Ask Dr. Mia: Conversations on Aging Well

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

Music & disclaimer

Video on Ask Dr. Mia YouTube channel
Transcripts 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 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.

Music & disclaimer

Video on Ask Dr. Mia YouTube channel
Transcripts 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.

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/

Music & disclaimer

Video on Ask Dr. Mia YouTube channel
Transcripts 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.

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. 

Music & disclaimer

Video on Ask Dr. Mia YouTube channel
Transcripts 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.

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.

Music & disclaimer

Video on Ask Dr. Mia YouTube channel
Transcripts 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.

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.  

Music & disclaimer

Video on Ask Dr. Mia YouTube channel
Transcripts 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 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. 

Music & disclaimer

Video on Ask Dr. Mia YouTube channel
Transcripts 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.

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/

Music & disclaimer

Video on Ask Dr. Mia YouTube channel
Transcripts 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. 

Music & disclaimer

Video on Ask Dr. Mia YouTube channel
Transcripts 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

 

Music & disclaimer

Video on Ask Dr. Mia YouTube channel
Transcripts 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

Music & disclaimer

Video on Ask Dr. Mia YouTube channel
Transcripts 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

Video on Ask Dr. Mia YouTube channel
Transcripts 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.

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.

Video on Ask Dr. Mia YouTube channel
Transcripts 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.

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. 

Video on Ask Dr. Mia YouTube channel
Transcripts 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.

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.

Video on Ask Dr. Mia YouTube channel
Transcripts 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.

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

Video on Ask Dr. Mia YouTube channel
Transcripts 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.

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/apply

This episode was edited and transcribed by BearBeat productions. 

Video on Ask Dr. Mia YouTube channel
Transcripts 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.

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. 

Video on Ask Dr. Mia YouTube channel
Transcripts 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.

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

Music & disclaimer

Video on Ask Dr. Mia YouTube channel
Transcripts 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.

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. 

Music & disclaimer

Video on Ask Dr. Mia YouTube channel
Transcripts 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.