Episodios

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

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

    Resources List:

    The Hygge Nurse Hosted by Rachel Zimmer

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

    UCLA Caregiver Education Videos and Resources:

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

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

    https://www.enhancedmoments.com/

    Dementia Matters Podcast:

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

    Brain Spotting Music on Spotify:

    - Bilateral auditory stimulation music for stress relief.

    https://brainspotting.com/

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


    Key Takeaways:

    1. Understanding Caregiver Well-Being:

    - Importance of self-care for caregivers.

    - Strategies to find moments of respite and self-care activities.

    - Differentiating between internal thoughts and external constraints to reduce self-blame.

    2. Navigating the Healthcare System:

    - Challenges caregivers face in the healthcare system.

    - Tips for managing transitions of care, such as moving from home to hospital.

    - Importance of clear communication and finding language-concordant care.

    3. Practical Tips for Caregiving:

    - Handling common dementia-related behaviors like refusal to bathe or take medications.

    - Importance of creating joyful moments despite the challenges.

    - Utilizing mindfulness, journaling, and bilateral stimulation techniques like brain spotting for stress relief.

    4. Research Insights:

    - Overview of a study on the well-being of Black and Latino caregivers.

    - Impact of cultural and language barriers on caregiver experiences.

    - Importance of presence and empathetic listening in caregiving.



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    Transcripts on www.miayangmd.com. Transcripts are automatically generated and may contain minor inaccuracies.
    Email: [email protected]
    Opinions expressed are exclusive of Dr. Mia Yang and not reflective of her or guest speaker's employers or funders.

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

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

    Here are some of the resources mentioned:

    National Council on Aging: has a lot of resources on fall prevention and about evidence-based exercise programshttps://www.ncoa.org/older-adults/health/prevention/falls-preventionhttps://www.ncoa.org/article/evidence-based-falls-prevention-programs - this is where people can go to learn about the different types of programs available nationallyWorkout to Go: Booklet and videos from NIA's Go4Lifehttps://goaging.org/wp-content/uploads/2015/11/workout_to_go.pdfhttps://www.youtube.com/playlist?list=PL4k5szV5a-xDyNmxsceJikRn6EBUzPxmPhttps://www.nia.nih.gov/health/exercise-and-physical-activity/exercise-and-physical-activity-worksheets --> this has some great worksheets to help people get moving Silver Sneaker Online Exercise Classeshttps://www.youtube.com/playlist?list=PLVcN_NI2Mb2-7HN8nS4c2VTYdMHMjcK9hhttps://tools.silversneakers.com/Search/OnlineClassesAARP Videoshttps://www.youtube.com/playlist?list=PLXQ-JEOv9JjGq9MbKmsIl4GlhcRR2mfMchttps://www.aarp.org/health/healthy-living/staying-fit/Local places to look for exercise programs; Senior Centers/Community Centers/Multigenerational Centers, Libraries, Universities, Churches, Parks and Recreational DepartmentsMatters of Balance: https://healthyagingnc.com/workshop/a-matter-of-balance/.



    Takeaways

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

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    Transcripts on www.miayangmd.com. Transcripts are automatically generated and may contain minor inaccuracies.
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    Summary

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


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

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

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

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

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

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

    Takeaways

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


    00:00
    Introduction and Overview

    03:00
    The Importance of Exercise for Healthy Aging

    08:39
    Eating Well: The Mediterranean Diet

    14:27
    Improving Sleep Hygiene and Managing Stress

    22:10
    The Impact of Social Connections on Aging

    25:50
    Promoting Positive Age-Related Beliefs

    30:13
    Conclusion

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    Transcripts on www.miayangmd.com. Transcripts are automatically generated and may contain minor inaccuracies.
    Email: [email protected]
    Opinions expressed are exclusive of Dr. Mia Yang and not reflective of her or guest speaker's employers or funders.

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

    The site to find certified senior advisors is

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


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

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

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

    Contact and learn more about Bill Cohen:

    https://cohencaregivingsupport.com/services

    https://linktr.ee/CohenSupport

    [email protected]

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

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    Transcripts on www.miayangmd.com. Transcripts are automatically generated and may contain minor inaccuracies.
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    Dr. Mia uses a composite patient Ms. Smith's story to demonstrate her journey through different levels of care, from home to hospital, to skilled nursing facility (SNF), and then back to home. She discusses assisted living vs nursing home vs memory care unit and insurance payment options for them.

    Additional resources:
    Eldercare Locator (acl.gov)

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

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

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

    Transcript & more info on www.miayangmd.com

    Music & disclaimer

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

    Support the show

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    Transcripts on www.miayangmd.com. Transcripts are automatically generated and may contain minor inaccuracies.
    Email: [email protected]
    Opinions expressed are exclusive of Dr. Mia Yang and not reflective of her or guest speaker's employers or funders.

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    Summary

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

    Keywords

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

    Takeaways

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

    Chapters

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

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

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    Summary

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

    Keywords

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

    Takeaways

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

    Chapters

    00:00
    Introduction and Background

    04:20
    The Uncomfortable Topic of Grief

    13:40
    Navigating Feelings of Helplessness and Guilt

    28:07
    Finding Moments of Joy in Grief

    31:07
    Conclusion and Final Thoughts

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    Email: [email protected]
    Opinions expressed are exclusive of Dr. Mia Yang and not reflective of her or guest speaker's employers or funders.

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

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

    Takeaways

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

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    Summary

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

    Takeaways

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

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    Transcripts on www.miayangmd.com. Transcripts are automatically generated and may contain minor inaccuracies.
    Email: [email protected]
    Opinions expressed are exclusive of Dr. Mia Yang and not reflective of her or guest speaker's employers or funders.

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

    Chapters

    00:00
    Introduction and Podcast Statistics

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

    02:27
    Inspiration from a Couple's Story

    03:26
    Honoring the Extraordinary-ness of Caregiving

    04:26
    The Love and Care Provided by Bill

    05:21
    Moments of Clarity in Pat's Decline

    06:20
    Bill's Continued Connection with Pat

    06:50
    Bill's Experience Shared with Medical Students

    07:19
    The Power of Caring

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

    09:35
    Communication Strategies for Dementia Care

    10:35
    AVR: Acknowledge, Validate, Redirect

    12:58
    Holding Space and Staying Grounded in Caregiving

    14:13
    Processing Grief in Caregiving

    15:10
    Grief in Anticipation of Loss

    16:07
    The Complicated Relationship with a Loved One

    17:35
    Grief in Moments of Crisis

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

    21:35
    The Work of Grief and Soul-Making

    24:31
    The Importance of Feeling and Holding Space

    27:25
    Taking an Extended Break and Gratitude

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

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

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

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

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

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

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

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

    If people want to participate in ACE study: [email protected]; and https://www.acetrial.org/

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

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

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

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

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

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

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

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

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    In this episode of Ask Dr. Mia podcast, Dr. Mia talks to her colleague, neuropsychologist and memory researcher Dr. Bonnie Sachs.

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

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

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

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

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

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

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

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

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

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

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

    More information on Dementia with Lewy Bodies

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

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

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

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

    The Association for Frontotemporal Degeneration

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