Episode 18

April 17, 2023


#32 | Kimberly Akers | Activities of Daily Living

Hosted by

Tony Siebers Bina Colman
#32 | Kimberly Akers | Activities of Daily Living
Parent Projects - Aging In America
#32 | Kimberly Akers | Activities of Daily Living

Apr 17 2023 | 00:54:37


Show Notes

Kimberly Akers is a Certified Senior Advisor® and owner of Amada Senior Care. Amada Senior Care is Arizona’s trusted provider for In-Home Care and Long-Term Care Insurance Advocacy. Amada Senior Care assists seniors in staying independent in their homes by providing compassionate caregivers to assist with activities of daily living, medication reminders, meal preparation, and light housekeeping.


Article link: https://stage.parentprojects.com/adl/


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00:00 – Intro

01:02 – Welcome to the Show

02:20 – Introduction to Kimberly Akers

02:58 – Kimberly Akers’ Call to Action

11:54 – Zoho One Ad

13:03 – Activities of Daily Living

35:14 – R.O.S.E Ad

37:10 – Uncomfortable Activities of Daily living

51:30 – Closing Thoughts

53:16 – Outro


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Episode Transcript

Speaker 1 00:00:08 If you're caring for aging parents, you need parent projects connect. Here's why. First, you get access to a verified business network, so you're only working with the most trustworthy vendors who won't take advantage of your situation. Second parent projects guides you through modules and tasks on health, financial, real estate, and medical decisions. So you're always prepared for what's next. Third, you can invite family members into your project so your family is in the know and working together. Get started with a free 30 day trial [email protected]. Speaker 2 00:01:03 Home is where the heart is. And over the course of this month, we've been talking about ways that you can break up some of those loggerheads or some of those, those opportunities where your family gets stuck. Today. Uh, we're gonna transition into talking of how activities of daily living, which are used by the insurance industry, uh, are ways that you can communicate and pull out real facts and the things that help you access things like your long-term healthcare insurance plans, but also how you communicate with Prof, other professionals in senior home care, uh, in-home care, non-medical, medical, uh, all the way down into senior living communities. Uh, stay tuned for this. If you are looking for a way to break up, uh, and remind your loved one, that home is where the heart is with some real facts. Stick around. Speaker 3 00:02:11 You're listening to parent projects, a family media and technology Group Production. Now, here's your host, Tony Siebers. Speaker 2 00:02:21 Welcome in everybody this week, home is where the heart is, and we are gonna talk and utilize activities of daily living, uh, and have a great conversation. I'm really looking forward to introducing you. Uh, Kimberly Acres, certified senior Advisor. She's an owner of our verified business networks in Phoenix, Amada Senior Care. Uh, and Kimberly, thanks for joining us today and digging in and helping us explore this what started as an in insurance industry kind of trend, and has kind of turned into some way that we can have conversations, uh, with our family members. Thanks for joining. Right. Speaker 4 00:02:54 Thanks so much, Tony. I appreciate you having me. Speaker 2 00:02:59 So, Kimberly, let's, let's back into, um, you, you know, you, you have an organization who works with in-home care mm-hmm. <affirmative>, uh, and, and handles those, the, that advocacy, that long-term advocacy, you yourself, especially being a certified senior advisor, just speaks to the amount of time that you've spent and dedicated to your craft of understanding end of life issues, or even just aging issues as a family. Mm-hmm. <affirmative>, how, how did you come into this being something you had so much passion about? Speaker 4 00:03:28 Oh, well, uh, thank you for asking and, and we all know sometimes things aren't linear. Right. <laugh>, it's not from point A to point B Tony. So, um, I was a former educator. Um, I actually taught eighth grade math and science for about 18 years. And I just love educating people because I do feel the more, you know, the more you can help. Well, and as obviously my life, you know, started journeying on my, I have aging parents and, uh, discovered that there is, um, a whole set of people that are just like me, adult children that need to be educated. Uh, there is no book that just says, you know, how do we help really guide and embrace and enrich this journey that our parents are going on? And so, I I, I got into the industry after being a teacher, but honestly, I also grew up watching my dad as an insurance agent. So I really understand the ins and outs of what the insurances are looking at as far as activities of daily living. So kind of all melded together into a multi Yeah. Senior care <laugh>. Speaker 2 00:04:53 Well, I, I, I love the educator approach in a background, right? Because that, I mean, this is truly, it's an education. Um, it is literally, I, I think every time I start getting into it, I really, I, in the back of my head, I can hear this. Okay. Buckle up buttercup. <laugh>, like this is, there is a lot. It is. Someone else is is called it drinking from a fire hose. Oh, yes. So much to come at you. But, uh, you know, that's also really fascinating that that insurance was seeing that kind of growing up and, and maybe hearing those conversations mm-hmm. <affirmative> in, in your formative years would, would kind of help inform things, because it seems like access to capital, or dealing with the financial costs become one of the first kind of major push points or drivers. Uh, they get, they get family members to, to kind of start stepping in. Right. They, there's some major expense and maybe mom and dad can afford it, but maybe it's time for them to utilize that insurance policy that they bought, you know, in, in 85, and they're not quite sure exactly how that turns on, or, or it's slow to turn on, or, and Speaker 4 00:06:01 You just, or just the definitions. You're right. Um, right. You know, just the definitions of the ADLs that we'll talk about <laugh>. Speaker 2 00:06:09 Right, right. And, and we, we laugh a lot too, because I think part of that journey and understanding your parents is, uh, I'll speak for myself off of this, but there's this, this thought when I was younger, I, I just thought that one day I would just know what all this was about. I would just wake up and the, you know, the, uh, social security ferry would, you know, sprinkle us what that looks like, and I'd understand Medicaid and Medicare, and where all those things were gonna come around. And with long-term care, like you just, it really is something that you tend to learn by watching a family member go through it. Uh, ma'am, some, some cultures they do it with grandparents. And actually, I really like that the more we see, we, we have a, a great melting pot, the more I see young people like millennials, even today, they get involved with their grandparents. Uh, the more I really, man, I, I, I think that there's, there's really something in that. Some cultures are awesome about it, and I think others would do really, really well to pick some level of that up. Right. But is that anything you've seen as you've, you've kind of come across, or when families get involved, is it usually one specific generation or do you ever see younger families get involved in Speaker 4 00:07:20 This? So, and I, from my perspective, um, in, in our country, and I think that's just it. And, and we are in Arizona. I know this is pr you know, uh, right. Projected nationally, but in Arizona, you know, we have so many people that just retired here from, you know, back east or in the Midwest. Right. So their families are still over there, which are grandchildren and, and things of that nature. So I don't see it as much here, but I can tell you that my family has been living, we call it intergenerationally for 10 years. Um, so we have had my parents, um, my husband and I, and our children. So we have all the way from 28 to 11 years old that, um, kind of just have been doing life together with everybody. Yeah. Speaker 2 00:08:16 Well, you know, and that also, especially as we start talking then to activities of day living, which we're gonna go through today specifically, they're not uncommon to the same kind of things you even look at with your children to understand and assess their capability of being independent, hopefully able to do that by the time we get 'em out of the, outta the nest. Right. And, and get 'em moving. But, uh, and, and there are two very different, I don't, what I, what I don't wanna do is be wrong to think that we're just equating that that end of life is like being a child. Cause it's not. Yes. But it is, it is. E even in raising young people today, uh, you know, as a parent of five and from seven up to to 22, I've learned that it's about assessing and giving them opportunities to practice their autonomy in every possible way. Mm-hmm. <affirmative>, I possibly can. I try to let them make that, and I give 'em a safe place to make mistakes against that and, and give grace against those things. And the more I can do that with my parents and my grandparents when, when I was dealing with my grandparents, the better that communication, the better that relationship tended to go. Uh, when, you know, when we saw that mm-hmm. <affirmative> Activities of Daily Living just happened to be a couple of insurance terms that also help us maybe gauge that what's working and what's not. Yeah, Speaker 4 00:09:31 It does, it helps us to, to gauge and just start having some conversations that are more factual instead of emotional. Yeah. And I think that that's where a lot of adult children, um, can maybe just start the conversation is, is, is centering around these activities of daily living. And the more that we just get comfortable with conversing with our parents about that, it's, it's just gonna become second nature. Right. Um, same with our children, right. When we start talking to them about, you know, certain issues and growing up, if, if we, if we're hesitant on talking about it, and we, we try to stay away from it, it all, it's always gonna be just uncomfortable. But if we continue to just get comfortable with being uncomfortable initially, um, it can have, it can be a really great conversation and help take the emotion out of it. Speaker 2 00:10:32 Yeah. Well, in data, data and facts, um, man, it, it can do so much to help here. It, it can take some of that, it can give you a reprieve emotion. And I talk with, whether I'm talking to my kids or, or we're working with other families, it's always okay to feel the way that you feel. Yeah. How you make decisions. You just, you gotta learn and develop. You know, we, we hopefully we learn throughout our lives and how to check that for a moment against reality and, and what the situation really is. So we don't go charging in on too many assumptions and especially a bad assumption, which, which might actually make things more difficult for us. But to do that check, you gotta have facts, you gotta have your information. It's gotta be kind of collected. So, great. I wanna dive into when, you know, we're gonna take our first break here, but when, when we come back, I'd really like to, um, to, to dive into that, the ADL's flat out. Speaker 2 00:11:23 Let's, let's break 'em down. Let, what are the, what are those major pieces? Uh, and for those of you that are falling along at home, you know, uh, if you wanna put up onto another browser, parent projects.com/adl, um, that's parent projects.com/adl. That will get you, uh, the link off where we're gonna begin that conversation. You can kind of fall on to be able to see some of that. But we'll be back in, uh, right after this break from one of our sponsors with Zoho, uh, with Kimberly Acres of Ahma Homecare, where home, uh, is, where the heart is Speaker 5 00:11:55 Introducing Zoho one. Zoho one gives you a unified suite of business and productivity applications to manage your sales, marketing, customer support, hr, finance, and operations custom solutions and more. All the business applications in Zoho one are fully integrated with a unified app suite like Zoho, one that seamlessly connects your marketing and sales. You can now measure the effectiveness of your marketing campaigns based on the leads and deals it generates. You can also connect sales with your inventory management system to update stock counts. Likewise, you can streamline your invoices by integrating your sales and accounting, automate sourcing, tracking and hiring to recruit the best talent and build great teams. When your business runs on one unified suite of apps, silos, dissolve and insightful strategies emerge. When apps work together, your business runs better. Zoho one, the operating system for business. Speaker 2 00:13:04 And welcome back. Uh, this week we're discussing, uh, this month really home is where the heart is. And this week we're talking about activities of daily living with Kimberly Acres of Ahma Home Care, uh, in the Phoenix, uh, verified business network, uh, located in Phoenix, Arizona. Kimberly, again, thanks for joining us. Speaker 4 00:13:22 Thanks so much, Tony. Speaker 2 00:13:24 So, uh, you know, a lot of our audience are, um, you know, quite often it's, that profile is 50 to 65. It is a working mother. She's balancing running some level of, usually a company of some kind or, or working as an exec. They've worked for a full, you know, really has their own career. They're balancing that. They've got kids maybe in college, maybe still in high school, really late, late side of that. Uh, and mom and dad are needing more and more help. They're understanding the creep of that as it's coming in and finding those opportunities to push in, um, can be really, really difficult. We, we have found in industry, and we being, I think both of our businesses and the other businesses we work with, that activities of daily living, um, is a set of, of, um, activities that you can begin those conversations around. Right. Can you, can you make a, maybe an early introduction to us on activities of daily living and what it means for you Speaker 4 00:14:20 Guys? Sure, sure. Um, well, first of all, it, I'm so passionate about helping, um, seniors stay at home and family stay at home. I do believe that that's just where, where we are just more enriched, right? We just feel comfortable, loved, secured, um, at home. And so let's talk about those activities of daily living. Um, Tony, what I'd like to do is first name those activities of daily living, and then if we can with, uh, a conversation, kind of dive deeper into 'em, um, of the definitions and kind of how that maybe we can look at it with our parents. Um, and so again, these six activities of daily living, um, many of the hospital system, the medical organizations, as well as the long-term care insurance organizations, um, or veterans benefits really, um, kind of work off these, um, activities of daily living. Um, and so I am going to, let me see, I think your first one, I'm, I can't see the whole screen Tony, but I know that one of the first ones is transferring. And so transferring is, uh, we'll go into that in, in detail a little bit later, but a second one is dressing. Yeah. Uh, third is bathing or showering. Uh, fourth is toileting, fifth is incontinence, and, and sixth is eating. And so, um, let me know, uh, can we dive deep into those? Is that okay? Speaker 2 00:15:57 Yeah, I, I, I think that's great. I think that's great. In the article that I've been able to throw up here in, just in case they're following along from home, again, it's a, at parent projects.com/adl, uh, we've, we've got the exact same by the, cuz this is what they are if you're looking out there. So feeding oneself one of the first ones. Yeah. Um, seems somewhat self-explanatory, but what are you looking for? What, what is, what is that assessment? Speaker 4 00:16:21 Yeah. So many times people will misinterpret this, so, so let's make that clear as feeding oneself doesn't always mean meal preparation. I, I wish it did. And, and that is definitely something that, that needs to be addressed, but it's actually being able to take a utensil or, or something and being able to, to get food into our mouth after it's been placed. I see this a lot, um, when some of our, our patients have been, uh, maybe diagnosed with Parkinson's. There's a lot of aesthetic, essential tremors with that. Um, and so it's hard to get, you know, food into the mouth sometimes with a stroke. Um, there's, there's an issue again, one side, um, has been impacted and, and it's hard to kind of navigate that many times with arthritis. Even if you've, um, really have an extreme rheumatoid arthritis or a, you know, really hard arthritis, sometimes that dexterity being able to hold a utensil, um, becomes quite complicated and overwhelming when those kinds of things are happening. Then what happens is it's a domino effect, Tony. And then there becomes just a, a lack of nutrition. Right. I, I think you and I, like, sometimes I just get frustrated with something and you're like, forget it. Right? Yep. And so we see that in, in those that are growing older that have that difficulty. And, and then it just becomes a lack of nutrition and also hydration because, you know, again, being able to, to take a cup and, and get that hydration that we need, Speaker 2 00:18:01 Right. Uh, yeah. Manipulating bottles. Uh, is that, so, you know, another interesting thing you brought up too is, and oftentimes stroke the, the, it could present at one level and it could resolve that can kind of 80 as these ADLs come in, for instance, feedings, oneself might be something that becomes a problem for a period of time and then resolves from a period of time. Right? Right. It's not, this isn't all, again, it's not linear. Few things, few things that in any of this is linear, right? Speaker 4 00:18:30 Yeah. Speaker 2 00:18:30 Right. Uh, and so understanding that, and I think when you think about it that way, and sometimes even presenting that, you know, in, in my own family where we've had a family member's had stroke, um, there were things that got difficult immediately after that. And being able to talk to that, being a difficulty in time, and then watching that resolve and everybody being un understanding upfront about just the facts of that this is, this is what happens at this particular stage of this mm-hmm. <affirmative>, we'll look to see this subside and, and for this to come back, you need to get this back. It took the pressure off of us like, judging, you can't do this. Right. Right. Right. It, it, it gave something there. Any talking points, if you're, if you're noticing somebody who's having a difficult time feeding, uh, feeding themself, any, any talking points or something through that or tips that families can be thinking about while they're putting this together? Speaker 4 00:19:19 Well, I I think you mentioned something really powerful is not judging, right? Yeah. And, and, and not judging and, and kind of walking that journey with them. It might be, um, trying, you know, everything's a trial and error. Like what, what works for one person might not work for another. So it might be, um, having some modified utensils, modified cups that are a little bit easier to hold and manage. Um, yeah. You know, it might be, um, having foods that are, that don't require tens utensils. Right. That it's easier to maybe manipulate with something that isn't a, uh, an easier finger food. Speaker 2 00:20:02 Sure, sure. In preparation of that Yes. Food too, making sure it's, it's foods that are easier to, to prepare. Yep. I, I know in, in many cases, one of the, one of the ones we'll hear if, if, uh, if mom dies and dad's left is in, in this generation, dad hasn't made a meal for himself. And, and there is a period of time where they are trying to make sure that dad's not just eating hot dogs, you know, every day for the first coup, you know, first couple of weeks before somebody figured it out. And they're trying to make some adjustment to that. And dad can learn those things. But a addressing and working through this sometimes could be just to your, your background. Like education can be about education and teaching them how to work through that thing. Right. Speaker 4 00:20:42 Right. Speaker 2 00:20:43 Yeah, I love that. So, uh, moving on, nu number two, uh, bathing and cleansing's one's body. Uh, what are, what are we looking for in bathing? Speaker 4 00:20:51 Yeah. Well, some of the things that I look for, and I began asking to get some facts and, and you might have to dive deep, is, you know, how often do you take a shower? How often, uh, do, do you bathe as we become older, um, many times that's where all the falls happen is in the shower, outta the shower around, you know, during kind of that time period. And if there has been a fall, um, surrounding that shower, many of us are, are really hesitant about getting in again, you know, trauma fear, and, and, and it's a, it's an understandable fear, right? Yep. Yeah. Um, they were lucky that time that nothing was broken, but you know, it might be that there's just this fear and so they start to decrease their personal hygiene. And so that's, yeah, that's one of the things to look out for. Maybe start asking, um, maybe if you're an adult daughter, just, you know, maybe start kind of looking at the clues, looking at, you know, how often, um, are there wet towels if you're over there? You know, that kind of thing. Um, but that's kind of a, a time that to just really have some facts. Now, Tony, the thing, what I like to impress upon people is that sometimes they feel that, oh, well, if I need help in the shower, that means somebody's gonna have my hands all over, you know, their hands all over me. Speaker 2 00:22:19 Yeah. And, Speaker 4 00:22:20 And I try to say, no, that that's not it. You know, many times you can be very independent in a shower. It just is helpful to have somebody turning it on for you, making sure the temperature is, is well, uh, or, or at a good, uh, temperature. Uh, just making sure that the mats, that there's safety mats down. Um, and that when you get out of the shower, sometimes it's making sure that you're, that there's a seat available to sit down and dry off your upper and lower extremities. It really doesn't mean somebody's just hands all over. Speaker 2 00:22:55 Yeah. I, I've heard some great early interventions on this for families have been, um, uh, one has been just being present at the time in which, and, and part of their visitation routine was present so that they could just walk through the bathroom, make sure that the clothes were up off of the ground, because sometimes bending over gets difficult. Yes. So things can get cluttered down low, taking things, if you notice there's a lot of clutter down below, you know, the knee level or lower, that might, that might indicate they're having a hard time getting low. Bring those things up to them. The stoves where the extra toilet paper is stored, where those things, right. Like where, where is all of that up? Is it accessible for what they're capable of? Going to keep that autonomy. And then in that time planning, I've heard people talk about, well that's, that's when I go to mom's and I start the shower and then I'm just right outside the door. Speaker 2 00:23:44 And so she knows I, I'm just, I'm just out here and I can hear if she's gonna, you know? Right. That just brings some level of comfort, um, grab bars to understand too. Mm-hmm. <affirmative>, it, it opens up these opportunities. I would be helpful if we had, what if we had a handle here, professional handle that was done, and, and making sure that those by the way, are installed professionally and, and done done well, so they don't rip out of the wall and, and really cause an injury. Or cause them to rely on something that then fails cuz it wasn't done properly. And then they won't trust, they won't trust that thing again. Right. Speaker 4 00:24:18 Agreed. Agreed. Uh, I also like the handheld, um, shower heads that can be taken down, um, and, and used as well as a shower chair. So those are all wonderful. Yeah. Uh, you know, really slight modifications. Right. That can be right. That can be easily made. Um, if I could add just one thing, if they have like a glass shower, um, you know, the sliding showering. Yeah. Um, one of my things is, you know, maybe try to, to get rid of that and <laugh> and, uh, because a lot of times people will try to hold onto that cuz it does have a little railing. Speaker 2 00:25:00 It's not even a handle. It's a, it's a, it's a towel holder. It's a towel. Speaker 4 00:25:03 Rack. Speaker 2 00:25:05 Rack. Yeah. Speaker 4 00:25:06 Yeah. Yes. And so I, I know just, you know, try to just get that and, and get the old fashioned shower curtain all over again. Speaker 2 00:25:14 <laugh>, you know, tho and those are actually, you know, that's a great one looking at how high they have to step Right. To be able to get in and out of the shower and, and being able to relieve those little modifications go a long way of keeping them independent against that. And then you can kind of ramp that up. And if you're not able, if it gets to the point to where somebody's gotta be there and you can't, now you're starting to note where you're gonna need a push-in of help. Right. Uh, against some of those. Awesome. Love that one. Um, getting dressed. Let's go that next step there. Getting dressed by themselves. Yeah. Uh, what, what are we looking for in, in here? Speaker 4 00:25:45 So getting dressed at this is, this is where again, people think, okay, I need to be totally kind of, you know, bedbound or something of that and somebody's gotta fully dress me. No. Let's kind of rethink that. Um, I think a lot of seniors are prescribed compression socks, but they don't utilize them because it's, it's hard. Speaker 2 00:26:12 They're hard cult. Yeah. They're hard. Speaker 4 00:26:15 Yeah. And so that can constitute its dressing. Um, I recently met, uh, a lady the other day and due to arthritis and, and shoulder surgeries that she's had in the past, um, she has a difficult time lifting her arms just even above her sh like shoulders. And so getting on a jacket or some clothes are just a little difficult. So maybe having somebody hold, you know, that, um, you know, sometimes we have just difficulties with either the upper, the lower extremities or even getting on shoes. So just starting to look at those little things and not thinking it has to be the whole package. Right. Like it doesn't have to be everything Speaker 2 00:26:58 <laugh>. Totally. And, and, and knowing too, ebbs and flows of that, you know, an, an injury, a shoulder injury Oh yes. Could take longer to heal and that could cause some of these things. So, so look at that. When, when you see those little things come up, start thinking the, the, this again can present some time where maybe you can push in while they're in that recovery stage. This would address itself and come back down, but now you've got something factual. You can, you can go to them with like, oh, well you've hurt your shoulder off of that. I can just be here and time our time to do that. Or we can have somebody that at that time to make sure you're able to, to manipulate or do to do those things. Orthopedic shoes is another one. Yeah. You know, especially if they're having other challenges or they get into where they have to, um, you know, they're, um, they've, they've, they can't bend down as easily. Uh, maybe especially if there's been a lot of weight gain or other things mm-hmm. <affirmative>, these, this, there can be a lot of help as they get older. They're going to need help in these types of things maybe sooner than later. But, um, but I, I love that. It, it's not, it's not, um, actually, I'm not gonna say it's not, I love that you point out that there really is a bonafide concern sometimes about your privacy. It's the space of somebody coming in. Most of these things in ADLs, they're very intimate things. Speaker 4 00:28:14 Personal. Mm-hmm. <affirmative>, Speaker 2 00:28:15 They're personal. There are times at which you're very vulnerable. Right. And the time where you're doing that particular thing. Um, so there's gonna be some emotion when it comes from that and, and it makes a lot of sense to give space for that emotion. Try not to feed into that beast and try to look more to just the practical standpoints. Mm-hmm. <affirmative>. Um, okay. So, uh, mobility walking, mechanical assistance, transferring, moving one place to the other. Talk to us about what that is. What, what are we looking for in Speaker 4 00:28:47 Mobility? Right. Well, we're looking, um, first of all, if, uh, they've had any recent falls, you know, you wanna start looking at that and, you know, maybe getting some therapy, maybe some balance issues are off or, or something of that nature. Um, but really mobility is being able to transfer or get in and out of a, a chair or a bed safely. So, um, again, looking at kind of how that is going is, is really helpful for the adult children or looking at your parents in that in essence or essence. What I did wanna point out though, um, Tony, is that sometimes when we have a diagnosis of a, of a disease, so let's just talk about like maybe C O P D or c h f many times these ADLs, while we can do them like mobility, showering, dressing, we become quickly out of breath and tired. And so when we're, when we're trying to exert ourselves with a limited amount of energy, um, it, it might create issues later on, like falls or something like that, right. Like sure. If if somebody's Speaker 2 00:30:10 Cause fatigue sets in during the course of the day, that's even just an age thing. That's just, that's just a people thing, right? Right. Speaker 4 00:30:18 Exactly. Exactly. And so, you know, that's where we're looking at these things and while maybe somebody can do it, it's just taking a lot of energy to do that. Speaker 2 00:30:29 Yeah. And, and you know, what I also would would like about that would, would, would make sure we stress is, um, can they do that prolong at different times of the day? Can they do that at night when they need to as well as they can in the morning, uh, and, and throughout different periods of day? Or are there gaps in those areas that could help inform when's a good time to push in or to provide push-in assistance to them. Right. Uh, and give you a more accurate, so when you look at these, don't just pick a, you know, a fix the best time. Make sure that you're really looking across the board, um, in doing that. Hey, talk to us about, um, um, the use of, um, do vehicles come into mobility? Common question that families will ask about, where does that mom can't drive anymore off of that dad can't drive anymore. What is that? Um, is that part of mobility? Does it work within that they can't get themself around or not, or how does that work? So Speaker 4 00:31:21 That's not part of an activity of daily living, believe it or not. It's, it's basically being able to get from, you know, in, in your house basically. So that mobility. But that is a hard conversation about the independence with vehicles and, uh, there are many strategies. It's, it's a, it's a hard conversation Speaker 2 00:31:43 <laugh>. I I would, I would say, and I that's, I I appreciate that clarification. Um, if they have the ability to get in and out of vehicles without assistance, right, right. Uh, safely moved, can they, can they move from a vehicle to inside the home, Speaker 4 00:31:58 Inside or from Speaker 2 00:31:59 The home right. Outside back into that. Right. The, these are things that will open up opportunities of maybe improvements of ramps or Exactly. Which you don't think is gonna be as emotional an issue until you start having a conversation about a ramp. And the, just that projection of the, of the challenge, I think sometimes can be something you should be prepared for. And, Speaker 4 00:32:21 And looking at the size of the vehicle or the height of the vehicle, I love when people have kind of prepared and started buying vehicles that are a little bit, you know, that it's easier to kind of get into instead of the lower vehicle or a higher vehicle. Yeah. Um, and there's a lot of assistive devices in vehicles that you, you know, you can install certain, um, grab, uh, assistive devices in a vehicle besides sql. Right. The, the normal manufacturer settings in there. Speaker 2 00:32:55 And, and I think that makes yeah. Be, be cautious. This, I I would say also, if vehicle is a part, and I don't wanna get distracted too much, but from the mobility standpoint of transferring in and out of the vehicle, that is kind of a touchpoint where you, where we worry about and start thinking about. Right. Um, you know, tall vehicles become an obvious one. One that really surprised me to hear a lot was minivans. You think of, wow, a minivans gonna be so much easier that sliding door and there's plenty of space to work through, but sliding within that door and getting over to that seat is, it is actually, it takes effort. It's usually our kids that are doing it difficult <laugh>. Yeah. Speaker 4 00:33:34 Yeah. Speaker 2 00:33:35 So, um, so that's something to think about as well. You know, there is, there's some great reports that sit out there. I, we don't plug any one vehicle over another, uh, you, you know, I, I'm not qualified to do that. I do know some vehicles we found that we really like, we like the, the Ford Escapes and that size of vehicle is, is really seems to work well. The gmc, um, the, the small GMCs, the Envoy, the Arcadia. Yeah. The, you know, things like that. They, Speaker 4 00:34:03 How funny. I was just about to say, I don't know if we could give a plug, but like you, you know, those mini SUVs, that's kind of, Speaker 2 00:34:09 They are Speaker 4 00:34:09 Seems like, um, is, is really helpful, you Speaker 2 00:34:14 Know, right. That Speaker 4 00:34:14 The, Speaker 2 00:34:15 The seat is closer to the door. Uh, you can generally turn at their height. They can generally turn when you start thinking about it. If you've ever been in and out of a bed or working from that, or you ever been hurt, you know, you, you, you think about how that turns, how that transfers in. Can you simply turn with your back to the seat and sit back on it and be able to hit the seat? Or if when you go to hit and you and the seats go back into three inches, that might be something to think about or they have to step up to get that in now, kind of crunch. Anyhow. Um, I won't digress too much further. Yeah. Hey, we're gonna, um, we're gonna take one, one more commercial break here and we're gonna come back. We're gonna talk, uh, the last two keys. Personal hygiene and probably one of the, the most difficult when we get in with, uh, using the, using the toilet toileting. A very personal side of that. So stay tuned. We are talking through activities of daily living with Kimberly Acres of Amada Senior Care. Uh, join us in, stay tuned. Speaker 6 00:35:14 Hi, I'm Joyce Petrowski, founder of Rose Resources Outreach to safeguard the elderly. I have a very serious question to ask you. What is the significance of 1.7 billion? This is the amount, the 60 plus population in the United States lost to frauds and scams during 2021. The 60 plus population in Arizona lost about 54 million to these frauds and scams in 2021. Rose was founded in 2021 in Phoenix, Arizona. Our mission is to prevent the financial exploitation and defrauding of the elderly through advocacy and education. Our vision retirement should be the best years of your life. It should be protected at all costs. Our goal is to reduce the number of victims and monetary loss. Rose is leading the way with effective, concise, and face-to-face educational programs for the elderly and their families. So they will become more aware of the frauds and scams and have tips and tools to help them not fall victim to these frauds and scams. We have a lot of valuable information on our website, www.roseadvocacy.org. Speaker 2 00:36:50 And welcome back to everybody. Uh, that was, uh, rose, uh, which is an advocacy group that we just absolutely adore. They do a lot of great work here in the Phoenix market, but they also push that information out across the board for other families. If you are looking for more information on some of those scam dangers or other things happening, we highly recommend them. You can find more information about them on parent projects.com and our resources section. And, uh, you know, let's get back into our pick up on our conversation here today. We've been talking about that, that home is where the heart is over this month, specifically Kimberly Acres with Ahma is helping us understand those activities of daily living and the influence of those, um, and, and how we can gather some facts and start finding some, some factual ways to talk with our, our family members about it. Kimberly, again, thanks. Thanks for joining us in the show today. Speaker 4 00:37:43 Thanks so much. So let's, uh, if that's okay, Tony, and let's dive into to some of the others that sometimes are kind of uncomfortable to talk about. Speaker 2 00:37:54 Oh, personal and uncomfortable. Okay. Yes. Personal hygiene. We kind of touched a little bit of the bathing side, but the details of this in personal hygiene, I mean Yeah. The man, uh, when you get older things, just, you, you, you note that you, you'll go into a lot of places, things can, you have different senses and different feelings of things around that. What, what is normal? What kind of comes with age? And then what are you looking for as part of an A D L? Yeah. Speaker 4 00:38:21 So, so we're looking at, if that's okay, let's go ahead and, and move to toileting. We've talked about, um, some of those others, if that's okay. <laugh>, I'm just gonna go right in. Okay. Speaker 2 00:38:32 Okay. Speaker 4 00:38:33 Yeah, we're, we're gonna look and, and you really wanna look at facts, but also really be proactive. And, and I think this is gonna be one of my soapbox and and it's just because I am a woman, uh, Tony, um, most elderly women, we are prone to urinary tract infections. Mm-hmm. <affirmative>. And that just, uh, is, is terrible. And it's actually preventable because what happens is, um, we just are not doing a good job as we grow older with personal hygiene in that area. And so bacteria really builds up. Um, I'm not sure if anybody knows, but, uh, usually when I get a call from an adult daughter that says, you know what? I know mom is, is showing signs of cognitive impairment, but in the last two weeks it has just been unbelievable. Yeah. Like, it is fun. And I usually say, and again, I'm not a medical professional, but I usually say, you know, please go and get her a urinary analysis. Speaker 4 00:39:37 Most likely it's a urinary tract infection. And so what I would love to impress upon adult children is that urinary tract infections in the older generation, um, they manifest themselves in behaviors and, and in cognition, um, uh, a decrease in cognition. It's not what we normally would've thought as a urinary tract infection when we were younger girls. But, um, you know, it, it manifests itself. It comes out as symptoms as maybe exasperated behaviors. Maybe moms a little bit more off, uh, a really decrease in cognition. So get a urinary analysis. So that my, that's my soapbox. Sorry. Speaker 2 00:40:19 No, it, it, it's, it's a real good one. And, and just as we talked with some of the other issues, there's a totality of circumstances here. So if you've got a loved one who's having a difficult time with water intake Yeah. Right. Or they're on a new medication, that start change, that starts changing in that balance or the, from, from pH balance to just generally, again, the food or the nutrient intake or what they're eating or how that's eating there becomes that, that will change the cycles at which they might be used to Yes. Using the restroom or toileting or, or what they have to do in personal hygiene. Right. The same way that foods impact us, different foods and stress and lifestyle impacts you just as much and, and if not even more so as you get older. And I love that you've, that you, you've identified one of the big ways we, we really can start seeing that when we get older is in our behaviors Yes. And where that is. So I, I think, I think you're just right on it. You're right on it. So if you're, if you're seeing what, what are things, if they're having difficulties with something like that, any low hanging fruit, early push-in stuff or things that you guys have recommend or have seen that have been successful for families? Speaker 4 00:41:28 Well, what a couple of things that I recommend even, you know, maybe, maybe there's not an issue, it's just a proactive approach. <laugh>, and I'll be honest, I'm probably one of the people that, that, uh, I'm probably one of the few people, but start installing a b day for mom and dad. Yeah. I love them because it does, uh, again, I, I don't mean to be too blunt, but you know, we all, we are created, we all Speaker 2 00:41:56 Right, right. Speaker 4 00:41:57 <laugh>, but number one, installing a bidet, Costco, Sam's Club, you can, you know, put it on the toilet, you're not having to take it all the way out, you know, and it's not like the European ones that you have a separate one, but if you put up day on your toilet, it allows cleanliness. Um, and then as we age, sometimes the range of motion, you know, to use that personal hygiene absolutely. Becomes complicated. And again, again, Tony, I don't want to, but as women, if we don't have that range of motion, then we're, then we're wiping differently. I'll just be honest. Yeah. Speaker 2 00:42:34 Right, right. Absolutely. Yep. Speaker 4 00:42:36 Then, you know, can exasperate and cause UTIs. So anyway, bad day, um, is, is is doing that. Um, but even before the bid day, what I would do is totally, uh, buy a higher, a higher toilet. They do now make higher toilets. I understand some people put, um, an expander on toilets. I get that. Um, totally not my favorite if we can try to find some other things. But sometimes there's some heightened toilets that you can, um, and then est and installing some rails around the toilet, so it's easier to get on and off, uh, than the day as well. Um, some of the things that you're gonna be looking for though, as, as an adult child, you're, you're starting to look at smells. And again, as we age, um, you know, we just, we can't smell as well as we used to. And so we cannot smell our own maybe, um, elimination leakage or things like that. And we're not knowing that those kinds of things need to be changed or, um, you, we need to clean ourselves better. So those are some things that, that we can start kind of like looking out for. But what I've mentioned previously is just some great proactive measures, um, to start getting people used to those measures before it's really needed. Speaker 2 00:44:01 Yeah. I I, I love, I love the, uh, it is, you say it bluntly, uh, but no, it's, I, I've got, I've got daughters, right? And, and, and a wife. And so I know there's a, there's an understanding and we, we can pay a lot of attention to that. There's a time at which, uh, they might not be able to, so Right. Keep an open ability to have those conversations. So, um, as, as we, I think as we've kind of rounded off from those ADLs, how, one of the top questions, and, and I see we, we've got a question up here. What talk to us about the insurance coverage we opened up and we talked about a lot of that comes, uh, comes from the insurance standpoint and they use ADLs in some way, shape, or form. What should we know about when we're utilizing this, not just as a fact to address mom and dad, uh, or are their loved ones, but when we're talking about looking at their long-term care, sh insurance policies or veterans benefits or other things that might work off of them. Speaker 4 00:44:59 So some of the things you'll wanna look for is that there are a need for at least two. So most insurance companies or, um, veterans benefits or anything else that you're, you're applying for usually, um, typically we'll say that there needs to be evidence that someone needs assistance. And it can either be stand by or hands on. So you'll need to get some clarification by the, the specific thing that you're applying for. So sometimes insurance companies, um, they will say it has to be hands-on or other insurance companies will say it can either be hands-on to standby, so assistance. Um, and so you'll want to look that your loved one needs help with at least two or more of those activities of daily living. Okay. At least two or more of those activities of daily living. Really having, um, an expert in activating that long-term care insurance is very helpful. Speaker 4 00:46:05 Um, when amata goes in, when we go in, we are really assessing and making sure that that person does meet the qualifications of two activities of daily living assistance, uh, before we start making a claim on the insurance. Uh, cuz we just have a good understanding and we want it to be a successful claims process or application process for that senior and and their family. Um, so it's really also just, again, understanding activities of daily living that it doesn't always have to be, it's an all or nothing. We talked about the dressing. It could be that I just need help with, you know, putting on my shirt, but I can do all the other stuff myself. Speaker 2 00:46:59 Yeah. Speaker 4 00:47:00 And, and so that would constitute as needing assistance with dressing as an activity of daily living. Speaker 2 00:47:08 Okay. The, uh, the, the checklist that we've kind of gone through here, you guys utilize, uh, you've got a checklist that's available, right? And, and, and you guys have something that, that kind of help get those conversations going with your, with your loved ones and with your other family member, right? Speaker 4 00:47:25 We do. We do. I have what's called an activity of daily living assessment and an instrumental of daily living assessment, which I'll talk about in just a minute. But okay, I, I give this to all the family members so many times I'm sitting down and, and this is a first initial conversation, right? And, and it's an education and let's, let's talk about, let's assess our loved one from our, all of our viewpoints on how they're doing with these activities of daily living. And so what we're doing is we're taking a lot of the facts and I as a, I'm in there and I'm usually mediating and asking, okay, so what do you see? Not just how you feel, what are you seeing? What are you witnessing, um, in, in mom, you know, with dressing, right? Yeah. And so let's just get to the, get to the facts now, Tony. Um, the other side of that assessment is instrumentals of daily living, which are the things like the cooking, the cleaning, the, the meal preparation, the grocery shopping, managing the finances and, and all of that. Um, we can focus that on another time, but I'm glad that we focus on activities of daily living because that is a lot with the medical, uh, industry uses the organizations as well as the insurance and the veterans benefits. Speaker 2 00:48:52 Uh, brilliant. Brilliant. And it's an awesome teaser <laugh> for the next opportunity that you and I get to sit down, which are these other great places to step in. But generally, you know, it, uh, as we walk through this, you, you've hit a couple of great points. First of all, understanding those six basic ADLs, um, finding ways that you can be proactive against those six. So, you know, go back and listen to this if you need to. In the episode, we, we, we, we did a, a pretty good detail of, of what would be entailed from those and, and throughout a couple of, of ideas to stay in front of that. Again, always early and often is what we talk about whenever you're starting to kick into this and you start those conversations address and understand, or maybe we could say meet the emotional, but don't just stew in that and be in that and don't, don't, don't put that back. Speaker 2 00:49:40 Meet there, be there. Let that, let that happen. Let the emotion involved with assessing these things kind of be, but move into the facts. Look from the facts, understand it pragmatically as, as much as maybe you could expect a doctor coming in to help with some of those things. Uh, again, you're looking, you, we've covered, we're looking for about two of them. And to understand when we're making an assessment, is this something that they would need hands-on help with or standby assistance with? Maybe something that's important, uh, for their specific insurance policies or their entitlement program, which they might be signing up with. Um, there's, you, you talked about understanding those upfront and that you guys help families unfold those conversations. You, you're one way. And so, you know, home healthcare organizations, imagine across the board and we, we've seen can, can help with that conversation. Speaker 2 00:50:30 One gap that I might slide in if I can is if you're, if that insurance policy is really a challenge, you talked about using professionals to really help you with that. Mm-hmm. <affirmative> understanding the language of that, or if you get tripped up into that, the use of a good healthcare advocate, this would be an ideal opportunity for them to be able to push in and just help figure that out. They know the ins and the outs. They know, they know then what the insurance company kind of steers away from and where it might be and what, how to help communicate most clearly, succinctly and quickly, I think to help you get that help. So, um, so I would put that out if the, if the home care company that you're working with in your market doesn't have that portion or capability with them, you know, check out parent projects.com, you can find some healthcare avid advocates that can assist you and help you with that. Um, and that, um, and I guess that is kind of is a, I'm trying to think, is there anything that I missed on that or as we wrap through it? Speaker 4 00:51:29 No, I, I think you covered it all. Um, I, I just appreciate having this conversation and helping, um, I guess my generation, you know, help their parents age gracefully and their home. Um, I, I'm so passionate about it. I also want my generation to be preserved because I can see so many stressed out adult daughters and there's a domino effect. You know, sometimes their marriages are under stress because of them taking care of their aging loved ones. And so as much as we can be proactive and starting to have these conversations early and often with our parents is really just going to benefit, um, the whole family in the long run. Speaker 2 00:52:20 Yeah, I, I agree. And if as you're going through this, uh, if, if you're starting to struggle with anxiety or depression or other, just, just it, it's a normal thing to go through processing. This is, it's hard. We, and we'll all do it by the grace of God. We've all had, we've all had parents. And if you're lucky, you still do. And so there's a, you know, a level of this you're dealing with, it is just, it's part of that cycle for those being able to, to, uh, reach out, make sure you take care of yourself as you're going through this process. Be good to yourself from that. Be realistic with yourself on that. Engage other folks. You're not on your own. There are others here to help you. And today, Kimberly, I really appreciate you joining us and being that help for some families working their way through the ADLs. Speaker 4 00:53:08 Thank you so much. Tony. Speaker 2 00:53:11 Thank you again for joining us, for sharing just all of your time, talents, and treasures. God bless you. Speaker 7 00:53:20 Well, that's it for the team this week, and thanks for joining us. If you've enjoyed the content, remember to subscribe and to share this episode on the app that you're using right now. Your reviews and your comments, they really help us expand our reach as well as our perspective. So if you have time, also drop us a note. Let us know how we're doing for tips and tools to clarify your parent project, simplify communication with your stakeholders and verify the professionals that you choose. You can find us on YouTube, follow us on Instagram and Facebook. Thanks again for trusting us. Until our next episode, behold and be held. Speaker 3 00:53:53 Thank you for listening to this Par Projects podcast production. To access our show notes, resources, or forums, join us on your favorite social media platform or go to parent projects.com. This show is for informational and educational purposes only. Before making any decisions, consult a professional credential in your local area. This show is copyrighted by Family Media and Technology Group Incorporated and Parent Projects llc. Written permissions must be granted before syndication or re-broadcast.

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