better able to respond.

And in fact, the moment when we take that deep breath also allows us to think about what we wanna say and maybe soften what we were about to say. Yeah, and I 

Diane Hullet: love that idea, and you really talk about it so eloquently in one of the early chapters of the book, the power that we carry, this regulating possibility with us all the time in our own lungs, their own noses and mouths.

And so to use that and you know, it’s easy to kind of dismiss it and go, oh yeah, yeah, I know. Breathe deep, whatever. But really in a stressful situation, it does make a difference. And so. Pausing, remaining calm, you are in that role of mediator, most likely. So using that is a, a genuine tool that I, I think we too often dismiss as being overly simple, when in fact it’s the base.

Yeah. 

Allison Applebaum, Ph.D.: So much is taken away from us in terms of control. I think caregiving is, you know, an environment of powerlessness and helplessness. There’s so much uncertainty. So one of the things we, we do have control over though, is our breath, and that’s where I encourage taking control over this one thing, which is so powerful.

Diane Hullet: Yeah, you, you devote a full chapter to talking about direct care workers and, you know, there’s a whole bunch of different names for what they can do and a bunch of different roles they play. But let’s talk about kind of what they bring to a situation and, and how for most people, they wish they had brought help in sooner.

Allison Applebaum, Ph.D.: Yeah, yeah, absolutely. So, so, right. So there’s many terms used to describe different delineations of direct care workers. I’m gonna use the phrase home health aid for simplicity here to refer to someone who comes to the home to help take care of your care partner. And based on state and federal regulations, home health aids can, can perform a variety of different skills and tasks ranging from helping with activities of daily living and instrumental activities of daily living to actually.

Dealing with some of the nursing and medical tasks that, that you and I talked about earlier. A theme I hear again and again from my, my patients is the wish that they had included a home health aid on their team earlier. Now, I would say in part, you know, I work in a cancer center where oftentimes the, the caregiving journeys are, are, are, are shorter than long haul dementia or Lewy body disease caregiving.

So the time to implement care might have not been there. But, but oftentimes I will hear this wish to have implemented care sooner. And I think this is because at first there’s often hesitancy to involve a direct care worker, a home health aide. Many caregivers will say to me, nobody can do this as well as I can.

I am the expert on my, my husband or my, my child or, or my parent. And while that might be true, I, I personally felt strongly that I was my, the expert on my dad. I knew Stan Applebaum better than any healthcare professional out there. That didn’t mean that the team of home health aides that we had didn’t also become experts.

And weren’t able to very beautifully knowledgeably in a caring way, take care of him. You know, another concern, and this goes back to the, the topic of mediation is many caregivers will say, you know, if I bring a stranger into the home, the dynamic at home is gonna change. I wanna validate that that’s real.

There absolutely can be discomfort in bringing someone new into the home, especially someone who likely will be assisting with very intimate acts like bathing or toileting, that that could be challenging. But I strongly encourage you to consider the benefits of having that individual and, and the benefit to you as a caregiver.

The more that we can delegate some of those intimate activities of daily living, that that hands-on and quite frankly arduous, physically challenging caregiving. The greater energy we’re gonna have to be present with our loved one to be present with our care partner. So ultimately, while, yeah, sometimes I felt like there wasn’t privacy at home for me to talk to my dad about that, that thing that I wanted to talk to him about privately.

Ultimately, having those home health aides allowed me to be much more present with my dad than I would’ve ever been able to be without them. And so I strongly encourage caregivers to consider integrating home health aides onto the care team as early as possible. 

Diane Hullet: And what about when the care partner says, Nope, I don’t want anybody in the home.

Yeah, it’s, 

Allison Applebaum, Ph.D.: look, it’s difficult. The reality is we can’t force it, right? And I certainly, if my dad had said, I don’t want anyone in the home when he was oriented, I would have listened to that. I think ultimately in cases where patients and caregivers have been discordant and their desire for help, unfortunately, oftentimes there’s an event that happens.

A fall, an accident, something in the home, that that is the red flag that says, you know what? Actually we need help. Now, I will also say something many caregivers have found helpful in my practice when the patient is resistant, is to open a conversation with the medical team about the possible benefits of having a home health aided home for many patients.

Hearing that message from a physician or a nurse on the healthcare team sometimes. It drives at home stronger than hearing it from the caregiver. 

Diane Hullet: You know, I love you. Talk about that. Your goal in writing the book in some ways is to create empowered and educated consumers, you know? And that’s, that’s I think so key because I think we fall into this role without a lot of education.

And, and as you said, it is a role of helplessness on some level. So this idea that we can be empowered through this role, I think is really powerful. And you also spend a whole chapter, which I found really moving, talking about. You know, finding meaning in caregiving. Can you talk 

Allison Applebaum, Ph.D.: about that a little?

Absolutely. It’s possibly my favorite topic. So I, I wanna preface this and, and certainly I do so also in the book with saying that, that this is not about the power of positive thinking. This is not about turning lemons to lemonade. You know, that’s not who I am as a psychologist, and it’s certainly not who I am as a person for those who know me personally.

But this is acknowledging that suffering and meaning can coexist. We can be put into situations of challenge and hardship and loss, those we did not choose, and caregiving is one of them. And at the same time, connect to an, you know, a very intense feeling of meaning and purpose. And I, I use a metaphor in the book, I’ll, I’ll share, I’ll share with listeners, and that is of my favorite dessert, which happens to be the creme brulee.

For those of you listening who are not crime relay aficionados, when a crime relay is done properly and, and it, it rarely is, I, I’ve maybe found it twice, but when it’s done properly, it’s crispy on the outside and it’s creamy on the inside and it’s cold on the inside and it’s hot on the outside, and you take that first bite and there’s so much going on.

And this is, this is how I think about the emotional experience of caregiving. At any one time, we can feel sadness and heartache, and hopelessness, and fear, and anxiety, and isolation, and guilt, and disgust, and love, and hope, and connectedness and growth. We can find our voice. We can be strong. The suffering and the meaning can coexist in a brilliant creme brulee.

While we don’t choose to become caregivers, most of us, or we don’t choose the circumstances in which we are, we are thrown, we can actually choose to connect to meaning and purpose. It is always there. Sometimes it’s hidden at first, but it’s always there. And I think one of the silver linings here is that caregiving provides us repeated opportunities to connect to meaning and purpose.

And while I certainly would trade in my caregiving journey for my dad to be here to give me a hug when I get off this. This podcast, you know, I’ve emerged from caregiving as Alison 6.0. I’ve grown, I’m stronger. I’m more peaceful. I’m more outspoken because of it. And that’s what I’ve heard again and again from thousands of caregivers.

And I’m guessing that many of your listeners have found that as well and, and certainly it doesn’t. It doesn’t compensate, it doesn’t make up for loss, it doesn’t make up for suffering. But it is, it is a gift in some ways to be able to say, despite all that I would give back, I have grown. 

Diane Hullet: Beautiful. This, this feels like the perfect moment.

We are coming to the end and it feels like the perfect moment to say a little more about your dad, Stan Applebaum. Because the title of the book Stand By Me, really comes from the famous song that most of us know. Stand by Me and say a little bit about your dad. 

Allison Applebaum, Ph.D.: Yeah. I’d love to tell you a little bit about my dad.

So my dad, Stanley Applebaum was he was born in 1922. So he would be celebrating this coming March. He is a hundred and, oh gosh, we’re over a hundred now. We’re we’re 101 birthday, 102 birthday. He actually initially wanted to be a surgeon and he fell out of a tree when he was seven years old, and he broke his pinky finger and the doctor who took care of him suggested that he tap his finger on the player piano that my grandparents had.

That doctor did not realize that his prescription led to a musical career that lasted nearly a century. My dad, after fighting in World War II, returned home, used the GI bill to study music and composition, and by the time he was 30, he became one of the most sought after arrangers in orchestrators in New York, and by the time he was 40.

He was writing arrangements for some of the great artists at that time, including Benny King and Neil Sadaka, Connie Francis, and Brian Highland. And as you shared, my dad is perhaps best known for his arrangement of Benny King’s Stand By Me. My dad had a hand in all aspects of that piece, but what I strongly believe and many believe made that song a piece of art.

Was the symphonic string section in the middle, and that is Stan Applebaum. And so any of you who’ve heard stand by me and have heard that piece, have already met my dad in some way. Beautiful, 

Diane Hullet: and I, I think he would be so pleased with how you’ve woven his story with your education and professional work in this tale of caregiving that is also so filled with gems for the caregiver, and not only practical gems, but also as we just said, meaningful gems.

And so how do you go through this fire of caregiving and come out the other side? I think your dad would be so pleased at your book and all the work that you’re doing. 

Allison Applebaum, Ph.D.: Thank you so much. I happen to agree. 

Diane Hullet: Yeah, yeah, absolutely. Well, you can get a copy of Stand By Me, A Guide to Navigating Modern Meaningful Caregiving, and you can Google Alison Applebaum and you’ll find all kinds of amazing articles about her work.

And I just thank you so much for joining me today. 

Allison Applebaum, Ph.D.: This has been great. Such an honor. Thank you so much for having me say where 

Diane Hullet: people can find out a little bit more about 

Allison Applebaum, Ph.D.: you. You can find me. Let’s see. You can find me on Instagram, Dr. Allison Applebaum. You can find me on Axe or Twitter, Dr. Alison Applebaum.

You can find me on AlisonApplebaum.com and, and I always keep those updated with interviews and, and other podcasts and print media and really looking forward to getting to speak a lot more about this topic. I think you’re 

Diane Hullet: just warming up. I think this was her warm-up interview. I’m excited to hear more.

Well, thanks so much, and as always, you can find out about the work I do at bestlifebestdeath.com. Thanks for listening.