For a variety of reasons, underserved populations – rural, elderly, low education, minority groups, etc. – often experience barriers to accessing healthcare, and their caregivers find particular challenges to providing needed care. In this podcast, interviewers Frances Hall Founder & Executive Director, of ACAPcommunity, and AJ Kerley Director of Professional Relations at PACE@Home, will discuss with John Uche, MD – Medical Director for PACE@Home the social determinants of health, barriers to accessing care, health literacy, and other factors that affect healthcare for underserved populations.
This episode of The Caregiver Community is made possible by our sponsor, Pace @ Home in Newton, NC.
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[00:00:02] What you want, when you want it, where you want it. This is The MESH.
[00:00:08] This episode of The Caregiver Community is sponsored by PACE at Home.
[00:00:13] During this uncertain time, PACE at Home is enrolling participants who wish to continue to remain at home.
[00:00:19] Partnering with families, PACE at Home provides caring medical support for all of our program's participants.
[00:00:26] Visit us on our website or give us a call at 828-468-3980 to talk with a representative that can discuss with you the PACE at Home all-inclusive medical approach.
[00:00:41] PACE at Home is the champion for seniors wishing to remain in their community.
[00:00:52] The Caregiver Community, this is a place where we talk about the joys and the challenges of caring for our aging parents and loved ones,
[00:01:01] as well as caring for ourselves.
[00:01:03] I am Frances Hall, Founder and Executive Director of ACAP, Adult Children of Aging Parents.
[00:01:10] In this podcast, we're talking about factors that affect healthcare for members of underserved populations and their caregivers,
[00:01:18] and what steps can help remedy the issues and the concerns.
[00:01:22] I am delighted to be joined by Dr. John Uche, the Medical Director for PACE at Home in Newton, North Carolina.
[00:01:31] He is an experienced physician and medical leader who has spent much of his career practicing medicine
[00:01:38] in underserved urban communities in academic, community health, and value-based settings.
[00:01:44] Dr. Uche has practiced medicine for over 30 years and truly understands the importance of not only caring for his patients,
[00:01:53] but also supporting their caregivers as well.
[00:01:57] Dr. Uche, thank you so much for being with us.
[00:02:01] Good to be with you, Frances.
[00:02:03] Thanks.
[00:02:04] I also am happy that AJ Curley, who is the Director of Professional Relations at PACE at Home,
[00:02:10] is my co-interviewer.
[00:02:12] AJ has worked in various aspects of healthcare for her entire career and has been involved with PACE for eight years.
[00:02:20] Her mission, both professionally and personally, is to make sure seniors are connected with local resources
[00:02:26] to help them continue to have full and productive lives no matter their level of care.
[00:02:32] Hey, AJ, it's always good to have you with us.
[00:02:35] Thank you, Frances. It's always good to see you.
[00:02:38] Thanks.
[00:02:39] And for you who are listening, full transparency,
[00:02:43] PACE at Home is a sponsor for all of our ACAP podcasts.
[00:02:48] We are extremely grateful, not only for the great work that they do in our area,
[00:02:53] but also for their continued affirmation of ACAP.
[00:02:57] Okay, so let's get started.
[00:03:00] Lots of information, lots to unpack here.
[00:03:03] Okay, AJ, when we talked about unserved and underserved populations, who are we really talking about?
[00:03:16] Yeah.
[00:03:18] Underserved communities are described by people who have limited access to healthcare.
[00:03:24] The United States Health Resources and Services Administration designates medically underserved areas and populations as those having too few primary care providers.
[00:03:39] So in a place where you don't have enough primary care providers, that's an underserved community.
[00:03:47] It also refers to places where they have high infant mortality, as well as high poverty rates and high elderly population.
[00:03:59] So those are the basic definitions of underserved communities.
[00:04:04] Okay.
[00:04:04] Okay.
[00:04:04] Basically, that a lot of the services that we might think would be available, maybe they are not available to them so readily,
[00:04:14] or that there is some reticence to access them.
[00:04:18] Is that a pretty good summation?
[00:04:20] Yeah, I would agree.
[00:04:22] Sometimes we talk about underserved communities as geographical places, but it can also be individual experiences.
[00:04:33] Good point.
[00:04:34] Good point.
[00:04:35] Because you can live in a place where it's otherwise fully served, but you still have limited access to healthcare.
[00:04:42] So we have to look at those two positions, you know, hand in hand when making this presentation.
[00:04:53] Right, right, right.
[00:04:54] Thank you.
[00:04:55] Thanks for helping us.
[00:04:56] And they usually will include like rural areas and areas where there is high elderly population and places where you have low literacy,
[00:05:09] as well as, of course, where there is lower socioeconomic status.
[00:05:14] But like I said, you can have these communities also in areas that don't have underserved communities as a definition.
[00:05:22] Thank you for that, because I think a lot of times we don't think about rural areas being included in unserved or underserved populations,
[00:05:35] but more and more they are because medical is so scarce sometimes.
[00:05:44] Thank you.
[00:05:46] So, Dr. Uche, you've talked a little bit about this already, but maybe you can expand a little bit more on it.
[00:05:53] What are some of the issues caregivers in these underserved communities, what are they facing?
[00:05:59] What experiences may be different than a community that's not considered underserved?
[00:06:07] Yeah, that's a good question.
[00:06:09] But, you know, like I said, underserved can be some of the things that are very peculiar to those underserved communities can also affect people who live in otherwise well-served communities.
[00:06:22] And some of those are lack of access to health care support services.
[00:06:27] You know, they have limited availability of health care providers.
[00:06:31] That's number one definition.
[00:06:33] Limited availability, especially in rural areas.
[00:06:37] Most of health care providers tend to stay in the big cities.
[00:06:42] So, as we begin to go away from the bigger cities, then less and less health care providers are available to go and work in the rural areas,
[00:06:51] even though there are government incentives to cause them to go and work in those areas.
[00:06:58] But being away from the big cities makes it a little bit more difficult for you to assess the level of care that you need just because there is limited availability of health care providers.
[00:07:11] And there is also insufficient access to specialized care.
[00:07:14] You know, you may have the care, but maybe you may lack specialized care like mental health care.
[00:07:22] You may have problems with assessing palliative care and problems with tertiary level of care.
[00:07:31] For instance, you tend to have neurosurgeons in the big cities, even though you still have people in the rural areas who have need for neurosurgeons.
[00:07:42] So, those specialties, they are not as numerous as you have primary care providers.
[00:07:49] And so, they are not going to be in every city.
[00:07:51] For instance, last week, I had one of my patients in the center here who was supposed to go to Winston-Salem to see her neurosurgeon.
[00:08:00] So, that distance is a barrier for her to assess the care.
[00:08:03] So, that is the way it is.
[00:08:05] There are also financial strain and economic challenges in underserved communities.
[00:08:12] You know, the cost of health care, the cost of medications, even transportation is a big problem for them.
[00:08:20] So, they have limited opportunity to have some of the things that are available in the bigger places.
[00:08:30] So, that's something that, you know, is very prevalent in underserved communities in terms of how they are able to access the care.
[00:08:40] There is also general mistrust of the healthcare system by people who live in underserved communities.
[00:08:49] And this can be demonstrated by anecdotes.
[00:08:54] People have heard stories of what happened to people when they go to see their doctors.
[00:09:00] People feel somehow disconnected from the system because they have language barriers,
[00:09:08] especially when you come to a place where there is diversity of all kinds of people come from different kinds of areas.
[00:09:16] The majority of language in America is English and sometimes, you know, Latino.
[00:09:25] And people who don't belong to those two, they have to have, like, translation services for their cases to be resolved in the offices.
[00:09:39] So, it's difficult for them when they feel like they have to go and get a translator for them and they wish maybe they didn't have to go.
[00:09:49] There are also biases.
[00:09:51] You know, people feel like there is some kind of implicit bias by, you know, providers of healthcare.
[00:09:57] And if I don't look like you look, I feel sometimes maybe I will not get the best treatment from you.
[00:10:07] So, people have that kind of, even if it is not true, it is a feeling that they have for themselves.
[00:10:14] So, how they are able to navigate all that is a problem.
[00:10:19] There is lack of knowledge of how the system actually operates.
[00:10:24] So, sometimes it's not just because there is language barriers or there is low education,
[00:10:30] but they don't know how the system actually operates.
[00:10:33] So, they're finding it difficult to really assess the level of care that they need in underserved communities.
[00:10:42] Of course, in addition to all this, there is this emotional toll and psychological toll, you know, taking care of your loved ones.
[00:10:52] Sometimes people have physical exhaustion.
[00:10:56] Not that it's restricted to only people in the underserved areas.
[00:11:02] Any caregiver, actually, wherever you may be, is affected by physical exhaustion, taking care of your loved ones.
[00:11:09] There is a sense of loneliness and lack of social engagement.
[00:11:14] These folks, they feel isolated because they spend a lot of their time taking care of their loved ones.
[00:11:22] And that makes it difficult for them to engage in social activities that they used to enjoy before this actually started.
[00:11:30] There is also fear and anxiety about the well-being of their loved ones.
[00:11:35] So, that makes it difficult.
[00:11:37] Some people feel guilty.
[00:11:39] You know, sometimes you'll be thinking, how?
[00:11:42] If I had just asked them to take that medication, maybe they would not have had the stroke.
[00:11:48] If I had just taken them to the doctor.
[00:11:50] Sometimes that feeling of guilt makes it difficult for people, you know, to really do their work as caregivers.
[00:12:02] So, those are some of the issues that they feel, even in underserved communities.
[00:12:09] And there is also a sense of difficulty in navigating the healthcare environment.
[00:12:17] You never know how difficult it is to really go to a doctor's office or a big hospital where you don't know anyone.
[00:12:28] And just being transported from your own area to go to access health in those communities is very, very difficult.
[00:12:36] Even for some of us who are in the medical field.
[00:12:39] You know, sometimes we don't really become patient.
[00:12:43] But when we do, we see how strange that experience can be.
[00:12:47] Not to talk of people who didn't have the kind of learning and education that we do have.
[00:12:53] There is also burnout, which is a state of physical, emotional and mental exhaustion caused by chronic stress from caregiving.
[00:13:04] And we should not underestimate the power of burnout in our caregivers.
[00:13:12] Dr. Uche, you are singing my song.
[00:13:16] My mother, I live in a small community.
[00:13:19] But we have a hospital here that is connected with a bigger system.
[00:13:25] And so, very, very grateful for the medical system that we have here in my community.
[00:13:30] But my mother lived in a very tiny town in Alabama.
[00:13:34] And the closest medical facility was 25 miles away.
[00:13:42] And, you know, so it was almost a medical desert.
[00:13:46] And when you're talking about people who present differently, look differently or sound differently,
[00:13:58] it was not the same at all.
[00:14:00] And I know that.
[00:14:01] But I even experienced with my husband that he was very much of a,
[00:14:09] that he was passionate about a particular basketball thing.
[00:14:14] And one of his doctors, during his leukemia treatment,
[00:14:18] one of his doctors rooted for the other, for an opposing team.
[00:14:22] And my husband truly believed that he would not get as good care
[00:14:27] because of his affiliation with the different basketball team.
[00:14:32] And that's a small example.
[00:14:36] My heart just goes out to people who believe that they are not going to get the same kind of good care
[00:14:45] because they look different or sound different than a medical provider.
[00:14:50] So thank you for talking about all of that and helping explain exactly what we, you know,
[00:14:57] all the bread of what we were talking about with this.
[00:15:01] Well, Dr. Uche, are there health issues that are more common among the underserved population than any other?
[00:15:09] I mean, it's difficult to really say because if people are going to have diabetes,
[00:15:17] they'll have diabetes in the city, they'll have diabetes in the rural areas and underserved communities.
[00:15:22] It's how this is managed that's actually a problem.
[00:15:27] You know, if people are traveling on the street and they have a motor vehicle accident,
[00:15:32] they're going to have injuries, whether it's in the village or whether it's in the city.
[00:15:36] So the most important difference is ability of people in underserved communities
[00:15:44] to access the health that they need to take care of their problems.
[00:15:49] There's not much difference between what they have, what they can have, and what they already have.
[00:15:57] If I have hypertension, for instance, how am I able to receive the care that I need to take care of my blood pressure?
[00:16:08] That's the difference between underserved communities and places that are not underserved.
[00:16:14] Some other places you are able to go, you see a doctor, you don't have a problem with that.
[00:16:18] And that really takes me to what we call the social determinants of health.
[00:16:22] The social determinants of health, even though you have the health care provided,
[00:16:28] you are not able to access it because of other social factors.
[00:16:32] And some of those include lower education and lower socioeconomic status.
[00:16:38] If you don't have enough education about how to access needs for yourself,
[00:16:44] it's difficult even when other people are enjoying the same level of care in your area.
[00:16:48] So education and lower socioeconomic status is a big problem in terms of social determinants of health.
[00:16:57] Language barriers, like we said before.
[00:17:00] Somebody comes from maybe Vietnam and they live in a community
[00:17:05] and they want to go and see their primary care provider.
[00:17:08] There is no translation services, for instance.
[00:17:12] I know many offices are now trying to get translation services, even online availability is there.
[00:17:19] But that can make you not want to go because you think they won't understand you or you won't understand them.
[00:17:28] And language is really a big barrier.
[00:17:31] And also transportation, you know, inadequacy or absence of transportation can make it difficult for people to access health.
[00:17:43] And it's a big social determinants of health.
[00:17:46] And for us in Pace at Home, which is one of the big things we offer here, is transportation.
[00:17:54] You know, folks can be taken to wherever they need to be seen because transport is available.
[00:18:00] And especially for the older community that we serve, you know, they cannot drive themselves even if they're hard cars.
[00:18:10] So having a way of providing transportation to take them to places where they need to be,
[00:18:16] it's a good thing to have to solve those social determinants of health.
[00:18:24] People also live in inadequate housing.
[00:18:27] So whether it's housing insecurity, it's a difficult problem for them, even if the doctors are all there.
[00:18:35] But if you live in a neighborhood that is not safe, people don't want to navigate in the evening times
[00:18:42] because maybe you think you're going to be mugged or something.
[00:18:45] So it's difficult for people when you say, oh, you know, take walks in the evening or exercise or do all this to help you to maybe get some strength in your extremities
[00:18:57] or if possible lose weight.
[00:18:59] People are not able to do that unless they live in a safe neighborhood.
[00:19:04] So the places you live can be a problem, you know, for you to assess the level of, you know, health care that you need.
[00:19:14] And we also, I want to talk about the sandwich generation.
[00:19:18] That's where folks are taking care of their own parents as well as taking care of their own children.
[00:19:25] It's a big thing.
[00:19:26] You don't know whether to go to the appointment for your daughter or go to the appointment for your mom.
[00:19:33] So this is a huge thing.
[00:19:35] And we as providers, sometimes we are not really aware of that.
[00:19:42] You know, if someone misses their appointment, we are just saying, oh, if they do this third time, then we are going to strike them off the roster.
[00:19:52] But there are other reasons why people are not able to come to see the doctor.
[00:19:56] So those are what we call the social determinants of health.
[00:20:01] So basically, Dr. Uche, I guess you're saying the health issues are not necessarily different among the two different communities.
[00:20:09] It's just the social determinants of health that may be making it more challenging for the underserved community versus the other communities.
[00:20:20] Is that correct?
[00:20:20] Yes.
[00:20:21] Okay.
[00:20:22] Okay.
[00:20:22] So given that, given everything you've said and you've said so much, but is there some particular advice that you would give caregivers, particularly in underserved communities, to help them better advocate for their loved ones?
[00:20:46] Are there some particular things that caregivers can do?
[00:20:50] So the advice to caregivers, unfortunately, many caregivers are not prepared for what happens to them.
[00:21:00] They are not trained to be caregivers.
[00:21:02] Life just happens.
[00:21:04] All of a sudden, you need to start taking care of maybe your spouse, you know, or you start taking care of your child or your child starts taking care of a sibling.
[00:21:18] All those things.
[00:21:20] People didn't come out planning to see this is what we can do.
[00:21:24] Even when people have children that have neurod developmental disabilities, you know, like have someone in the autism spectrum, you didn't train for it.
[00:21:37] so life just happens to you
[00:21:40] and you have to just take it
[00:21:42] so the advice is
[00:21:44] always know your
[00:21:46] why
[00:21:47] why you are
[00:21:49] involved in this
[00:21:50] you need to think of the relationships
[00:21:53] you need to think of the relationships
[00:21:55] and you need to stay positive
[00:21:57] and you need to stay strong for yourself
[00:21:59] you need to recognize
[00:22:01] your emotions
[00:22:02] because sometimes you really feel tired
[00:22:05] sometimes you feel guilty
[00:22:07] sometimes you feel exhausted
[00:22:09] sometimes you feel like
[00:22:13] there is no end in sight
[00:22:15] like there is
[00:22:16] just
[00:22:17] absolute hopelessness
[00:22:19] this is a situation you don't know
[00:22:22] when it's going to change
[00:22:23] and there is a difference between
[00:22:26] terminal illnesses
[00:22:28] and acute
[00:22:29] you know problems
[00:22:31] you know somebody goes into the hospital
[00:22:34] they have
[00:22:36] maybe a fracture
[00:22:38] and they fix the fracture
[00:22:40] after two or three months
[00:22:42] they get better
[00:22:43] versus someone who is taking care of
[00:22:46] you know a person that has
[00:22:47] maybe Alzheimer's disease
[00:22:50] this is a terminal illness
[00:22:53] and as time passes
[00:22:54] it gets worse
[00:22:55] so if you are involved as a caregiver
[00:22:59] you know for a person that has
[00:23:01] Alzheimer's disease
[00:23:03] then you really need to buckle up
[00:23:05] because this is not going to get better
[00:23:08] as a matter of fact
[00:23:09] your experiences are going to get worse
[00:23:12] so we just say
[00:23:13] hey
[00:23:15] take some help
[00:23:18] when you need it
[00:23:19] you know there are some
[00:23:20] family dynamics
[00:23:21] let people come in
[00:23:23] you know
[00:23:24] use help
[00:23:25] wherever you can find it
[00:23:27] whether from brothers
[00:23:28] whether from sisters
[00:23:29] from other family members
[00:23:32] from church groups
[00:23:33] you know
[00:23:34] do not feel guilty about anything
[00:23:36] try to relax
[00:23:38] when you can
[00:23:39] do something for yourself
[00:23:41] because at the end of the day
[00:23:43] you need to remember
[00:23:45] if you are not there
[00:23:46] to take care of your loved one
[00:23:48] no one will be able to take care of them
[00:23:51] so you need to take care of yourself first
[00:23:53] you know when we enter the aircraft
[00:23:55] and they say
[00:23:56] when the oxygen depth
[00:23:57] you know goes down
[00:23:59] put the mask on yourself
[00:24:00] before you put on the next person
[00:24:02] this is not being selfish
[00:24:04] this is just going to prepare you
[00:24:06] to be able to take care of the people
[00:24:07] that need your help
[00:24:09] so
[00:24:11] that's the exact analogy I was thinking
[00:24:13] yes
[00:24:13] yes
[00:24:15] so
[00:24:15] and you need to know
[00:24:16] what supports are available in your area
[00:24:18] you know
[00:24:20] sometimes there is respite care
[00:24:21] sometimes there is adult daycare
[00:24:24] places where people can go
[00:24:25] and stay
[00:24:27] and sometimes
[00:24:28] you know
[00:24:29] for those who can afford it
[00:24:31] you can also engage
[00:24:32] paid
[00:24:34] caregivers
[00:24:35] who can come in like home care
[00:24:36] or something to
[00:24:38] you know help you with
[00:24:39] what you need
[00:24:40] but you have to stay strong
[00:24:42] you have to stay positive
[00:24:44] this is
[00:24:45] going to be for the long haul
[00:24:47] especially for those that have
[00:24:50] terminal illnesses
[00:24:51] when we talk about terminal illnesses
[00:24:53] we're talking about dementia
[00:24:55] we are talking of
[00:24:56] end stage
[00:24:57] pulmonary heart
[00:24:59] heart problems
[00:25:00] these things are not going to ever get better
[00:25:03] in fact over time
[00:25:04] they tend to get worse
[00:25:06] so the caregivers
[00:25:07] are not going to be relieved
[00:25:10] anytime
[00:25:10] you know
[00:25:11] so what they need to do
[00:25:13] is to encourage
[00:25:14] other family members
[00:25:16] or church
[00:25:18] communities
[00:25:18] or whatever they can get
[00:25:20] so that
[00:25:20] you know
[00:25:21] once in a while
[00:25:22] they can
[00:25:23] get respite
[00:25:24] and get them to help them as well
[00:25:26] and so often
[00:25:28] people who are caregivers
[00:25:29] are just such giving people
[00:25:32] that they
[00:25:33] it's very hard
[00:25:35] for them to say
[00:25:36] I need help
[00:25:37] so thank you
[00:25:38] for the permission
[00:25:39] and the encouragement
[00:25:41] for people to do that
[00:25:43] because that is so important
[00:25:45] yeah
[00:25:46] Dr. Uche
[00:25:48] you've touched a little bit
[00:25:49] on this next question already
[00:25:50] but are there any additional
[00:25:52] things that you can share
[00:25:54] that would help a caregiver
[00:25:55] better care for themselves
[00:25:57] first and foremost
[00:25:58] and then also prepare
[00:26:00] for their future
[00:26:02] as an older adult
[00:26:04] caregivers
[00:26:06] provide care
[00:26:07] for those that need it
[00:26:09] the first thing
[00:26:10] about caregiving
[00:26:11] is to really take care
[00:26:12] of your own self
[00:26:14] like I said
[00:26:15] so
[00:26:15] you have to be sure
[00:26:17] that you are able
[00:26:18] to take care of yourself
[00:26:19] before you can take care
[00:26:21] of other caregivers
[00:26:23] you need to
[00:26:24] you need to be proactive
[00:26:27] sometimes
[00:26:28] you are taking care
[00:26:29] of a condition
[00:26:30] that you don't really
[00:26:31] know about
[00:26:32] so you need to educate yourself
[00:26:33] you need to empower yourself
[00:26:35] to know about
[00:26:38] disease trajectories
[00:26:39] and work with your doctors
[00:26:42] you know
[00:26:43] the way the system
[00:26:44] is set up
[00:26:44] sometimes
[00:26:46] I am the doctor
[00:26:48] for the patient
[00:26:49] and the caregiver
[00:26:51] has a different doctor
[00:26:53] sometimes
[00:26:53] when they need help
[00:26:55] you ask them
[00:26:56] to go to their own doctor
[00:26:57] there is a way
[00:26:58] the system
[00:26:59] is set up
[00:26:59] it makes it difficult
[00:27:01] for them
[00:27:02] to really
[00:27:04] provide
[00:27:06] the kind of care
[00:27:07] they need
[00:27:07] to provide
[00:27:08] for their loved ones
[00:27:09] just because
[00:27:10] they have to be
[00:27:11] in two different places
[00:27:12] for them to
[00:27:13] have
[00:27:15] what they need
[00:27:17] so
[00:27:18] we need to work
[00:27:19] we need to work
[00:27:21] with the doctor's offices
[00:27:22] and especially
[00:27:23] doctors also
[00:27:25] and clinics
[00:27:26] they need to understand
[00:27:28] the burden
[00:27:29] that caregivers
[00:27:30] have
[00:27:30] in taking care
[00:27:32] of the patients
[00:27:33] so
[00:27:34] if
[00:27:34] if you need
[00:27:35] like
[00:27:36] FMLA
[00:27:38] opportunities
[00:27:38] if they're available
[00:27:40] you know
[00:27:41] doctors should be able
[00:27:42] to help you
[00:27:43] like
[00:27:43] NPs
[00:27:44] they should be able
[00:27:45] to help you
[00:27:45] to assess those
[00:27:46] you know
[00:27:47] help you to
[00:27:49] get enough
[00:27:52] respite for yourself
[00:27:53] so that
[00:27:54] you will be strong
[00:27:55] enough
[00:27:55] to take care
[00:27:56] of
[00:27:56] you know
[00:27:57] your loved ones
[00:27:58] and sort of
[00:28:02] following up
[00:28:03] on that
[00:28:03] what about
[00:28:04] the medical
[00:28:05] providers
[00:28:06] are there
[00:28:08] some
[00:28:08] are there some
[00:28:10] things
[00:28:10] that would be
[00:28:11] helpful
[00:28:11] for health care
[00:28:12] providers
[00:28:13] to know
[00:28:15] so they can
[00:28:16] support
[00:28:17] when you
[00:28:17] you've
[00:28:18] said so much
[00:28:19] and you are
[00:28:20] a medical
[00:28:20] provider
[00:28:21] but are there
[00:28:22] some other
[00:28:23] things
[00:28:23] or
[00:28:23] or as one
[00:28:25] medical provider
[00:28:25] to another
[00:28:26] do you have
[00:28:27] some words
[00:28:28] of wisdom
[00:28:28] and encouragement
[00:28:29] for fellow
[00:28:30] medical
[00:28:31] providers
[00:28:32] people didn't
[00:28:33] really talk
[00:28:34] about caregiving
[00:28:34] as a problem
[00:28:35] in the medical
[00:28:37] community
[00:28:37] so until
[00:28:39] recently
[00:28:39] especially
[00:28:40] with
[00:28:40] these
[00:28:42] many cases
[00:28:43] of Alzheimer's
[00:28:44] disease coming up
[00:28:45] so providers
[00:28:46] are beginning
[00:28:47] to know
[00:28:48] that
[00:28:49] it's a real
[00:28:50] problem
[00:28:51] and that's
[00:28:51] why we are
[00:28:52] even talking
[00:28:52] about it today
[00:28:53] so as
[00:28:56] a medical
[00:28:57] provider
[00:28:57] if someone
[00:28:59] brings
[00:28:59] a loved
[00:29:00] one to
[00:29:01] my clinic
[00:29:01] I need
[00:29:02] to acknowledge
[00:29:04] that caregiver
[00:29:06] I need
[00:29:06] to say
[00:29:07] to them
[00:29:07] you are
[00:29:09] doing a
[00:29:09] great job
[00:29:10] without you
[00:29:11] your loved
[00:29:12] one will
[00:29:13] not be
[00:29:13] in this
[00:29:14] situation
[00:29:14] I just
[00:29:16] want you
[00:29:16] to know
[00:29:16] that what
[00:29:17] you are
[00:29:17] doing
[00:29:18] is great
[00:29:18] and I
[00:29:19] want to
[00:29:20] encourage
[00:29:20] you to
[00:29:20] do
[00:29:21] everything
[00:29:21] that you
[00:29:22] can
[00:29:23] for your
[00:29:23] loved
[00:29:23] one
[00:29:24] that's
[00:29:24] number
[00:29:25] one
[00:29:25] number
[00:29:25] two
[00:29:26] feel free
[00:29:27] to always
[00:29:28] let me
[00:29:28] know
[00:29:29] what I
[00:29:29] can do
[00:29:30] to make
[00:29:30] it easier
[00:29:31] for you
[00:29:31] the medical
[00:29:33] provider
[00:29:33] has to be
[00:29:34] available
[00:29:35] for the
[00:29:35] caging
[00:29:36] you know
[00:29:37] if they ask
[00:29:38] questions
[00:29:38] there should
[00:29:39] be
[00:29:41] a fast
[00:29:42] turnaround
[00:29:42] time
[00:29:43] for their
[00:29:44] questions
[00:29:44] to be
[00:29:44] answered
[00:29:45] if they
[00:29:46] are not
[00:29:46] able to
[00:29:47] bring
[00:29:47] their
[00:29:47] loved
[00:29:48] one
[00:29:48] to come
[00:29:49] and see
[00:29:49] you
[00:29:49] in the
[00:29:49] clinic
[00:29:50] we should
[00:29:51] make
[00:29:51] opportunities
[00:29:52] available
[00:29:53] for
[00:29:53] virtual
[00:29:54] visits
[00:29:55] so you
[00:29:56] can check
[00:29:56] in with
[00:29:57] them
[00:29:57] to see
[00:29:57] what is
[00:29:58] going
[00:29:58] on
[00:29:58] just
[00:29:59] have
[00:30:00] a sense
[00:30:01] that
[00:30:01] there is
[00:30:02] much
[00:30:02] more
[00:30:03] than you
[00:30:04] can do
[00:30:04] in a
[00:30:05] 20
[00:30:05] minute
[00:30:05] visit
[00:30:06] and some
[00:30:07] of these
[00:30:07] clinics
[00:30:08] you don't
[00:30:08] even have
[00:30:09] up to
[00:30:09] 20
[00:30:09] minutes
[00:30:10] to see
[00:30:10] this
[00:30:11] person
[00:30:11] and they
[00:30:12] don't have
[00:30:13] enough
[00:30:13] time to
[00:30:13] tell you
[00:30:14] all their
[00:30:14] experience
[00:30:15] is
[00:30:16] unlike
[00:30:17] here
[00:30:17] in
[00:30:18] place
[00:30:18] at home
[00:30:19] where we
[00:30:19] have
[00:30:19] a lot
[00:30:21] of time
[00:30:22] to get
[00:30:23] to know
[00:30:23] the
[00:30:23] participants
[00:30:24] we have
[00:30:24] a lot
[00:30:25] of time
[00:30:25] to know
[00:30:25] the
[00:30:26] caregivers
[00:30:26] we have
[00:30:27] a lot
[00:30:27] of time
[00:30:27] and there
[00:30:28] are a lot
[00:30:28] of different
[00:30:29] professionals
[00:30:30] who can
[00:30:31] work with
[00:30:31] them when
[00:30:32] they come
[00:30:32] into the
[00:30:32] center
[00:30:33] it is not
[00:30:34] like that
[00:30:34] in some
[00:30:34] of these
[00:30:35] other
[00:30:35] primary care
[00:30:36] offices
[00:30:36] so
[00:30:37] if you
[00:30:38] should
[00:30:38] have
[00:30:38] someone
[00:30:39] that's
[00:30:40] caring
[00:30:40] for
[00:30:41] a
[00:30:41] loved
[00:30:41] one
[00:30:42] and they
[00:30:42] come
[00:30:42] to your
[00:30:43] office
[00:30:43] you should
[00:30:45] acknowledge
[00:30:45] them
[00:30:46] and see
[00:30:47] how you
[00:30:47] can help
[00:30:47] them
[00:30:49] to do
[00:30:50] better
[00:30:50] in
[00:30:51] their
[00:30:52] caregiving
[00:30:54] thank you
[00:30:55] for that
[00:30:55] there are
[00:30:56] some
[00:30:56] health
[00:30:57] care
[00:30:57] providers
[00:30:57] who
[00:30:58] are
[00:30:58] wonderful
[00:30:59] very
[00:31:00] compassionate
[00:31:01] very
[00:31:01] caring
[00:31:02] very
[00:31:02] aware
[00:31:03] of
[00:31:04] how
[00:31:04] difficult
[00:31:05] caregiving
[00:31:06] can be
[00:31:07] but
[00:31:08] sadly
[00:31:09] I have
[00:31:09] encountered
[00:31:10] some
[00:31:10] that
[00:31:11] are quite
[00:31:13] the opposite
[00:31:14] of that
[00:31:14] so
[00:31:15] thank you
[00:31:16] for that
[00:31:16] encouragement
[00:31:17] and that
[00:31:17] understanding
[00:31:18] that the
[00:31:20] health
[00:31:20] care
[00:31:20] provider
[00:31:21] is
[00:31:21] key
[00:31:22] in
[00:31:23] this
[00:31:23] whole
[00:31:25] journey
[00:31:26] with
[00:31:27] caring
[00:31:27] for
[00:31:28] a
[00:31:28] loved
[00:31:28] one
[00:31:29] so
[00:31:30] thank
[00:31:30] you
[00:31:30] for
[00:31:30] that
[00:31:31] Dr.
[00:31:32] Uche and
[00:31:33] AJ
[00:31:33] thank you
[00:31:34] so very
[00:31:35] much
[00:31:35] for
[00:31:36] helping
[00:31:36] us
[00:31:36] understand
[00:31:37] the
[00:31:38] variety
[00:31:38] of
[00:31:39] health
[00:31:39] issues
[00:31:40] related
[00:31:41] to
[00:31:41] older
[00:31:41] adults
[00:31:42] and
[00:31:42] caregivers
[00:31:42] in
[00:31:43] underserved
[00:31:44] communities
[00:31:45] it's a
[00:31:46] particular
[00:31:47] topic
[00:31:48] that I
[00:31:49] wanted
[00:31:49] us
[00:31:49] to
[00:31:50] address
[00:31:50] because
[00:31:51] there
[00:31:51] are
[00:31:52] differences
[00:31:52] there
[00:31:53] are
[00:31:53] some
[00:31:53] similarities
[00:31:53] for sure
[00:31:54] but
[00:31:55] there
[00:31:55] also
[00:31:55] are
[00:31:56] differences
[00:31:56] thank
[00:31:57] you
[00:31:57] to
[00:31:58] you
[00:31:58] our
[00:31:58] listeners
[00:31:58] hopefully
[00:31:59] this
[00:32:00] insight
[00:32:00] and
[00:32:01] this
[00:32:01] information
[00:32:01] will be
[00:32:02] helpful
[00:32:02] to
[00:32:03] you
[00:32:03] and
[00:32:04] again
[00:32:04] many
[00:32:05] thanks
[00:32:05] to
[00:32:05] for
[00:32:09] sponsoring
[00:32:09] all of
[00:32:10] our
[00:32:10] community
[00:32:10] all of
[00:32:12] our
[00:32:12] caregiver
[00:32:12] community
[00:32:13] podcasts
[00:32:14] this
[00:32:15] podcast
[00:32:15] is part
[00:32:16] of the
[00:32:16] mesh
[00:32:16] network
[00:32:17] of
[00:32:17] online
[00:32:17] shows
[00:32:18] and
[00:32:18] podcasts
[00:32:19] we
[00:32:19] record
[00:32:20] one
[00:32:20] new
[00:32:22] ACAP
[00:32:22] podcast
[00:32:23] each
[00:32:24] month
[00:32:24] addressing
[00:32:25] a wide
[00:32:25] range
[00:32:25] of
[00:32:26] topics
[00:32:26] related
[00:32:27] to
[00:32:27] caregiving
[00:32:27] and
[00:32:28] advocating
[00:32:28] for an
[00:32:29] older
[00:32:29] adult
[00:32:30] loved
[00:32:30] life
[00:32:30] you
[00:32:31] will
[00:32:31] find
[00:32:32] all
[00:32:32] of
[00:32:32] our
[00:32:32] podcasts
[00:32:33] on
[00:32:33] any
[00:32:33] platform
[00:32:34] where
[00:32:34] you
[00:32:35] listen
[00:32:35] to
[00:32:35] podcasts
[00:32:36] as
[00:32:36] well
[00:32:36] as
[00:33:30] iTunes
[00:33:31] and
[00:33:31] YouTube
[00:33:31] check
[00:33:32] us
[00:33:33] out
[00:33:33] online
[00:33:33] at
[00:33:33] themesh
[00:33:34] dot
[00:33:34] tv
[00:33:35] discover
[00:33:36] other
[00:33:36] network
[00:33:37] shows
[00:33:37] and give
[00:33:38] us
[00:33:38] feedback
[00:33:38] on what
[00:33:39] you
[00:33:39] just
[00:33:39] heard