Advice for Seniors with Channe Fodeman, MSW, LCSW

Larry (00:04):

I'm Larry Barsh and you are listening to specifically for seniors. Today's guest is Channe Fodeman, MSW LCSW. Channe is a licensed clinical social worker. She specializes in life transitions and aging issues. She is a polished lecturer and has appeared on cruise ships. That's interesting as well as for hospitals, the national association of social workers, various assisted living communities and for other local groups. And on a personal note, Channe is one of the most caring individuals I have ever had the pleasure of meeting. Thanks for coming on specifically for seniors, Channe,

Channe Fodeman (00:51):

Thank you for your cotton words, Larry. It means a lot. Thank you. Oh,

Larry (00:55):

And you meant a lot to us as well. How did you choose social work as a profession?

Channe Fodeman (01:03):

I didn't choose it. It just kind of happened. As I had mentioned, my original profession was I wanted to be a physician. As a kid, I had asthma, I had allergies, so I was in a physician's care quite a lot as a kid. So I thought that was a really, onderful profession because you really got to help people. You got to learn a lot going to medical school, doing a residency that you were really very well informed and you could make a difference. So the reality sunk in, o a number of levels. As I got older, one is the time it took up to become a physician to the expense. It would take to become a physician and three, my own insecurities of could I hack it. There were not a lot of women physicians, whe I was in college. And I think maybe if there had been that would've been a, a role model for me to say to myself, I can do it. I don't have to be a social worker. So then how did I become a social worker? My sister became a social worker, so I followed suit.

Larry (02:13):

Yeah, what's the difference between a social worker and a clinical social worker?

Channe Fodeman (02:20):

A clinical social worker means that they have spent a number of hours on a test that they have to pass. And to take that test, they have to have been supervised by a clinical social worker for, I, I don't really remember the exact number, but let's say 300 hours or something. There had to be supervision and the test, and then you can be, become a clinical social worker.

Larry (02:46):

Getting back to the,talk about, wmen in medicine. When I was in dental school, our dental school had the first two years with the medical students. Okay. And in the class of a hundred plus there were like five women who were treated very badly by the professors.

Larry (03:13):

Every embarrassing moment in early medicine was assigned to the women.

Channe Fodeman (03:20):

Yeah.

Larry (03:21):

Yeah. And things have fortunately changed

Channe Fodeman (03:24):

For the, well, I can actually speak to that, Larry. So my husband went to medical school probably the time you were going to school as well. And there were five women in his class when my son went to medical school fast forward. Half of his class were women.

Larry (03:43):

Yeah. I'm seeing that in the dental school now where the women are outnumbering the men.

Channe Fodeman (03:51):

Well, I think that's probably gonna be the future of medicine as well, judging by how many women,are in medicine today. And, ou know, when my son went up there to get his diploma, I was looking at these women, they were holding three kids, ad, geting their diploma. And I do think it's the way of the future. I think you're gonna see in the end a lot more women in medical school than men,

Larry (04:21):

Just, just the word about our listeners, the listeners to this podcast belong to the, what I like to call the, remember when generation, because it encompasses a bunch of generations and there are at least two generations. The youngest is now seen the decision as to whether to place their elderly parents in a senior living facility. And the oldest of the generation is trying to decide when a good time for them to come into a senior living facility.

Channe Fodeman (04:56):

Right.

Larry (04:58):

What can you tell us about trying to make that decision on both ends of the spectrum?

Channe Fodeman (05:05):

Well, what I've seen is it's a very difficult decision. It's a really a accumulation of different insights and each person has a different, roblem that they're coping with with their loved one at home. And, s it, it may be a, a combination of one is they never expected to have to be dealing with, agressiveness violence. You know, they thought they could have home care and they're running away from the person that's been hired as a home care. They're not stimulated in the home. And they're recognizing that, justa lot of things start adding up and then the person who's been taking care of them, let's say, it's the spouse. Let's look right now with the spouse. You know, they're starting not to sleep. The Dr. May be saying, you know, you really need to think about placing your loved one.

Channe Fodeman (06:01):

They may be realizing that they haven't laughed in a long time. They're, they're maybe realizing that they haven't been able to get together with friends in a long time. They're feeling very lonely. There may be just a whole long list of, of, you know, it's not a simple decision. Like you wake up one day and you say, you know, I need to have a life. I, I can't, I can't help her anymore. I think to me, that's the, the key is when the person you're caring for you start to realize that you're not really helping them by keeping them home, but it doesn't come, you know, doesn't come just easily to make that awareness, to make that decision that maybe I need to start to look at an alternative and it, it's not easy for the, the spouse that remains home to, you know, acknowledge that you couldn't do it, hat, you know, and we're all raised to, you know, honor our loved one and sickness and health we're we're, you know,

Larry (07:05):

Sorry, they are cutting the grass outside.

Channe Fodeman (07:10):

No, that is no problem. But anyway, it's, it's an accumulation of different feelings of realizing it isn't selfish. It isn't you know, you don't need to feel guilty that taking care of yourself is, is like, when they announce on the airplane, you gotta put the oxygen on, on yourself first, because even when you place your loved one in a community, it isn't the end of your relationship with them. It's a different kind of relationship, but now you can be that husband because you're not trying to, or a wife, you're not trying to figure out, you know, how to get them to eat or how to get them to be stimulated with something besides watching the television all day. So it's, it's, you're still very much an advocate. You're still very much involved, but it's a very tough decision and it's not easy to make. And you really need to spend time and not have to come to a, a crisis where you have to place someone because it takes time to really have a understanding of what's the right community for your loved one, talking to the other families that have loved ones in the community, talking to other people that don't have loved ones in the community. So it's a very intensive, loving decision and very hard to make.

Speaker 3 (08:22):

Yeah.

Larry (08:23):

How, how do you find the appropriate facility independent versus assisted living versus memory care? How do you decide what the right one is and the right facility general? Some, some facilities have a beautiful exterior, but the care isn't as, as good as it could be.

Channe Fodeman (08:50):

Right. Well, you know, those are not easy decisions. And, and that's why it's better to make a decision outside of a crisis situation to be able to take your time. I mean, there is, I have not been on the website, but I'm gonna share it. It's called,www Florida health finder.gov, and, hat rates some of the communities, tere also is a telephone for the agency for healthcare administration. And you ask for the assisted living unit, yo know, they can be helpful, but the, some of the differences are so in an independent living, comunity, the expectations are, you're just gonna need help with maybe a ride to the doctor you're gonna maybe need help with, excuse me, meals, you know, maybe three meals, maybe two meals. There's gonna be a, a dining room component to independent living. And, theres gonna be somebody to come in to clean your apart.

Channe Fodeman (09:56):

That's independent living. Now, when you start looking at assisted living, it's, they're really answering different needs. They're maybe answering someone that has beginnings of cognitive impairment. So maybe they need a little bit of supervision with their medication. Maybe they need a little direction reminding them to go downstairs to have a meal, ut, but minimal direction. And unfortunately you have to pay for everything. So cost is also a factor, you know, as you said, some places are very beautiful and charge of fortune and the care really isn't adequate, but you know, cost is important. You know, you have to really look at what does it cost and what are you getting for your money? What is a memory care, memory care? Is there, the assumption is you really need total reminders about getting yourself dressed. There's an activity today in the, yu know, I don't know the lounge, but you need constant help in terms of your, your daily functioning in a memory care.

Channe Fodeman (11:04):

So that's the big gaps between them and also memory care because they do give you more assistance will be more expensive. I mean, everything they give you be it assisted living or memory care you pay for. But I feel the best will way to assess is to spend time there. I know that I had recommended a community that I thought was wonderful, but my vision of, of their community was very limited. I would go in there to see,a program that they were having, or maybe a, a function for professionals. And the thing that impressed me about them was that they didn't shoe away the residents, because oftentimes I would go to these other programs in, in communities. And if they were having a program for professionals, they would ask and direct. If the person and memory care, they would direct 'em out of the, the area.

Channe Fodeman (11:57):

And I thought that was horrible because this is their home. You know, how, how dare they take them out of their home and say, you can't be here. So that was the way I was looking at it, but, but it has to be bigger than that. You really have to pay attention to the dining room. How helpful is the staff in the dining room with, with memory loss, sometimes people will stop eating. They need to be encouraged to eat. Is the staff respectful of the person that lives there? Are they calling them, honey? Are they calling them by their name? Little things mean a lot, because it gives you an inkling into how the staff has been trained. And it comes back to training. I mean, if the staff is adequately trained and there is ongoing training for the staff, that's what you wanna see.

Channe Fodeman (12:42):

And you wanna see it from the little things of how they address them to the bigger things in terms of do they encourage them and how do they actively encourage them to, you know, go, go to a program or to eat their, their meal. So it's, it's a lot, a lot of work. And the best time, as I said before is really when you're not in a crisis situation, you know, where you're so burnt out and there is burn out and caregivers that you're so burned out and you really can't assess it because you're under is pressure of, you know, I really don't wanna place my loved one, but I can't, she's not thriving or he's not thriving and I'm not thriving.

Larry (13:25):

Right. you know, bringing up the cost issue,what do you think of long term care insurance to help? And when should people start considering that?

Channe Fodeman (13:37):

Well, people need to consider long term care insurance when they're younger, where no one wants to think they're getting older, because we all think we're gonna live forever. Just the way we are. You know, we're never gonna have a memory problem. We're never gonna have a problem walking. We're never gonna have anything because we're gonna live, you know, at, at the way we are at 40 and we're gonna die the same way at 40, you know, aging.

Larry (14:01):

I thought that was just me.

Channe Fodeman (14:02):

No, it's all of us, but that's really when you should think about long term care insurance because the older you are when you get the long term care insurance, the more expensive it is. And I think the other thing that needs to be talked about is that I don't have the best impression of long term care insurance. Some policies are very good, but some policies have gone broke. Some policies I feel are just waiting,for the person who's in the community to do. I, ecause they hassle you with progressing on the application. I have seen that over and over again with, so, you know, just be a very astute consumer, do your homework before you invest in a long-term care policy, cuz they're expensive. But to have one is a big savings when your loved one does need, ether in-home care or a community.

Larry (15:02):

You just mentioned something I wanted to bring up anyhow about driving. When I announced you were gonna be on the ship. Oh,a woman in Boyton beach dropped me a note and said, quote, the major issue I had with my mother is taking away her car at almost 93, walking with a Walker, requiring a health aid to shower. My mother thinks she can still drive. What do you suggest for others for facing this issue? And when should we give up our own driving?

Channe Fodeman (15:36):

Well, I'll tell you driving is a very tough issue. I know I, I handled that with my dad very poorly because they lived on a farm. There was no transportation available for them. So I kind of looked the other way when I knew he shouldn't be driving anymore and it didn't have a good result. Just to share personally, ne day my dad was driving on our little road in the country where we lived and he hit a horse with children on it. Thank God the children were fine, but the horse and remember he's a farmer. The horse had to be killed, but the, he was so upset that this could happen to him. You know, that he could actually hit a horse. You know, he hit the gas pedal, which is a common accident with older drivers instead of hitting the brake.

Channe Fodeman (16:28):

And he was devastated, devastated to the extent that he eye, he had a heart attack from the, the horror of what happened, that he hit a horse. But back to the question, so the question is very difficult. I know that oftentimes what I recommend is if there's any way to get somebody to disable the car, get a dis disabled, or is there any way to say the car needs some, you know, mechanical work, get it over to a garage and never pick it up, say, oh, they found something else in it. Oh, this needs this. I don't know, you know, with an old car like that, if it's worth that,eventually hopefully it will, again, that they can function that either they can use some kind of public transportation door to door transportation, Uber, r the adult child is willing to get them to where they wanna go.

Channe Fodeman (17:27):

And it'll be kind of be something that they let go of, but it's not an easy transition. And when should somebody let go of driving when they start to have memory problems, when they find that they're not where they thought they were going and their, they thought their memory was fine or when their vision, their reaction time,their hearing are so impaired, hat they've had near misses, you know? And so you can see it sometimes on a person's car. You go, I used to do home visiting. I would go to the person's home and I would see, you know, oh my gosh, it's like smack smashed here, smashed there. I mean, that's a tell time sign. Tell times, anyway, you got the, well,

Channe Fodeman (18:15):

Thank you. Sign that. There's something going on with their driving, even when the person denies it. I mean, I had one gentleman, I mean, his car was such a wreck, but he would say, well, a tree fell on the car when I was parked at Publix. I mean, you know, stories, but those are tell those are signs that maybe you need to think about and there's, you can be tested, you can have your,driving tested. You can go out with the driving instructor and have them evaluate is your driving safe, but there are a lot, lot of good ways to think ahead and not wait till your 93 to say, I'm not giving up my driving. Cuz usually by 93 there have been some significant changes. Not with everybody. I mean I had a couple, Ithink I had a 95 year old and a 91 year old that were still both working and they're they had been tested and they was very, very, they were driving very well. They had no issues when it came to driving.

Larry (19:18):

Interesting. You know, we're on that subject. Most people think of baby proofing a house when they have an infant. Right. But we seldom think of adult proofing a house when they're seniors,falling stairs, dementia wandering, ven down to wound care. What, what, avice can you give people?

Channe Fodeman (19:48):

Well, what you're saying is, is very true. We should,change our, our way of living the hand. You know, something simple, like the handle on a door, you know, should be changed. It should have, you know, different kind of handle, not one. You turn with your hand because a lot of times we have arthritis in our hands and being able to have something, you know, that we own that enables to open a jar more easily, little things mean a lot in, in terms of stairs. You know, maybe you don't wanna use the stairs anymore. Maybe there's a, some way to convert a room downstairs, ino a bedroom and have a bath somewhere there nearby because we do chat. I mean, we're not gonna be the same person at, you know, different people age differently, but we're not gonna be that same person.

Channe Fodeman (20:40):

So, you know, sometimes when we're sleeping I've seen people get disoriented and get up and fall down the stairs just got totally disoriented in their own home. And they were, you know, pretty cognitively high functioning, but they were kind of like sleep walking. So there need to be changes, you know? So I think that the little things of, you know, as I mentioned, the door handle to having a jar opener, to, to thinking about moving downstairs and certainly when there's memory impairment, there needs to be a number of changes, you know, changes about, aybe the doors, a a person gets more disabled to think about a wider door, changing the doors in their house, besides the handle, log list of, you know, grab bars by the, the toilet grab bars in the shower, shower, seat, shower handle in the shower.

Channe Fodeman (21:35):

There's, I mean, this could be a a discussion of 20 minutes of all the changes that are really important to make as we get older. And we, you know, I could share another story. So I had a tooth pulled this summer and I was given,a, pioid for the pain and I took the opioid and I went into the shower, turned it on too hot. And that's another thing the water temperature should be changed, but turned it on too hot and passed out. I was very lucky, tat when I passed out, I was able to just, I plopped down on my tush. I was very lucky. I didn't smash my head. You know, so even those kinds of things, like not showering by yourself, being aware if you just had surgery. One of my clients was he hip replacement surgery and they gave her a number of narcotics for the pain. And she was telling me she was woo woozy. And I was saying, are you taking a her by yourself? And I, she said, yes. And I, she said, I was just fine. Then I told her my story that we think we're fine when we're maybe not fine. So in terms of thinking about the medications, if we're taking a shower and we are taking serious medications that can affect our balance, maybe somebody needs to be there when we take our shower.

Larry (23:12):

Yeah. Yeah. And then there's this situation of traveling with a Walker and a wheelchair and having the help necessary to get these appliances into the back of the car. As far as door handles, nfortunately I had to change some of the lever handles back to knobs because my dog learned to open

Channe Fodeman (23:43):

The doors so well, you know, and the other thing, you know, when you have an Alzheimer's patient and they will wander at some point they will wander or dementia, not even call it Alzheimer's, it could be vascular dementia. You know, you really need to have a lock higher up. So they're not able to go out the door, but that just kind of a few clues to make us all aware of that we do change and we need to accommodate those changes with our, within our environment.

Larry (24:13):

And that's another reason to put on an alarm in the house because yeah, it lets, you know, if somebody's breaking in, but it also lets, you know, if somebody's going out out

Channe Fodeman (24:26):

Absolutely

Larry (24:26):

In the middle of the night

Channe Fodeman (24:28):

And there is technology, there's wonderful technology that, you know, if you're married and, and your spouse, you feel is, you know, has maybe mild cognitive impairment, but you're a little concerned, you know, you should change the knobs on the stove so they can't turn it on. But there are technologies. Now you can put in place if you're still working and leaving the house where you can watch during the day, you know, every so often tune in and see what your loved one is doing. And that's important too. And certainly if you have, you know, home care, you might wanna have a camera in your home. So that you can keep tabs on how the home care aid is taking care of your loved. One lot of things I think should be done. As we age,

Larry (25:19):

What about oxygen safety with a stove with a gas stove?

Channe Fodeman (25:25):

Oh my God, I have a horror story. You know, you just reminded me. I hadn't thought about this for a long time. So she had been a realtor and a very heavy smoker and she was an oxygen. She had emphysema full-time oxygen and,she was told and she wasn't cognitively impaired, but you know, this was very sad. She says to me, the only thing that makes her feel like herself is smoking. So one day she lit a cigarette and blew herself up. She ended up in the burn unit. She ended up dying. So would I recommend someone on oxygen around a gas stove? No. Would I recommend somebody on oxygen lighting a candle? No. you know, oxygen needs special care. Again, there are so many topics around your environment and changes you need to make, depending on what kind of assistive devices, you know, the, a wheelchair certainly changes how you have to change your home and the cabinets and the countertops. It's a very big topic.

Larry (26:45):

Oh, there is so much to talk about.

Channe Fodeman (26:49):

Yes.

Larry (26:50):

And we're sort of running out of time. I just want to ask you probably the most important question. What advice can you offer to anyone listening on how to stay active, committed, and fulfilled as one ages. Now there's a topic that will take three hours to answer.

Channe Fodeman (27:12):

Well, you know, we all need meaning in our life. That's one of the things that keeps us healthy. And so I think we have to look within ourselves and say, what's important to me. Is that being connected to my family? Is it being connected to friends? Is it being connected to my church or synagogue? What has meaning to me, is it writing my story, talking about my life? Is it, you know, being part of a support group, if my family member has dementia and I have placed them and I'm having a lot of, of grief around it, I think we have to do a little soul searching. I think we have to be in touch with what gives us joy. You know, sometimes, e don't even think about, you know, what makes me happy. I'm always interested when I ask a client, what makes they them happy?

Channe Fodeman (28:01):

And they have no clue what makes them happy? What about nature? Can you enjoy nature? Can you enjoy your routine of getting up, opening the drapes and seeing the sunshine? So I think there's a lot of questions and that could be a whole other topic. Because all these topics you've asked, they're all good questions. They're all important questions. And they're all lengthy questions answered very lengthy, all of 'em, but that just gives you a little snip snippet of what, what needs to happen for us. You know, cuz it's more than, he exercise. It's more than, te friends. It's also what we say to ourselves. You know, we can be doing lots of, we can be eating the right foods, but are our words toxic? Are we saying things to ourselves that are crippling us big topic?

Larry (28:55):

Oh, there's so much more. I, I, I want to talk to you about relationships with adult children. When we get to this age, I, I want to talk to you about telemedicine. I wanna talk about storytelling. I want to talk about depression, loneliness and seniors. Can you come back again?

Channe Fodeman (29:20):

Of course I'd love to come back.

Larry (29:22):

I would love to have you on again.

Channe Fodeman (29:25):

I'd love to

Larry (29:26):

Thank you so much for being with us.

Channe Fodeman (29:29):

Thank you Larry for doing this. I think this is a very important service.

Larry (29:34):

We'll we'll have you back please. Sure. If you enjoyed this podcast, click on the follow on the follow button or subscribe button, wherever you listen to podcasts and tell your friends until next time I'm Larry bar and you have been listening to specifically for seniors.