Ask Dr. Mia: Conversations on Aging Well: Recent Episodes

Dr. Mia

Ever wonder how to help you or your aging loved one through physical or cognitive changes? Want to find a geriatrician, a clinician specializing in the care of older adults, but they are few and far in between? Dr. Mia Yang is a board-certified internist and geriatrician who is here to answer your questions on how to age well. Transcripts, bio, and submit questions to Dr. Mia at www.miayangmd.com

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In this episode, Dr. Mia welcomes Dr. Monique Nugent to discuss how caregivers can effectively advocate for loved ones in hospital settings. Dr. Nugent is also the author of Prescription for Admission: The Power and Potential of Hospital Medicine, a must-read for patients, caregivers, and medical professionals alike. This book offers an inside look at hospital care, breaking down complex medical processes and providing actionable insights for anyone interacting with the healthcare system. Topics include communication strategies, managing hospital ecosystems, and planning for discharge to ensure safety and dignity.

Chapters

00:48 Introduction and Overview of Care Partner Importance
03:45 Navigating Hospital Communication as a Care Partner
06:19 The Role of Information in Patient Safety
11:01 Setting Expectations for Communication
15:54 Actionable Steps for Effective Care Coordination
19:21 Navigating Hospital Communication
22:03 Improving Hospital Experiences for Families
24:08 Planning for Discharge from the Hospital
26:18 Understanding Delirium in Hospitalized Patients
27:47 The Challenges of Hospitalization for Older Adults
31:05 The Benefits of Home Hospital Programs
33:14 Reevaluating End-of-Life Care Expectations

Meet Dr. Monique Nugent – Healthcare Speaker, Hospitalist, and Author
A Passion for Transforming Healthcare
Dr. Monique Nugent is a board-certified hospitalist, author, and sought-after healthcare speaker dedicated to improving the way patients, families, and healthcare professionals navigate the medical system. With years of frontline experience, she has witnessed firsthand the challenges and opportunities within hospitals and is passionate about bridging the gap between medical expertise and patient advocacy.

Dr. Nugent’s mission is to make healthcare more accessible, understandable, and effective for everyone. Whether through her book, public speaking engagements, or thought leadership in medical education, she is committed to empowering both patients and providers with the knowledge they need to make informed decisions.

https://drmoniquenugent.com/

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This episode features Gina and Allie from Care Patrol discussing the complexities of transitioning seniors into retirement communities. They share insights on planning, choosing the right care level, understanding state regulations, and navigating family dynamics to ensure a smooth and suitable move.

Allie Spangler, OTR/L, CSA brings extensive experience and deep passion for helping others. She has supported hundreds of families in navigating care options for their loved ones with confidence and clarity.

Prior to joining CarePatrol, Allie worked as an occupational therapist across a variety of healthcare settings, primarily serving geriatric patients in acute care, long-term acute care, and inpatient rehabilitation. Through this experience, she developed a strong ability to guide individuals and families.

Gina Gordon, RN, CSA brings over 30 years of healthcare experience and a deep passion for serving others. Inspired by both her professional background and personal experiences, she opened CarePatrol of Winston-Salem to better support families navigating senior care decisions.

Prior to CarePatrol, Gina built a long and meaningful career in healthcare, gaining firsthand insight into the complexities of care and the importance of advocacy. As the daughter of aging parents, she understands both the rewards and challenges families face and values the opportunity to connect with each client on a personal level.

CarePatrol of Winston-Salem

Allie Spangler, Occupational Therapist (OTR/L), Certified Senior Advisor (CSA)®

PO Box 20302 Winston-Salem, NC 27120

O: 844-218-2273 | D: 564-565-4562 | F: 336-866-0758

CarePatrol.com | Senior Care Podcast | Facebook | LinkedIn

Other Resources

North Carolina Assisted Living Regulations - https://www.ncdhhs.gov/about/divisions/licensing

Memory Care Best Practices - https://www.alz.org/help-support/caregiving/stages-behaviors/memory-care

Care Management Resources - https://www.care.com

Chapters

00:00 Introduction to Care Transitions
03:00 Proactive vs Reactive Planning for Care
06:16 Navigating Community Transitions
08:54 Understanding Care Levels and Community Types
12:03 State Requirements for Assisted Living
16:46 Staffing Ratios and Their Importance
18:37 Leadership and Stability in Care Communities
25:22 Advice for Sandwich Generation Caregivers
31:55 Choosing the Right Agency for Care

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In this insightful interview, Annie Guest shares her journey through caregiving, the importance of radical acceptance, and how interior design can support mental health during challenging times. Discover practical tips for managing burnout, decluttering, and creating spaces that nurture the mind and body.

Annie Guest had a varied career in book publishing, advertising, and law, before she took another jump to work as a mental health therapist and publish her first book. In Design For Your Mind, Annie combines her passion for people and their potential with her love for interior design and her appreciation for the design choices that support the mind and body.

Visit https://www.annieguestdesignforyourmind.com/

Chapters

01:00 Navigating Caregiving Challenges
08:50 The Journey of House Redesign
15:11 Empowering Caregivers
24:00 Preventing Burnout in Caregiving

Resources

Design for Your Mind by Annie - https://www.amazon.com/Design-Your-Mind-Annie/dp/XXXXXX
VVA Pickup - Furniture Donation Service - https://vvapickup.org
Attention Restoration Theory - https://en.wikipedia.org/wiki/Attention_restoration_theory

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None

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This episode covers recent advances in Alzheimer's research, including the potential link between shingles vaccination and dementia prevention, the biological shifts in aging, and promising biomarkers and treatments like lithium. Dr. Mia discusses how these findings could impact future therapies and personal health decisions.

Shingles Vaccine: The Wales/Australia Natural Experiment in Cell: https://www.cell.com/cell/fulltext/S0092-8674(25)01256-5?_returnURL=https%3A%2F%2Flinkinghub.elsevier.com%2Fretrieve%2Fpii%2FS0092867425012565%3Fshowall%3Dtrue

More Recent Article on Shingles Vaccine and Cardiovascular Risk: https://techfixated.com/shingles-vaccine-drastically-cuts-heart-risk-nearly-in-half-in-new-study/

Massive Biomolecular Shifts: Scientific article in Nature 2024: https://www.nature.com/articles/s43587-024-00692-2

From ruins to research: How an ancient brain survived to help understand Alzheimer’s
https://www.nuscimagazine.com/from-ruins-to-research-how-an-ancient-brain-survived-to-help-understand-alzheimers
Ancient Brain, GFAP and NFL; The Scientific Paper on GFAP and NFL in blood: https://pubmed.ncbi.nlm.nih.gov/41376134/

Lithium as an Alzheimer's Treatment: https://news.harvard.edu/gazette/story/2026/01/an-alzheimers-breakthrough-10-years-in-the-making/ (or the pretty pictures in this: https://hms.harvard.edu/news/could-lithium-explain-treat-alzheimers-disease)
The pilot study in humans: https://jamanetwork.com/journals/jamaneurology/fullarticle/2845746#250915094

Chapters

00:00 Introduction to Alzheimer's Research News
03:34 The Shingles Vaccine and Dementia Prevention
06:03 Shingles Vaccine: Heart Health Benefits
10:43 Timing & Accelerated Aging
14:02 Ancient Brain Discoveries and Alzheimer's
19:33 Exploring Lithium for Alzheimer's Treatment

Alzheimer's, dementia, shingles vaccine, biomarkers, lithium, aging, neurodegeneration, Alzheimer's research, health tips

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In this insightful interview, Sue Lloyd-Davies discusses her book Pinkie’s Turnabout (Fitzroy, February 2026), inspired by her own experiences caring for a loved one with dementia and her work with children in caregiving situations. The conversation explores the emotional journey of caregiving, the importance of understanding dementia, and how families can foster open conversations about these challenges.

Chapters

00:00 Introduction to Pinky's Turnabout
00:54 Inspiration Behind the Book
03:20 Challenges of Caregiving
06:41 Advice for Young Caregivers
09:34 Navigating Grief and Emotions
12:58 The Role of Pets in Caregiving
15:36 Using the Book for Family Conversations

ABOUT THE AUTHOR

Sue Lloyd-Davies lives and writes in an old cottage in quirky Gulfport, Florida, where fuzzy cat, Arlo, loafs beside her keyboard and occasionally types an extra space or two into her stories. Caring for her mother, whose life — filled with friends, quilting and church — drifted into dementia, inspired her novel about Pinkie.

When she’s not writing, Sue can be found under the oaks handing out hazelnuts to rescue squirrel Owen or careening around the community center in a line dance. Visit her at Suelloyddavies.com, where you can purchase a copy of the book (available wherever books are sold).

PRAISE FOR PINKIE’S TURNABOUT

“Drawing on personal experience, Lloyd-Davies confronts the hardships of caring for a loved one with dementia in this brutally tender debut. It’s a surprise-packed narrative that counterbalances nuanced examinations of complicated relationships and hard-earned life lessons against Jack’s delightfully snarky quips.” Ages 9–12. (Feb.)
—Publishers Weekly – STARRED Review

“Pinkie’s Turnabout is a layered story and an appealing pick for middle grade readers. An entertaining, heartfelt story and a great pick for classroom reading and discussion, all ages will find value in its themes of love and forgiveness, becoming self-aware, not judging by appearance, and the unmasking of subtle prejudices that often go unrecognized. Conflicts and troubles abound for Pinkie at every turn, but love and forgiveness win out in the end in a way that will make your heart grow three sizes. Never preachy, never didactic, the story shows through action and event how to be a better person.”
―Clara Gillow Clark, writing coach and award-winning author of Hill Hawk Hattie and Hattie on Her Way

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In this heartfelt interview, Karen McGovern shares her personal and professional journey caring for loved ones at the end of life, highlighting the importance of compassion, preparation, and presence. Discover insights into end-of-life care, the role of doulas, and how to navigate grief and caregiving with grace.

About Karon Keller McGovern

Karon is a Certified End of Life Doula, Reiki Master and Reverend. Her business Loving Embrace – Transition Service Guiding the Client
and Family through the final Transition after Karon saw a real need to change how end-of-life patients were not receiving the best care with our medical system.

Contact her by: LovingEmbraceNC@gmail.com or 214-930-1195.

Chapters

00:00 Introduction to End-of-Life Care
05:21 Navigating Dementia and Family Dynamics
10:50 Becoming an End-of-Life Doula

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Dr. Mia explores the groundbreaking Finger Study, a global research project on brain health and Alzheimer's prevention, and the US version, called POINTER study. Discover why lifestyle changes like exercise, diet, and cognitive activities can significantly improve brain resilience and delay cognitive decline.

Chapters

00:00 Introduction to the Pointer Study
02:44 Understanding the US Pointer Recipe
05:28 The Role of Exercise in Brain Health
08:16 Dietary Impacts on Cognitive Function
10:57 Gut-Brain Connection and Its Implications
14:01 Cognitive Exercises and Health Monitoring
15:51 Empowerment Through Lifestyle Changes

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In this conversation, Dr. Mia and Dr. Catherine Madison discuss the complexities of caregiving for individuals with dementia, drawing from personal experiences and professional insights. They explore the importance of understanding advanced care planning, and the vulnerability of dementia patients to health challenges. The discussion also covers legal considerations for caregivers, tools for initiating end-of-life conversations, and lifestyle changes that can enhance brain health. Dr. Madison emphasizes the need for open dialogue about death and dying, as well as the significance of research in improving dementia care.

Dr. Catherine Madison, a board-certified neurologist and author of Navigating Memory Loss: Essential Questions and Answers on Alzheimer’s and Dementia. With over 40 years of experience in clinical neurology, Dr. Madison has dedicated her career to helping individuals and families understand, manage, and live well with cognitive decline.

As the founding medical director of the Ray Dolby Brain Health Center in San Francisco, she developed a groundbreaking model of care that supports both patients and their loved ones, a holistic approach that has since influenced dementia programs nationwide. She continues this work through her private practice and her role with Jewish Family and Children’s Services (seniors at home), where she educates families on brain health, cognitive aging, and care planning.

Dr. Madison is known for blending clinical expertise with a deeply human touch. Her new book translates the most current research on Alzheimer’s and dementia into clear, compassionate answers for those facing these conditions. She’s an engaging and empathetic guest who can speak on:

How to recognize the earliest signs of memory loss—and what to do next
The latest science on Alzheimer’s and other dementias
How families can plan for care, maintain connection, and protect quality of life
Practical steps for supporting brain health as we age

Goodreads: https://bit.ly/4h7UbN5

Amazon: https://bit.ly/4of9qGv

Book: navigating memory loss

https://codaalliance.org/go-wish/#faqs

https://seniorsathome.jfcs.org/

Chapters

00:00 Navigating Memory Loss: Introduction to Dementia Care
02:31 Personal Journey: The Impact of Caregiving
05:16 Understanding Anosognosia: Awareness in Dementia
08:08 Advanced Care Planning: Preparing for the Future
10:55 The Vulnerability of Dementia: Health Challenges
13:43 Legal Considerations: Directives and Estate Planning
16:22 Conversations About End-of-Life: Tools and Techniques
19:07 Lifestyle Changes: Enhancing Brain Health
21:19 Research Insights: The Future of Dementia Care

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Ever wonder why the news reports on Alzheimer's causes are so confusing and what's the fuss about these amyloid plaques?

This conversation delves into the evolving understanding of Alzheimer's disease, highlighting the shift from traditional diagnosis of exclusion to new definition by underlying pathology.

Dr. Mia explains the differences between Alzheimer's disease and dementia, the role of amyloid plaques and tau tangles, and the complexities of diagnosing and treating Alzheimer's in the context of vascular dementia.

This episode contains visuals, which could be followed along by YouTube video.

Alzheimer's disease, dementia, amyloid plaques, tau tangles, cognitive impairment, vascular dementia, diagnosis, treatment, brain health, memory loss

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In this conversation, Alex Drane and Dr. Mia discuss the challenges and realities of unpaid caregiving, emphasizing the importance of self-identification, data, and community support. They explore how caregivers often overlook their own needs while focusing on those they care for, and the necessity of finding respite and grace in their roles. The discussion also touches on the impact of caregiving on mental health, especially during stressful times like the holidays, and the need for a supportive community to help caregivers navigate their responsibilities.

Archangels website: https://www.archangels.me/

Intensity score quiz: https://www.archangels-cii.me/get-started/?utm_source=aacaregiverpage&utm_medium=weblink&utm_campaign=general

About Alexandra Drane

Alexandra is co-founder and CEO of ARCHANGELS — a women-owned, public benefit corporation and omni-channel platform shamelessly hustling to make change happen for the 43% of adults across our nation serving as unpaid caregivers. ARCHANGELS engages and supports caregivers across all 50 states through partnerships with employers, consumer brands, health-plans/systems, communities, and states.

Chapters

00:00
Introduction to Archangels and Caregiving

02:58
Understanding the Caregiver's Role and Identity

05:44
The Power of Data and Storytelling in Caregiving

08:28
Navigating Intensity and Self-Care as a Caregiver

11:38
The Importance of Respite and Support

14:23
Finding Grace and Permission to Care for Yourself

17:09
Community and Connection Among Caregivers

19:56
The Impact of Holidays on Caregivers

23:08
The Future of Caregiving and Advocacy

26:02
Closing Thoughts and Encouragement for Caregivers

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In this episode, Dr. Mia talks about the common questions that come up in memory clinic such as:

Chapters

00:00 Understanding Dementia and Alzheimer's Basics
02:54 Differentiating Between Mild Cognitive Impairment (MCI) and Dementia
06:19 Exploring Types of Dementia
11:01 Stages of Dementia Explained

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The "Mom, You're Grounded Podcast" hosts Allison and Jennifer discuss the GUIDE program with Dr. Mia, an innovative Medicare initiative designed to support caregivers and patients through comprehensive services and respite care. Mia Yang, a geriatrician, shares her expertise and insights on GUIDE (GUiding an Improved Dementia Experience) program.

Self refer:
GuideAHWFB@advocatehealth.org -NC Triad

Guide@advocatehealth.org- NC greater Charlotte area

www.MiaYangMD.com

"Mom, You're Grounded Podcast"
https://youtu.be/u_VH0SAWuk4?si=Xepgc__BXNyxZvzn

Chapters

00:00 Introduction to Caregiving Challenges
01:09 Understanding the GUIDE Program
02:11 Mia Yang's Background and Expertise
04:44 Innovative Approaches in Dementia Care
06:39 Respite Care and Financial Support
08:40 Adult Daycare Options and Benefits
10:05 Navigating the GUIDE Program
12:28 Eligibility and Enrollment Process
14:45 Choosing the Right Medicare Plan
18:38 The Evolution of the GUIDE Program
20:23 Geographical Coverage of GUIDE Programs
22:09 Respite Care Options and Limitations
23:56 Success Stories from the GUIDE Program
26:40 Recognizing the Need for Help
29:19 The Emotional Toll of Caregiving
32:32 Connecting with the GUIDE Program
35:45 Mia Yang's Podcast and Resources

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In this episode of the Ask Dr. Mia podcast, Dr. Mia speaks with Jodi Colada, a director of caregiver outreach, about engaging activities for family caregivers of loved ones living with dementia. They discuss the challenges caregivers face in getting their loved ones to participate in activities, the importance of creating a supportive environment, and various creative expressions that can foster connection. Jodi shares practical tips, resources, and tools to help caregivers engage their loved ones meaningfully, emphasizing the value of participation and the joy of shared experiences.

Chapters

00:00 Engaging Activities for Dementia Caregivers
00:17 Introduction to Jody Kalata and Her Expertise
00:45 Connecting with the Audience
01:00 Engaging Activities for Dementia Caregivers
11:13 Creative Expression Through Art and Music
21:06 Practical Tools and Resources for Caregivers

Jodi Kolada is the Director of Caregiver Outreach and Non-Clinical Team Member Education with Well∙Spring Solutions. Jodi has a master’s degree in Gerontological Studies from Miami University of Ohio. She is a certified co-leader of Powerful Tools for Caregivers. She is a certified instructor of the Dementia Dialogues Program from the Arnold School of Public Health at the University of South Carolina. She leads the agency’s efforts to successfully provide a combination of evidence-based programs, educational classes, retreats, and monthly support groups to family caregivers. She also presents to faith, civic and community organizations about caregiving issues.

Below are some of Jodi's helpful resources;

SITES
www.nationaldaycalendar.com – online database of holidays and celebrations – can spark great conversation and incudes activity ideas

www.backthenhistory.com – provide an email address to receive a daily message about the history of everyday objects - can spark great conversation and activity ideas

https://dementianc.org/helpsupport/music-memory-at-home/ Music & Memory is an evidence-based program which helps people living with dementia find joy and connection to life through musical favorites. They help to develop a personalized playlist, and provide a Music & Memory at Home Kit, which includes a digital music player uploaded with the person’s favorite music, headphones, a Bluetooth speaker and written guides. Both the primary caregiver and the program listener (person with a dementia diagnosis in a home setting) must be in NC.

https://www.goldencarers.com/activities - activity ideas & helpful resources

https://mariasplace.com/ - activity ideas

Free APPS

Word Search Colorful

Flower Garden

Jigsaw Puzzles Real

My Reef 3D Aquarium

GAMES

Shut the Box -basic math

Rory’s Story Cubes - storytelling

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In this conversation, Dr. Mia discusses her personal experiences with caregiving and grief, emphasizing the importance of understanding one's role as a caregiver, the challenges of caregiver burnout, and the necessity of seeking support. She reflects on her relationship with her mother and the complexities of love and acceptance in the context of caregiving.

Important Resources from this episode;

Archangels Caregiver Quiz and Resources

https://www.archangels.me/for-caregivers

ianacare- The Platform For Caregivers

https://ianacare.com/caregivers/

Chapters

00:00 Introduction to Caregiving and Burnout
02:15 Personal Journey with Caregiving
05:31 Navigating Grief and Caregiving
07:44 Defining a Good Daughter
10:02 Acceptance and Presence in Caregiving
11:06 Navigating Caregiving and Personal Relationships
16:38 Resources for Caregivers

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In this episode, Dr. Mia discusses the top misconceptions surrounding dementia and Alzheimer's disease, emphasizing the importance of understanding the differences between the two, the complexities of diagnosing dementia, and the implications of early diagnosis. She also addresses the common belief that Medicare covers in-home care for dementia patients and clarifies the realities of dementia care funding.

https://www.cms.gov/priorities/innovation/innovation-models/guide

Chapters

00:00 Understanding Dementia: Common Misconceptions
00:51 The Role of Medicare in Dementia Care
01:02 Understanding Dementia and Alzheimer's Disease
09:20 The Complexity of Diagnosing Dementia
18:18 The Importance of Early Diagnosis
26:13 Navigating Medicare and Dementia Care

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In this episode, Dr. Mia and Dr. Christina Hugenschmidt discuss their insights from the Alzheimer's Association International Conference (AAIC 2025) this summer, and the importance of early diagnosis and lifestyle interventions. They explore the gut-brain connection, innovative drug research, and the impact of nutrition and environmental factors on cognitive health. The conversation emphasizes the need for social engagement and support for caregivers, highlighting the multifaceted approach required in managing dementia and promoting brain health.

Chapters

00:00 Introduction to Dementia Caregiving and Research

02:01 Personal Journey in Caregiving

03:51 Understanding Dementia: A Personal Journey

15:57 Lifestyle Interventions for Brain Health

27:57 The Impact of Hormones on Caregiving

39:53 Research Innovations in Dementia Treatment

45:47 Environmental Factors and Brain Health

Christina Hugenschmidt, PhD, MS, LCMHC, is a Associate Professor, Director of Wake Forest Memory Counseling Program. She is a neuroscientist and a counselor. Her experiences in clinical practice led her to question how support groups can be used to improve brain health. She began working with the Memory Counseling Program (MCP) after joining Gerontology and Geriatric Medicine and the Sticht Center for Healthy Aging and Alzheimer’s Prevention at Health/Wake Forest School of Medicine in Winston-Salem North Carolina in 2012 and was recently appointed MCP director following Dr. Shaw’s retirement. Her experiences leading and developing a support group for people with dementia have profoundly shaped how she views dementia and her research into how positive experiences like this group can support the well-being of people living with dementia and their care partners. Her research uses brain imaging to explore how common aging-related changes in the body, such as mobility, obesity and diabetes affect brain health, and how these effects on the brain can be modified by everyday lifestyle, like engaging in exercise and arts practices. https://improvment.wfu.edu/about/improvment-team/

AXS-05 dextromethorphan and bupropion for AD agitation

US version of world wide FINGER- US POINTER study

MIND diet slows cognitive decline with aging

Other AAIC 2025 press conferences or highlights: https://aaic.alz.org/releases-2025/highlights-aaic-2025.asp

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In this episode, Dr. Mia provides a comprehensive overview of Medicare and Medicaid, explaining their differences, coverage options, and the implications of recent legislative changes. She emphasizes the importance of understanding these programs, especially for vulnerable populations, including the elderly and immigrants. The discussion also highlights the challenges faced by those needing long-term care and the critical role of advocacy in shaping healthcare policy.

Chapters

00:00 Understanding Medicare and Medicaid Basics
09:57 Medicare Coverage and Misconceptions
13:59 The Impact of Recent Legislation on Medicaid
18:31 Challenges for Immigrants and Healthcare Access
27:18 Advocacy and the Future of Healthcare Policy

Medicare, Medicaid, healthcare, insurance, legislation, advocacy, immigrants, dementia care, long-term care, eligibility

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In this heartfelt episode of the Ask Dr. Mia podcast, Dr. Mia sits down with Tamra Stokes, a transformational life coach, author, speaker, and founder of Reimagining Life Coaching. Known as The Authentic Caregiver Coach, Tamra empowers overwhelmed family caregivers to heal emotionally, rediscover themselves, and find fulfillment amid the demands of caregiving. Drawing from over 20 years as an educator and 4.5 years as the primary caregiver for her mother, Tamra brings wisdom, empathy, and lived experience to her work. Her coaching blends mindset shifts, emotional release, breathwork, nature-based grounding practices, and journaling to guide clients through emotional discord and into purposeful transformation. Together, they explore the dynamics of sibling relationships in caregiving, highlighting the importance of understanding personal strengths and maintaining open communication. Tamra also discusses valuable resources like the Caregiver College and Wake Forest Memory Counseling Program that provided her with essential tools and community support. Additionally, listeners can find support through the Alzheimer's Association support group search. Tune in to discover insights on family bonds, caregiving challenges, and the power of shared experiences.

To book a discovery call with Tamra, visit: link.coachgrowthsolutions.com/widget/bookings/talkwithtamra. Follow Tamra on social media: Facebook: The Authentic Caregiver Coach, Instagram: @tamistokes422, YouTube: @ReimaginingLifeCoaching, TikTok: @siasees. #SiblingSupport #CaregivingJourney #FamilyFirst

Follow Dr. Mia on YouTube and BlueSky and Instagram

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In this episode of the Ask Dr. Mia podcast, Dr. Mia invites her husband, Dr. Alex Fertman, to discuss the nuances of palliative care and hospice, particularly in the context of dementia. They explore the differences between these two forms of care, the challenges families face when dealing with dementia, and the difficult decisions surrounding feeding tubes and end-of-life care. The conversation emphasizes the importance of understanding what constitutes a 'good death' and the dynamics within families as they navigate these tough discussions. Dr. Alex shares valuable insights on how families can prepare for serious illness and the significance of having open conversations about healthcare decisions.

As an Assistant Professor in Palliative Medicine, Dr. Alex Fertman provides care to patients during serious illness. He works with patients and their families to provide care for the whole person, with particular focus on alleviating symptom burden and coordination of complex care. Dr. Fertman address all aspects of a person’s health, and collaborates with an interdisciplinary team consisting of counselors, chaplains, social workers, and pharmacists to provide excellent and comprehensive care. He enjoys active clinical teaching on inpatient rounds with students, residents, and fellows about palliative care and the art of being a great palliative care consultant.

Chapters

00:00 Introduction to Palliative Care and Hospice
03:46 Understanding Dementia and Its Challenges
07:08 Navigating Feeding Decisions in Dementia
09:58 The Concept of a Good Death
12:47 Family Dynamics in End-of-Life Care
16:05 Advice for Families Facing Serious Illness

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In this episode of Ask Dr. Mia, Rohan Ramakrishna, co-founder of Roon, discusses the innovative healthcare technology platform designed to provide patients with reliable medical information.

Roon aims to bridge the gap between patients and healthcare experts, offering personalized guidance and 24/7 support. Rohan shares insights into the journey of building Roon, the importance of expert vetting, and the platform's commitment to keeping the service free for users. The conversation also touches on the global reach of Roon and its future aspirations to expand access to healthcare information worldwide.

Rohan Ramakrishna is a professor of neurosurgery at Weill Cornell Medicine and New York Presbyterian hospitals and the Co-Founder of Roon. He attended medical school at the University of Pennsylvania. He then completed training in neurosurgery at the University of Washington and MD Anderson Cancer Center.

Like & Subscribe. Follow Dr. Mia on social media @askdrmia

Chapters

00:00
Introduction to Roon and Its Purpose

02:57
The Journey of Building Roon

06:03
The Unique Features of Roon

09:14
Expert Vetting and Content Quality

11:51
User Engagement and Feedback

14:57
Global Reach and Future Aspirations

Roon, #healthcare technology, #patient information, #expert guidance, #caregiver support, #medical information, #health app, #user experience, #global access, #mental health

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In this episode of the Ask Dr. Mia podcast, Dr. Mia interviews Amanda Gengler, a sociology professor and author, about her personal experiences as a caregiver for her mother with Alzheimer's and her young son. They discuss the complexities of navigating the healthcare system, the emotional labor involved in caregiving, and the challenges of family dynamics. Amanda shares insights on advocacy, the impact of her mother's recent fall, and the strategies she employs to manage stress and communication within her family. In this conversation, Amanda Gengler shares her experiences navigating the complexities of caring for a parent with dementia while also raising her child. The discussion delves into the emotional challenges of family dynamics, the importance of communication with children about illness, and the unique burdens faced by the sandwich generation. Amanda reflects on the surprises and difficulties encountered in her caregiving journey, emphasizing the need for open conversations about death and dying.

Disclaimer: There were audio issues with this episode and some of the interview was edited out. For the full unedited video check out the Ask Dr. Mia Channel on YouTube. Link below;

https://youtu.be/iBrJKKqWoJw?si=67JXHVSFq-v1YNjY

About Amanda Gengler, Ph.D

An associate professor of sociology at Wake Forest University who completed her PhD in Sociology at Brandeis University and a Masters degree in Social Work at the University of Wisconsin-Madison. She is the author of the book, "Save My Kid" How Families of Critically-Ill Children Cope, Hope, and Negotiate an Unequal Healthcare System, and her current research examines the emotional dynamics of routine pediatric care. She regularly teaches undergraduate courses on the Sociology of Health and Illness, the Sociology of Birth and Death, and the Sociology of Care Work.

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In this episode of the Ask Dr. Mia podcast, host Dr. Mia speaks with Sam Simon, a lawyer and playwright diagnosed with early-stage Alzheimer's disease. Sam shares his journey, including the impact of his diagnosis on his family, the importance of communication, and the challenges of navigating legal and financial planning. He discusses the emotional and practical aspects of living with dementia, the role of family dynamics, and the significance of advocacy.

Sam Simon shares his personal journey with Alzheimer's disease, discussing the challenges and adaptations he and his wife, Susan, have made. He emphasizes the importance of finding meaning and purpose in life, and the power of love and connection in the face of adversity.

To learn more about Sam and his play Dementia Man visit his website at https://www.dementiaman.com/

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In this episode of Ask Dr. Mia, Jane Smith shares her experiences as a caregiver for her mother-in-law, who is facing dementia. The conversation explores the dynamics of caregiving, the challenges of setting boundaries, and the emotional complexities involved in caring for aging family members. Jane discusses her close relationship with her mother-in-law, the division of caregiving responsibilities among family members, and the impact of these responsibilities on her own family life. The episode also touches on how to communicate with children about dementia and the importance of maintaining family relationships amidst caregiving challenges.

Visit the Ask Dr. Mia channel or visit https://www.miayangmd.com/ for more info and episodes or follow @askdrmia on Instagram, BlueSky

Chapters

00:00

Intro

00:49

Intro and Navigating Caregiving Dynamics

10:29
The Good Cop, Bad Cop Dilemma

20:03
Balancing Family Relationships and Caregiving

29:59
Communicating with Children about Dementia

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Pharmacist Molly Hinely talks about how to help those who might forget to take meds with Dr. Mia.

Good vs bad medications for memory
Right use of technology in helping to remember meds
Potential benefits and risks of various supplements.

Sign up for Dr. Mia's email list to get a medication organization sheet.

Molly Hinely, PharmD, BCPS is the manager for the Atrium Health Wake Forest Baptist Health pharmacy population health team located in Winston Salem, NC. She leads a pharmacy team who supports the organization’s transitions of care and value-based care programs in collaboration with nurse navigators, social workers, and community health workers. She also is the residency program director for the PGY2 Population Health Management and Data Analytics program at Wake Forest Baptist Health. Molly’s areas of interest include care transitions, post-acute care, value-based care, medication adherence, social determinants of health, progressive care models and health outcomes. She earned her Doctor of
Pharmacy degree from the University of South Carolina, completed a pharmacy practice residency at New Hanover Regional Medical Center in Wilmington, and has been in practice for 13 years.

Links: hero dispenser: https://herohealth.com/
Med Minder pill dispenser: https://medminder.com/
Live Fine med dispenser 28 days with lock https://www.livefineproduct.com/products/automatic-pill-dispenser-with-frosted-lid-and-large-display

Follow Dr. Mia on social media including YouTube and BlueSky @askdrmia

Keywords

pharmacy, transitions of care, medication management, community pharmacist, memory loss, supplements, geriatric care, caregiver support, medication technology, patient advocacy

Chapters

00:00 Introduction to Transitions of Care Pharmacy
02:51 Navigating Medication Management for Loved Ones
06:10 The Role of Community Pharmacists
09:06 Simplifying Medication Regimens
11:54 Technology in Medication Management
15:11 Understanding Medications That Affect Memory
20:02 Supplements and Their Impact on Memory
30:11 Advocating for Better Medication Management

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In this episode, Dr. Mia and Dr. Kristin Beavers discuss the relationship between weight loss and bone health, emphasizing the importance of exercise, nutrition, and monitoring bone density through DEXA scans. They explore the impact of new diabetes medications GLP-1 inhibitors (such as ozempic, wegovy) on bone health and provide practical tips for maintaining bone density, particularly in older adults.

Kristen M. Beavers, PhD, MPH, RD, is a Professor of Internal Medicine, Section on Gerontology and Geriatric Medicine and an Associate Director of the Sticht Center for Healthy Aging and Alzheimer’s Prevention at Wake Forest University School of Medicine. She received her BS from Cornell University in Human Biology, Health, and Society; MPH and RD from The University of North Carolina at Chapel Hill in
Nutrition; and PhD from Baylor University in Exercise, Nutrition, and Preventive Health. Dr. Beavers’ academic and professional interests lie in the study of nutrition and exercise as interdisciplinary sciences, specifically as they relate to prevention and etiology of chronic disease and disability. She has been continuously funded by the NIH for the past decade and has developed a strong research program focused on mitigating loss of bone mass and strength in persons undergoing intentional weight loss, with three NIH-funded clinical trials underway.

Takeaways

Weight loss can lead to bone loss, especially with caloric restriction.
DEXA scans are crucial for assessing bone density and osteoporosis risk.
Calcium and vitamin D are essential for bone health, especially during weight loss.
Protein intake should be increased to help preserve bone and muscle during weight loss.
Weight-bearing exercises are important for maintaining bone density.
New diabetes medications GLP-1 inhibitors may be associated with bone loss, but more research is needed.
Balance training is important to prevent falls and fractures in older adults.
Older adults should be screened for osteoporosis, especially if they have risk factors.
Maintaining adequate nutrient intake is challenging during weight loss.
Prior fractures are a significant indicator of osteoporosis risk.

Chapters

00:00
Introduction to Bone Health and Weight Loss

02:56
Understanding Bone Loss During Weight Loss

05:56
DEXA Scans: Measuring Bone Density

08:59
Osteoporosis: Risk Factors and Screening

11:59
Emerging Diabetes Medications and Bone Health

14:57
Exercise: Loading Bones to Prevent Loss

17:57
Nutrition: Key Nutrients for Bone Health

20:59
Practical Tips for Maintaining Bone Density

23:57
Conclusion: Summary of Key Takeaways

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In this episode of Ask Dr. Mia, host Dr. Mia Yang speaks with Josh Marquess about his family's journey in transitioning his grandmother with Alzheimer's into a memory care facility. They discuss the special bond Josh has with his grandparents, the early signs of Alzheimer's, the emotional challenges of witnessing the progression of the disease, and the difficult decision-making process regarding care options. Josh shares insights on the benefits of memory care, the importance of family support, and the positive aspects of change in caregiving situations.

Takeaways

The bond with grandparents can be profound and impactful.
Early signs of Alzheimer's can manifest in confusion and anxiety.
Recognizing the progression of Alzheimer's is crucial for family members.
The decision to move a loved one to memory care is often difficult but necessary.
In-home care can be a viable option for early stages of Alzheimer's.
Memory care facilities offer specialized support and activities for residents.
Long-term care insurance can alleviate some financial burdens of memory care.
Understanding the differences between assisted living and memory care is essential.
Positive experiences can still be had in memory care settings.
Reframing the narrative around caregiving can lead to a more positive outlook.

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In this episode of the Ask Dr. Mia podcast, Dr. Mia speaks with Jeannine Bryant, a downsizing expert, about the challenges and emotional aspects of helping seniors transition to smaller living spaces. They discuss the concept of "right sizing", the importance of planning, and when to seek professional help.

Jeannine shares practical tips for decluttering, navigating family dynamics, and handling crisis situations, especially for those with memory issues. The conversation emphasizes the emotional journey involved in sorting through belongings and the importance of timing in the moving process, along with resources available for families.

Takeaways

Right sizing is about finding the perfect balance in living space.
Planning ahead is crucial for a smooth transition.
Professional help can ease the burden of moving.
Emotional attachments to belongings can complicate downsizing.
Start the decluttering process early to avoid overwhelm.
Focus on keepsakes that bring joy and memories.
Family dynamics can create tension during the moving process.
Crisis situations require careful planning and support.
It's important to respect the wishes of the older adult.
Resources are available to assist families in the transition process.

Rightsizing expert Jeannine Bryant is the owner and CEO of Changing Spaces SRS, a senior move management company in Lincoln, Nebraska. She has helped provide rightsizing and relocation services to seniors since 2010. During that time, she has been actively involved in the downsizing and moving processes of thousands of older adults.

She is the author two books on the rightsizing process, Keep the Memories, Not the Stuff and Ready to Rightsize? A step-by-step guide to your rightsizing journey.

She provides free resources filled with downsizing tips for older adults on her website www.EasyRightsizing.com, including downloadable worksheets, books, and an online course to guide people through the downsizing process with ease.

Bryant has been featured on numerous podcasts and is a regular contributor on various TV news stations. Originally from North Dakota, she holds a Bachelor of Arts degree from Northwestern College in Orange City, IA and a Master of Arts degree from University of Nebraska – Lincoln.

Website: https://easyrightsizing.com/
Facebook: https://www.facebook.com/EasyRightsizing/
Instagram: https://www.instagram.com/easyrightsizing/

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Summary

In this episode of Ask Dr. Mia, Dr. Mia shares her personal journey as a caregiver for her mother, who passed away from ovarian cancer. She discusses the challenges of navigating caregiving, grief, and the complexities of relationships between caregivers and their aging parents. Dr. Mia emphasizes the importance of understanding and accepting the wishes of loved ones, especially when it comes to treatment options, and reflects on her own experiences and feelings of unresolved anger and abandonment. The podcast aims to provide valuable insights and support for caregivers and those dealing with aging-related issues.

Takeaways

Dr. Mia shares her personal journey as a caregiver.

The importance of understanding the wishes of loved ones.

Navigating the complexities of caregiver relationships.

Grief counseling can help caregivers cope with their emotions.

Alternative treatments can be a point of contention in caregiving.

The podcast aims to bridge the gap in geriatric knowledge for the lay audience.

Caregiving often brings unresolved feelings to the surface.

Communication styles can differ significantly between generations.

Acceptance of a parent's limitations is crucial in caregiving.

The podcast serves as a voice of solidarity for caregivers.

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Opinions expressed are exclusive of Dr. Mia Yang and not reflective of her or guest speaker's employers or funders.

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In this special crossover episode Dr. Mia is interviewed by Rachel Zimmer, host of "The Hygge Nurse." In this episode they discuss Dr. Mia's origin stories- how she decided to go into geriatrics and her current career focus. Rachel and Mia also talk about a recent study they worked on, which examined at the impact of caregiving, specifically on Black and Latino populations. They also discuss caregiving tips, including managing stress and navigating the healthcare system. Links to "The Hygge Nurse" podcast and other resources are below.

Dr. Mia podcast will take a hiatus after this episode.

Resources List:

The Hygge Nurse Hosted by Rachel Zimmer

https://www.hyggeabode.com/pages/the-hygge-nurse-podcast

UCLA Caregiver Education Videos and Resources:

https://www.uclahealth.org/medical-services/geriatrics/dementia/caregiver-education

Creating Moments of Joy Along the Alzheimer's Journey by Jolene Brackey

https://www.enhancedmoments.com/

Dementia Matters Podcast:

Podcast by the Wisconsin Alzheimer's Disease Research Center on memory care research.

Brain Spotting Music on Spotify:

Bilateral auditory stimulation music for stress relief.

https://brainspotting.com/

https://www.youtube.com/playlist?list=OLAK5uy_kHWc_TguRKMYgq0b_4ajY8phTP-VfhDYk

Key Takeaways:

Understanding Caregiver Well-Being:
Importance of self-care for caregivers.
Strategies to find moments of respite and self-care activities.
Differentiating between internal thoughts and external constraints to reduce self-blame.
Navigating the Healthcare System:
Challenges caregivers face in the healthcare system.
Tips for managing transitions of care, such as moving from home to hospital.
Importance of clear communication and finding language-concordant care.
Practical Tips for Caregiving:
Handling common dementia-related behaviors like refusal to bathe or take medications.
Importance of creating joyful moments despite the challenges.
Utilizing mindfulness, journaling, and bilateral stimulation techniques like brain spotting for stress relief.
Research Insights:
Overview of a study on the well-being of Black and Latino caregivers.
Impact of cultural and language barriers on caregiver experiences.
Importance of presence and empathetic listening in caregiving.

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Dr. Mia interviews Dr. Mariana Wingood, a physical therapist specializing in geriatrics. They discuss the importance of physical activity for older adults and strategies to motivate them. Dr. Wingood emphasizes the need to understand what is important to each individual and tailor exercise programs accordingly. They also explore the benefits of incorporating physical therapy into activities like gardening and provide resources for finding exercise programs. The conversation touches on preventing injuries, recovering from injuries, and the role of healthcare providers in empowering older adults to be active. Dr. Wingood shares her research focus on empowering healthcare providers to support older adults in their physical activity goals.

keywordsphysical therapy, geriatrics, physical activity, motivation, exercise programs, gardening, injuries, recovery, healthcare providers

Here are some of the resources mentioned:

National Council on Aging: has a lot of resources on fall prevention and about evidence-based exercise programs
https://www.ncoa.org/older-adults/health/prevention/falls-prevention
https://www.ncoa.org/article/evidence-based-falls-prevention-programs - this is where people can go to learn about the different types of programs available nationally
Workout to Go: Booklet and videos from NIA's Go4Life
https://goaging.org/wp-content/uploads/2015/11/workout_to_go.pdf
https://www.youtube.com/playlist?list=PL4k5szV5a-xDyNmxsceJikRn6EBUzPxmP
https://www.nia.nih.gov/health/exercise-and-physical-activity/exercise-and-physical-activity-worksheets --> this has some great worksheets to help people get moving
Silver Sneaker Online Exercise Classes
https://www.youtube.com/playlist?list=PLVcN_NI2Mb2-7HN8nS4c2VTYdMHMjcK9h
https://tools.silversneakers.com/Search/OnlineClasses
AARP Videos
https://www.youtube.com/playlist?list=PLXQ-JEOv9JjGq9MbKmsIl4GlhcRR2mfMc
https://www.aarp.org/health/healthy-living/staying-fit/
Local places to look for exercise programs; Senior Centers/Community Centers/Multigenerational Centers, Libraries, Universities, Churches, Parks and Recreational Departments
Matters of Balance: https://healthyagingnc.com/workshop/a-matter-of-balance/.

Takeaways

Understanding what is important to older adults is key to motivating them to be physically active.
Incorporating physical therapy into activities like garde

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Summary

In this episode, Dr. Mia discusses five things that can help with healthy aging: exercise, diet, sleep, stress and mental health, and positive age-related perceptions. She emphasizes the importance of aerobic exercise and getting at least 8,000 steps a day. She also recommends a Mediterranean-style diet (MIND diet) with plenty of fresh vegetables. Dr. Mia provides tips for improving sleep hygiene and managing stress, including meditation and journaling. She highlights the impact of social isolation and the importance of positive age-related beliefs. Overall, she encourages small steps towards a healthier lifestyle to age well in the future.

Study on 8k steps: https://pubmed.ncbi.nlm.nih.gov/32207799/

MIND diet: https://pubmed.ncbi.nlm.nih.gov/34334393/

Podcast episode with Dr. Jamie Hughes Sleep Hygiene Episode
https://youtu.be/fxZNWR6HBSQ

Dr. Rebecca Levy: https://ysph.yale.edu/about-school-of-public-health/communications-public-relations/publications/public-health-magazine/article/becca-levy-and-the-fight-against-ageism/

Dr. Levy’s study on positive aging perspectives on cognition: https://pubmed.ncbi.nlm.nih.gov/32527600/

Keywords:
healthy aging, exercise, diet, sleep, stress, mental health, positive age-related perceptions

Takeaways

Regular exercise, particularly aerobic exercise, is crucial for healthy aging.
A Mediterranean-style diet with fresh vegetables is beneficial for overall health.
Improving sleep hygiene and managing stress are important for well-being.
Social connections and positive age-related beliefs contribute to healthy aging.
Small steps towards a healthier lifestyle can make a significant difference in aging well.
Chapters

00:00
Introduction and Overview

03:00
The Importance of Exercise for Healthy Aging

08:39
Eating Well: The Mediterranean Diet

14:27
Improving Sleep Hygiene and Managing Stress

22:10
The Impact of Social Connections on Aging

25:50
Promoting Positive Age-Related Beliefs

30:13
Conclusion

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Bill Cohen, a certified senior advisor, shares his experience in helping families navigate the challenges of caregiving for a loved one with dementia. He emphasizes the importance of open communication and allowing each family member to express their opinions and concerns. Bill also discusses the training required to become a certified senior advisor and the holistic approach they take to caregiving. He highlights the role of financial considerations in caregiving decisions and the potential for family disputes. Bill provides insights on when to seek the help of a counselor, social worker, or senior advisor, and the importance of self-care for caregivers.

The site to find certified senior advisors is

https://portal.csa.us/locator/

Bill Cohen’s loving and talented mother, Sheila, lost her home to Hurricane Katrina. Then, she lost her health, ability to create beautiful art and, ultimately, her life due to Alzheimer's. For almost 10 years, Bill was her primary caregiver and advocate, not just her son. He turned his personal loss into his passion supporting other caregivers.

After “retiring” from state employment and entering his “encore career” seven years ago, Bill is a caregiver support group and memory café leader, a podcast guest, a speaker, a Certified Senior Advisor (CSA)®, a trained elder mediator, and a caregiving support consultant. He has completed several caregiving courses through the Alzheimer's Association and the Society for Certified Senior Advisors (CSA)®, and earned business degrees from Boston and Portland State Universities.

Bill is a native New Englander and has lived in the Portland, Oregon area for almost 40 years with his wife and supporter, Lori.

Contact and learn more about Bill Cohen:

https://cohencaregivingsupport.com/services

https://linktr.ee/CohenSupport

bill@cohencaregivingsupport.com

Find your local Certified Senior Advisors at https://portal.csa.us/locator/

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Dr. Mia uses a composite patient Ms. Smith's story to demonstrate her journey through different levels of care, from home to hospital, to skilled nursing facility (SNF), and then back to home. She discusses assisted living vs nursing home vs memory care unit and insurance payment options for them.

Additional resources:
Eldercare Locator (acl.gov)

Nursing home facility ratings per Medicare: enter your zip code below
Find Healthcare Providers: Compare Care Near You | Medicare

Transitioning into assisted living, memory care, or other retirement community:
Find Assisted Living, Memory Care and Senior Living | A Place for Mom

Geriatric care managers:
What Is a Geriatric Care Manager? | National Institute on Aging (nih.gov)

Transcript & more info on www.miayangmd.com

Music & disclaimer

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Email: ask@miayangmd.com
Opinions expressed are exclusive of Dr. Mia Yang and not reflective of her or guest speaker's employers or funders.

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Summary

Jenny Kim, a family caregiver for her elderly parents, shares her experience managing their finances and healthcare. Her father, who has severe dementia, insists on withdrawing large amounts of cash and giving it away. Jenny has power of attorney but faces challenges with banks and bill companies. She hired a geriatric case manager to help with appointments and medical coordination. Dr. Mia suggests involving an elder law lawyer to address the financial issues. Jenny emphasizes the importance of cherishing the moments of lucidity and appreciating the life her parents have had.

Keywords

family caregiver, elderly parents, finances, dementia, power of attorney, geriatric case manager, elder law lawyer, lucidity

Takeaways

Managing the finances and healthcare of elderly parents can be challenging, especially when they have cognitive decline.
Having power of attorney may not always be sufficient to handle financial matters, as banks and bill companies may not honor it.
Hiring a geriatric case manager can provide support and assistance in managing appointments and medical coordination.
Involving an elder law lawyer may be necessary to address financial issues and establish stricter controls on spending.
Cherishing the moments of lucidity and appreciating the life of elderly parents is important, even in the face of difficult circumstances.

Chapters

00:00 Introduction and Background
08:17 Realization of Cognitive Decline and Taking on Responsibilities
12:46 Challenges with Financial Management
29:12 Seeking Legal Assistance for Financial Issues

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Summary

In this episode, Dr. Mia opens up about her personal experience with her mother's ovarian cancer diagnosis and the grief she is going through. She discusses the initial diagnosis, the challenges of treatment, and the emotions she has been experiencing, including anger, helplessness, guilt, and grief. Dr. Mia shares her strategies for processing grief, such as self-coaching, journaling, exercise, meditation, and finding moments of joy. She emphasizes that there is no right way to grieve and that everyone's journey is unique.

Keywords

grief, ovarian cancer, diagnosis, treatment, emotions, anger, helplessness, guilt, strategies, processing grief, self-coaching, journaling, exercise, meditation, moments of joy

Takeaways

Grief is a common and uncomfortable emotion that everyone experiences differently.
There is no right way to grieve, and it's important to give yourself permission to feel and process your emotions.
Strategies for processing grief include self-coaching, journaling, exercise, meditation, and finding moments of joy.
It's important to distinguish between real guilt and fake guilt and make decisions based on your values and what is best for you.
Grief is a lifelong process, and it's normal to have waves of intense emotions even after the initial loss.
Finding ways to connect with your loved one's memory can bring comfort and solace during the grieving process.

Chapters

00:00
Introduction and Background

04:20
The Uncomfortable Topic of Grief

13:40
Navigating Feelings of Helplessness and Guilt

28:07
Finding Moments of Joy in Grief

31:07
Conclusion and Final Thoughts

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In this episode, Dr. Mia interviews David McLawhorn, a grief counselor, about his work and the topic of grief. David shares his personal journey into grief counseling and discusses the differences between grief and depression. He also explains the phases of grief and the challenges of anticipatory grief and ambiguous loss. David provides insights into how grief counselors can support individuals who are grieving and recommends resources for further reading. The conversation emphasizes the importance of being present, listening, and practicing self-care when supporting someone who is grieving.

Keywordsgrief, grief counseling, loss, depression, phases of grief, anticipatory grief, ambiguous loss, grief support, companioning, self-care

Takeaways

Grief work often chooses the individual, as many people involved in grief counseling have been personally affected by loss.
Grief and depression have similarities, but grief is a normal and necessary response to loss, while clinical depression can block the healing process.
Grief is not a linear process and can involve a range of emotions and grief bursts that come in waves.
Anticipatory grief occurs when individuals grieve the losses they have experienced and the losses they know will come, such as in cases of cancer or dementia.
Grief counselors provide support by companioning individuals, being present, listening, and avoiding platitudes or trying to fix the grief.
Self-care is essential for any helping professional to prevent burnout and maintain their ability to support others.
Recommended resources for understanding and navigating grief include books by Dr. Alan Wolfelt, Claire Bidwell Smith, David Kessler, and Megan Devine.

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Summary

Dr. Mia interviews Dr. Monique Nugent about her book 'Prescription for Admission' and discusses various topics related to navigating the healthcare system and hospital stays. They cover the inspiration behind the book, common questions and quick guides for patients, understanding inpatient medicine, options for discharge, safety and goals of care, improving communication with the inpatient team, transitioning to post-acute care, choosing the right rehab facility, and mental health tips. The conversation provides valuable insights and practical advice for patients and their loved ones.

Takeaways

Take an active role in your healthcare and participate in your hospitalization.
Understand the options for discharge and consider post-acute care settings.
Improve communication with the inpatient team by requesting a family meeting.
Choose the right rehab facility by visiting and considering your goals and needs.
Practice mental health tips, such as square breathing, to reduce anxiety.

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Email: ask@miayangmd.com
Opinions expressed are exclusive of Dr. Mia Yang and not reflective of her or guest speaker's employers or funders.

In the final episode of season three, Dr. Mia reflects on her love for working with people living with dementia and their caregivers. She shares the inspiring story of a couple, Bill and Pat, who exemplify the extraordinary daily acts of caregiving. Dr. Mia discusses the importance of acknowledging, validating, and redirecting communication strategies for dementia care. She also explores the complex emotions and grief that caregivers experience and emphasizes the need for self-compassion and mental health support. Dr. Mia concludes the episode by expressing her gratitude to the listeners and announcing an extended break before the start of season four in April 2024.

Chapters

00:00
Introduction and Podcast Statistics

01:28
Why I Love Working with People Living with Dementia

02:27
Inspiration from a Couple's Story

03:26
Honoring the Extraordinary-ness of Caregiving

04:26
The Love and Care Provided by Bill

05:21
Moments of Clarity in Pat's Decline

06:20
Bill's Continued Connection with Pat

06:50
Bill's Experience Shared with Medical Students

07:19
The Power of Caring

08:19
The Poem 'Do Not Ask Me to Remember'

09:35
Communication Strategies for Dementia Care

10:35
AVR: Acknowledge, Validate, Redirect

12:58
Holding Space and Staying Grounded in Caregiving

14:13
Processing Grief in Caregiving

15:10
Grief in Anticipation of Loss

16:07
The Complicated Relationship with a Loved One

17:35
Grief in Moments of Crisis

18:36
The Interplay of Parkinson's Disease and Cancer

21:35
The Work of Grief and Soul-Making

24:31
The Importance of Feeling and Holding Space

27:25
Taking an Extended Break and Gratitude

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Email: ask@miayangmd.com
Opinions expressed are exclusive of Dr. Mia Yang and not reflective of her or guest speaker's employers or funders.

In this episode, Dr. Mia interviews Jeff Bloomfield, an estate planning lawyer from Carolina Estate Planning, to discuss the importance of estate planning and related legal documents. They cover topics such as the difference between a trust and a will, the probate process, and the impact of Medicaid on long-term care services. They also address common issues with power of attorney and guardianship, and emphasize the importance of estate planning for everyone, regardless of their wealth. Jeff provides insights on finding a reputable lawyer and highlights the limitations of online estate planning programs. Overall, this conversation highlights the need for advanced planning and the benefits of consulting with a lawyer for personalized advice.

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Email: ask@miayangmd.com
Opinions expressed are exclusive of Dr. Mia Yang and not reflective of her or guest speaker's employers or funders.

Dr. Mia talks with her colleague Dr. Tim Hughes, about vascular and metabolic conditions' contribution to Alzheimer's disease and related dementias.

Timothy Hughes, PhD, is an Associate Professor in the Department of Internal Medicine at Wake Forest School of Medicine. He is a neuroepidemiologist cross-trained in cardiovascular epidemiology and multimodal brain imaging. His research focuses on untangling the complex relationships between vascular and metabolic diseases' contributions on dementia.

Lancet commission report - https://www.thelancet.com/article/S0140-6736(20)30367-6/fulltext

Summary of SPRINT MIND: https://www.nia.nih.gov/news/does-intensive-blood-pressure-control-reduce-dementia

MESA participant webpage: https://www.mesa-nhlbi.org/ParticipantWebsite/default.aspx

Alz Association’s Trial Match: https://www.alz.org/alzheimers-dementia/research_progress/clinical-trials/trialmatch

Research Match https://www.researchmatch.org/

If people want to participate in ACE study: ACETrial@wakehealth.edu; and https://www.acetrial.org/

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Dr. Mia talks with Caroline Prioleau, writer for the Global Brain Health Institute at University of California San Francisco's Memory & Aging Center and co-lead of the Hear/Say oral history project that collects stories from people's experiences with dementia, aging, creativity and caregiving. We talked about a new documentary called Keys Bags Names Words - about hope in dementia.

Sign up for a virtual or in-person screening here.

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Dr. Mia talks with Dr. Ashley Sanderlin about how to advocate for yourself or your love ones within the healthcare system.

Ashley H. Sanderlin, PhD is a passionate researcher that investigates modifiable risk factors and early interventions for Alzheimer’s disease. She was the first African American to attain a PhD in Neuroscience from Michigan State University. As an Assistant Professor in Biology at NC A&T State University, Dr. Sanderlin serves as the site Principal Investigator of the North Carolina Brain Health Registry and lead faculty in the Center for Outreach in Alzheimer’s Aging and Community Health (COAACH), which is the nation’s most prominent outreach and education centers focused primarily on the impact of Alzheimer’s on African Americans and their caregivers.

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Dr. Mia talks about the other main reason why people end up in nursing homes- "legs not working" aka falls, especially the factors that affect people's balance and what to do about each of the risk factors.

New format of episode with screen share, check out Dr. Mia's new YouTube Channel if you would prefer to follow along visually.

Medications that increase risk of falls
CDC's STEADI program on fall prevention
STEADI program's brochures specifically for patients & caregivers: home safety check list and chair rise exercise
MyMobility plan: plan ahead for mobility changes as we age

How to use Apple Podcast app to subscribe on iPhone- tutorial video
Or subscribe via email on my website: scroll down, on right side.

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Email: ask@miayangmd.com
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In this episode of Ask Dr. Mia podcast, Dr. Mia talks to her colleague, neuropsychologist and memory researcher Dr. Bonnie Sachs.

Dr. Bonnie Sachs is a board-certified clinical neuropsychologist who specializes in working with older adults with memory loss and other cognitive disorders. Her areas of focus, both clinically and in research, include mild cognitive impairment (MCI), Alzheimer's disease (AD), and other forms of neurodegenerative diseases like Parkinson's disease, Frontotemporal dementia, Vascular dementia, and Lewy Body dementia. Dr. Sachs is an Associate Professor in the Departments of Neurology and Internal Medicine, Section of Gerontology & Geriatric Medicine, and is also an Investigator with the Wake Forest Alzheimer's Disease Research Center (ADRC). Additionally, Dr. Sachs enjoys education training and she currently co-directs the Clinical Neuropsychology Fellowship Program at the Wake Forest School of Medicine.

Dr. Sachs talks about how she became interested in the field, the training for neuropsychologists, what they do, and when patients should see a neuropsychologist.

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Email: ask@miayangmd.com
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Returning back to Season 3 of Ask Dr. Mia Podcast talking about what is Comprehensive Dementia Care and Medicare's new program to pay for it.

Health Affairs' article on Comprehensive Dementia Care: https://www.healthaffairs.org/content/forefront/payment-comprehensive-dementia-care-five-key-recommendations

Medicare's GUIDE program: Guiding an Improved Dementia Experience: https://innovation.cms.gov/innovation-models/guide

D-CARE Study: https://www.dcare-study.org/

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Support the showTranscripts on www.miayangmd.com. Transcripts are automatically generated and may contain minor inaccuracies.
Email: ask@miayangmd.com
Opinions expressed are exclusive of Dr. Mia Yang and not reflective of her or guest speaker's employers or funders.

For the last episode of season 2, Dr. Mia talks about lecanemab, a monoclonal antibody against amyloid, results since the show's most popular episode on lecanemab released on 10/7/2022.

Lecanemab or Clarity AD clinical trial results in New England Journal of Medicine (NEJM)
Death related to lecanemab, reported in Science, related to Cerebral Amyloid Angiopathy
Donanemab press release by Lilly

Key points:
1) Aducanumab approval process eroded public's trust and careful screening for patients for real-world implementation of lecanemab is needed to build back trust.
2) Actual number of patients eligible for lecanemab will be much smaller than the total number of persons living with Alzheimer's disease in the country: studies estimate anywhere from 1% to 12% of patients seen in real world clinics.
3) Our healthcare infrastructure is not ready for early, timely, and accurate detection of Alzheimer's disease and tracking patients on monoclonal antibodies.

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Support the showTranscripts on www.miayangmd.com. Transcripts are automatically generated and may contain minor inaccuracies.
Email: ask@miayangmd.com
Opinions expressed are exclusive of Dr. Mia Yang and not reflective of her or guest speaker's employers or funders.

In this episode, Dr. Mia talks with Dr. Trey Bateman about Lewy Body dementia, unique challenges in diagnosis, different treatment options compared to Alzheimer's dementia, and his research on Mild Behavioral Impairment.

Dr. James (Trey) Bateman is a behavioral neurologist at Wake Forest University School of Medicine and the Salisbury Veterans Affairs Medical Center. His clinical care is spread across both Wake Forest and the Salisbury VA, where he focuses on the evaluation and care of people with neurodegenerative conditions, especially those with prominent neuropsychiatric symptoms. His research is focused on the role of chronic psychosocial stress and dementia risk and the role of early neuropsychiatric symptoms in the prodromal stages of neurodegenerative cognitive disorders.

More information on Dementia with Lewy Bodies

Anticholinergic medications based on the 2023 American Geriatrics Society Beers list of medications to use with caution in older adults

Support groups specifically for caregivers and persons living with Lewy Body Dementia

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Support the showTranscripts on www.miayangmd.com. Transcripts are automatically generated and may contain minor inaccuracies.
Email: ask@miayangmd.com
Opinions expressed are exclusive of Dr. Mia Yang and not reflective of her or guest speaker's employers or funders.

With the recent news of Bruce Willis' diagnosis of frontotemporal dementia, I talk with Dr. Halima Amjad about her own personal journey with her late father's FTD diagnosis as well as her professional role in dementia care and research.

Dr. Halima Amjad is an assistant professor of medicine at the Johns Hopkins University School of Medicine. Her career as a geriatrician and health services researcher centers around people living with dementia. She cares for patients at the Johns Hopkins Memory and Alzheimer’s Treatment Center. Her research focuses on medical care challenges in dementia, including underdiagnosis, hospitalization, and primary care support. Her advocacy work includes serving on the Board of the Association for Frontotemporal Degeneration and as chair of the Maryland Virginia I. Jones Alzheimer’s disease and related dementias council.

The Association for Frontotemporal Degeneration

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Support the showTranscripts on www.miayangmd.com. Transcripts are automatically generated and may contain minor inaccuracies.
Email: ask@miayangmd.com
Opinions expressed are exclusive of Dr. Mia Yang and not reflective of her or guest speaker's employers or funders.

Sleep, everyone wants it or better versions of it. Dr. Mia talks with Dr. Jaime Hughes about sleep for older adults.
Jaime Hughes is an Assistant Professor at Wake Forest University School of Medicine, Department of Implementation Science and Section on Gerontology and Geriatric Medicine. As an implementation scientist, Dr. Hughes focuses on how to spread programs that work into different settings, including healthcare clinics and community-based services. She has a particular interest in programs to help older adults sleep well and move more. Her work is supported by a team of public health and clinical researchers who comprise the AMAZE Research Team – Atrium Health Wake Forest Baptist Movement And Zzz’s for Everyone. Dr. Hughes received her PhD from UNC at Chapel Hill and her MPH and MSW from University of Michigan.

Interested in learning more about research opportunities in sleep and aging? Email Dr. Hughes' team at AMAZEResearchTeam@wakehealth.edu.

Other resources:

Sleep and Aging

Healthy Sleep Habits

Cognitive Behavioral Therapy for Insomnia

Support the showTranscripts on www.miayangmd.com.
Email: ask@miayangmd.com
Opinions expressed are exclusive of Dr. Mia Yang and not reflective of her or guest speaker's employers or funders.

Dr. Mia talks with Dr. Rosanne Leipzig, a trailblazer in transforming the way we approach aging individually and as a society. In her 40+ year career, she has treated thousands of patients and trained hundreds of doctors and practitioners in all specialties of medicine. She is the Gerald and May Ellen Ritter Professor and Vice Chair, Emerita of the Brookdale Department of Geriatrics and Palliative Medicine at the Icahn School of Medicine at Mount Sinai in New York City. We talked about her new book, Honest Aging: An Insider’s Guide to the Second Half of Life.

Rosanne's inspiration for writing the book
Ageism, both external and internal
What is normal as we age and how to talk to loved ones about it
How old is too old to hold public office
Sex! No, older adults don't just stop having sex when they get to a certain age

You can purchase Honest Aging book from the publisher, on GoodReads, Bookshop, and Amazon.

Support the showTranscripts on www.miayangmd.com.
Email: ask@miayangmd.com
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None

Dr. Mia talks with Frances Hall and Bob Cain about the unique needs of adult children who are caring for their aging parents and how their organization Adult Children of Aging Parents (ACAP) helps. Frances Hall is the founder of ACAP, a 501(c)(3) non-profit organization providing information, resources, and community for adult children caring for their aging parents and themselves. Bob Cain is a Chapter Coordinator for the Winston-Salem NC chapter of ACAP and Vice President of Marketing for Piedmont Home Care.

We talked about why the word "caregiver" is notably missing from ACAP's name.
ACAPCommunity Podcast; specifically sibling dynamics episode with Alyssa Botte (Dec 20, 2020). Videos from various chapters on YouTube.
Locating via zip code on Eldercare Locator your Area Agency on Aging's Family Caregiver Specialist. Piedmont Triad Area contacts here.

Email: info@ACAPcommunity.org
Toll-free 1-877-599-ACAP (1-877-599-2227)

This episode was edited and transcribed by Bear Beat Productions.

Transcripts on www.miayangmd.com.
Email: ask@miayangmd.com
Opinions expressed are exclusive of Dr. Mia Yang and not reflective of her or guest speaker's employers or funders.

Dr. Mia talks with Dr. Mariah Robertson and Dr. June Howell about seeming contradictions: geriatrics was the lowest filled medicine specialty in the 2022 match yet geriatricians are among the happiest physicians.

2022 Medicine & Pediatric Fellowship Match rate- graph on Twitter

Program for All-inclusive Care of Elderly (PACE)

Hospital at Home

Home-based Primary Care via Independence at Home (IAH) Medicare Demonstration Project

CAPABLE program

Editing and transcript by Bear Beat Productions.

Transcripts on www.miayangmd.com.
Email: ask@miayangmd.com
Opinions expressed are exclusive of Dr. Mia Yang and not reflective of her or guest speaker's employers or funders.

Dr. Mia talks with Dr. Debbie Freeland, geriatrician and Health & Aging Policy Fellow 2021-2022, about policies and advocacy for older adults.

We discussed big "P" Policy vs little "p" policy:
"P"olicy: Congress and/or State level legislation: SNL parody on "How a Bill does NOT become a law"
"p"olicy: agencies that carry out laws such as Health & Human Services, CDC, FDA, CMS, local health departments,

D-CARE Study
Senate Special Committee on Aging in DC contact
Congressional Committees- another way to influence policy
How to write an Op Ed
Master Plan on Aging

Transcripts on www.miayangmd.com.
Email: ask@miayangmd.com
Opinions expressed are exclusive of Dr. Mia Yang and not reflective of her or guest speaker's employers or funders.

Dr. Mia talks with Neal Shah, CEO and Co-Founder of CareYaya, a new way to find eldercare at home: leveraging college students interested in healthcare careers and technology to create affordable $15/hr direct pay between the person who need care and the student.

Newly expanded into NC triad (Winston-Salem, High Point, Greensboro) area as well as Wilmington area.

Families/clients to request care from CareYaya here.
Frequently Asked Questions (FAQ)
Students who are interested in becoming a caregiver: www.careyaya.org/applyThis episode was edited and transcribed by BearBeat productions.

Transcripts on www.miayangmd.com.
Email: ask@miayangmd.com
Opinions expressed are exclusive of Dr. Mia Yang and not reflective of her or guest speaker's employers or funders.

As part of Innovations in Aging mini-series, Dr. Mia talks with Dr. Peter Abadir, Associate Professor in Geriatric Medicine and Engineering at Johns Hopkins about technology in aging. Dr. Abadir talks about Artificial Intelligence and Technology Collaboratory for Aging Research (AITC) and Gerotech Incubator Program that brings together teams of students, trainees, and faculty members from medicine, engineering, nursing and business to collaborate on innovative solutions to improve life for aging people around the world.

Send in real-world problems to gerotech@jhu.edu

Alzheimer's related technologies: www.alzstore.com

This episode’s editing and transcription by Bear Beat Productions.

Transcripts on www.miayangmd.com.
Email: ask@miayangmd.com
Opinions expressed are exclusive of Dr. Mia Yang and not reflective of her or guest speaker's employers or funders.

Dr. Mia talks about common physical, cognitive, and emotional changes in older adults, that adult children and other family members who may have noticed over the recent holidays.

More info on specific negotiating tips with your family members here: https://www.negotiage.com/resources/tactics

Self-administered memory test: SAGE, available in multiple languages: https://wexnermedical.osu.edu/brain-spine-neuro/memory-disorders/sage

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Email: ask@miayangmd.com
Opinions expressed are exclusive of Dr. Mia Yang and not reflective of her or guest speaker's employers or funders.

Welcome to ask Dr. Mia podcast conversations on aging well. I'm a geriatrician on the mission to empower older adults and all who care about them to thrive with aging. As a primary care doctor and a memory specialist practicing the full range of medicine from home to the hospital, I bring on diverse guests to embrace the complexity within you and in the world around you.

For far too long, geriatricians have been talking about innovations in aging and developing innovative models of care amongst ourselves. Ask Dr. Mia podcast is my attempt to share this amazing body of knowledge and amazing people to you, the global public.

There are only 7,000 geriatricians within the United States and certainly we are not able to care for the 56 million older adults older than age of 65 living in the US today, much less than the growing number of older adults who are going to be 73 million by 2030. But we can spread geriatric knowledge to the world. And that's why I'm so excited to share season two of Ask Dr. Mia podcast with all of you.

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Email: ask@miayangmd.com
Opinions expressed are exclusive of Dr. Mia Yang and not reflective of her or guest speaker's employers or funders.

Season 1 of Ask Dr. Mia podcast concludes after a baker's dozen of episodes. Dr. Mia talks about the highlight of each episode in season 1, behind the scene happenings, and upcoming Season 2 in 2023.

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Continuation of the conversation with Dr. Sharma, dual board-certified in physical medicine & rehabilitation and pain management, about holistic pain solutions based on the 5R's in Dr. Sharma's book The Pain Solution: refuel (food), revitalize (exercise), recharge (sleep), refresh (meditation/mindset), and relate (social connections). This part 2 talks the remaining 2 R's: mindset and social connections.

The Ask Dr. Mia Podcast will pause for the holidays and return for Season 2 in Jan 2023. Happy Holidays!

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None

Dr. Mia talks with Dr. Sharma, dual board-certified in physical medicine & rehabilitation and pain management, about holistic pain solutions based on the 5R's in Dr. Sharma's book The Pain Solution: refuel (food), revitalize (exercise), recharge (sleep), refresh (meditation/mindset), and relate (social connections). This part 1 talks about the first 3 R's: refuel, revitalize, and recharge.

More info on Dr. Saloni Sharma
Johns Hopkins' Chair Yoga exercises
Kaiser Permanente meditation resources
NIA's short exercises for older adults on YouTube

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Transcripts on www.miayangmd.com.
Email: ask@miayangmd.com
Opinions expressed are exclusive of Dr. Mia Yang and not reflective of her or guest speaker's employers or funders.

None

Dr. Mia talks with her colleague, Dr. Matt Kern, a geriatric psychiatrist about how he became interested in the field, how to counter mental health stigma, and living our best lives.

Music & disclaimer

Transcripts on www.miayangmd.com.
Email: ask@miayangmd.com
Opinions expressed are exclusive of Dr. Mia Yang and not reflective of her or guest speaker's employers or funders.

Dr. Mia talks about the new FDA authorization for sale of hearing aids over the counter, our amazing hearing system, and how to distinguish hearing loss from memory loss with Dr. Jack Hitchens, audiologist.

Jack Hitchens Au.D's bio
FDA's new ruling about OTC hearing aids (NPR news)

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Transcripts on www.miayangmd.com.
ask@miayangmd.com
Opinions expressed are exclusive of Dr. Mia Yang and not reflective of her or guest speaker's employers or funders.

Dr. Mia talks about the newly released preliminary results of anti-amyloid drug: lecanemab, the context of this newest drug development, and more questions than answers going forward.

News release of clinical trial Clarity AD (lecanemab) trial results
Biogen & Eisai's 50/50 relationship for lecanemab
Other trials including lecanemab
Biogen's recent $900 million lawsuit settlement due to improper physician payment
ARIA (Amyloid-related Imaging Abnormality): key side effects in lecanemab

Transcript & more at www.miayangmd.com
*Disclaimer: views expressed are Dr. Mia Yang's solely and do not represent her employer, National Institute of Health (NIH), or Patient-Centered Outcomes Research Institute (PCORI). Dr. Mia has no pharmaceutical company funding.

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Dr. Mia talks about her mom's story with lifelong anxiety as well as a recent surprising diagnosis.

How to help someone with anxiety: https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/how-to-help-someone-with-anxiety

New 988 hotline: https://www.samhsa.gov/find-help/988

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Dr. Mia talks with Samantha Culler, LCSW at Atrium Health Wake Forest Baptist's Memory Counseling Program about her professional and personal journey of being a care partner. Neither of them speak on behalf of their employer and views expressed are theirs only.

Memory Counseling Program: https://www.wakehealth.edu/locations/clinics/m/memory-counseling-program-sticht-center

Dementia care partners' support group manuals and books: https://www.centerforloss.com/bookstore/a-support-group-for-people-living-with-dementia-the-leaders-manual/

Dr. Ed G. Shaw's books on Amazon: https://www.amazon.com/Edward-G-Shaw/e/B01D8Z3QKY?ref=sr_ntt_srch_lnk_3&qid=1662576971&sr=8-3/

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Dr. Mia talks about the difficult but common safety issues in Steve & Nina's story.
4 M's of safety problems in people with mild/early stage dementia: money, medications, meals, and mobility/driving.

Driving safety: https://www.nia.nih.gov/health/driving-safety-and-alzheimers-disease
Older adults & driving: https://www.nia.nih.gov/health/older-drivers
Find an OT who does driving tests: https://www.aota.org/practice/practice-settings/driving-community-mobility/driving--community-mobility-toolkit-for-professionals
Social security scams reporting: https://faq.ssa.gov/en-us/Topic/article/KA-02238
Pillbox with alarm & other technology: https://www.alzstore.com/early-stages-of-alzheimers-s/1817.htm

4 common types of dementia: Alzheimer's dementia, vascular dementia, Lewy Body Dementia, and Frontotemporal dementia

Leave reviews on Apple Podcast or on www.miayangmd.com

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Dr. Mia describes the domains of memory/cognition:

short-term memory
executive function
visuospatial memory
language
attention
speed of processing

Memory mimickers that can confound memory evals:

anticholinergic meds
obstructive sleep apnea
hearing loss: hearing amplifier PockeTalker on Amazon
alcohol use: 2 or more drinks/day for men, 1 or more drinks/day for women
head injury
low thyroid, low B12

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Dr. Mia talks about two composite patients: Barbara and Steve who demonstrate two very different tales of Alzheimer's disease, what's sexy vs not in Alzheimer's research, and disease-modifying therapy that is NOT aducanumab.

Dr. Mia's prior NPR Morning Edition interview about aducanumab:
https://www.npr.org/sections/health-shots/2021/11/08/1052833252/cost-and-controversy-are-limiting-use-of-new-alzheimers-drug

National Institute of Aging clinical trial search tool:
https://www.alzheimers.gov/clinical-trials

SPRINT -Mind original article:
https://jamanetwork.com/journals/jama/fullarticle/2723256
More SPRINT-mind discussion in a nuanced way. " [get avg SBP in 120s] reduces mild cognitive impairment or reduces the risk for mild cognitive impairment and there seems to be a signal that it reduces dementia, but it’s hard to tell because the trial was cut off early.":
https://geripal.org/does-intensive-blood-pressure-lowering/

*Dr. Mia Yang does not speak on behalf of her current employer: Atrium Health Wake Forest Baptist or Wake Forest School of Medicine. Views expressed are her own.

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Dr. Mia uses a composite patient Ms. Smith's story to demonstrate her journey through different levels of care, from home to hospital, to skilled nursing facility (SNF), and then back to home. She discusses assisted living vs nursing home vs memory care unit and insurance payment options for them.

Additional resources:
Eldercare Locator (acl.gov)

Nursing home facility ratings per Medicare: enter your zip code below
Find Healthcare Providers: Compare Care Near You | Medicare

Transitioning into assisted living, memory care, or other retirement community:
Find Assisted Living, Memory Care and Senior Living | A Place for Mom

Geriatric care managers:
What Is a Geriatric Care Manager? | National Institute on Aging (nih.gov)

Music & disclaimer

This episode I tell you the story of how I became a geriatrician and a couple who inspired me during my training. I use their example to talk about the 5M's of geriatrics: Mind, Mobility, Medications, Multi-complexity, and Matters Most. I also touch upon a reason why I think there are too few geriatricians.

More info about 5M's: https://www.healthinaging.org/tools-and-tips/tip-sheet-5ms-geriatrics.

Where to find age-friendly health systems that put the 5M's into practice: http://www.ihi.org/Engage/Initiatives/Age-Friendly-Health-Systems/Pages/default.aspx

Submit questions to Dr. Mia and see transcription on www.miayangmd.com

Music & disclaimer

Welcome to Ask Dr. Mia podcast: conversations on aging well. Dr. Mia introduces herself, why she started this podcast, and explores 4 different ways from her own grandparents on "aging well." www.miayangmd.com.

Music & disclaimer