BETTINA MORROW - Everything You Wanted to Know About Adult Protective Services (But were afraid to ask!)

If you have ever wondered just what the role of Adult Protective Services truly is, when should you contact them, what kinds of investigations they make, and how much power do they actually have when it comes to protecting your loved one or any vulnerable adult, then this is required listening! (Even if you have never wondered, I recommend this show!)   

My co-host, Don Priess, and I had an incredibly candid and enlightening  conversation with Bettina Morrow,  currently the Supervisor of Adult Protective Services in Jefferson County, Colorado.

Bettina shares her invaluable, honest perspective of the program  that promotes "the safety, independence, and quality-of-life for vulnerable adults who are, or are in danger of, being abused, neglected by self or others, or financially exploited, and who are unable to protect themselves."  A program that can differ from state to state and even from county to county in terms of definitions, client eligibility requirements and standards of practice.

With over 20 years of international experience, Bettina Morrow started her career in her home country of Australia before moving to the UK. There she practiced social work for 9 years, eventually leading to her move to the U.S.  Bettina is a true unicorn, having spent the last 15 years working with at-risk and vulnerable adults with specific expertise in elder abuse, dementia, and guardianship.  Bettina has obtained a Bachelor of Social Work and a Masters in Dementia, is a Nationally Certified Guardian, and has presented at state and national conferences. 

Transcript

Susie Singer Carter: 0:00

Hi everybody, it's Susie singer Carter and I just wanted to take a minute to tell you about a wonderful product I just discovered. It's called sociopathy. And so CRV in Latin means to share and unite. It is the simplest way for older adults and people with disabilities to connect and engage with their family and friends. There's no username, no password, no login and no app to choose from. It's just a dedicated device. It's the sociol the C to M connect to me device it's always on and ready to use. And families and caregivers just install the app on their smartphone. And then you can just begin sending photos, videos, and even have live live video chats and your loved ones. They don't have to do anything. They just love it. And because all of us must fight elder abuse and work together to bring awareness to this issue says the obvious supporting my efforts to produce my vital documentary, No Country for Old people. When you subscribe to sociology for your loved ones, they will donate the payments received and you can help us reach our goal while connecting with your loved ones in the simplest way CCRB connecting generations made simple globally. To learn more, please visit their website at www sosiale.com. And when choosing the payment, select the annual subscription the proceeds will go to help the production of our documentary, No Country for Old people and I thank you so much. When the world has gotten down,

Don Priess: 1:30

and Alzheimer's sucks, it's an equal opportunity disease that chips away at everything we hold dear. And to date, there's no cure. So until there is we continue to fight with the most powerful tool in our arsenal. Love. This is love conquers all is a real and really positive podcast that takes a deep dive into everything. Alzheimer's, The Good, the Bad, and everything in between. And now here are your hosts Susie singer Carter and me, Don priests.

Susie Singer Carter: 2:06

Hello, everybody. This is Susie singer Carter.

Don Priess: 2:10

And I'm Don priests and this is love conquers all. Hello, Susan.

Susie Singer Carter: 2:14

Hi, Donald. What's up? What's going on? Well, ah, let's see. Well, I spent the weekend with my two little grandbabies. And I'm tired.

Don Priess: 2:29

They're little and they're energetic. And one of them's three and the other ones eight months. And oh, my goodness,

Susie Singer Carter: 2:39

they're so cute. I'll picture up. I'll put a picture up in the edits. Because you know, why we gotta

Don Priess: 2:46

do? No reason you wouldn't. Right. But yeah, they are chock full of energy. And yeah. And yeah, so you had the three year old for two days is that

Susie Singer Carter: 3:00

I did, I did. And we got to the park. And you know, I just want to say, I'm trying to get fit again. Because I've been, you know, working so much and I forget that I'm when when you're writing or if you're editing you it's like you're in a time warp. There's something weird that happens like you start at nine in the morning, and then you look up and you go, No, it's not four in the afternoon. And it is and I've been sitting at my desk so I started running. And I I've been running between like six to eight miles each time. That's freaking good. It's too

Don Priess: 3:35

much. It's too much for me. makes me tired. You know, it actually burns calories. Just as think about it. It burns calories so

Susie Singer Carter: 3:46

well. It hurts my feet. Does anybody have any suggestions? My feet hurt. I got news. I have ones helping.

Don Priess: 3:52

What Don't run. Don't run.

Susie Singer Carter: 3:56

Fine. I'm getting like midlife belly but I don't know where it's coming from.

Don Priess: 4:01

But are you showing your midlife belt? I'm

Susie Singer Carter: 4:03

trying to show my midlife belly there's Why do

Don Priess: 4:06

you think I wear black? I've had midlife belly for like 10 years and yeah, and I don't even run so I guess we're even I don't even have

Susie Singer Carter: 4:19

because you eat like you eat like Jethro and I eat like a bird and it's still happening and I'm running eight miles and it's still it's not happening so I need I need advice I need I need diet advice you guys I don't

Don Priess: 4:32

know she's considering does she fast anyone know about fasting does Yeah. Can you tell us about that? I don't know about that. My I consider a fast one hour of naughty

Susie Singer Carter: 4:46

That's right. And here's the thing, you know, I don't know if it's all midlife. I do think and let's get to the caregiver part. Like the past year. I've been under a lot of stress. And so

Don Priess: 4:59

which kid call cause that type of thing that causes that. That's what is the it's called the here somebody out there is going DOI. It's the

Susie Singer Carter: 5:10

it's cortisol Don da it is.

Don Priess: 5:13

I was gonna say that. I didn't

Susie Singer Carter: 5:16

read she didn't. So, okay. Okay, Pierre. Okay. I'll be transparent. I did stop the recording and look it up.

Don Priess: 5:25

Look it up. I was gonna say, you know thou good. Paul says, Yeah, great. I know.

Susie Singer Carter: 5:33

Yeah, from my Google on my phone. Anyway, my cortisol level is raging and has been raging. So I think and apparently that makes you and then lack of sleep also can add the poundage on?

Don Priess: 5:45

Yeah, so it's stress, lack of sleep, sitting at your desk for eight to 10 hours without standing up. These are all, you know, I mean, they're they're elements that could cause and is absolutely causing what's going on right now? Because there's no other there's no other answer. Why

Susie Singer Carter: 6:03

are you 15? Are you saying that you just said it? He just said no.

Don Priess: 6:08

I said, No. I said, What's happening right now? Oh, no, I shouldn't use air quotes is that I'm not allowed to use air quotes. Correct? No. Okay. I will not use any air quotes in this episode. I promise. No more.

Susie Singer Carter: 6:21

I can't show below my waist. There's a tiny bit of crap happening. I like my body. I'm fine. I'm positive.

Don Priess: 6:29

I know how many people are going Shut up. You know, people are out there going Shut up.

Susie Singer Carter: 6:34

No, I Oh, that's yeah. I get it. But here's the thing when you have like certain size clothes, and all your clothes are that size, and suddenly it doesn't fit becomes very expensive.

Don Priess: 6:47

And well, that's why I give you all my old jeans. So you do I like

Susie Singer Carter: 6:51

Don's old jeans. I I rip them up and I make them look cool. Anyway, we digress.

Don Priess: 6:57

Where are we? Well,

Susie Singer Carter: 6:59

I'm trying to make things light because we're the topic we're going to talk about today's a little bit heavy. Well, but yeah, that's okay. It's okay. Sometimes we have to hear the bad so we can get to the good. We have to go through the weeds so we can get to the flowers. Look at that.

Don Priess: 7:16

Absolutely. Wow. And, and our guests is like a gardener a gardener who gets us through those weeds. To the flowers.

Susie Singer Carter: 7:24

She's right. She's amazing. She's from Australia and my love her accent. And she's beautiful girl woman I should say. And beautiful inside and out. i We interviewed her for No Country for Old people. And I was like, Oh my God. Our audience on love conquers all is going to love you because she's an expert in dementia, Dawn, and also works for the adult protection services, which I had no idea what they did. So it's gonna be this is going to be a great show. Yay.

Don Priess: 8:00

Indeed. I'll tell you all about are you ready? Yeah. With over 20 years of international experience, Bettina Morrow, started her career in her home country of Australia before moving to the UK. There she practiced social work for nine years, eventually leading to her move to the United States. Bettina has spent the last 15 years working with at risk and vulnerable adults with specific expertise in elder abuse, dementia and guardianship. She has obtained a Bachelor of Social Work and a master's in dementia is a nationally certified guardian and has presented at state and national conferences. We are absolutely thrilled to have her here today. So let's not wait another moment and say hello to Bettina Morrow. Hello, Bettina.

Unknown: 8:43

And good afternoon. Hi.

Susie Singer Carter: 8:45

So happy to have you on this show. And like I we interviewed you for the documentary, and I realized you're you're just an amazing resource for this show. Because of all that you're doing in the dementia arena and and which is really rare. So, so happy to have you.

Unknown: 9:11

Thanks for having me. Very excited to be asked. So it's definitely my pleasure to be

Susie Singer Carter: 9:16

Oh, good. Good. And we like your accent so there's a bonus a bonus accent you guys. Yeah. So So Don introduced you and I think you know I'm just in like I said in our interview for No Country for Old people. It's amazing to me that there are so few if any, I don't think I've met anyone other than in our community outside of any facilities that are actually are have studied and are really have a focus in dementia and our hands on which you have done and and I think that's it's a good I can't believe that you are the unicorn in this in this I mean it every, almost everybody, how many people do you reckon in your studies end up with some form of dementia or Alzheimer's?

Unknown: 10:10

Actually the most the largest population group of at risk adults that we work with have a form of dementia, Alzheimer's. So I would say that the way that we measure the data, though, has different elements. At the intake phase, we have over 30%. But I would say that that number is increasingly much, much higher, because what we often find is we go out to meet people, and they've clearly got actually cognitive deficits that we can identify based on our training and our skills. So I would say it's well in excess of like, half of who we interact with have a cognitive deficits.

Susie Singer Carter: 10:50

See, that just blows my mind. Because you think you figured that people that are in this industry, and they've made it their career choice and their business choice to, to take care of people in this in this population in this demographic? Who, who, like you said, have a really high percentage, somewhere between 30 to 40%, maybe more, and that they absolutely know, zero, about the disease and the progression, and how it manifests and how it presents. And so, you know, well, so what, what made you well, let's talk about you first, like what made you choose this focus for your for your career?

Unknown: 11:35

Yeah, I my career actually started working with children. But after about 11 years of working with children, I had the opportunity to transition into to working with adults in a hospital discharge in an inner city, London hospital. And I found that literally, within my first week, I was like, I love children, but I love older adults, way more. There was just like, there was something about it. And as I was going through my training process to transition my skill set, specifically around risk assessment into the adult world, I really honed in on dementia, because that was a big part of our population group and people who had experienced strokes, and was fascinated fascinated by everything that came with dementia, especially the neurobiology side of it. And then how are we as a hospital treating and caring for people with dementia specific to their needs, and not just as a patient. So my my love and my passion and interest really developed way back in 2009. And I've really incited dedicate myself really to the adult protection Adult Safeguarding arena, and really emphasize that with the dementia population, because what we know is people who are at risk of elder abuse, one of the single largest risk factors is having a cognitive deficit. So as the years progress, and I furthered my studies, I eventually led myself into the direction of undertaking a master's in dementia through the University of Tasmania in Australia, which is an incredibly unique Master's it is, as far as I'm aware, the only university in the world that offers a master's program that is just on dementia, it's not Gerontology it is just on dementia. So you have four components that you focus on being health and social welfare and cap, policy and policies International. So it's not just focus on Australian policy, it is international policy on dementia, neurobiology, that was definitely something I had to knuckle down on. And public health, which was interesting, because I was studying also at the time that COVID swept around the globe. So amazing opportunity, incredible university that not only offers this level of study, but also offers free training certificates to anybody. Their commitment to educating people on dementia is so external. And so far from just making any levels of money from tuition. They offer this course to anybody around the world. And it has gained incredible success and notoriety and how beneficial that actually has been to professionals and to families who can sit at home at you know, 12 o'clock at night because that's when they're actually out and actually like learn what is happening to their loved ones. It's an incredible, they call it a MOOC. It's a massive online open course. I highly recommend it to anyone. All of my new staff are required to undertake the MOOCs as part of their orientation to their employment with me.

Susie Singer Carter: 14:46

Good Good on you. So as far as to when you say my staff, what is your company? What do you say your steps? Yeah.

Unknown: 14:57

I said I work for a local county government. and I oversee a team of investigators I work in within adult protection services in Colorado. So we investigate allegations of abuse, neglect exploitation for at risk adults, and our largest population is older adults. But we also include people who have intellectual and developmental disabilities. But our largest group is definitely investigating whether there's been abuse of some description to an older adult in the community, as well as in facilities. So we cover facilities as well in the state of Colorado.

Don Priess: 15:31

And what led you to that section of you know, the, was there an experience that you had? Was it just hearing what was going on what led to that? Yeah, that's

Unknown: 15:41

actually an interesting sort of historical component. When I, when I transitioned from children into adults. In within this hospital in London, they were just introducing safeguarding adults, which is the same as federal protection, it was just being formalized and introduced into their system. And at that time, my staff that I had in London, their whole role was about discharge planning, they had no training, or education on risk assessments and how to undertake any sort of investigation. So I was in a really unique position that I could take all of my historical child protection, risk assessment, forensic interviewing skills, and adapt it to the adult sector that we were working with. So I then started to produce a lot of the trainings for all of the staff to help them navigate these new policies and procedures of safeguarding adults within the London system. And from there, I became the Adult Safeguarding manager that oversaw the service within for that particular team within the hospital. And then 10 years ago, I moved to the United States. And they, you know, in the States, we have a very well structured adult protection services across the country. And so when I was looking for jobs, there was a position right there. And I was like, that's my, I'm going for it. It's my position, and it's got my name on it. And I was very lucky. And I'm sure enough, I got the job.

Susie Singer Carter: 17:08

I'm so glad you did. And you answered one of my questions. I was gonna say in terms of adult protection services, which I don't think any of us really know what they do. And you know, first of all, it is state by state. Correct. But there are guidelines from the federal government that says here's because it is. It's financed. It's, it's paid for through through taxpayer. Right.

Unknown: 17:32

Yeah, but not through the federal government. So we are working on that. So you're right. So it is state by state. There's there's some guidelines at the federal level from some associations, but there's no regulations that come down from the federal government, because we don't have any federal funding. So each state has to fund their own program, through whatever measures they've actually determined internally. So there is currently actually a process it's undergoing to look at federal guidelines being implemented for adult protection, and how do we look at uniting across the country, some of the larger beliefs and practices that underpin all of our practices across the country?

Susie Singer Carter: 18:15

Right. So who does fund the programs? Are there?

Unknown: 18:20

It is, it is taxpayers. So it's taxpayers dollars through the state

Susie Singer Carter: 18:24

level through the state level? So all right, so here's the here's the the crappy question, and that is, how much how much power do you have as as an adult protection service agent? You know, when if, if we're, if I'm to call you up and say, my mom is being neglected and abused, and here's where, what, what would be the next steps taken and how, and with all due respect, and I mean, like 1000 pounds of respect for you. It's like, I know, what, what goes on out there in these programs, and you know, especially state to state and when they're not really highly regulated. That also means they're not highly

Don Priess: 19:12

enforced. enforced. Yeah.

Susie Singer Carter: 19:14

Yeah.

Unknown: 19:15

Yeah. And you know, there is actually the risk of some elements of not being enforced. So quick summary, a referral come in, we have hotlines referral can come into our hotline. We gather specific information that helps us determine per legislation and our rule and our policies, what the guidelines are that we're looking for. If it meets those criterias, we will undertake an investigation, where we interview that client collateral contacts, their power of attorneys, family members, we work with police, if it's appropriate if we've got a very identified clean criminal activity that's occurring. Our first and foremost is to mitigate risk to improve safety and mitigate risk. That's our first and foremost. From there we do case plants to see how we can better support the at risk adult to lead a healthier, safer life, predominantly to age well in the community. And as part of that process in the state of Colorado, and this is different across all the states, we do actually have findings. So we conclude our investigation per finding and determine whether the finding has actually occurred. So it can either be substantiated, inconclusive or unsubstantiated. And that is against who the person is that's been identified as the alleged perpetrator. And so an alleged perpetrator can be anybody, it can be a family member, it can be a neighbor, it can be a con artist, it can be a professional, professional guardian, a professional nursing home staff member, it can be anybody. Their names can be placed on a list within Colorado that then is legally required by certain employees to check to determine if they have been substantiated as causing harm to an at risk at all. The goal is to reduce the number of specifically professionals that bounce between employments and continue to cause harm to at risk adults and vulnerable people. A real specific area that is to really look at the nursing home, industry, and the it because they're so grossly understaffed. And it's so easily to just jump between nursing homes and never be trapped for the abuse or the exploitation that they may actually be causing to at risk adults, especially for people with dementia, who maybe aren't able to advocate for themselves clearly, to say, I am being harmed, I'm being physically hurt, I'm being neglected, they're stealing money from my drawer being the most popular vulnerability. So that's a quick synopsis. So in some ways we do because we can put people's names on the registry, which can impact their employment, their future employment, we work very strongly with the law enforcement departments to really push for criminal prosecutions. In going through the justice system, we really believe that to make progress in this area, people have to be held accountable. And if they're not shown that there are consequences, people will continue to do it. There are limitations, though, fully recognize there are limitations in what we can and can't do, which are incredibly frustrating at times.

Don Priess: 22:27

Do you oversee the the system though, meaning that if it's a systematic problem within a nursing home, where it's just you know, from the top down, that you're talking about the individual, but when it's the practice,

Susie Singer Carter: 22:41

right, that was gonna be my God at all? Yeah, well, yeah, you have if you're, if you're, if you're indicting, you know, a CNA or, you know, whatever, the director of nursing, you know, that's an employee of, and so, what, sometimes, obviously, there's, there's bad people out there, just individuals who are awful and take

Don Priess: 23:08

Bravo for you, after them,

Susie Singer Carter: 23:11

for sure, for sure. But a lot of the neglect comes from the top down. Huge, huge amount. So in which what you mentioned understaffing so what kept let's talk about those cases, because those are the most those are the most under the radar, those are the things that are under the radar. And everyone thinks, well, they don't understand that this this is this is the norm. This is the standard, folks.

Unknown: 23:38

Right? Yeah. And I'm not going to tell you, Susie, I know anything new when you hear the statistic that 70% of nursing homes across the United States are actually privately owned. That is the business of providing care to older adults in a residential care setting is big business. There is a lot of money, it is millions and millions and millions of dollars of profit that is made off the back of very vulnerable people. The systematic issues of understaffing, there is so much research and it's not even just the United States. There's actually international research that shows how regularly for profit facilities will intentionally under staff to increase their profit margin. And not only will they intentionally understaffed, they will not employ the right educational and training levels. So instead of having a population group that needs three nurses and 10 CNAs, they will intentionally employ one nurse and five CNAs. So that's understaffed, and it's a complete deficit in the actual skill and training of those that are physically there. That is definitely something we see. We have investigated that within my budget killer service, the further out remit can go is that we can actually hold administrators and directors responsible. I would say my team is one of the few that will actually go that far. I wouldn't say that, even though it's permissible, it's not maybe as common practice. Our belief is that you're being paid six figures, your job is to be responsible for the care of everybody there, you may not directly be actually providing bathing, but the staffing is your responsibility. And if you knowingly, are aware that your business, the home, whatever you want to refer to, is intentionally being understaffed, you will be held accountable. Because we have had situations where people have died, we're not just talking about they didn't get their meals on time, or they didn't get the bath or the shower when they wanted. We're talking about abuse and neglect. That is so serious and chronic, that people haven't been bathed in a month, that they have not received their medications, that there is nobody providing wound management. We've had a situation where somebody who had zero qualifications or training and wound management was administering it. And we've had people who have died, because their wounds have become so exacerbated. And then they're developed sepsis, that the wound is an open hole, you can see down to the bone, that I realize it's hard for it for people, the general public who don't visually see the forensic photographs of what this looks like. But it's horrifying. And it's agonizing. It is absolutely torturous to do this to anyone. So we will go as far as them. The part that we don't have the power is we can't we don't we can't supersede that. So the actual management companies that often enforce the reduced staffing levels, we don't have direct access to for accountability. And I know, CZ, in our previous conversation I had shared with you a situation we had investigated here, that was incredibly serious. And we were looking very closely at the administrator. And the administrator actually came back to us, and not that this excuse what happened, but was able to show very clear evidence that they had been communicating with the management company about the seriousness of the state of the nursing home, and how desperately he needed funds to be released to get staff in because of actually the rest of residents and the management company saying no. Like, yeah, I mean, you couldn't get any clearer

Susie Singer Carter: 27:46

of get any clearer than that. That's, it's no, it's so heartbreaking. So I get asked this, or I get told this a lot from people as I'm, as I'm trying, you know, raising money and interviewing people and keep trying to get this as as public as possible this problem, and I get, I get a lot of like, yeah, there are bad places, Suzy, but there's some really great places. I mean, how would you answer that if someone said that to you?

Don Priess: 28:16

And I'm sure they do. And,

Unknown: 28:19

and I would say, you know, they're they're actually, I would say that there actually are a couple that I have actually been somewhat surprised about that actually have it's like, goodness, like I turn up unannounced and like, displaces, like, they've got all the stuff that they're supposed to have, if not actually more at some points. And like, why is it two activities coordinators here like it's like, and they're actively doing, like, actively engage, and they almost look like they're enjoying themselves, like as if this is what they want to be doing. But what I would say that it's not just a few bad apples. This is a chronic chronic issue that is across the country. And in some ways, I would almost compare it to society's unwillingness or inability to accept how serious domestic violence is to accept how serious and chronic child abuses or sexual assault of women, you just don't want to actually acknowledge or maybe fully understand how rampid some of these issues are. And unfortunately, the crisis we have within nursing homes is actually no different. It's not just a couple of bad ones. It is actually across the country, and it needs such significant attention to it. Right.

Don Priess: 29:35

Like you're using the bad apples as I mean, if somebody gave you a basket full of apples, and 95% of them were rotting, and you say Oh, but there's a couple of good ones out there. Thank you. Seriously I guess they're all good.

Susie Singer Carter: 29:56

Don't really it's like there's there's a million people that are hungry. But I found one apple.

Unknown: 30:02

That'll get it right.

Susie Singer Carter: 30:05

I mean, that's it. I also had somebody write on my post. You know, I'm all about I get that nursing homes need some reform, and I'm all about that. But you know, what I'm not about is scaring people? Well, I am people need to be scared. I'm scared. What do you think? I mean, don't you think people need to, like you said about the wound, what she said it was exactly my mother's. You know, that was her journey. That's what happened to her. And I saw that wound go down to the bone. And I saw her be, you know, no matter what, with me advocating every day, I couldn't get her to get the kind of care needed

Don Priess: 30:45

to record talking directly to the doctor and them saying, no, no, our will look into it. We'll look into Yeah, we'll look into it. Yeah. Which is basically no.

Susie Singer Carter: 30:54

So I mean, I don't want to scare people. It's not like I get a thrill out of it. I don't like scary movies. It's not, it's not my bag. But at some point, we all have to put our big, big girl big boy, big person pants on and just go. This is the reality, folks, do you agree?

Unknown: 31:11

Yeah, you know, it, it is hugely complicated. And I get this thing you don't, they don't want to be scared. And I would never want any family I'm working with to be scared either. But I think the part that's really, really, actually the most important part is that people need to be informed. How can you make a decision about your loved one, if you are not informed of the reality? It's no different to if we go to our doctor, and they suggest a medical procedure? If we don't know all the benefits in the rears, how can we make an informed decision about whether that's in our best interests, or for our child or a parent? And nursing homes are much the same? That? No, we don't want to scare because we understand and appreciate that there are many people that can't continue to provide the care in their community homes. However, if we don't actually address the issue, all the people that don't want to be scared, are going to be horrified when they find that it's them and their loved ones if this is happening to. So I mean, we don't want to scare people. No, of course we don't. But it's happening. It's happening right now. It's actually it's not like, Oh, it's just bad luck. If it does happen. People need to be informed, if you are informed, you can have a voice. And that voice can be effective for change. So that future people do not have to be at risk of this happening. We have to we have to say to people, this is what's happening behind closed doors, you should be angry about it. You should be demanding your local your advocates, your politicians, whoever it might be your senators, that this will not be tolerated. It's my taxpayers money. Exactly. Pain, to profit people who are intentionally causing harm, and distress and pain and death.

Susie Singer Carter: 32:58

Exactly. Okay. And I mean, even like, I think about the me to movement, or, or right to life, and all those kinds of moves, you know, movements were, you know, growing up, you would see all these movies about abortion, and women, you know, giving themselves self abortion, because there was no place to go. And it was against the law. And and yeah, it's grotesque, and it was awful. But those are the kinds of those are the kinds of scenarios that that impact so that you go, because if you just say, well, then women are going to be, you know, trying to abort themselves. That's very benign. In this you know, what that entails? Yeah. Right. And I didn't know what a bedsore was, I thought it was literally like a red mark on somebody's soul, a little sore, like you've been leaning too long on your elbow. That's it. Yeah. Who knows until you know, so. And I also want to talk about since you You're such a, you're such a great resource for both sides of this, you know, because you have this, this expertise on dementia, and I want to talk about ableism because it's rampid. And so you talk about neglect and abuse for people that are residents in a in a nursing home situation or long term care but then you add on dementia and Alzheimer's and you've got you know, the the ability to neglect and abuse is I'm sure double tripled whatever. And within the industry there, I'm sure you come up against it with with very naive people that don't understand because I did like what what can you speak to that?

Unknown: 34:45

Gosh, have we got long enough? I, the most vulnerable people that we have in nursing homes. We've got the cognitive decline. What many people don't realize is that dementia is not just about losing memory. It's actually affecting your executive functioning, your decision making your safety awareness and your communication. Many people, if not most, will lose their ability to speak and form sentences as the disease progresses, so they're highly vulnerable. With that we have big issues of not just the risk of abuse, but how very undertrained and understaffed facilities address and care for people with dementia. So two big areas we see us restraints, physical restraints that are imposed on people with dementia and chemical restraints. So physical being, they have them to their position that they can't get out of bed freely. They have them situated in a chair with a dinner table in front of them knowing that they can't physically move. We've even had a case where staff intentionally placed furniture in front of their rooms, so they couldn't even exit their room. Chemical restraints is actually even bigger issue for me, because the amount of nursing home residents who have a diagnosis of dementia and are being prescribed anti psychotic medications is just horrifying. anti psychotic medications is so commonly used in people with dementia, even though there is hundreds and hundreds of research papers that show the efficacy of using them is about this much. And the risk is exponential. The risk of using any psychotropic medications increases fold, it increases the risk of stroke, heart attack and death. And they're more likely to become more confused. Why would we do that to anyone to anybody? Why would they do that?

Don Priess: 36:42

Because it's easier for them.

Unknown: 36:44

It's easier. Exactly. And it's because of former sedating, we just sedate. And they use off label. I talked recently in a different podcast about a big an actual federal review that was being undertaken about the inappropriate use of psychotropic medications on nursing home residents with dementia. And one of the interesting things they found is that throughout part of the study, an overview was over a period of time is that the prescriptions of them actually went down. But what happened was it magically, a whole bunch of older adults with dementia suddenly had schizophrenia listed on their face sheet on their diagnosis sheet. Because it's not recorded the same way. prescribing said he psychotic or psychotropic medication for someone with schizophrenia is not recorded the same way as it is with dementia. So even though there was zero symptoms, or medical evidence to show why they would suddenly have schizophrenia, the dots were all because it was a way of getting around government oversight. And it's largely Yeah, it's largely because they don't know actually, the skills and the training of how to provide true holistic person centered care. That's nonpharmaceutical nonpharmaceutical care held basically zero risk to the individual. Yeah. What, why would we balance a zero risk with death?

Susie Singer Carter: 38:08

So I know, I and you talked about it. And my mom was a victim of Depakote. So I know I know what it does to people. And I didn't know she was on it until it was a bit too late when her regular doctor said, your mom's on Depakote, and it's a Black Label drug for someone with dementia. And she lost her mobility and she became incontinent when we got her off of it. She didn't gain either of those back. And her cognitive, you know, level went down, of course. So but here's what you hear as as a caregiver is that this is the natural progression of dementia and Alzheimer's. Oh, yeah, it looks like it because they pushed you pat, like seven stages. So So and then they say, but this is this is what happens, honey, this is what happens. This is the natural progression. So you know, when my mom was was, you know, when they were trying to kick her out the door, basically they'd go, this is this is the progression. This is how people with Alzheimer's die. Yeah, that's how everyone dies. But but that's what death looks like. But how does that justify her being at this point now?

Unknown: 39:19

Right? Yeah, yeah. And they're not the same things. They're completely gets everyone dies. And, you know, there are stages of dementia. And if you're not fully drugged up on psychotropic medications, you actually can observe those stages of dementia. But when you expedite that by giving them prescription drugs that are not clinically tested on people with dementia, that's a completely it's not even like the same argument at all at all. It's not even within the same sort of like remit of discussion. You know, often what we hear is facility staff or professionals in the health care system, say to families, it'll make them more comfortable. It's like, that's not informed consent. That's what informed consent should always like, well, let's see, what else have you done to make them more comfortable? What actually have you done, how many facilities their staff members truly understand and or practice, that if you walk up from behind for someone with dementia and put your hand on their arm from behind, the absolute fear that imposes peripheral vision actually is lost with dementia, as the tops in the plane go up, sorry, plaques and tangles actually started to deteriorate the the cells and actually, literally shrinkage of the brain. peripheral vision is something that's actually lost in people with dementia. So they don't even not only walk in from behind, but even standing to the side, they can't sense that the education levels are actually very, very low. We also know from studies that even for staff members who hold higher levels of education, their ability to recognize delirium is grossly inadequate. And delirium is an incredibly high medical issue that actually occurs in nursing homes and specifically with people with dementia. So there's, there's a lot of education, you know, often you'll see on websites like, oh, all of that stuff, undertook a tip of snow training. And so we're also qualified and like, Wow, that's great. But don't bring tip or snow into it. Because we know that you're not actually like, you get it once, five years ago, when you stop, it turned over like, tenfold since then. None of them are actively doing it anyway. So

Susie Singer Carter: 41:31

Right. It's like taking CPR when you have a baby and saying, Well, I took CPR 20 years ago, I'm good to go. Yeah, so let's talk about the big question, which is ethics. You know, because there's, there's, it just feels to me, and I know, this sounds very Neela stick, but I can't help it, since I've got to this place, after all of my hell last year, is to say, we have to really sit back and think about why are we keeping our loved ones alive? To suffer? Because when they say that they're more comfortable? Would you want to be in a room all day long in by yourself? Would you want to be flipped like a pancake back and forth? Because no one's taking care of your wound, but they're going through motions of like, look, we're taking care of her, we're flipping her, you know? And would you want to not eat food for a year of your life? But there would is that comfort? And why would i Why are we keeping people alive? Or is that torture? Is that torture and the ethics of it to me, because, you know, I the last thing I wanted was my mom to die like my best friend lover, my favorite person in the world next to dawn. But

Don Priess: 42:45

I say come on.

Susie Singer Carter: 42:46

But I I you know, I finally got to that point, like the week before she died. I was like, I can't anymore, like I can't. And this is just torture, like my mom is being tortured. And you just want to, and there's nothing you can do. And, you know, as I started to learn the the structure of the business of nursing homes and long term care, I realized they're just making money off of her. They're warehousing her. Yeah.

Unknown: 43:15

Yeah. That's, I mean, that's a big area of ethics is a very challenging, challenging area. And there are a lot of hard questions that need to be asked in that area. And Susie, I think there are many, many families that go through probably similar experiences that you have, but I want to keep my loved one alive. But is it? Is it really the quality of life that they actually wanted? Because it's really what they would want if they were here looking down on themselves. We get through a lot of that. So it's a service I work in we we are guardians, for a number of people who don't have family members to where their court appointed guardians and we make all their legal, social medical decisions. And it's paramount for us that we treat everybody with such humanity and really balance out where where do we draw the line of enhancing their quality of life? And then how do we also educate other people that we work with on areas like end of life and CPR? CPR is not like the movies. It's not you don't get pulled out of a river and you give CPR and like the coffin splutter, and everything's good and fine CPR and an 80 year old person who is had dementia or has osteoporosis or has like diabete, any number of clinical issues. That's not what's going to happen. The chances of it actually being successful is so minimal. The chances of them leaving for a short while and having chronic brain damage are actually really high. their lungs being completely shattered, and puncturing their lungs through the process are really high. These these questions of quality of life and ethics are really big. I The the team we've developed we have a very specialized guardianship program is a constant conversation around how do we promote what we know is important to that individual. We also have no playing the game except for to do the right thing. Our service doesn't we don't have any, any profits to make. So it's different. Add an element with his profits to make. Especially if you're just leaving someone there.

Susie Singer Carter: 45:26

So as guardian, which is really interesting that you, you know, you guys become these professional guardians for people. So you bait in essence, you know, go up against the same issues that we are. Yep. And and so, you know, like you said, you have to make decisions like, but you it feels like you should have an edge because they should have some more respect and fear of you as as someone who works in a job. Yeah, thing you would think, you know, like, if you walked in and saw that you're one of your, you know, people were in a hot room on their side, no music, no, nothing, you know, not at all. I mean, what will you do? What, what I mean, how would you handle that? Because you're up against this huge machine. And even though you're fierce and awesome, and your team is fierce and awesome. You handle it?

Unknown: 46:21

Yeah, I feel like we're probably pretty annoying to people. Because I do I work full acknowledgement to my team, because I work with the most exceptional people like exceptional people, and especially the guardianship caseworkers that manage our guardianship clients and all the aspects of their life. They're incredible. There is no topic we weren't getting to at all, we will we will challenge and we will speak to any staff member at any time and repeatedly. And we will go over and over and over and over their rights, our expectation, the case plan, if the long term care ombudsman needs to get involved, if we need to. We'll investigate them for actually caretaking neglect of our guardian. You they're clearly not actually doing it. Like that's an element. That's a process that we could go down. But my staff are professional, they are educated, they are intelligent, and they themselves are. I want to say they brave. They have they know that our clients come first. And they will push an advocate for them with every breath that they have of every minute that they are within a nursing home and outside. And we have we have nursing homes, who will a month later say oh yeah, no, we change their medications and prescribe them this anti psychotic, like, you legally have zero rights to do that. And then we have to go through this whole conversation again. So yes, you would think that we have or that they may listen to us. But I guess that holds to the actual point. If we have that as the state entity that investigates abuse and neglect if we still have to deal with that, how big of an issue are we dealing with? Yeah,

Susie Singer Carter: 48:13

that's what I mean. I mean, it's like, here, that's what I'm saying, here. Here's this fierce team that you have you've you've aggregated this team and you're so amazing, like seriously folks is is like such an unicorn of a woman I just I can't I just have so much respect for you. And and you are so up against it, and I know it and that's you know, to me that's set really does paint the picture so clearly because a we have to be and not everyone can do this not everyone, people have to support their own their families, their children, their so how much time can you balance advocating I just happen to be, you know, have grown children so I could take some time off and I decided, you know, I'm gonna I have to be there because I wasn't that girl wasn't that helicopter daughter until I had to be. And so I tried to be and also, you know what, I've said this before I have the disease to please and I was always like, catch you. So sorry to bother you test it out. And then finally, by the end, you're freaking Shirley MacLaine, and you're screaming like, come on, she's hot. What's going on? She's thirsty and hungry. I hate you, all of you.

Unknown: 49:27

Families are in the most impossible situation. They aren't because people are dealing like it's if you have little children, you're trying to balance them children, a house, a mortgage, you're working yourself and you've got a parent or a loved one in a facility. This strip the strength and the energy that you have raven like or even the understanding, and that's a big part about what we find really important is about educating people to know your rights. No, you are allowed to say what the hell you are allowed to say no, you're not prescribing that like you can't push back because you have the right to do that. up. And I will also acknowledge a that it's scary for families because I know in Colorado and I'm guessing it's the same across other parts of the country, we have a really big chronic cert availability of a nursing home beds. That's right. So push too hard. And all of a sudden, they're not appropriate for our level of care. We think they should be somewhere else if you like. But there isn't anywhere else and Medicaid. If you're private, you can kind of get a bed where you want all the time. Yep, take your money to your home, you can take care if you want to. You can't do that. That's true. That's absolutely cruel to do that to family to so not fair for professionals to say something like that.

Don Priess: 50:44

So is there Oh, I was gonna say, oh, go ahead to something because you're just gonna say on the thread, I have an okay. No, I was just gonna say, is there? Or can there be any, you know, Portal, websites, social media saying this place sucks. This place is not good. This is a one star facility, not a five star facility. Here's all the cases. And so when you go to, you know, set up something for your that basically start shaming these places, they're in business, and businesses, you know, there's the Better Business Bureau, do they do anything? No, but you can always go there and say, here's the 50 complaints.

Susie Singer Carter: 51:19

Like, here's the problem with that, like, but just what just what patina just said, there's, there's some most places don't have any, there's a bed shortage. So you're sort of stuck. So you think this place May that may be the only place available and your loved one needs long term care?

Don Priess: 51:37

I understand what I'm talking about, you know, we got to start, but these are businesses, and they do. Yes, yeah. Do Is that something you have? Or?

Unknown: 51:48

Yeah, yeah, there's two ways here. And one of them I know is across, they both actually gonna be across the country in many formats. So there's one they are online to online forums where you can actually rate and then they do actually, they are given a rating of like one to five, I would say, though, I would, I would tell anyone to take those ratings with a grain of salt, because we investigate everything from one to five, and that's

Don Priess: 52:14

talking about something, something coming from your perspective from you here. This is our official Star ratings, you know, because if it came from you, the people who are in charge of kind of overseeing this thing, not from some, I just think there would be some power to that.

Susie Singer Carter: 52:32

But there is some there are some done, there's some there are some transparency, organizations that are starting to do that. And, and even identifying who the owners are, you know, the true owners, there was the there was a regulation from CMS, or they're still there, I think they're in the middle of it trying to enforce that or to to create a regulation. But at the end of the day, it is what you know, this is what we have. That's all we have, we have one apple, that's it.

Unknown: 53:01

And now the Department of Health here will publicly release investigations and concerns into facilities. What I would say to that is a some of the difficulties or challenges they have is that by the time they've released it, it's can often be a considerable time after the fact. And the majority families don't even know that they can go there and access it.

Don Priess: 53:22

Well, that's the thing. It's where it needs to be that that's part of the education is it's part of educating the public and saying there are these, you know, these these facilities are these things that you can go and see where you're going. Where's your where's your loved one going? So I don't know. I mean, I know everything you can always say, hey, well, we'll try it. We can't do that. We can't but I think it's got to be a multi 1000 prong attack on change. And you know,

Susie Singer Carter: 53:51

because it has to come at the top because that's that's where

Don Priess: 53:55

the top Yeah, yeah, no, yeah, let's say write your congressman writer that but that that's fine. But what are your what's your congressman doing?

Susie Singer Carter: 54:04

Because the nursing home lobby are, you know, holding hands with

Unknown: 54:09

this pretty powerful, which I think that would be surprising to a lot of people as to know actually how powerful the lobbyists are in that area. Like it shocked me when I started to learn like they even have lobbyists.

Don Priess: 54:23

Well, corporations it's a big corporations so

Susie Singer Carter: 54:27

yeah, my my partner who is a federal prosecutor for years and years, he reckons that they're, they're more powerful than the pharmaceutical lobbyists. So they're and they're not they're not on the radar because nobody would think it.

Unknown: 54:41

Nobody would notice because you would ever connect a nursing home to a lobbyists right now, whatever the nursing home politics like, yeah, at all, but they're there because there's a lot of money to be made. Yeah, you know, research again also shows that and this is like very, very different kinds. trees is that mortality is actually increased. If you enter a not for profit nursing home, you are more likely to have healthier and better care and live longer healthier in a not for profit nursing home than if you are actually in a profit for profit nursing home for sure.

Susie Singer Carter: 55:17

And but the nonprofits

Don Priess: 55:18

doing it for the right reasons.

Susie Singer Carter: 55:21

There's still some issues there. There's still some nonprofits that are you know, there's, there's a way of structuring

Don Priess: 55:27

or in quotes. I do Oh, I'm sorry, I did air quotes.

Susie Singer Carter: 55:34

That's it. Okay.

Don Priess: 55:38

I, I get one an episode.

Susie Singer Carter: 55:43

So, let me see if I have any more notes on my free people. Receipt.

Unknown: 55:48

Very sophisticated. Yeah, yes,

Don Priess: 55:50

we are professional.

Susie Singer Carter: 55:53

Yeah, no, I was taught now I think like, what, because I was really listening to our conversation before our pre interview, and I was listening to your interview on all home care matters. And, you know, and it just, it just, I feel like the conversation is, it's on a, it's on a, on a merry go round. We're just, you know, we're going that did it. You know, it's, it's, it's very depressing to me, and and I just, I love that you're so honest and open to say what you're doing and what you're doing, I think, being the thorn in the nose and the noisy, then, you know, making making good wiki, you're making good trouble. I think we all as much as we can need to make as as big a trouble as we can until the system changes, you know, from from the top down, until we can just break it down, blow it up and start all over again. So it's so

Unknown: 56:52

important, its efficacy, it's just pure efficacy, it's so important, like, this is us in years to come. If we're privileged enough to live, it's all of us like, it's not the others. It's not somebody else, this is potentially any one of us. Why would we want that for us? And why would we want it for our moms and dads and our sisters and our grandparents? We just don't want that. So why are we funding it through our taxpayers? Like a does, it needs to be dismantled? We need to go from this merry go round to a Gravitron. And then something that's going to actually like shoot it off. Right? It's really like set it up again.

Susie Singer Carter: 57:28

Right? Yeah. So in the meantime, until that happens, which I hope that this documentary will at least you know, cause enough noise that for people to actually take a look and go, Okay, we need to we need power, power to the people and get out there and make you know, we have the power, we just have to get people to that's where the education becomes really important. And if if we have to scare people, then we have to scare people. I'm sorry, but that's the way it is what it is. I didn't do it. I'm not making this up. And I'm not. I'm not trying to be inflammatory or you know, what's up Catholic? Or you're a conspiracy theorist. That's not me. Verschuren that's not me. You know,

Don Priess: 58:13

this isn't what you want to be doing right now. What you want to be doing

Susie Singer Carter: 58:17

now, you don't want to be doing this patina, you want to be able to go in and fine. It's like for the few bad actors. Like that's what I think people look at. Right, right. Yeah, there you go. Okay, you're out, you're gonna get you're penalized. This is what's happening to you. And then it up. But that's not it. So you guys are like pushing, pushing the rock up the hill to and so in everybody's getting, you know, if they eventually you get burned out, because you know, and I've talked to so many caregivers who have gone through what I've gone through, and when their loved one passes away, they're done.

Unknown: 58:53

Yeah, yeah. Oh, the the toll not just emotionally, but physically on care providers is enormous. And the other thing I would say is, you know, often obviously, we can butt heads a little bit with nursing home. But we also, we were all on the same page in the same patients being let's just do the right thing for the actual resident, we actually could help them. Because why would they want the liability of having someone that's abusing as an employee, like we actually can identify, have them put on a registry and save their entire business, from actually having these people employed? Like, if we were working together for the common goal, we could actually be changing the system as it is. And you know, sometimes our staff on the ground level who do want to do that, and I have to say, we have had staff members on the ground level, who have privately said stuff to us about their management company that their management company would just fire them on the spot if they knew they had disclosed off to my staff. Absolutely fire them on the spot, because their belief is about actually The residents, for sure, and they do care, but, but they don't have the power. So somebody has to like come together to actually formulate this power and then make it happen. Wait, you know, another thing that I actually think is really important, and this is going to be very unpopular. That is, I think nursing home, they need to look at fingerprinting for their background checks at the moment. Many states only require name checks. Name checks. Yeah, I mean, you're carrying for the most vulnerable population, my argument would be that, you know, we really do need to look at fingerprinting checks so that it's federal, across the whole country, so people can't commit serious crimes in one state and go to another with an apparent clean slate, like that's a really important element of protection and safety. There are so many other health professional industries that require but fingerprint checking checks,

Susie Singer Carter: 1:00:53

look at them loved good nurse that which is based on a true story. And that nurse that guy that was killing people putting whatever you put into the, into their IV, I mean, he went from facility to facility, and he would end because, you know, when we when there becomes a shortage, and people are they're desperate these places to to hire. And so like you said, they're the background checks are minimal, or, you know, they, um, they're cursory, cursory and so and I, I told you this last time, we talked that when I've interviewed many, many nurses that are have been disruptors and have you know, lost their job, because they've gone to the top and said, No, this is happening, and I can't be a party to it. And then they get fired. And then I said, Well, how do you get hired again? And they said, because nobody checks?

Unknown: 1:01:47

Frightening? isn't that scary?

Susie Singer Carter: 1:01:49

So see, I'm sorry, but that is scary. And I'm scared. So people, we need to be scared. We need to be scared.

Don Priess: 1:01:58

Is there? I mean, I know that the pushback the privacy issues, the cost, the you know, the rights of the, as there ever been talk of putting cameras in these rooms? And so you can see what the heck is going on in their sounds? You know, and and if, and if they do, I can't imagine it, I got to imagine it's going to cut down some of the issues, especially abuse, neglect is hard to show on camera. And I know neglect is abused, but there's still a different as opposed to actual, you know, but is there what is what is where's the state of that

Unknown: 1:02:33

the actual official state of the new government say would never be able to enact that. But there are some there are different stories of like actual family members, like inserting some of them have been hidden, some a bit more overt, mostly have been hidden. And they're the ones that are because for a reason, they're suspecting something. And, and unfortunately, they've actually been proven right with their suspicions many a time. And that's such as here. We have plenty of cases, sadly enough in Australia to where our Aged Care System has just undergone an enormous government inquiry because of the abuse and neglect and the poor standards there as well. So it's not even just the United States. It's unfortunately, something that needs to be tackled at a higher level. But yeah, cameras, cameras does hit the issue of like safety, privacy. All those areas. Yeah. Who

Don Priess: 1:03:21

we who we tried to protect who was trying to protect?

Susie Singer Carter: 1:03:25

Well, yeah, obviously, if a facility says they they're not allowed, but it's also statewide.

Don Priess: 1:03:29

What do you wanted to take? Yeah, you wanted to take a picture of your mother's bed sore, that's your mother, they would not allow it. They said, No, you can't do that, that tell you that you cannot do that against policy and you can't do it. It's like, really?

Susie Singer Carter: 1:03:44

Yeah. But what happens is that you get to a point where you, you, you know, they your bar gets lower because you're up against, it's like Stockholm Syndrome, because it's like, Okay, I gotta choose my battles. So it's like, Fine, I won't take a picture because they're gonna cause a big problem that's even more distracting from taking care of my

Don Priess: 1:04:05

mom and threatened to kick your mom out. Yeah, yeah. Or just

Susie Singer Carter: 1:04:09

don't care about her. And just you know, so the retaliation kind of, you know, fear that we have as Carol

Don Priess: 1:04:15

even when you were when they came into Turner, they'd say, Okay, you got to leave. Really, you have to leave your the conservative of your of her person. You are her daughter, and you have to leave because they didn't want me to see unless they needed you to help them because they were understaffed. Yeah. Yeah, so

Susie Singer Carter: 1:04:37

Well, what else is there anything that you what I have to emphasize love conquers all as you guys

Don Priess: 1:04:56

well, you obviously you must love what you do because you do Do this get her

Susie Singer Carter: 1:05:01

she's amazing. Look at her. I mean, we all of us that are doing this, we have to keep fighting. Because we can at least if we help a little tiny bit, and get noisy and big and make, you know, it's like when a bear comes, what are you supposed to do? You're not supposed to run away and you're not supposed to lay down, you're supposed to get big. Right? I was just telling Dawn and then you're supposed to, you know, growl really loud. And then that you are that's what they tell you.

Don Priess: 1:05:28

So depends on the bear. But that's no, no,

Susie Singer Carter: 1:05:31

it's true. I say get big and loud. get as big as you can, and as loud as you can, until we can fix this freaking system. Do you agree? Yeah,

Unknown: 1:05:42

I do. I, I 100% believe that, when people come together, they actually can affect change. They do. Sometimes it takes a really long time. But if you're committed and you stick to it, you can I mean, State of Colorado has done some incredible things with legislation and practice within in my particular area, which has just been really impressive. And it's motivational and and I think that we can be doing on a much bigger scale, we can do it nationally here. And you know, what, if nationally, here we are together, and we are showing what can be accomplished. Imagine how beneficial that is for other countries who can actually see if the United States accomplish this, then we can too, we can actually affect change for our residents and our nursing homes as well. So there's a lot at stake and I do I just believe that together, we're so much stronger, and we actually can make a change,

Susie Singer Carter: 1:06:30

I agree to and I think, you know, you only you can look at it in the opposite way. And we are we are role models for the world. You know, America is very, very powerful that way. And, look, what our western individualism has done is it's permeated all so many countries that didn't have that, that were really, you know, much more communal. And, and, and it's it, you know, I hear from people in, in Egypt, and then in Asia, you know, and where they used to revere their, their elders, and it's permeated, it's become, you know, that that has become the that that is the paradigm. And also, you know, even in, like you were saying in England, where you think, and also Australia, I mean, it's there. It's this individualism that's permeated everywhere.

Don Priess: 1:07:22

Yeah, we can do round, right, so we can

Susie Singer Carter: 1:07:24

do it negatively MIT, let's do it positively, positively. Yeah. And if it if it's capitalism, that is the motivation, then let's figure out a way to make that, you know, work in that direction, but in a good way. I don't you know,

Unknown: 1:07:37

yeah, yeah, exactly. You know, it's not about like, even the can be money made. But where, where are our priorities, like, as human beings as a society? Yeah, we should be we should be doing better. And also

Don Priess: 1:07:55

one thing and evidence that this is such a huge problem, it's overwhelming. How can we, if you were to save one person's life today? I think you'd go home feeling pretty good. Oh, yeah, I see. Good. So if we sit, you know what I mean, it's got to start somewhere. Yes. And we can't fix it all at once. But we can start making a difference now. And it's it's one, and if it's saving one person a day, or making one person's life better a day, so be it and then go from there. But let's not look at it this fatalistically. Let's look at you know, yeah, that's how you have to wake up in the morning.

Unknown: 1:08:27

Absolutely. And these are the benefits of people like Don and Susie and Lance because all home care matters. And other people who are doing podcasts is providing this platform to all of the communities and societies for people to tune into and go, Ah, I do have those rights, or I didn't know that before. And I didn't know there was the benefit of this other danger that they held all of these platforms that you have developed for everybody around the country to dig into. I mean, this is part of that movement is helping educate and support everybody out there. I just saw the statistic was actually now at 6.7 million people with dementia, or might have actually just been specifically Alzheimer's across the country. So we we know we're on a trajectory of growing and your platforms, some of the strength base foundations to help people be motivated and be like, I need to say more. I'm not going to accept this. I'm not going to tolerate it.

Susie Singer Carter: 1:09:21

Thank you. Thank you for that. Thank you. And I think that you know, it is it is about love. Because that's I wouldn't be doing this if I didn't love and care. I wouldn't be putting myself out there like this, you know, I would be talking about oh, here's tips on what to do for an activity in the afternoon with your loved one. And there's plenty and that's worthwhile. But yes, but I saw things that I can't unsee going

Unknown: 1:09:47

on. See? Yeah, yeah, that's a different place. And those those those guidance and tips are really great for different people at different points and stages of where they are because you know some people If if there's any sort of like light, who who do experience pleasant confusion, that would be like the ultimate if you're going to if you're going to experience dementia and pleasant confusion is like your single symptom or not your single but your single primary symptom, as compared to the spectrum that we have, there's a really big spectrum of how dementia can affect people. So you can have pleasant confusion, or you can have really out near Big outbursts, like significant psychological symptoms of dementia, that, you know, you might be lashing out at people and have lots of very intense delusions and hallucinations. And so, they're, those tips are really good for when you can have someone at home. But we know that everyone's experience is different from the person with dementia to the person providing care and all their surrounding families. And what you where you're at, is, you're at this end of the spectrum, you've seen the worst of the worse. And now, your goal and where you're places in this world is to be helping everyone else who has seen but you can't unsee as well, because there are more of you out there. And they need support as much

Susie Singer Carter: 1:11:08

do they do and I and I, I think it's an honor in a way to do this. So, you know, and I and I didn't, didn't sign up for it. It's like I always say that Leeza Gibbons, who's like one of my good friend, and she's been in this in this field for a long time. She always she always says, you know, nobody grows up saying I want to grow up and be a caregiver. It's not. It's not sexy. It's not glamorous, and there are no caregiver Barbies, you know, and so there should be yeah should be so I'm promoting for caregiver Barbie. And and so so be it. Let's just be loud, you guys. Anything else you wanted to say before we say I do.

Unknown: 1:11:59

I thank you for having me on your platform. And thank you for everything you're doing to like support everyone out there. It's it's so invaluable. And I very much appreciate both the effort and time you both put into this vac actually

Don Priess: 1:12:12

appreciate you completely and I'm sure a lot of people out there appreciate what you're doing. So keep it going.

Susie Singer Carter: 1:12:18

Thank you. Thank you to be continued.

Unknown: 1:12:22

Absolutely.

Susie Singer Carter: 1:12:23

Take care. Bettina Morrow is good, good, good people. Good good people. I really because

Don Priess: 1:12:30

only a good person would do what she's doing, obviously. Yeah, but she's just such a spirit too. She's just got this energy and positivity and considering what she's doing to have that yeah, is amazing. Still, you know, not be run down by it, you know? Yeah. Fabulous.

Susie Singer Carter: 1:12:49

I hope everybody got a lot out of that. And we didn't mean to be so negative, but we're not being negative because it's really leading towards change. So we're just trying to, you know, be transparent of what we see. You know, and I think that she really, I think Bettina really gave a good side to it, you know, being being a professional, a professional advocate and, and what she's up against and her team. So that that really, that really paints a picture for us as caregivers, what we are up against because we don't know and they they know all the ins and outs and it's still so hard and it's still they have to go and keep advocating keep advocating so the point is until it changes keep advocating get big. Get big like a bear. Get Fisher voice.

Don Priess: 1:13:43

Raul growl Krakow can't really.

Susie Singer Carter: 1:13:47

Yeah, and Yeah, cuz that's, it's it's really at the end of the day about

Don Priess: 1:13:53

love between obviously loves what she does she you know, you can't do that without loving it. So it's all love, love, love. Yeah. So and that ends. Why we? Because that's right. And that's because love is powerful. Love is contagious. And love conquers all. We thank everyone including you out there who who listened or watched today. Please always share like, do all those good things. And please do look into supporting our upcoming documentary No Country for Old people. We need your help. And we need it in a big way. And we have to say it's it's money at this point.

Susie Singer Carter: 1:14:30

Yeah, it's for all of us and, and if you can't again, I just encourage you to share it, share and and and find if you've known any like minded philanthropist. That's awesome. And until then, we'll talk to you. We'll see you next time.

Don Priess: 1:14:46

Take care bye bye

Susie Singer Carter: 1:14:56

hey, this is Susie singer Carter and I just wanted to take a minute to talk to you About bedsores, I know but if you're like I was you probably don't have a clue what a bed so really is. Most people don't. I mean, no one told me and I really just assumed it was part of the body that was like the name says sore from lain in one position too long and then if you change the position, all better. Wrong. bedsore is really a euphemism for more appropriate names such as pressure wound, and to keep it as ulcer. Unfortunately, I discovered what a bedsore really was. When my mom was admitted into the hospital last year with a stage four ulcer, that is the worst level, you don't ever want that to happen. bed sores can develop quickly and worsen rapidly and can lead to serious health issues, even death if they're not properly treated, or properly treated. And that includes cleaning and dressing the wound, but most importantly, reducing pressure off the sore by frequently changing the position of the person off of their wounds so it can heal and that can mean propping the person up 30 degrees to the side, far enough to be off the lower back, but not too far as to be on the side hip where there isn't much cushion right between the skin and the bone. This is why I'm so excited to tell you about that sir rescue, which was designed by an amazing woman when jewel a nurse who is tired of fooling around with simple pillows and bulky wedges that just don't work. The beds are rescue positioning wedge cushions are uniquely designed to provide ergonomically correct and comfortable support for a sustained period of time without touching the sore and the curvatures and bilateral angles make it possible for the bedside cushion to be used to support many other body parts as well. You can flip the heels you can put it under the head, you can put it under the arms behind the knees, both sides. You can even use it as a breakfast in bed table the curvatures of the bed sir rescue fit the curvatures of your person's body and it's made to meet all the patients safeties, and bed bound positioning standards for acute and long term care facilities. I wish I had it for my mom, I really do. So chances are if you have a loved one in long term care facility, or at your home, you may become a pressure injury soldier too. But bed sores should never never get to stage four. And one way to ensure that they don't is to make sure that as soon as one begins to develop, you keep the pressure off. You can do that easily with beds so a rescue and you can find bedsore, rescue and many other pressures solutions online at jewel nursing solutions home of the patented bedsore rescue positioning which cushions pads and pillows that's Jul, je w e l l nursing solutions.com. And when you use the special code and C F O P the entire amount of your purchase will go to support our important documentary No Country for Old people, which chronicles my mother's journey navigating the nursing home long term care crisis that literally began with an unreported untreated pressure wound. So take the pressure off yourself and your loved one with the bedsore rescue