If you already heard Part I, then you know that this is an episode you do not want to miss! Personal and professional, we dive into what matters most. What are the values and models we hold in caring for the aging? Is there an opportunity to turn towards this often-avoided topic? Rather than jumping over the hard parts and romanticizing about “a good death,” can we instead stick with the mundane, vulnerable realities of aging? 

https://getaging.com

https://courtneyemartin.com

Transcript:

today I’ve got two really interesting guests. I always love doing two people ’cause it just enriches the conversation. We go all kinds of places. So first of all, Courtney Martin, welcome. Thank you so much. And Carla, welcome.

Thank you. And Carla, you get to say your last name so I don’t get incorrectly. 

Speaker 2: Yeah, sure. My name is Carla Beto and I’m a geriatrician and palliative medicine physician. Fabulous. 

Diane Hullet: So Courtney is an author, a journalist, podcast host, activist. I’m probably missing some things there. Courtney, you’ve got a mother 

Speaker 3: daughter.

Yeah. Passion advocate. Yes. 

Diane Hullet: So this is kind of fun how this podcast came about, which is that one of my best friends lives in California and she sent me this incredible article that Courtney had written and I think just the title of it is even really provocative. So the title is. Lack of elder care is [00:01:00] unconscionable.

And I was like, wow, who wrote this? So I reached out to Courtney, and then Courtney, as you and I were talking, you said, well, you know what could be really interesting is to bring in this doctor that my family’s worked with and see, you know, what she adds to the conversation. So we wanna talk about elder care and aging and death and dying and sort of the whole nine yards here.

So. Maybe let’s just start by each one of you kind of fill in a little more about your biography and how you come to your passion in these areas. 

Speaker 3: Do you want me to start? Go for it, Carla. Yeah. Well, first of all, I’m so glad you do this podcast and explore this area because I just think it’s so critical and there aren’t enough people talking about it.

So thank you for your work. Diane. So yeah, I’m, I’m this person who like moves through the world having my own personal experience of something and then. It always leads me down these rabbit holes of asking like cultural and systemic questions about, about that thing and equity questions about [00:02:00] that thing.

So my dad got diagnosed with dementia about a decade ago, roughly, and most recently I’ve moved in with my parents and started, I. Really taking care of them in a pretty deep way. I mean, I was always very close with them and always like thinking a lot about how I could support them, but I became like a true sandwich generation caregiver a year ago.

I have daughters who are 11 and eight, and so caring for my dad as he’s gone, you know, towards this more advanced stage has just led me down, like I said, a rabbit hole of a million questions. One of them being like, why isn’t there more accessible? Elder care in this country. And that’s what the PC reference was about is we finally found this incredible day program for my dad where he could go during the day and it gave all of us a primary caregivers a break.

And he had community and there were just these incredible professionals there. And then like three months after we’d gotten him there, it closed because of a whole list of, of infuriating reasons, but mainly because of Medicare reimbursement [00:03:00] rates and how they haven’t changed in a million years. So that led me to.

To write about it, ask these systemic questions. And you know, my last book was on race and public education and white parents and integration. And you know, that came about because my kids were entering the school age and I started asking a lot of questions around that. So yeah, I’m always just kind of linking the personal and the political, and I think it’s both like just how I’m built, but it’s also quite cathartic for me to feel like I’m not alone in this struggle.

And furthermore, that I’m usually. Coming at it from the most privileged position. So the pain I’m feeling, it really leads me to ask like, hell if we can’t do this as like white economically privileged people, like what the hell is everybody else doing? So it’s cathartic for me to make that linkage. I.

Diane Hullet: That’s fantastic. The personal and the political and how much those personal experiences do lead to these kind of questions. You just say, wait, what the heck? If I can’t figure this out. Mm-hmm. How are other people doing it? And you’ve got a pretty intact family and your mom is still involved and your dad is the person you’re dealing with, and yet I.[00:04:00] 

It does, it leads down, I love the term rabbit hole. It just leads down this rabbit hole of questions of how can we be doing this so poorly as a country and how could we do it better? 

Speaker 3: Yes. So then 

Diane Hullet: how did Carla come in the scene? 

Speaker 3: Well, I had a friend actually through activist circles and also a reader of my substack examine family who, when I first.

Started being public about my dad’s illness, came up to me outside of a summer camp pickup actually. And she was like, you’re Courtney, right? And I was like, yeah. And she was like, I’m journey and I’m a nurse practitioner who focuses on dementia. I’ve been reading your stuff. I wanna help you. And I was like, oh my God.

Thank you so. So much. It was literally like an angel moment. And she, among many resources she connected me to, told me about Dr. Otto’s work. And as soon as I looked at her, I was like, oh my gosh, this person sounds incredible. Not only does she do house calls, which is such a beautiful thing that maybe will have time to talk about that just feels like holistic and integrated.

But she actually, this is funny ’cause. Carla was with my sister-in-law [00:05:00] and my mom yesterday visiting my dad and my sister-in-law, who I just love so much, said she’s like a real person. And that’s like the biggest compliment. I, I don’t know how Carla feels about it. I do, but for me that’s like such a huge compliment for a doctor is just like.

The moment we met her, we were just like, she’s a real person. She’s like a friend of our family now. And it does make me constantly be like, are we over like friendly to Carla? Because I’m just like, no, she’s got this huge practice and this busy life and as a mom herself and all the things, but it does just feel so special to have a doctor in our corner who we actually just relate to so deeply in a just like real person way.

So that’s how she came into our life. 

Diane Hullet: Gorgeous. And 

Speaker 3: Carla, tell us 

Diane Hullet: about how you got on this path and all that you specialize in. 

Speaker 2: Yeah, well, I mean, Courtney, hearing your story, I feel like there’s so many parallels and probably why, you know, we do work so well together as a care team caring for, for your dad primarily, but both your mom and your dad.

So you know, I’m, I was one of these maybe [00:06:00] strange people that from a young age knew I wanted to be a doctor, but like I really. Did become a doctor. But I also came from to doctoring from an anthropology and understanding of the world and society and culture and where is that person in the context of their whole lives.

So that’s always been my perspective from public health and I. Think, you know, like Courtney asking questions about why are these injustices, you know, in high school, writing a letter to my newspaper in Santa Barbara saying, why did my black friend just get turned away from the emergency room? And not realizing that that was kind of a big thing to write about.

And that getting called by the hospital, CEO and being like, I’m only 15 years old, by the way. Wow. You know, and then to the more mundane of writing to the Top Ramen company, telling ’em to stop using palm oil. But, you know, those are little things that, and then you fast forward to aging and realizing that aging is one of the last forms of, well, these days, another form of discrimination that’s tolerated and injustice in a way that ageism is just [00:07:00] accepted.

And in medical school, as I was going through all the specialties, you know, I thought I wanted to do OB GYN, and then I was like, I cannot deliver babies in the middle of the night. That’s not my deal. And then I met older adults and I’m like, these are my people. You know? It was just the life stories, the recognizing that we were not doing justice to people in terms of how we care for them.

And then I met geriatricians. I’m like, no, those are really my people in terms of seeing people where they are. And I could tell you a million. Stories of being in New York and meeting cool people and just and that’s how I came to it. And so I think similarly, I look at aging and geriatrics really in part about social justice and doing the right thing for people and honoring people in their last stages of their lives, whether it’s decades or days or hours.

And, you know, I feel very, very lucky and very humble to be doing the work that I do for families and for individuals. 

Diane Hullet: Currently [00:08:00] you have a private practice that’s part of what you do, but you’ve also been a professor. 

Speaker 2: Yes. So I’m, I’m smiling because I, I don’t like calling it a private practice because that assumes I make a ton of money, which is not the case.

It’s a geriatrician accepting Medicare and Medicaid reimbursement. But, so I will call it an independent practice and, and I’ll tell you a little bit about that. Yes, I, you know, I did my training on the East coast and then fellowship in geriatrics at UCSF and was on. UCSF faculty for, you know, 15 years still am on faculty ran and, you know, developed a lot of our geriatrics programs at UCSF, including you know, growing our home-based primary care practice.

But I, I think also from an equity and social justice perspective realized that there’s a lot of people that don’t have access to academic medical centers and how do you expand the love and the availability? And so I actually have. Two practices. One outside of Atlanta, Georgia, really serving, you know, semi-rural [00:09:00] populations who are homebound and then here in the Bay Area as well.

Interesting. 

Diane Hullet: How do you make you go back and forth? 

Speaker 2: Because I’m crazy. Crazy passionate. Yes, but I, but I just feel so strongly about this that I do go back and forth every couple months I’ll go into Atlanta. I have a team in Atlanta that sees patients. And, you know, the whole idea is how do we build models of care that are geriatric focused in minded, where you can have a team that believe in the care of older adults in the same way that I do.

I think the problem is that I love what I do so much is that I have a hard time. You know, letting go. ’cause I’m like, no, I wanna do it all because I just, you know, there are days when I’m so tired. You know, last night I got home from a memorial at like 9:00 PM but I’m like, but I, I love what I, I love what I do.

And it was a memorial for a well-known musician who I took care of, you know, over eight years ago. And there I was at her memorial and it was just really beautiful. 

Diane Hullet: So beautiful. I mean, I think there, [00:10:00] there is something about the beauty of the individual stories of older people that is so, so strong. And then at the same time I’m just like jumping outta my seat over this models of care, right?

Like this is the thing and, and I am reminded again of, you know, there’s this great part in the book being Mortal by Atul Gawande, which of course was. I think of it as a, as a culture changing book. I don’t know, maybe that’s the people I hang out with. But it’s a book that came out, I think 20 years ago, maybe even more now, written by a doctor, his father was also a doctor, and telling the story of elder care in our country.

There’s this incredible part in it, which jumped out at me so fully, which was a little town in the northern Midwest, somewhere where the doctors in the town, it was a small enough town that they got together and said, what if we created a form that everybody filled out when they came in for an annual general checkup?

And we started doing that when they turned 60 or 65, whatever it was, and it talked about end of life. And what they found was those [00:11:00] conversations made a bigger difference for that small community than anything else. And yet these conversations are so missing and, and that’s just like the tip of the iceberg of a model of care, right?

That says, how do we begin to talk about aging? How do we talk about what you want as you age? How do we talk about what you want as you die? And then how do you do all that in the context of dementia? Right? So, I mean, these are such big, big, simple topics. Simple, simple topics. We’re gonna solve this today, super straightforward.

We’re gonna do a couple episodes here and just solve all this. I mean, it’s so big, and I’m also so struck by how every, every, every situation is so individual and so unique. Mm-hmm. So what do we do? 

Speaker 3: Yeah. Well, and one thing that Carla said to me that I just think is so brilliant, so I hope she’ll talk a little bit about it, is that I do think that book was a breakthrough for our culture, and I’ve been a part of a lot of reporting about death and dying.

I covered the Zen Hospice Project when it was alive, and then as it transitioned into a new program and also used to host [00:12:00] this gathering called End Well. Like I’ve really been in this space and really interested in it way before this current journey with my dad. And, but I think. It is, it’s almost been romanticized, which is something that Carla helped me see that there’s a lot of us who intellectually are attracted to this topic.

But when it comes to actually unpacking what happens before death, which has to do with like disability and profound vulnerability and bodies decaying and capacities lowering and you know, actually living this end of life moment. Which I’m saying end of life, like a big broad, I don’t even know if that’s the correct term to use, but sort of this advanced moment with my dad, I’m like, oh, this is like profound.

Like even for me to say like depends in front of my friends is like what you’re talking about, like adult diapers in front of us. Like this is crazy, but it’s like we’re talking about. The romance of dying all day, but then when it’s actually like, no, like actually I’m having to learn these skills [00:13:00] that like none of my friends are talking about, and it’s totally uncouth to say out loud, which, you know, I just pointed out as a symbol of like so many things that I feel like we don’t talk about.

Carla, do you wanna riff on that a little? Yeah. Since this is really your idea, like I said. 

Speaker 2: No, I think you’re right. And I think the other way I phrase it is that, you know, and I think this is where it came, came about that, so no one steal the title of my paper that I’m working on, that I’ll probably publish in like 10 years, which is that like it’s sexy to talk about dying, but not about aging.

And you know, there’s this misconception or this ideal that like you live fully and then you drop dead one day and fall asleep and that’s so, and you have a 

Diane Hullet: beautiful in your bed surrounded by family with final words kind of moment. Correct? Like on tv? No. And, 

Speaker 2: and that happens sometimes, but not often.

And so. In reality, there’s a lot of heterogeneity and aging, and it’s not all glamorous, but there are parts that are absolutely beautiful. I have a a, a patient who’s currently terminal at the moment in his last probably days, and you know, his [00:14:00] daughter’s been capturing these. Beautiful moments and actually had a picture of me at the bedside.

And it’s really neat to see these, these very intimate moments in those last moments. But I think, as you say, Courtney, we’re not talking about, you know, the not being able to get outta bed, the incontinence, the Foley, the confusion, the loss of self, especially with dementia. And, and yet sometimes if we strip it all away, this is where I think being also part of a sandwich generation in terms of, I have an aging mother, a father who, who passed away after pretty debilitating depression, pro stroke.

It’s you know, my 4-year-old sometimes sees things with clarity that I’m like, can’t we all see that? And I will, you know, spill the beans that there are times that I have to take, take a patient phone call in the car with my daughter and she chimes in right. So, so answer, answer, social worker, voice to the picture.

Exactly. So I mean, this is, so this is the I, I’m sharing this because it’s so quintessential about what we’re talking about and what happens is we get socialized that this suddenly [00:15:00] becomes not okay to talk about. So she was overhearing me talking to a family member of a 90 something year old woman who’s monolingual Spanish, speaking with dementia, who’s refusing to go to the hospital or scared to go to the hospital.

And so she’s like in the background, mama, mama, all they have to do is take something that they really love, like they’re lovey to give them comfort and they bring friends that they like and they wear the special underwear like I had when I was a kid and I had to potty. And I’m like, that is so genius.

And actually that is the care of older adults is that we bring people in the hospital like things that are familiar to them and things that are comforting and yet. It’s in simple words, we can talk about it. But then as you say, Courtney, that depends the, you know, special underwear, the, you know, even saying the word incontinence can be hard.

Like it’s so hard to talk about. And you put that in the context of this billion dollar industry of anti-aging right now, where suddenly, unless you live to a hundred healthfully, you failed. Like, we are just doing a disservice [00:16:00] to all of us because FYI, we’re all aging right now. All of us. All of us. 

Diane Hullet: Yes, yes.

And we think we 

Speaker 2: have control over it, but we don’t Completely. 

Diane Hullet: Yeah. Meanwhile, the Botox industry, you know, takes off and says, you’ve gotta look young and be young and keep it all up together. And yet there’s this inevitable marching towards aging. And as you’ve said, we don’t wanna talk about it. And I think depends.

Saying the word depends is just like the tip of the iceberg, right? Yeah. Mm-hmm. Because there’s so much that I see with friends and family that goes into the caregiving. And Courtney, I don’t know if you wanna talk about that. I mean, it’s time, it’s effort, it’s waking up at 3:00 AM thinking, how am I gonna juggle all this?

What decisions am I gonna make? How do I find caregivers? How do I keep caregivers? If I can afford caregivers. Meanwhile, I’m trying to work a job or two jobs, and oh, by the way, what happened to my relationship with my husband, who I haven’t seen, except for logistics conversations. I mean, it’s just really taxing on the caregiver and I, I don’t [00:17:00] know that there’s very much support for that role, and there’s a lot of isolation.

Speaker 3: Absolutely. Yeah, and this is part of why I. I grew so incensed at the closing of this really beautiful day program because, you know, systemically we know that these day programs are the cheapest form of professional care and also really profound quality because it’s communal. It’s like a collective experience for our elders.

It, you know, they can bring in music and there was a OT and PT on site and a nurse and you know, it was just like everything you could possibly want a space like that to be not in a fancy. Building, you know, nothing fancy about it, but just all of the elements that you want for your person and getting him out of our house, which was a huge thing because my mom needed to have some rest and be here, and I had to work and I work from home.

So like that. Solution was so elegant for all the things you just mentioned for us. And again, the cheapest possible thing for the state of California. And it closed [00:18:00] because Medicare hasn’t raised its reimbursement rates in like 20 years. And so these incredibly talented professional. Folks went to other programs.

And there aren’t enough programs, obviously. There’s like just a total dirt. There’s no other program in the Bay Area that is specific to folks with dementia, Alzheimer’s like this one was, and it had been around for three decades, like they had just scraped by. So yeah, there are solutions for this.

It’s, I mean, there’s no solution for my dad dying. There’s no solution for my grief. There’s no solution for the complexity of what we’re talking about around like vulnerability and aging and our bodies. Falling apart and these like deep spiritual questions, but there are solves for making it less terrible for people.

And particularly again for people without the financial resources to figure out some other solutions. And it’s just, again, unconscionable, you pointed out that word to me that we don’t make the stuff that could be easier on people. Easier on people. ’cause the rest is gonna be hard and beautiful no matter what.

Diane Hullet: [00:19:00] Why do you think that is? That we don’t come up with some of the easy solves? I mean, when I read the article, I was just stunned, like you were as a member of the community, like how did this not stay open? How did this not make absolute sense for the people who it, and it isn’t just the people who participated in it, it’s really their extended circle who’s caring for them, right?

So. Oh yeah, everybody benefited. It probably benefited, I don’t know, 800 people or something. Hugely. But it’s, sorry. No, jump in. Go. I really 

Speaker 2: worked up. I mean it’s, it sounds very simplistic, but, but be it’s, it’s our values and we’re ageist. And, you know, it is very frustrating growing up in, in in an era of, of so-called evidence-based medicine.

We actually have a decent amount of evidence in geriatrics, in the care, Boulder adults, but we don’t follow it. Why do we not follow it? Because that’s not what our values are. Why did, why did we build a children’s hospital at UCSF when actually the largest number of people using healthcare services are older adults?

Why are we investing in [00:20:00] hospitals when we know that actually taking care of people in their homes is cost effective? Why do we do that? Because we don’t value older adults and we don’t, we don’t actually recognize that we don’t value older adults. We say that we do and we don’t. 

Speaker 3: Yeah, and just like mothers, so you have Exactly, you have caregivers, just like caregivers are at large, but especially mothers, right?

So it’s all tied up, up together. 

Speaker 2: Yeah. And we look at the, with the short game, we’re not looking at the long game. We see that currently politically, what’s going on. We we’re like acting on a day-to-day basis and not thinking about the long-term game because, you know, adult day health centers, which are what, you know, Alzheimer’s services at the East Bay are.

They’re actually a Medicaid benefit or a private pay. And if you think about what is the, in terms of insurance benefits, who pays for long-term care? It’s actually Medicaid, not Medicare. And so if, if adult day centers can actually delay nursing home admissions, to Courtney’s point, this is actually cost saving.

But you have to make the investment upfront in the same way that for me to provide care at people at home financially, it was very difficult to sustain in. What’s [00:21:00] called a fee for service model in Medicare where you get paid per visit. But the long game I know is that I’m saving the health system, whoever the system is.

’cause I don’t see a system that’s actually operating well together. But it’s cost saving and it is better for people. But we don’t do it or we do it only if you have private funding and. Lots of other things. So where, 

Diane Hullet: where are these, these we don’t value it. Who’s the 

Speaker 2: we, who’s 

Diane Hullet: the 

Speaker 2: All of us doesn’t value us.

I mean, it’s, it’s all of us directly. I mean, it’s, it’s, it’s each one of us and it’s from the little comments we may say about ourselves as we’re getting older. Oh, look at my gray hairs. You know, when I had my daughter at 42, I was a geriatric, you know, prima gravita. It was an older woman having her first child.

It’s you know, it’s, it’s, it’s in the language. It’s. Built into the language that we speak. It’s our own fear of our own decline in mortality. And so it’s, it’s, it’s just ingrained in so much what we do. Is it purely American? No. Is it worse here? Yeah, probably.

Speaker 3: [00:22:00] Yeah. And I also, I think about the lack of advocacy.

Being so tied up, and this is gonna be so nerdy, but I feel like Carla will appreciate, ’cause we both did go to Barnard that I was a sociology major and I remember this moment where we were learning about Marx and like capitalism and why doesn’t the proletariat class rise up because they’re the ones being screwed by the system.

And this guy who I became close friends with and, and dearly love said. I, I don’t know if this makes sense, but like, aren’t they exhausted? Like the proletariat’s like coming home and like all they wanna do is like watch TV and have a beer and everybody laughed and I was like, actually that’s genius.

Like the sandwich caregivers, like me and Carla are exhausted. So like the, what it takes for me to both be having this experience and research and report it and write it is entirely dependent on both my privilege, but also that I happen to be a gifted. Very fast writer. Mm-hmm. So that’s, but that’s like a unicorn, right?

It’s like most people do not have that [00:23:00] bandwidth and don’t have that particular gift. I mean, other people have a million other gifts. This just happens to be mine. So it’s like, I think it makes it very hard to advocate Yeah. When you’re in the belly of the beast and you can’t even articulate what you’re experiencing.

And to that point, like I. I started interviewing some of the people, my sort of peers who were adult daughters whose parents had been in this program with me. And every single one was so eager to get on the phone with me for like 30 minutes to explain their situation. And they were all in tears. And none of them have the bandwidth to advocate, right?

They need someone to translate what they’re experiencing. And you know, the lobby in Sacramento is like the least powerful possible. Lobby group that’s trying to like argue on behalf of all of us for these day programs. So it’s, I think it’s both very deeply like about our culture and our, our reluctance to acknowledge aging and vulnerability and all of these things.

And it’s very structural that we just, the people who would have the most to say don’t have the bandwidth to say it. They 

Diane Hullet: don’t, they don’t [00:24:00] have the bandwidth. They don’t have the money. They don’t have the voice, they don’t have the advocacy, they don’t have the time. And I’m struck too by how, oh gosh. I mean this comes into gender, right?

Mm-hmm. That females are the primary caregivers. Mm-hmm. And I think our whole medical system around aging is based on free female caregiving. 

Speaker 2: Mm-hmm. Correct. And and I think geriatrics as a specialty is primarily women. And I will just put the little caveat that while I absolutely love being mortal, I think what’s fascinating is that it is a surgeon that wrote that I.

So 

Diane Hullet: I think that’s interesting 

Speaker 2: too. I started to say that to, which is beautiful, but it’s also like, why do we need a surgeon to say that? Yes. I mean, there’s another book by Louise Aaronson called Elderhood. She’s a geriatrician. She talks about these experiences. She’s gotten some press on the book, but not nearly as much.

And so I think again, there’s these I think Courtney, as you say, who holds the power and you know, I. My day-to-day decision making are, you know, as I ruminate with all these [00:25:00] angry thoughts or frustrating thoughts in my head is do I sit down and write the paper or do I spend my time as I’m driving home last night, talking to the hospitalist who’s taking care of my patient in the hospital so I can try to make sure that they don’t kill him while he is in the hospital by giving him an appropriate medicines.

And so I’m making this decision daily. Around what part of me can be the activist and go out there and make policy decisions and change versus take the direct care of patients. And that’s a constant struggle that I have. 

Speaker 3: And I’m like, do I watch Queer Eye or do I write this article? Carla is a more sophisticated human than me, but I, I do feel like, like, you know, people in her position.

And this is part of why I admire her so much. And by the way, Carla’s an incredible writer too. She’s written this piece that I would be good fodder for this podcast too, about death certificates and what, you know, what doctors write on death certificates. What is the actual cause of death? And thinking about some of these power issues and structural issues that we’re talking about.

But I, yeah, the, the, [00:26:00] these, there are these incredible people like car out there giving such. Profoundly human care to people. And then they’re also expected to like fight these structural issues and figure out how to pay their bills. And you know, it’s like, and, and I noticed this with the daycare director too, was like she’s, she’d been working for three decades.

She’s incredible woman with such profound insights about how to take care of elders. But she didn’t know how to balance a budget with Medicaid, not reimbursing stuff. And why should she? Like, I don’t have those kinds of multidimensional skills, like mm-hmm. I, there’s a lot of stuff I just dunno how to do and I’m not asked to do it.

But I feel like doctors and elder care providers are often asked to do things that. It’s just too much. 

Diane Hullet: So this kind of comes back to this really big picture, and both of you have this you know, ability to have your lenses go like super wide and super sharp focused, right? So you, you’re focused on your caregiving for your dad or the caregiving of a patient in a really personalized way, [00:27:00] and you can.

Zoom out and say, what’s the model for shifting this? Mm-hmm. Have you seen good models or, and or should this be part two of our conversation? Is there lots to say here and we should pause for this week? Maybe that’s a, maybe that’s a place to start on our second one. 

Speaker 2: Yeah. Sounds good. I think that’s probably right about like Okay.

Diane Hullet: Any, 

Speaker 2: let’s have some hope about, you know, 

Diane Hullet: coming in part two, hope. Any, any other comments about this section just in terms of like what we value and how complex it is to get voices heard to be advocates for this kind of care? 

Speaker 3: I, well, I will echo, you know, one thing that I have learned through this process and, you know, I learned this.

Becoming a parent. I’ve learned this at every hard moment in my life, is that the only way through is to not be alone. And I think that we have. You know, isolated elders so profoundly. We hear a lot about the loneliness epidemic, but we’ve also isolated caregivers so [00:28:00] profoundly. And I’ll share just like a tiny story, which is, I was at the elder care facility where my dad is on Friday, and I sat down at a table and you know, I was kind of in my own head thinking, how am I gonna interact with my dad?

Is he recognizing me today? Like, how is he doing? Sort of like trying to just assess. And then this woman sits down next to me and she. Turns out she was also an adult daughter caregiver, and her mom had gone into this facility two weeks ago and there was just this instant like warmth and relief and sense of like, oh, like, and she has an 8-year-old daughter and she has a, she’s living with her father.

And then she needed to leave. Earlier than I did. And her mom is a little less advanced in her dementia, and I could tell her mom was having like attachment issues which I was very familiar with, with my dad, even though he’s like past that stage. And so I was like, Hey, you know, Gail, come here, sing some karaoke with me.

And just got kind of aggressive about like welcoming this woman’s mother into the fold with me and my dad. And she left and we had already exchanged [00:29:00] text messages and she sent me a text being like, that was literally like the. Kindest thing someone has done for me in like weeks. And it was so small and it was so cathartic for me because I have this skillset that I am happy to use to help anyone’s day be slightly better because I’ve been through so much around it and it’s like that is.

The, the thing that I think for me as a caregiver has just been tremendous to ever, and any kindness like meeting Carla, meeting journey, like any kindness that people show your person who’s in so much pain and suffering so much is just like the most profound gift in the world. 

Speaker 2: I think if I can add to that and I know we need to move on, it’s, it’s this idea of turning towards rather than away.

I love that and. You know, I think it it, I shouldn’t disclose this too loudly for any potential patients in the future, but like I maybe have a little bit of boundary issues with patients and families. Get a little close, get a little attached. [00:30:00] You know, you know, some of them have met my daughter, some of them met my husband, but to me that’s what.

Doctoring is, it’s not this super removed. I mean, I would love for not everyone to text me at 10:00 PM but like, you know, I have this beautiful moment of years ago, probably over 10 years ago when I took my husband to meet one of my, my dear, dear patient Charlotte, who’s now deceased, who had this massively disfiguring cancer on her face.

And he said, Charlotte, you have such beautiful eyes, and to just. Look past that and see the person or my daughter at four and a half. Who with my mother, who she calls? No. Which is, I’m, I’m first generation American. Half Italian, half Mexican is a combination of, so, no, let me hold your hand ’cause you have a hard time walking and I’ll take you to bed.

It is turning towards, it is, it is being open to the realities of what we live every day and that that will be us one day. So stop discriminating against ourselves. 

Diane Hullet: Hmm. So beautiful. Well, [00:31:00] thank you so much both of you for this first part of our conversation and let’s head into part two. Thank you.

You’ve been listening to the Best Life Best Death podcast, and as always, you can find out more about the work I do at Best Life. Best death.com. Thanks for listening.