Crafting a Holistic Dementia Care Plan: Insights from a Caregiver Advocate

On this episode of Advice From Your Advocates,  Attorney Bob Mannor sits down with Senior Care Advisor and Advocate, Bill Cohen. Bill shares his own, personal journey as a caregiver for his mother who had Alzheimer's disease. He became her advocate and primary caregiver, handling her financial, legal, and care issues for 10 years. After her passing, he became a caregiving support consultant and advocate, turning his personal loss into his passion.

Both Bob and Bill emphasize the importance of a holistic approach to caregiving, bringing together different entities and professionals to provide comprehensive care. They discuss common advice, support, resources, and referrals, and discuss how Bill helps families manage the care of their loved ones with dementia. Bill also highlights the impact of choices and environment on the development of dementia. 

The conversation focused on the importance of lifestyle, exercise, and exposure to chemicals in reducing the risk of dementia. It emphasized that dementia is not an inevitable part of aging and that there are ways to lessen the likelihood of experiencing it. For example, lack of sleep and stress are significant factors that can negatively impact caregivers' health. 

The conversation also highlighted the need for comprehensive legal planning, including advanced directives and additional language in legal documents for dementia cases. Bill's role in and the importance of elder mediation was discussed as a way to help families come to agreements and avoid court battles. The importance of self-care for caregivers was emphasized, including support groups and holistic care teams. If you are a caregiver of a loved one or a patient with dementia, you do not want to miss this episode of Advice From Your Advocates. 

Host: Attorney Bob Mannor
 https://www.mannorlawgroup.com/staff-profiles/bob-mannor-cela/

Guest: Bill Cohen CSA
https://cohencaregivingsupport.com/services

Executive Producer: Savannah Meksto

Transcript

Speaker 1: 0:00

Welcome back to Advice from your Advocates. I'm Bob Manor, I'm a certified elder law attorney in Michigan and today we have a very interesting guest, bill Cohen. Welcome, bill, thank you.

Speaker 2: 0:12

Honored to be here. Thank you.

Speaker 1: 0:13

So I've been excited about this podcast and learning more about your advocacy. Bill, just tell us a little bit more about who you are and why you're involved in the dementia space more about who you are and why you're involved in the dementia space, Sure.

Speaker 2: 0:31

So what I like to say is that if you had asked me about maybe making 20 years ago what was going to transpire with my mom and what the journey was going to be with her, and I'd be doing what I do today and talking to you today, I'd say you're crazy. Probably couldn't make out that scenario. It's pretty unbelievable. So back in the, I'll tell you a real quick version. My mom was living in Biloxi, Mississippi I'm not from there and she lost her home to Katrina. Some of the things we saw before and after, some of the things we experienced, but I became her advocate, her primary caregiver and helping take care of all her different financial, legal and care issues for approximately 10 years. She passed away about 11 years ago at age 83. And I thought I was going to do more volunteer work, came across this concept of a caregiving support consultant, and so it basically turned my personal loss and my pain into my passion in my encore career, you know it's interesting that you have tied Hurricane Katrina into that.

Speaker 1: 1:32

Did your mom experience some memory loss before the hurricane?

Speaker 2: 1:36

That's a great question. We were seeing some things that were concerning I don't know how much was memory loss, but she was increasingly agitated. Okay, not taking care of the finances, not taking care of the house? She was in the carrier role for my late stepfather, who had all kinds of conditions. He was on or off hospice and we thought, oh, is mom just getting tired? Is she stressed? Is?

Speaker 1: 2:00

she getting older.

Speaker 2: 2:01

Maybe if and I did take her to a doctor and got her on whatever medication was available at the time, it hasn't changed much. And we were thinking, if my stepfather passed away or went into a care committee, would mom bounce back? No, we never got that opportunity Because what did happen in August 2005 in the Gulf Coast Katrina completely swept away their home down to the elevation in the storm, and the trauma of seeing it gone accelerated in it and exacerbated whatever was coming out we realized later it was Alzheimer's.

Speaker 1: 2:35

So okay, so Alzheimer's. I was going to ask you because I know that's one of the questions I had for you later was the different types of dementia. Of the questions I had for you later was the different types of dementia. As you know, dementia is a category of diseases and it doesn't, you know, too often we get a diagnosis of dementia and my next question is okay, great, what type of dementia? And so what they believe is your mom was experiencing Alzheimer's type dementia. Is that right?

Speaker 2: 3:01

Exactly, and I'd like to say that because when I talk to my clients and I talk people in support groups, that file is very normal for a lot of us with a person with declining cognitive disability or the carrier. I'd say I did it twice, and one time was before the trina, and it's normal, I'll be fine, she's okay, uh, the other time was when she had to go into memory care isn't it too soon?

Speaker 2: 3:23

isn't there an intro step? But we looked at the symptoms, the behaviors, the signs of Alzheimer's, like Alzheimer's, but we didn't need a formal diagnosis, an autopsy. All the time we knew what she had.

Speaker 1: 3:37

Yeah, no, I get that. And so for those that aren't as familiar with the concept of dementia, is that we're not always, in fact, basically, doctors can't tell us 100% for sure what type of dementia it is until there's an autopsy. But we have a pretty good idea, right? There's a pretty good idea based on the symptoms, things like that, and various tests and various tests. I'll tell you my personal stories.

Speaker 1: 4:03

When my dad went into a medical procedure and I was there all day and I noticed this was the first time I noticed it with my mother that there was a significant deficit in her ability to comprehend what was going on around her, and I talked to my family. Like you say, people tend to be in denial. I talked to my family about it and they're like no, no, no, it's fine, everything's fine, it's all going to be okay. It was just the stress of the day. I said I'm not so sure about that, you know. And so I think what you're saying is it's very normal for families to be in a bit of denial about it and not, you know, really try to avoid the acknowledgement of it, you know, sometimes too long. So tell us a little bit more about your journey and how you got to be what you're doing today.

Speaker 2: 4:58

So I'm originally from New England. I went to school in Boston from originally from Hartford, newark Vacation. From my high school I'm a New England guy, even though I've been gone for many years. I had a business degree at Boston University. I ended up in the hotel business, I was in financial services and I was working for the state of Oregon, and it sounds like none of them have anything to do with the other, including the one now, but the common thread is customer service and helping people.

Speaker 2: 5:35

So after mom passed away and I'd already gotten another business degree and I dealt with all the legal stuff and the financial stuff and real estate, I thought I was just going to do more volunteer work Because a few months after she passed away I became the facilitator of a group I was attending for a few years. Wasn't expecting that, but I was doing the Walked In at Alzheimer's. I was going to the Capitol and advocating for more research, funding that type of thing. Then I came across this concept of a caregiving support consultant and I did a lot of research and reached out to everybody I could find in LinkedIn in the industry and made a lot of connections, built my network and learned a lot. So I started a little over seven years ago. I started my business. I'm a little different from other practitioners in the industry, which is why a lot of people haven't heard of me or what I do is that we're close to a lot of things but we're not that specific Provide advice, support, resources, referrals, help people take care of their loved one, manage the care, practice self-care and preservation or preventive care, and I help put together a team.

Speaker 2: 6:39

I put together a plan. I like to say I don't compete with anyone. I collaborate with everyone, including people in your, because these are all pieces of the puzzle. We don't work in silos. We should be all coordinating. I like to use the term that isn't used in elder law, but it is our elder care. But in child care is wraparound. We'll get everybody together on the same page and help take care of the loved ones who can't take care of themselves, and I work that way instead of one person, and they take care of the housing and that's all.

Speaker 2: 7:14

I work with the board of operators, and that's part of the reason why I'm a certified senior advisor to the CSA.

Speaker 1: 7:20

After my name is.

Speaker 2: 7:21

We take a holistic approach. We look at that broader perspective and take care of the, our most vulnerable population, their, their care, their safety and age, as as well as possible. So I like those are people I collaborate with too.

Speaker 1: 7:40

I like that. I like the holistic term. It's funny, I use that also and it's very true about both of our work that both you and I do. It's very holistic and I always think it's funny because you know, we're both old enough to know that. You know sometimes that was used as more of a hippie kind of you know, commune type of a thing, but it's important to note that that is a real thing, that most of the time the experts that you're working with are only looking at that narrow slice. Even lawyers, you know people, social workers, even discharge planners, you know they're all looking at that sort of narrow slice and somebody needs to look at the big picture right.

Speaker 1: 8:26

And that's the idea of the holistic concept here. So talk a little bit more about what that means to be a holistic service provider.

Speaker 2: 8:36

Kind of funny. You mentioned the kind of the woo-woo hippie thing. Is that for?

Speaker 2: 8:38

a while I was in a group called Holistic Chamber of Commerce and it was mostly the alternative treatments and practitioners and it was a bit of oh, nice people, absolutely. So what I try to do is and I'm going to give a story I think it's a good way of illustrating how I can help people because and I think you saw that I am also a trained elder mediator and this is almost a combination of my two hats. So this woman is originally from Portland but she's living in UK London for about 30 years. Her mother is in a care community here in Portland and she was being neglected by her stepfamily by the care community. It was reported to Adult Protective Services when it should have been probably the care community that was reported. I wasn't doing the job right. Her own doctor was neglecting her. To make a long story short is that she found me through the Alzheimer's Association, the daughter we got together. My mom was stuck in memory care and she shouldn't have been at that time.

Speaker 2: 9:46

She wasn't getting the care and attention needed, and so we had meetings and involved all those entities plus a house call geriatric physician among the people, the housing person and we, and of course, the Home Health Care Agency as well and got mom back on track, got her the health, got her the attention we need and got her on that mimicry unit where she shouldn't have been Now, to make a long story short, I've been working with that family for about 18 months now and various things have happened, as mom has had falls, hip fractures, declining cognitive.

Speaker 2: 10:23

but we continue to work in that holistic approach, bringing all the different entities in to make sure that mom is safe and has whatever quality of life is possible for whatever she has left. And I can't count how many times the daughter says thank you, thank you, thank you, thank you. I don't know what I would have done if I hadn't found you, so it's a challenging situation but very gratifying.

Speaker 1: 10:47

So you know, in a minute I want to get back to you. Know you're telling about your mom and how you kind of came into this, but I want to go down that path first about, ok, what exactly it is that you do and how do people find you. What's the initial? So I understand why people find me right. They are often looking for me because they're not sure how they're going to pay for care. They're not sure if they have the right legal documents in place. Now we do a lot more than that, right. We do advocacy, we do that holistic approach to things. But I understand why there's that motive to say, okay, we're not sure how we're going to handle this financially and legally. How do they find you and what is that sort of initial first step?

Speaker 2: 11:35

Well, I'm going to use your phrase depends, right, that's funny.

Speaker 1: 11:39

For those that are listening, that's the classic legal answer. Every lawyer you can answer any question with that depends Right and that's one of the things I don't do.

Speaker 2: 11:49

I don't practice law. I'm not a financial advisor. I can't give specific financial advice. I do hands-on caregiving. However, I've been through the legal side keeping mom eligible for Medicaid. I used to be in financial services, so I talk in general. I can help people with their long-term care policy because I can read it and I understand it and I do new companion work. I will spend time with clients, loved ones with dementia, like that woman I was just talking about. I go to visit her in the care home. So people either it's word of mouth I'm very involved, like my local chamber and other organizations. They can find me on my website. I'm very active on social media on all platforms, even TikTok. You won't see me dancing, but I do do videos there. That's great Me too.

Speaker 1: 12:35

So I'm a video campaign.

Speaker 2: 12:37

Usually at some point they will get on my website or they will have my uh calendar calendar to schedule an appointment. Initial conversation. Whether it's half hour hour, I don't care. Whatever they need, we'll talk, see what their needs are. Uh, regardless of affordability, I'll let them know very clearly. I either work in an hourly basis 75 an hour or uh for a minimum two. But, as we know, dementia in particular is a long term and very complicated and sometimes long distance because families are sprouting all over the place, like the case I was talking about, which was an extreme. So once they're getting beyond two or three hours, the monthly approach is better. It's $300 a month and it gives them about five, six hours and I'm very flexible. I can spend anything. I try to keep them very affordable.

Speaker 1: 13:32

So that's interesting that you mentioned the long distance when you were dealing with this with your mom. Was it a long distance issue?

Speaker 2: 13:40

Part of it. I almost said it no.

Speaker 1: 13:44

And you're able to help people long distance too.

Speaker 2: 13:46

Right and the pandemic made that really explode because people were looking for support everywhere. Right so being able to work online for a lot. But yeah, I was in Portland. She was in Mississippi with a continuous storm.

Speaker 2: 14:03

Then she was evacuated with a stepfamily to North Carolina and then one aunt in Delray Beach before I moved her out here. So yes, I was doing the long-distance caregiving, the travel to check in on her occasionally before I moved her out here, which we did before while she was still ambulatory and had enough cognitive ability to go along with the trip.

Speaker 1: 14:26

So I always like to make it clear to our listeners when we have guests, and sometimes they're very interested in saying oh, I want to. You know, could I work with that person? You can pretty much work with anybody in any area, right?

Speaker 2: 14:39

Absolutely. Yeah, like Grace is a woman mostly in New England, but her family is in South Florida and she's from the Dominican and actually in her podcast she says we need to talk.

Speaker 1: 14:51

My father has dementia, so we're helping that family all over the place as well ask you more about your mom because, um, you know, this is something that's very difficult for families and for people that are experiencing with this with their parents. Um, and it's really easy to gloss over things. You start seeing some red flags, you start seeing some things and it's, it's just really easy to, um boy, ignore, uh, the problem because it seems like such an avalanche that might be coming. So tell me a little bit more about you and your mom and what the symptoms were, what the things were that you saw that you realized you had to step in.

Speaker 2: 15:38

Sure. So again, while she was trying to take care of my late stepfather, we saw she was trying to keep him alive. I remember hearing about it when she was pounding on his chest and giving him the nebulizer and inhaler and all this stuff. So it was really wearing down on her. But yeah, as I mentioned, paranoia, agitation.

Speaker 2: 16:01

She was originally a professional artist, including printmaking, moved over into collage and other media, and she was also interestingly, left my right brain thing that she was the person who handled the finances. And in the 1980s, in her 60s, she was an early adopter not just of a computer but of a mat, which was very infrequent at that time. So once she was unable to do those things and do her art as well, these were big reasons for concern. That's why we did get her to a doctor and we were hoping that she would bounce back, but we didn't get the opportunity.

Speaker 2: 16:42

Again, that trauma and what's the interesting thing is that we usually hear about and I don't know if you were going to ask about this, but I'd love to talk about it because the research is coming a long way. We always hear about age and and we hear about genetics, heredity, right. However, no one else in the family has Alzheimer's Two. She was in her early 70s, about my age, when she was first showing signs and for people who don't know it, alzheimer's and other dementia frequently will be developing for many years before it even becomes symptomatic Right.

Speaker 2: 17:22

Symptomatic right and in her case, she's living in an area where toxins, pollution and chemicals in the air, foil and water, right mold and mildew. In that humidity she used to smoke, barely walk the dog, let alone any other exercise. She's in the caregiving role and she's socially isolated few miles off the coast. Plus with her artwork for many years, the intaglio process she was etching it to metal plagues and putting it into an acid bath.

Speaker 2: 17:47

Oh boy she is supposed to child. But the lesson is that and the Alzheimer's Association of Research is showing this more and more- Absolutely. With lifestyle choices and environment. These are huge factors and I think it's why we're seeing more early onset, younger people getting all those interventions, not just old people.

Speaker 1: 18:08

We recently had Dr Natalie Edmonds on the podcast and she talked about that that studies show that there is a percentage that is almost inevitable that it's based on genetics, but a much larger percentage is partially based on genetics and then partially based on environmental issues and decisions and lifestyle and things like that. But the largest percentage is actually lifestyle and and exercise and uh and exposure to, uh, you know, chemicals and things like that. And and I found that very interesting that for those of us that are worried about this and I understand the issues there are ways for us to make it less likely. I I've talked to so many people that think that, oh well, if it happens, it happens, it's inevitable. It's not necessarily inevitable. It is for a small percentage of people, but for most of us, there are things that we can do to lessen the likelihood that we're going to experience this type of dementia.

Speaker 2: 19:17

And I'm sure you know that dementia is not a normal part of aging. It is not inevitable. However, as you get older, your risk level does increase and one of the things and you could mention this to you to got a lot of the boxes is also getting your sleep, getting a good night's sleep and clearing that tongue-dodgy brain, the towels and tables and that type of thing Very very important.

Speaker 1: 19:41

I can't tell you I know I'll be honest with the audience I do struggle with sleep. It's one of the things I talk to my clients a lot about, because often what we're seeing is we have a caregiver spouse and then we have a spouse with dementia. Well, what's the problem with that? The caregiver spouse often is not sleeping, that they're worried, that they have all the weight of the world on their shoulders, that they're worried about the spouse with dementia getting up in the middle of the night, maybe wandering, things like that, and they're not getting proper sleep. And, frankly, that's a recipe for disaster. You know, the statistics tell us that the caregiver spouse is most likely to die first. Well, that's a lot because of sleep. Like you mentioned, the lack of sleep, the stress, the pressure that's on them.

Speaker 2: 20:27

Yeah, I don't know if you've heard this statistic. It's a rough number, but for dementia caregivers over 70 years of age, two-thirds two-thirds pre-deceased the person they're caring for. Not only is that tragic but it's preventable If people go to the wrong doctor, get their sleep, eat better, that type of thing.

Speaker 1: 20:50

We had a guest recently that was talking about how they offer therapy services for people with brain injuries and neurodegenerative disease and things like that, and he was talking about how many families become very you know, secluded when there's a dementia diagnosis.

Speaker 1: 21:10

In other words, they maybe they get the diagnosis, maybe they get the right, you know, they go to the right doctors but then they just kind of go home and just kind of seclude themselves and don't get the therapies that are available, don't get the right, you know they go to the right doctors but then they just kind of go home and just kind of seclude themselves and don't get the therapies that are available, don't get the you know, occupational therapy or the speech therapy or the services for the family that might be available or things like your services, and that it could not only extend the life of the caregiver spouse, not only extend the life of the spouse with dementia, but give them better quality of life for the time period that they have left.

Speaker 1: 21:48

And that many families I don't know if it's a matter of they're embarrassed or pride or whatever it is, but his experience was that many families choose to just kind of seclude themselves once you get that diagnosis of dementia and that there's so many things that can make life better for both partners, for the person with dementia, for the spouse, for the family, for the kids, including things like the services that you offer.

Speaker 2: 22:15

And I may be preempting with your questions, I don't know, but like one of the first things people should do, and besides making sure your loved one is safe, it's also making sure all the legal is in place. Yeah, our return to the advanced directive as needed wills, trusts, et cetera, because if you can't have access to the doctor's, you can't be advocating for your loved one. You're going to be in trouble.

Speaker 1: 22:43

That's a good question. I'll add a little bit to that. So it's almost like you're asking me the question on this. And so there is a thing that a lot of families think oh well, you know, in 1990, we went to a lawyer or we downloaded some documents or whatever. And frankly, that's not probably okay, that's not sufficient.

Speaker 1: 23:03

When it comes to things like dementia, we have to be not only have things up to date and current, but there's some additional language that we need in there. And if we wait too long and I'll explain that in a second, but if we wait too long the problem is it could get to the point where they're not legally capacitated to be able to sign new documents. So if you have, sometimes people say, well, just make sure you have your power of attorney, make sure you have your will, things like that Problem is, you know it might not be enough. You know, not every will is created equal and every power of attorney is created equal, and sometimes with dementia we need to have additional authority, additional language in there. And so many times people think you know. They're told oh, you have power of attorney, Okay, great, Well, you might need to update it on the early stages of dementia before it gets to the point where you can't, before it gets to the point where you can't.

Speaker 1: 23:57

So, specifically, what do I mean by that? There's a thing called extraordinary powers, extra authority. Why do we need extra authority? Well, because the person with dementia is likely going to get to the point where they're not able to authorize or give permission to do the things necessary to protect the family, to protect themselves, to transfer assets, to do things that are going to be able to allow them to qualify for government benefits, and so we need to have that in writing and we have to have clarity on that. And most lawyers don't include that in your standard power of attorney. Most lawyers don't include that in their standard legal documents, because most lawyers have never filed a Medicaid application. They've never filed a veteran benefit application. So I don't mean to uh, you know, overtake the the conversation here, but you brought it up and I think it's really important that people understand. That is a clear issue. It's not just about you have the documents that put you to.

Speaker 2: 24:52

Your documents have the right language in them now that's definitely job one, job one, a one of the two, and I I always refer to an elder law attorney because they do specialize in those subject matters. I was going to mention all you were talking about, the withdrawing, etc. That's where I know, like your sleep, it's socialization, making sure you, your eyewear is up, is current, you're getting your hearing aids if you need them and keep them programmed and charged, because if you don't, you're just your hearing aids if you need them and keep them programmed and charged, because if you don't, you're just going to withdraw. They're going to withdraw.

Speaker 2: 25:24

You're going to the world and it just accelerates, exacerbates the situation, which is very tragic because, like you said, if you do things, these things, early enough, when you see those first signs, it would be easier to maintain some quality of life for as long as possible. I want to do a quick, quick reference. When we're talking about sleep etc, and the burden of the people of the um taking care of the loved one, is that I got some studies from a local dispensary about studies, early studies, about using dbd and or thc, yeah, or the person with dementia, and because they were less agitated, etc. The caregiver, uh, burden was the lesson. So it's a win-win both ways, you know. Plus that's another thing to look at. You may want to go to your local dispensary. I'm not advocating for anything in particular, but even a little bit of thc along with cbd can help with sleep.

Speaker 1: 26:22

So something, maybe one second, you have to look at your other many patients, of course yeah, so of course, talk to your doctor on that, right, you know you'll agree with me on that. Talk to your doctor. But it is one of those things that unfortunately becomes controversial and maybe it shouldn't be. Maybe it's one of those things that you know it just carries whatever political baggage and whatever else. But the reality is, if this is something that can improve quality of life for our elder population, it's unfortunate that it has this baggage behind it. But again, we're not giving medical advice. We're just saying talk to your doctor and maybe incorporate this as part of your, your plan you know, unfortunately big pharma doesn't have all the answers yet right, uh, so I I can't agree with that more.

Speaker 1: 27:10

You know, a lot of times the answer for whenever there's a any, so two problems. Number one is often the diagnosis is generalized dementia. Well, that doesn't tell us much. Dementia is a category of disease. It doesn't tell us which type of dementia it is. And then, secondly, whenever there's this diagnosis of those drugs, acknowledge that it only helps a percentage of the people, a lot of people, that it doesn't help everybody.

Speaker 2: 27:47

And those medications have been out on generic for 20 years already. They haven't come up with anything better, which is quite unfortunate, but yeah.

Speaker 2: 27:55

It'll help with some temporary release. That's about it. So I want to go back to something you were just talking about, which is partly a catalyst for my doing what I'm doing. Is that rightly so? The emphasis on most diseases cancer, heart, dementia is on the person with the disease, because they can't take care of themselves. They may not be able to make their own decision. The problem is and this is what I found 20 years ago and it hasn't improved much is who's saying to the caregiver how are you doing? What support and resources do you need? And people feel let down. If they even get a diagnosis, specific or otherwise, they say where's the plan, where's the treatment?

Speaker 1: 28:39

Where's the that's a big deal and, frankly, from my perspective, and how we work with families is that's the thing that we have to address.

Speaker 1: 28:55

When families come to me, a lot of times they're saying, oh, this is about mom or this is about dad, and I say, well, yes, of course we've got to make sure that we've got a plan for the person that has the dementia or some form of dementia. We also and just as important is we have to have a plan for the caregiver spouse, the other spouse. Now, obviously, if it's a single person sometimes it's the caregiver daughter or the caregiver son or the caregiver grandchild but the thing is that we have to have a plan for them too, because you know, if they get sick, if they break their hip, if they fall down, if they have a stroke, if they die, the entire plan falls apart, and so it is just as much about the caregivers as it is about the person with dementia. Hey, bill, tell me a little bit more. I know one of the things that you do is elder mediation. So tell us a little bit more about what elder mediation is and how do you participate in it.

Speaker 2: 29:53

So, as many of us know, some families can't even decide on ordering pizza, let alone caring for their loved one. They're divided. They may not be all on the same page. Some people may have ulterior motives or other agendas. That's unfortunate. I was lucky. I had very good support from my family. They may have had different opinions, but we all cared about what was going on with my mom.

Speaker 2: 30:17

Elder mediation is when families cannot come to an agreement. They're at an impasse and they need probably an objective or neutral third party to help them keep talking, come to an agreement. I don't make the decision for them. I can't fix the family problems. I'm not a therapist, but we will keep talking and and try to help them come to that agreement. They can all live with real quickly. It was with a family of four different cities, three different states around the northwest. They're divided down the middle between the four of them about the terror and where and how mom will be taken care of, and we got on the calls. I remember one of the siblings said at one point well, at least we're not yelling at each other. That was a win. And one of the siblings at one point the one who hired me at one point went off camera. He was off mic. He says I'll be listening, so we kept talking kept going, came to an agreement.

Speaker 2: 31:14

He wasn't happy about it, about the outcome. They told me later you did your job and gave me a great testimonial so that kind of situation and mom is doing well ever since. It's very gratifying. It is a way, with all due respect to your profession, to keep you out of the courts.

Speaker 2: 31:32

It's not about the attorneys, it's about them and again, it's just with me and them. I usually will do a group call and then maybe individual conversations and then come back as a group and try to come to that agreement. If they will settle on yeah, which is great.

Speaker 1: 31:47

And you know I take the try to come to that agreement. They will settle on yeah, which is great, and you know I take the position of we're only going to help families that can come to that agreement. I'm not going to get involved in that. You know court battle where everybody's arguing and who should be guardian, and you know all of that. I simply will not take those cases and I know that that's a line in the sand that some people are upset by. But the bottom line is I am best at helping families that are willing to work together.

Speaker 1: 32:17

Now, like you, sometimes it doesn't mean that the family all agrees. Before we have to have that kind of family meeting where everybody sits down and we all, like you said, sometimes we disagree and commit, disagree to the. You know that you said you're the person that hired you wasn't real thrilled with the answer. But if we can commit to a plan and that's what's important is, you know, allowing the family to get through that, to allowing the family to have that, you know, and I here's my assumption my assumption is uh, I at least walk into the meeting with the uh assumption that the family is all well intentioned but they're getting voices from everybody. They're getting voices from culture, from movies, from their barber, from their neighbor, from you know, from whoever uh telling them that this is the way it should be. Uh, when we have a a parent in crisis, when we have a parent with dementia, there's lots of people willing to give advice.

Speaker 1: 33:21

Some of it's bad advice it is and so the idea is that you know to come together instead of come together in screaming, come together and say, OK, we've got to look for what's best in this situation. Find that light at the end of the tunnel.

Speaker 2: 33:39

And that's in the best interest of their person, who needs the attention.

Speaker 1: 33:44

And it's great that you do that because you have an advantage over me in that while we do that also, I have to worry about attorney ethics and conflict of interest, and so as soon as it seems there's conflict of interest, I have to say sorry, I can't help you anymore. Where you're able to still talk to the family and try to move forward to a conclusion where they're all going to be in agreement. As soon as somebody says I'm going to hire a lawyer, we're fighting about this, I have to pretty much shut it down and say, okay, then I'm out because I can't be involved in the Catholic interest. As a non-lawyer, you're able to mediate some of these things in a very positive way.

Speaker 2: 34:27

However, I still have one, as you say, a line in the sand. If everybody does not agree to mediation, how did it happen? Right?

Speaker 1: 34:37

Right, good point. So another thing that you do, and I think is very interesting and very important, is collaborating to create a care team, you know, coming up with that whole holistic team to figure out how do we move forward. Talk to me more about that.

Speaker 2: 34:54

So and I gave one example earlier and it's a real good one Of course, it again depends upon the situation. Not everything's necessary Then we already have the legal documents in place to have a review. So when I'm talking to people, what are your needs? What are your biggest concerns? I'm looking at, what can we bring in to the team to help collaborate and talk about the various issues? That's affecting not just the person with dementia or other condition, but also the family. So, because everybody is involved, no matter where they are, what they do, how much or how little, they're a carrier, they're part of the caregiving team, and that can be handling finances, that can be making calls or purchases, that can be coming in for a week and giving respite to the primary carrier. There's a lot of different ways that can work and that's what I help them come together. It's not a matter of I'm too far away, I'm too busy, I can't deal with it. No, there aren't always things that you can do.

Speaker 1: 35:56

Well, Bill, this has been a great conversation. I really enjoyed it. We're totally on the same page about what needs to be done when a family is dealing with this kind of crisis. I want to ask you one last question that I think is probably one of the most important questions that we can address today, which is the importance of self-care and prevention for the caregivers.

Speaker 2: 36:19

Yeah. So I gave an example myself about taking care of myself. So I was working full time. I was talking about sleep and those type of things. I was working full-time 45 minutes south of Portland while taking care of mom, but when she got out of here it was about a half hour north In an unfulfilling job with a how can I say it? A micromanager, narcissist boss, a boss from health. My stress level, my blood pressure was sky high and I got counseling. One of the first things I did was get into a support group. I made sure that I got away from my desk and took a walk occasionally, made sure I was getting my sleep. Those things were very important. One of them was a good example is I first started getting chair massages at work. Then I started getting regular massages and I realized this is not a luxury, this is a necessity and it's continued to this day.

Speaker 2: 37:22

The reduction of my stress is taking care of myself, making sure that, even though I don't have my mom's risk factors that I mentioned earlier, I'm very proactive about my health. That's very important because I can't take care of me and my wife. I can't take care of myself.

Speaker 1: 37:38

So you mentioned support groups For those that are local to our Grand Blanc office. So we have offices in Michigan and Rochester, grand Blanc and Brighton. So we have offices in Michigan and Rochester, grand Blanc and Brighton, if you're anywhere within a half-hour drive or so of our Grand Blanc office. We do have a support group now for dementia caregivers and that's on every third Tuesday. Okay, so you can go to our website to get the details of it, but it is a support group that is through the Alzheimer's Association and when we talk about the Alzheimer's Association, know that that doesn't mean that it has to be Alzheimer's, it's any form of dementia. That is the dementia support group.

Speaker 2: 38:20

And many of those support groups are still online and staying that way.

Speaker 1: 38:24

Yeah, so that's another great option. We have an in-person one. Sometimes it's nice. I enjoy having a face-to-face with people. There can be real good support for virtual, because sometimes it's really hard to get away when you have somebody that you're caring for.

Speaker 2: 38:40

24 hours a day.

Speaker 1: 38:42

So that's a resource that you can pursue. Pursue. The Alzheimer's Association has many options and a call number that you can call to get their support and information about support groups that you might be up to.

Speaker 2: 38:56

Right, and there are other places you can check as well by doing a search. But, for instance, I do another group that I started about seven years ago through a non-profit just north of us in Vancouver, washington, clark County, and I did the first one down in the Portland area and we do those every week. It's every Saturday. I started at the care community, which is literally across the street from me, but during the pandemic, of course, we went to Zoom, but people are joining us anywhere from New England to Hawaii. I didn't want to orphan them, so every other week is in person or online, so actually both people in sporting, which is very important.

Speaker 1: 39:36

Yeah, and that's great. And, bill Cohen, it was great to have you on the podcast. Excellent conversation. I appreciate what you do in the service that you provide to the community, what you do in the service that you provide to the community. So, thank you. If this is a topic that you found interesting, don't hesitate to subscribe to our podcast. So it's advice from your advocates. You can subscribe at any place that you listen to podcasts, or you can go to our website at mannerandlawgroupcom and you can watch them there or watch them on YouTube. Thank you for joining us, bill.

Speaker 2: 40:13

Thank you, it was an honor.

Speaker 1: 40:15

And I appreciate everything that you do and we'll see you next time.

Speaker 2: 40:19

Likewise.