Tiffany (00:03.288)
Today, we're joined by Carol Chang, occupational therapist and founder of Evolving Homes. Carol specializes in helping older adults age safely and confidently at home while protecting the health and wellbeing of those who care for them. She's also the author of a book on the biomechanics of caregiving, a guide that's transforming how caregivers prevent injuries, reduce falls and build independence. We'll explore how small shifts in technique, communication and lifestyle mentoring

can make a world of difference for both caregivers and the clients they support. Carol, welcome to the podcast.

Carol (00:39.37)
Thank you. Excited to be here.

Tiffany (00:42.456)
Carol, you've had such a fascinating career blending occupational therapy, home modification, and aging in place design. Can you share a little bit of your background with us as well as share what led you to focus on biomechanics and caregiver health?

Carol (00:58.006)
Yeah, absolutely. So I've been an occupational therapist for 27 years. So most of that time being in home health. And that means that I spent a lot of my time teaching caregivers, home health aides, how to move that patient safely and how to cue them in a way that keeps their back safe. And I think people think that's a bit strange that I spend 50 % of my time with a patient, 50 % of my time with the caregiver. But my rationale is that if a caregiver or aid hurts themselves, who's taking care of the patient?

So I feel like it's really important to look at that big picture, teach injury prevention right from the start, because if somebody hurts their back, it's not just the patient that suffers. That caregiver has a life outside of work and injured backs lead to lifelong consequences, pain, disability that affects the whole person, their families. So I just think that's a really vital step towards protecting that most valuable asset in our global aging crisis, right, our caregivers. So.

Let's protect them given the tools that they need, understand how they can make sure that they are staying safe throughout their entire work span.

Tiffany (02:00.45)
Yeah, I mean, it's so important whether you are a professional caregiver or a family caregiver. You know, there's that old saying, you can't pour from an empty cup. And a lot of times we think about that in an emotional capacity, but it's also physical. If we are not really, really smart with how we're moving our body, it can really put us into a position where we're not able to. And so it's really, really important that we are

Carol (02:11.244)
Now.

Tiffany (02:27.8)
doing things the right way and making sure that we learn what is the right way. So how do you support caregivers and clients with that process?

Carol (02:38.284)
Well, I think what I like to do is I'm going into their space. So I'm not here to tell people, okay, you're doing this wrong. This is not right. I'm looking at that space going, okay, show me what you're doing and let me see if I have some suggestions on how you can do this a little bit better. And I think in a lot of cases, the primary thing, the biggest mistake that I see is people jumping into early. So I think it really stems from our beliefs or love language of if I do it for you,

means I love you. I'm doing it. This is how I show that I care, that I cook everything for you and I bring it to you and I put on your pants and your shirt by yourself. But, you know, it's a little bit like thinking that I give you the fish instead of I teach you how to fish. So I try to teach people like, just stop, don't, don't do that. Just wait, let them try. Let them, if they need a little bit of help, give, you know, give, you know, verbal cues first.

Tiffany (03:11.555)
Exactly.

Carol (03:37.522)
then tactile cues, and then help them. So I'm training them essentially to be mini occupational therapists in that time frame of training, just making sure that they have the right mindsets in there. And what I'd like to say is stop stealing their therapy, because if you do it for them, then that's one more exercise they're gonna have to do that's really boring. But the job of living, of putting on your clothes, getting dressed, getting out of bed,

These are all way better sources of exercise because they're functional.

Tiffany (04:10.306)
Yeah, and I think you're right. We always are thinking, I love this person so much or I care about this client so much. I want their day to be great. And if I see you struggling at all, I just want to jump in and I want to make your day better. But we do have to remember that the more our clients can do and our loved ones can do on their own, it's just going to help them more in the long run. Keep that bit of independence. The more they can do on their own, that's their independence that they have.

Carol (04:36.8)
Yeah.

Carol (04:40.8)
And it gives them confidence, right? That I can do this myself because, know, and it sounds terrible because we do things for them because we love them, but it also stops them from thinking, ooh, wait, I can't do it myself. I haven't had any practice doing it myself. I don't know that I could do it myself. So you're eroding their confidence and almost infantilizing them by doing it for them. So I really look at it like, let them try.

Tiffany (04:42.658)
Right?

Tiffany (04:57.228)
Right.

Carol (05:10.432)
Let them see if they can do it. And the wonderful, beautiful thing about in-home care is you have time. Because the difference in a skilled nursing facility is that one aide has eight or nine patients. They need all dressed, ready to go for breakfast by 8.30. But when you're at home, you have this beautiful rhythm that is based on the care, based on what that person wants. So maybe they want 10 extra minutes of sleep. Don't worry, no big deal. I come back and...

Tiffany (05:24.867)
right.

Carol (05:38.856)
And because of that extra time, you can also sit down next to them and just chat while they're putting on their shirt, while they're putting on their pants. And you're there in case there is something that they need a little extra help with that would promote frustration if it kept going. Or just a little bit of training, encouragement. hey, why don't you try crossing your legs to put on your pants instead?

Why don't you try doing this over here? So people feel supported, they feel empowered because they can do it themselves. And then they have exercise. It's just this big, wonderful package together.

Tiffany (06:17.112)
What are some of those key biomechanical principles that every caregiver should know?

Carol (06:24.14)
Well, I think those are two different things. One, which is that we want to look to see what is the easiest way for the patient to be able to biomechanically move themselves. And then what is the way that the caregiver can facilitate those things. So I'll start with just the patient first. So one of the most common things that I see is people trying to get up from a chair when their butt is sitting all the way back. And I don't know if you've ever tried this by yourself.

It's almost impossible. When I do it myself, I look like a pregnant woman trying to like boost myself up and I'm trying to clear this entire seat space. It's just impossible. So biomechanically, we need to scoot our bodies all the way to the edge of the chair as much as you can without falling. You need to bring your knees back so that you are shifting your weight forward so that you can unweight your bottom. Because if all your weight is on your bottom,

Tiffany (06:53.006)
Mhm.

Carol (07:21.44)
You're not going to be able to stand up. So my cue is I want to see nose over toes and then stick your bottom in the air. So nose over toes, bringing their weight forward. And then they stick their bottom in the air, which helps to straighten out their knees. If they have lower, if they don't have as much quad strength and then they can pull their upper body up and use sometimes if they're using a walker, they can put their hands on a walker and use that resistance to be able to push back on it. So

I would say that's the most common one I see with sitting because people feel confused. Like, why can't I get up? I used to be able to get up. And I just say, well, we are so automatic. We don't break down those steps individually. now once I break it down for them and help them understand the whys behind it, why you can't get up if all your weight is back, then it makes sense for them and they can do it. From a caregiver perspective, the most common

problem that I see is people extending a hand and hauling people up. So that might look like, I see that at a restaurant all the time where people are trying to pull them up instead of, you know, just queuing them up. So one of the biggest things I teach is key points of control. so as a clinician, even in OT school, you learn that your shoulders, hips, and knees, these are all areas that require

This is how you direct people to move left, right, up, down. And one of the really fun exercises that I teach people to do, like home health aides, if I'm training them to, you know, a new home health aide to get into that space, I'll say, look, I want you to close your eyes, lay on the floor, and I'm gonna show you how I want you to decipher where I want you to go just based on the light touches from my hands.

So I can get somebody from in a laying down position. I can teach them to roll left and right just by pushing on their hips and they automatically realize that. So when you feel it, then you realize, oh, that's what I need to do to teach my patient to scoot to the front, pull their, give them like a little bit of forward motion at the hips. And if I want them to move left or right, then I need to push them on that side or this side. So sit to stand, for example. So if we want to come,

Carol (09:37.782)
kind of glue this together. So the patient now knows that they need to scoot to the front. The caregiver knows that if I want you to teach you to scoot to the front, I'm going to sit in front of you and I'm going to have both hands on both your hips and I'm going to pull one, then pull the other, pull one, pull the other to get to the front, Weight shifting. And then to stand up, I'm going to stand perpendicular to you. So I want to stand so that your body is at my chest level. My one hand is on your bottom, one hand is on your chest.

And now I'm just pushing gently, which means that I can get you, you know what I want you to do, which is tucking your bottom, bring your chest up. And so it's these little things that are even nonverbal. People don't even need to understand. They can feel it. And there's this automatic part in them that automatically that understands. And it's really, really beneficial for patients with dementia who maybe verbally they wouldn't understand what you're saying, but touching tactically, they get it. They get it.

Tiffany (10:31.99)
Right?

Tiffany (10:36.182)
And I imagine that there is a process that happens where we want the caregiver utilizing some of these small tools that can have such a big effect. But we also want the family doing that as well. I mean, I was thinking when you were talking about the restaurant, you always see those people just pulling people up. And so how do we also share that information with not just the caregiver, but maybe even those that are visiting once a week, once a month? How are we trying to share some of that?

Carol (10:51.393)
Yeah.

Tiffany (11:05.496)
so that we're all kind of on the same page.

Carol (11:08.266)
Yeah. So I think that when people understand why, then they understand better. So that's the family caregiving education that I give. And what I tell people is when you pull, you're out of control, right? So we just naturally will do an equal and opposite reaction. If you give me your hand, I will pull and you don't want to be thrown forward out of your chair, but you're also not sure how much you're going to pull. then people...

really are guessing at that. And I've seen people overshoot or if they undershoot, then they're frustrated. Why can't I get up? The momentum is weird. So in a restaurant, for example, I almost always just direct, I'll tell people, look, just direct them, use your voice. Like think about how you do it. So when people understand, they stop and think for a second, how do they normally do it? And then try to translate that to,

the person, that's really, I think that that's really beneficial for them understanding the whys. So, and one of the other things I think from the caregiver perspective is that they, they forget that if you don't have quad strength, you need armrests to push up from. So don't sit in a tiny little bistro chair that has a little round circle with, know, flimsy left and right things. Look around and choose a nice sturdy chair that has armrests that you can

Tiffany (12:21.645)
Right.

Carol (12:28.906)
you know, direct somebody to push up from and you can help them if they need a little bit of extra, extra push, but don't, don't pull them. And one of the little hacks that I like, I love, quick hacks is I had a client where he was so debilitated from being in the hospital for such a long time, that he just, he couldn't get sit to stand, but he was a businessman and he was used to going to nice restaurants and networking and he missed that with his wife. And so,

at home we were practicing using a sheet. So a sheet underneath them, tied up really tight next to an in a knot right in front of him. And then, you know, I would give him that pull. So I'm pulling only to cue him to tuck his butt in. I'm not pulling to do all the work. That's the really big difference in this, that it has to be a partnership that the person, the client needs to know that they're expected.

to use muscles to get up there. Because I don't, me as a caregiver don't want to hurt my back, but also you need the exercise. So I would teach him to pull up and then sit down. He could do that. But his wife said, well, I want to bring a big, giant queen size sheet to the restaurant. And I said, okay. So this is why I'm an occupational therapist. Like I can figure this out. So what we did was we cut a public shopping bag, just a regular cloth shopping bag, cut it down the sides.

And what happened was, that now you ended up with a long skinny piece with like little loops on it. And so, and it was black. it blended right in with his wheelchair cushion and we laid it on the wheelchair cushion and she just was able to grab the two loops, get them really nice and close and primarily, you know, him using his muscles, her using her arm, her hand at his bottom to tuck in that bottom and then give them a little pull with the shopping bag. So it's not like, I'm not advocating for transfer belt use.

I'm trying to say use all of those different components of everybody's got a job in there. He has to use muscles. She has to use tactile cueing. Plus you add a little bit of physical and now we can successfully get up and down from a chair in a restaurant in a way that is not drawing attention to that person.

Tiffany (14:36.846)
Exactly. Right. We're trying to keep dignity. We're doing something this client has enjoyed doing all of their life. So I really appreciate the mindset of and we're going to think outside the box. What can we do? How can we make this possible instead of just saying, well, we can't now all we can do is order takeout and we'll have it at home. But let's keep trying to do those things that people love to do.

Carol (15:00.266)
And that's a really good point that I feel like one of the biggest problems of mindset right now is that people think about aging as a list of a loss, loss of things that I can't do. So, my gosh, I'm getting too old for this. I can no longer sit in chairs that are this low. I can no longer blank. And I really want to push back on that because there is absolutely a way to do it, but maybe a compensatory way to do it, like what we were just talking about or.

Tiffany (15:10.797)
Yes.

Carol (15:28.78)
needing to up your exercise because your natural aging process, natural, not pathological, but your natural is to lose half a pound of muscle every single year after 35. So you do the math with that. And by the time you're 60, if you haven't upped your exercises in proportion to that loss, you will lose that. But that also doesn't mean that you can't gain it back. So the more exercise, if you bring that up there, you could sit in a chair down there.

as low as you want. I have Parkinson's patients that get up from the floor because they train for it. They teach themselves to do that because they don't want to be afraid of the floor. Because when you're afraid, you're actually more likely to end up tripping and falling. But my Parkinson's ones, if that's their biggest fear, that's what we're going to work on. How do you get up off the floor so that you don't feel embarrassed if you fall at a restaurant outside or even just that you feel like you can do it if you fell at home alone?

Tiffany (16:05.24)
Raise.

Carol (16:28.362)
that you have confidence that you could take care of it yourself and you don't need help from the outside.

Tiffany (16:34.84)
You talked a little bit about exercise and it just makes me kind of think, how does some of our daily routines really go into, you know, as we're aging, what should we be thinking about? Because, you know, like you said, we're losing muscle mass and if we're not thinking about that, you turn around and you think, my gosh, how did I get where I am now? you know, I'm thinking beyond that, the nutrition, medication adherence, right? Like all of these things, hydration, how does all that play into this?

Carol (17:03.968)
Yeah, it's a huge thing. you know, exercise happens throughout every day what we're doing, but you can't exercise if you don't sleep well, because you don't have energy or you don't feel motivated to do it. And you can't do that if you don't have enough water in your system, because water is something that the hydration is what gives you energy as well. And then nutrition. So when we think about what could we do, it's actually the easy stuff.

And I, and when people say, look, that seems too simple. say, look, just, just, you just have to look at Europe, Europe. If you go to the doctor and you say, I have a problem, they'll say, okay, well go home, eat well, sleep well, and exercise for three days and then come back to me. So if it's still a problem, then we'll talk about it. Right. Okay. So just to, just to validate the idea that this is truly something that helps. is lifestyle medicine, which is what I talk about. So first.

Consistent wake up time. mean, I think that one of the biggest struggles when I worked in home health was people saying, well, look, I couldn't fall asleep last night. I tossing and turning until two in the morning. Don't come because I'm going to try to sleep until 10, 11, 12, whatever. And I push back and I say, listen, you know, even if you were up until two in the morning, you need to start your clock at the same time every time. Why is that important? Because that's your circadian rhythm to be able to sleep the next night. It's making sure that you take your medications on time.

Cause if I sleep until 10 and now I'm four hours behind my morning medication and I'm playing catch up through the rest of the time, it's really easy to miss a dose, lose a dose, you know, and then you don't feel right. You don't feel good. So one consistent wake up time. So your meds are on time. You start your cycle to your daily exercise, making sure that you are moving around, getting lubrication into your joints. Stiffness is normal. Like that is normal. You've been laying in bed for eight hours. Hopefully that

Tiffany (19:00.171)
Right?

Carol (19:01.918)
it's unrealistic to think that you wouldn't need a little bit of stretching or moving around before you're going to feel better. you know, making sure that you're doing that, then it, but exercise is also something that regulates sleep. So, so if you don't burn enough of the energy that you have during the day, you won't be able to fall asleep well at night. People talk about getting much deeper sleep the night, the days when clinicians come to the house and it's right. It's because

We may do exercise and they feel better. Their mood is better. And that's a huge thing. And then that hydration part is, know, older adults struggle so much with hydration to the point where I've had clients who literally said, I drink an eight ounce bottle of water for the whole day. you know, it's incredible because if you don't have enough

Tiffany (19:30.443)
Exactly.

Tiffany (19:49.017)
wow.

Carol (19:54.316)
fluid in your body, your blood pressure drops because your blood volume is down, which leads you to feeling orthostatic, meaning when you stand up that you feel dizzy with potential for falls. And of course you feel lethargic, you know, don't have the energy in there and worse, you're prone to urinary tract infections. And that alone can create weakness, falls, know, altered mental status. So that hydration is super easy. And what I love about all the things we just talked about, they're all free. So

You know, the secrets of aging, they're free. You don't have to pay for crazy expensive things. You need to set an alarm clock, wake up and go out, stretch, do exercise, walk around the block and drink water.

Tiffany (20:24.814)
Right?

Tiffany (20:36.75)
And I think it makes sense, right? maybe when you first wake up and go, gosh, I just don't feel great today, but get around after about an hour, right? You've done some movement, you've maybe had some water, you've eaten something, the day may look different. And so I think that is so smart to say, let's not, okay, sleep in now half the day, let's still get up. Let's move on with the day and we might feel differently.

Carol (21:00.67)
Absolutely, yeah, don't make decisions when you first wake up in the morning.

Tiffany (21:04.418)
So our caregivers are really in a unique position because they are many times spending a lot of time with their clients. And so they're in this unique position to really be able to encourage healthy habits. What does that look like? Them kind of being a mentor to the client. What does that look like in practice?

Carol (21:26.154)
Yeah, it's super important. And I think the reason is because care in-home caregivers become their friends. They develop these trusted relationships. They understand what is underlying motivating them. And because of that, it helps them be accepting to help, to suggestions, even things down to bathing, which is really intimate. They feel safer if that person is there, therefore,

Tiffany (21:33.475)
Yes.

Carol (21:53.834)
they will take direction and then they will be able to accomplish these things well. People who have consistent eyes on the person, they know when there's something, when something is not in the pattern. Like this is not normal. You don't, you seem a little off today, but those little nuances are lost on a new, let's say even a clinician, a new clinician every two or three days. I mean, I would not notice those things, but somebody who spends,

time with them can see those patterns and they understand like this is something we need to catch early. So we want to avoid a hospitalization. Let's get this checked out early so we can address it so it doesn't get to be something bigger. And I think, you know, going back to the exercise part in this, know, exercise we know we have to do, but why don't we do it? It's the motivation part.

And what's wonderful about trusted relationships is you get to know them. You know them well enough to say, listen, I know you don't want to get up right now, but last week when we waited an hour and we, we, you know, took the dog for a walk, then you felt like you could do it. And more importantly, they know the more, more details of what drives them. So, you know, your grandson is coming for Christmas and I know you want to get down on the floor.

Tiffany (23:13.474)
Yes.

Carol (23:13.866)
So if you don't exercise, you're not gonna be able to do that. And you told me that you didn't want to not be able to be with him. So let's do this. This is one thing you can do that takes a step towards your goals. And they know those goals intimately because of that long-term relationships that they've built over time.

Tiffany (23:35.064)
There's really something to be said for consistency of having that same person, because you're right, the person that's coming in every two or three days isn't gonna know necessarily about the grandson that's coming to visit at Christmas. And so that person that's there and they know what motivates you, they also know what doesn't motivate you. It really helps just that consistency, that same person that's coming in, we're learning one another.

Carol (23:47.947)
Yep.

Carol (23:53.749)
Yes.

Carol (24:02.188)
Right. And, you know, I would say too, like with meal prep, that is also another area because we all like different foods. When you have somebody who's coming in every once in a while, like that's over salted, that's under salted, that's this or that. Right. And in-home caregivers can tailor things to improve, you know, eating more vegetables or healthy foods instead of what the option is normally is these microwave dinners that are crazy high in salt, sugar, and fat.

Tiffany (24:19.777)
Exactly.

Carol (24:30.782)
and aren't doing anything to support good exercise, good habits, even better sleep, all of those things. So when you can feed somebody well and you take care of them and you know how they operate, they will listen and they don't feel like it's nagging. And my favorite expression to say is, it's always your choice, but today's choices are tomorrow's consequences. So I'm giving you that decision. I'm not gonna force you to exercise.

But I just want to be here as your friend to remind you that these choices you're making today will have consequences later. And I don't want to see you suffer.

Tiffany (25:08.61)
Your work really reframes what it means to age in place. It's a whole lifestyle approach that touches everything from home modification to lifestyle mentoring. Can you share what inspired your evolving homes model and how caregivers can use that same thinking in everyday care?

Carol (25:27.532)
Yeah, absolutely. So, you know, this started because I started seeing this influx of basically what I call transactional grab bar installation, meaning, you know, you get these ads that say, okay, you need a grab bar. There's $300. We'll put in a grab bar for you. And, you know, we're used to that buy and sell. even patients just assume, oh, I'm falling. Maybe I need a grab bar. And, you know, even to the point where my own mother-in-law called me and said, Hey, I think, I think we need a grab bar in here because your father-in-law fell.

And I was like, wait, whoa, like, let's stop for a second. Let's think through this. And you know, when I started talking to him about it, I realized, I said, he doesn't need grab bars. He needs toilet arms because the problem was, is he couldn't get off the toilet. So, you know, there is a certain amount of problem solving and understanding those pros and cons and what is more suited to a person than just saying like blanket statement, grab bars will stop falling because they won't.

So an OT is a holistic profession. We're looking at not only falling, but we're looking at quality of life and we're looking at how you do everything. Each person is unique. We're multi-dimensional. Not the things that you like, they're probably not the things I like, or they might not be the things that you will accept and I will accept. So I have four cornerstones for my evolving homes model, which is really just a guide thinking. I mean, they're not set in stone or anything. They're really just to

to help people understand, look, there's home modification, which is grab bar installation. Absolutely, if your house is cluttered, you will have more risk of falls than if it's not. And if you have grab bars in there, you have less risk of not lifting your foot high enough to clear the tub. Physical fitness is important too, because as what we've talked about already, also just aging in place takes strength.

If you want to bring in your groceries, if you want to clean the floor, if you want to vacuum, these all take physical strength. So you need to be looking at how am I staying strong enough to manage the tasks that I need to stay at home? And lifestyle medicine we talked about, which for me, the primary goal is stay out of the hospital. Cause you're not aging in place if you're in the hospital, you're in and out in the ER. That's not aging in place. At that moment, people need to be in a higher level of care. That's just not something you could manage at home.

Carol (27:49.376)
And the technology for me is something really important to look at. You don't want to age in place in this island, in your neighborhood. If you live alone and nobody else knows that you fell and you need help, you can't access the help that you need or that you can't access the social engagement that you need, that's not aging in place either. And same thing, I would say, look, you're not getting enough of what you need at home. You need to think about something else. So it's really truly...

like a place to consider to help people recognize this is a big topic and you need to hear the cornerstones I want you to think about. And a big part of this is having that honest conversation between all those aspects of it. You know, like if you're not the kind of person who will exercise, that's okay. We can do grab bars, but exercise, but just remember that exercise is cheap and grab bars are expensive. So I want you to have a choice.

Tiffany (28:43.33)
Right?

Carol (28:45.388)
of where do you want to spend your money? And that money piece is, think, really important. It's chapter two in my book. Because to me, we can have 10,000 ideas and ideas of where we want to age in place. But if you haven't taken the steps decades prior to put aside that money and budget for those things, none of those are realistic. So it's so important to be thinking about this early enough so that you have the money put aside, but have those honest conversations.

with your potential caregivers. Because I'll tell you, a lot of people will assume that their wife is going to be their 24-7 caregiver. And you just have to do a quick Google search about burnout and caregiving to know that nobody can do that 24-7. I mean, even if she's going to take an eight hour shift, she can't do all of it, which is why in-home care is so vital. You need to understand what is it that you're capable of providing.

and how much is it going to cost to fill in those gaps? And recognizing that each person is different. Not everybody's built to be a caregiver, and that's okay. That's not a fault. That is a fact that you need to have a discussion over. That your kids, maybe one of your kids is really patient, the other one is not. So we just have to, you just have to have conversations to understand that part.

Tiffany (30:04.918)
And I think all of us that work in this industry, think one of the things, if I say what's kind of like the number one thing I've even thought about in the last year is these conversations and this plan of what you want aging in place to look like for you has to happen way sooner than you anticipate, way sooner than you're thinking. It can't be once I need help, what are we doing? It really has to be done much sooner than that.

Carol (30:26.284)
you

Carol (30:34.826)
Yes. And my book literally talks about starting aging in place planning when you buy your first house. And people think that's insane. But again, I counter with the idea that when you buy your first house, you almost always have a construction budget because you're getting rid of that avocado toilet and the pink bathroom. So you're going to be ripping down all those things anyway. At that moment is a perfect time for you to stop for a second, do a little research, figure out what is it that I'm going to need when I'm 60 and see if

Tiffany (30:40.876)
Yeah.

Carol (31:04.342)
you know, any of those fixtures or changes could be implemented now while you have the walls down. That would be much less money and then give you the peace of mind to know that if you need it, there's blocking behind the wall. Just throw up those grab bars, nothing to think about. You don't even have to worry about getting a contractor in there trying to guess where the studs are and hope that they don't like make a hole through the wrong part of your glass tile that can't be put back together again.

Tiffany (31:34.282)
That is just such a smart way to look at it. What can we do now that is setting us up for success later on? So how do you help families navigate when there's that emotional decision of whether they can stay at home or whether they need to move to a different level of care? What does that look like?

Carol (31:42.368)
Yeah.

Carol (31:53.388)
Well, think first thing you got to start with heart. You have to understand that we're talking about an adult, so not a child. You're not telling them what to do. You are having a joint conversation. So you want to, as much as possible, use objective measures to take the emotion out of it. think subjectively, people will say, dad, you can't do this. You can't live here by yourself. And that's just, you're inviting somebody to push back.

and say, yes, I can. You're trying to control me. Don't tell me that. So a different way, I'll give you an example. I had one where he lived alone and we had said, same kind of thing. He three daughters that said, look, you can't do this. You're going to have to move up with me and we'll put you like in a community nearby. And I said, okay, wait, there's a middle ground here. We could install sensors and just see. Let's just track for a month and see what happens.

And after that month, we sat down and looked and we're like, you door, like you're going to bed at a funny time and the stove was left on three times this past month. Like I'm worried about you. I love you and I'm worried about you. And are you worried about it? Like invite them to look at that data together instead of saying, accusing them like it's because of your memory. And that's the reason why it's a problem. So

Sticking to objectivity and recognizing this is a sensitive area. This is sensitive because you're talking about control and people don't like being told what to do. So see if you can invite them into a conversation together about it and really talk about it from that perspective of, I'm doing this because I care about you. I don't want to see you hurt or injured or anything to happen to you that I can't be there to help you with.

Tiffany (33:46.254)
Carol, I just want to thank you so much for your time today. As we're coming to a close, I just have one more question, and that is, what is one piece of advice that you would give to any new caregiver?

Carol (34:01.164)
I would say I would want you to prioritize body mechanics and build in breaks and just remembering that you can't help somebody else if you're injured. So it's worth the extra time, worth the extra brain power to learn that new routine. It keeps you healthy. And people laugh because I'll say, look, I want you to do less and encourage more. And they feel like I need to earn my money though. I have to do more. And I'm saying, no, you don't need to. The best thing that you can do

is to be somebody that sits next to them and I'll do this with you, not for you.

Tiffany (34:38.072)
I absolutely agree. How can our listeners, if they want to know more about you, the services you provide, your book, where can they go to find that?

Carol (34:47.2)
Yeah, my website is evolvinghomes.com. My book is available on Amazon, Barnes and Noble, bookshop.org. It's called Age in Place or Find a New Space. And yeah, I do like one-to-one eval home assessments, but really what I want people to do, the reason I wrote that book is to put my brain on paper so that people can start with going through that process themselves. know, look, the book is really written so that

I would start at the front door and I talk about like, what do I see? What am I looking for? And what are some DIY things that you could do that are easy? What are some things that maybe you might want to think about planning ahead for financially or having a professional take care of it? And I literally go room by room going through that and also talking about these bigger things that we've talked about with holistic, looking at it holistically, the money, the caregiving, when to know when to move to another space.

And I have an entire chapter in Parkinson's because Parkinson's is the fastest growing neurodegenerative disease. And that's because of longevity. It's because of other reasons that we don't know yet, but we need to understand what does that look like? How can I support somebody else who might have a diagnosis? Cause if you don't know somebody with Parkinson's right now, you will. And so that way you have the information so that you can be a sympathetic and empathetic ear for them.

Tiffany (35:48.408)
Miss.

Tiffany (36:13.336)
Carol, thank you so much for your time and expertise today.

Carol (36:17.334)
Thank you so much for having me.