Ask Doctor Jo’s Expert Tips for Preventing and Treating Caregiver Injuries
Being a caregiver can sometimes be a real pain in the neck. This week on Parents Are Hard To Raise… the Internet’s Physical Therapist, “Doctor Jo,” drops by with some great tips to help us avoid injuries, and work the “kinks” out of caregiving.
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Parents Are Hard To Raise® Episode 103 Transcript
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Announcer: [00:00:37] Being a caregiver can sometimes be a real pain in the neck. This week on Parents Are Hard To Raise®, the Internet's physical therapist, Dr. Jo, drops by with some great tips to help us avoid injuries and work the kinks out of caregiving.
[00:00:54] Join 180 million monthly subscribers who can now listen to Parents Are Hard To Raise® on Spotify.
Diane Berardi: [00:01:12] Welcome to Parents Are Hard To Raise®. Helping families grow older together without losing their minds. I'm elder care expert, Diane Berardi.
[00:01:22] Caring for our Aging Parents is not only mentally and emotionally challenging, but it can often push the limits of our physical health as well. When it does, we can easily suffer an injury that can put us out of commission for quite some time. And I'm sure my special guest this week would agree that it's better to prevent something from happening than to try to repair it once it has.
[00:01:46] Doctor Jo is a licensed physical therapist and host of the outrageously popular YouTube channel, Ask Doctor Jo. She earned her doctor a physical therapy degree from the University of South Carolina and has worked with a wide variety of patients ranging in ages from one to ninety-two, including NFL athletes and great great grandmothers.
[00:02:06] Doctor Jo's mission is to use her skills and knowledge to help as many people as possible through the benefits of physical therapy, especially for those who don't have access to adequate health care. And she's doing just that for the hundreds of thousands who seek her out each month through her social media platforms and her website, AskDoctorJo.com. Most importantly she's a dog lover.
[00:02:34] Doctor Jo, Welcome to Parents Are Hard To Raise®.
Doctor Jo: [00:02:38] Thank you so much for having me. I'm so excited.
Diane Berardi: [00:02:42] Well of course my first question is What are your dog's names? [laughing]
Doctor Jo: [00:02:49] That is the most important question. So, usually the three that you see, is Bear, who is a black Lab mix. Then there's Callie who is a pit bull mix and then there's Remmy who is a red mix of everything, so we're not exactly sure what she is. But she is a ball of energy as you can see in the videos, sometimes. [laughing]
Diane Berardi: [00:03:19] I think it's great. Oh well, we love dogs on this show, so...
Doctor Jo: [00:03:29] They bring lots of fun and entertainment.
Diane Berardi: [00:03:32] Yes they do. They bring a lot of joy to all of us.
[00:03:37] We wanted to talk to you today about something very important to all of us as caregivers.
[00:03:42] In order for us to take care of our parents, we have to take care of ourselves. But we often don't think about doing it or do it. We know we have to but we don't do it. So what can adult children do to take care of themselves?
Doctor Jo: [00:04:01] That's one of the great questions that I think as caregivers in general for anyone they need to ask themselves. Because you know if you are hurt or injured because you're trying to help someone you're not going to be able help anybody else. And I think some of the biggest things are, just simple things like learning proper lifting techniques. So you know if you're having to lift up your parents and help them move if you're not doing it correctly you're gonna get injured, you might injure them while you're trying to do it. A lot of times I see people try and you know pull somebody up by their arm or something like that. And that's just you know a risk of injuring you know the parent by pulling their arm too hard or you know injuring your back because you're not lifting properly.
[00:04:47] I also see things like looking out in your house for maybe loose rugs or objects on the floor in the hallways, including pets. You know sometimes they get in the way, but making sure there's things that you know if you might risk tripping over them or falling over and getting them out of the way, because I think a lot of times especially if your parent is coming to live with you, your house might be set up for things that you wouldn't think that they might not see it on the ground or, if they have an assistive device, it might be in the way because it takes up more room. And things like that would risk a fall. And if you get those things are the way ahead of time then you know that's really going to help.
[00:05:32] I think also a great thing is to do stretches and exercises with your parents. Not just you doing the stretches and exercises on your own or you know making your parents do it to keep them moving and healthy, but do it together to make it fun.
[00:05:47] And you know on my channel I have hundreds of videos that you can watch together and watch the puppies that your smile while you're doing maybe some exercises and then you don't always want to do. So you can really make it a fun thing where you're enjoying your time together but making sure both of you are staying healthy and potentially preventing injuries from happening in the first place.
[00:06:10] So I think that's probably a great place to start.
[00:06:14] I think another big thing is just to know what your options are to help you take care of yourselves and prevent injuries. You know often I'll see a patient that comes in who's a caregiver and already has those injuries. And so you know really just being able to learn those things and you can actually learn those things in physical therapy. A Physical therapist can teach you those proper lifting techniques and you're making sure that you're doing them safely for you and your parents.
[00:06:47] And sometimes even after the injury happens, they'll come into physical therapy and and just say I hurt my back trying to lift my mom or my dad and you know I'll give them stretches and exercises to do, and sometimes the saddest part is they say you know I just don't have time to do that, and I'm so busy taking care of my loved one I don't have time to do this for myself. And you know I'm like well you know it really feel like five minutes maybe two or three times a day, just you know to get some stretches and exercises in. And I actually have people say you know I don't have that much time for myself. And you know sometimes I think enough 15 minutes total throughout the day that they don't really seem like they have time to do hat.
Diane Berardi: [00:07:33] Yeah it's sad. You know, your day, it's chock full, and you don't even realize it. You know but you're right. We do... There's got to be some time where we can make to do it.
[00:07:44] I didn't realize how out of shape I am. You know because my mom, I wanted to take her to the store, and my husband got the wheelchair out of the car, but then I was trying to... I was just wheeling her and she's really very lightweight now. And I was just wheeling her up this tiny little incline and even getting her in the store and then just wheeling her around, and my back and arms, the next day... hurt. And I'm like, oh my gosh. You know, how can I be out of shape? But we don't realize, I guess that we really do need to do some exercises and stretch.
Doctor Jo: [00:08:25] Right. Exactly. And sometimes it's just because it's a movement that we don't normally do. You know I have people say, well you know I walk a lot. You know I'm helping moving them. But you know like you said, pushing the wheelchair, you're kind of in a bent over position that is straining muscles that you don't usually use. So I could definitely see that those kind of things, where it's like an "aha moment" of oh you know maybe I should think I should be doing something throughout the day for myself.
Diane Berardi: [00:08:51] Yeah. That's true. Because I'm not usually pushing and pulling and doing things like that. So yeah you're absolutely right.
[00:08:59] And I think it's a great idea. You know I was going to ask you that... Things that you can do with your parent. You know the exercises or the stretches, doing them together. Because a lot of times, we as caregivers we're like, OK do you exercise. The physical therapy showed you how to do that. You know... Do this. And we don't... You know that's a great idea.
Doctor Jo: [00:09:22] Yes absolutely. Yeah.
Diane Berardi: [00:09:25] And what are your ideas on who a caregiver can ask for help, if they want to take some time for themselves?
Doctor Jo: [00:09:34] That that's a great question. So, a lot of times I'll have my patients talk about how they are the only sibling that's close by, to be able to help their parents, or maybe they just don't have help, maybe their spouse is working all day long. And one of the biggest things I'd like to talk about with my patients is a sitter.
[00:09:57] And so basically a sitter is not usually a medically certified person. You know it's almost like a babysitter that you would have for your children, but they're not really certified like a certified nursing assistant or something like that. And so they would really just be there in case of emergency. So, you know in the same sense of like a babysitter you know depending on your parents level of need, you could call a high school or college student, when they're home for the summers and if they're you know baby sitters you can say hey you know my mom or dad all you really need to do sit with them just in case something happens for an hour or two. And you know they'd probably be more than willing to do it for the same price of babysitting. Because I know when I was a baby sitter growing up I would have much rather sat with an older person and had a wonderful conversation and then chase around a screaming child amd have to change their diapers.
[00:10:53] So you know, I think the biggest thing is sometimes you just have to ask because you know if you don't ask you don't know. And I think more often than not people are willing to help. You know even just a friend. You know if you've got a friend or neighbor that you really like and appreciate you know that you know they're going to be there for your parent. You know if one of my friends or neighbors said, hey you know my mom's here but I really need to get the store. Could you maybe just come over for a few minutes? I'd be happy to do that.
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Diane Berardi: [00:14:13] You're right Dolly. There are so many really cool new ways to listen to our show. It's hard to keep track. You can join the one hundred and eighty million listener is on Spotify. You can listen in your car, at the gym, or pretty much anywhere on your smartphone with Apple podcasts and Google podcasts.
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[00:14:58] Doctor Jo... I think that's a great idea. You were talking about a sitter, you know a high school or college student.
[00:15:05] I think sometimes we don't, as caregivers we kind of have tunnel vision and we don't think about something as simple as that. You know if you want to run to the store or you want to go to a movie, that if there's someone on your street that you know growing up, is a high school student or college student, that could certainly come and sit with your mom and they probably would love to do it.
Doctor Jo: [00:15:30] Right. Absolutely. You know I think that would be just as enjoyable for them as it would be for your parent because sometimes when there's that huge age difference it really lightens both of them up and they really enjoy each other's company. So I think you know it's a really great option if you happen to have some some of those aged people in your neighborhood or in your community that you could reach out to.
[00:15:57] Now some people worry about costs, of course, anything to do with health care. What insurance do to help?
[00:16:07] So it really depends on what type of insurance you have. Most of time I would say your parents would probably be at the Medicare level. So some might have also some supplemental health insurance as well. I don't believe Medicare covers sitters right now so it would probably be an out-of-pocket cost.
[00:16:31] I would say, I don't know I haven't done babysitting in a long time, is maybe 10 to 15 hours an hour. So you know for some time away I think it is probably worth it. You know I think it will be also worth calling Medicare to find out. I know that they are putting you know hopefully soon in the next couple years some plans in place to get more coverage for things like that. I really hope that that's going to be something that they end up implementing into the new coverage programs for Medicare in the future.
Diane Berardi: [00:17:12] And how about Medicare in terms of physical therapy?
Doctor Jo: [00:17:16] Yes. So in terms of physical therapy I know Medicare has Part A to somewhere in the middle of the alphabet. So there's a whole lot of parts to Medicare. [laughing].
[00:17:27] Biggest ones for physical therapy as part A and Part B. Part B is the one that's the main medical insurance where if you are going to outpatient therapy that will be what Part B of Medicare would cover. And they usually cover an 80 percent and then you pay 20 percent and then if you have a supplemental they would they would cover the rest of the 20 percent. But the great thing about Medicare Part B within the past year is, there used to be a dollar limit on how much physical therapy, occupational therapy, speech therapy could have. There's no longer that limit per calendar year. And so as long as it's medically necessary for you to go to physical therapy, Medicare will cover the ship as long as you're showing progress. So that's a new great thing that has come into place. You know we're very limited with in the past, now we're not so limited with that. That. That's a great thing for us.
[00:18:25] Medicare Part A is more the hospital type insurance or home health insurance. So that would be the one who you'd probably want to look in to with skilled nursing, physical therapy, occupational therapy, speech, social services coming out to your parents house or your house. But there are a lot of rules with Part A... Things that you have to meet to be able to get that. And one of the biggest ones is you have to be homebound and the doctor has to certify that someone has to come out to your house to get that care.
[00:19:00] So usually it's something after maybe like a surgery or a long hospital stay where you might just be you know not having the strength to do much. And so people can come out to your house and help you with that. And that's always I think another one that people don't always think of if the doctor doesn't mention it.
Diane Berardi: [00:19:18] Yeah you're right.
Doctor Jo: [00:19:19] And so yeah. And so always talking with the doctor and just keep saying, "therapy. Therapy therapy," in their ear until they say you know what maybe maybe your parent would really benefit from some therapy. And you know if they if your parents not eligible under those specific guidelines for Part A, just say, hey can we have an outpatient referral and I'll take them to therapy. So that's always an option as well.
Diane Berardi: [00:19:46] And you said as long as our parent is making progress. So how is that measured?
Doctor Jo: [00:19:53] Yes that's a great question. So sometimes it's not even making progress. Like there's a difference of being able to maintain something as long as it can. We weren't there. Maybe that person will be backtracking in their health. But showing progress is really basically on our shoulders as therapies to really write good documentation and say, OK so your mom came in to see me today and a test of her strength and she only had maybe three out of five strength. In physical therapy terms, five as the strongest. Three is maybe you can just lift your leg, but if I tried to push it down it would go back down. But then maybe two or three weeks later when I retested her, she has a three plus or a four, because she's getting stronger. Or maybe she was having some falls. And since I've been seeing her she's only had one fall of no falls. So those kind of things that we can show progress and we have outcome measures that we can ask our patients questions and then have their perception of it. They're getting better as well. And so we have a lot of tools to be able to say, you know hey... Yes they are doing much better. Because if they're less likely to fall, then you're not going to have to pay for a surgery, like If they break a hip or break their leg or something. And so I think Medicare is finally saying hey you know even if it's preventative you know if you are able to them 30 to therapy for three or four sessions and show preventative stuff, that's going to help in the long run as well. Because you're going to know what to do and you're going to be prepared if there is a fall how to safely get them up. How they can help you help them get up. So it's not just your deadlifting you're a parent, which is much harder than it sounds.
Diane Berardi: [00:21:49] No... It is hard. Yeah I know you don't realize any of these things. And I never understood with Medicare, you know they never wanted to cover anything preventative. They just didn't make sense.
Doctor Jo: [00:22:00] Right, right. Yeah. And I think they're finally figuring that out... That if they cover some preventative, in their eyes, it's going to save them money in the long run. And you know that's fine if they want to think that but I want to be able to prevent those things from happening for someone, because you know it is just bad all around for the person trying to help the person on the ground and all of that. So I think that you know in our scope of practice for physical therapy we are allowed to do prevention and wellness and you know quality of life type of things you know we wouldn't be able to do that forever. But again you know getting in for you know even five or six visits we could easily justify that as medically necessary. You know because I think anyone even at a young age of 65 I could probably find something that I could justify doing physical therapy with you. So you know it is always worth getting that evaluation and finding out what can be done.
Diane Berardi: [00:23:03] Oh yeah, definitely. Definitely. Doctor Jo, how do people contact you if they'd like to ask you a question?
Doctor Jo: [00:23:14] That's great. I have on my Web site. AskDoctorJo.com, a contact form. So you can e-mail me directly. Also on my Facebook page you can either leave a comment or private message me and usually when I'm not at work I'm checking it a couple times a day. And even when I'm at work I'm checking it a couple times a day. So I try to respond to people pretty quickly. You know sometimes without getting to evaluate somebody I'm really not going to be able to give a good answer, but I like to try and point people in the right direction, for sure.
Diane Berardi: [00:23:50] Oh sure. No that's wonderful.
[00:23:52] And can you suggest maybe equipment that people should have in trying to maybe you know bath their parent, or be in the home. Maybe pillows or something? Anything that people might not have thought of or aren't aware of?
Doctor Jo: [00:24:08] Sure. A lot of equipment. Again some of it can be covered by Medicare because unfortunately equipment isn't always inexpensive. A lot of times it is expensive. Yes but one of the things that makes me sad that Medicare doesn't cover that I always think is really important is to have a shower chair or a shower bench. Even if your parents feel like they can stand up safely in the shower I can say that I slipped in my shower a couple times while I'm not paying attention, and I have a shower seat in my shower. So I need to sit down and wash my feet or things like that. I think something like that... Because most falls end up happening in the bathroom. So if there was one thing I would recommend that would probably be it.
Diane Berardi: [00:24:57] No that's perfect. It's true. I slipped. You know you don't realize. And I assume, I know... Rails, made for people so getting in and out of the shower?
Doctor Jo: [00:25:11] Sure. Yeah. Grab bars are great I think. But yes those are gonna be I think they're not covered now but they're going to be covered. But there are also some very inexpensive ones that you know if you know anybody handy they can easily put those in the shower.
[00:25:29] But even things like you know stretching straps for the stretches and stuff in bed those are very inexpensive. But then your parent can just grab it not even have to get out of bed. A lot of times I think personally through my videos I'm on the floor doing them. If people think they have to get on the floor but you can always do stretches and exercises on your bed or on the couch so then you know if you have a hard time getting up from the floor you can easily get up off of your bed.
[00:25:57] So you know just having something like a stretch strap. And I often tell my patients, you don't even have to go by one. You can get a jump rope you know for a dollar at the Dollar Store.
Diane Berardi: [00:26:10] Oh that's perfect.
Doctor Jo: [00:26:12] Yes absolutely.
Diane Berardi: [00:26:16] Thank you so much, Doctor Jo. For being here.
Doctor Jo: [00:26:18] Well thank you so much for having me on your show.
Diane Berardi: [00:26:21] Oh we loved having you.
[00:26:23] And Parents Are Hard To Raise® family... I love getting your e-mails and questions, so please keep sending them. You can reach me at: Diane@ParentsAreHardToRaise.org. Or just click the green button on our home page.
[00:26:34] Parents Are Hard To Raise® is a CounterThink Media production. The music used in this broadcast was managed by Cosmo Music, New York, New York.
[00:26:42] Our New York producer is Joshua Green. Our broadcast engineer is Well Gambino. And from our London studios, the melodic voice of our announcer, Miss Dolly D.
[00:26:51] Thank you so much for listening. We love our parents, but Parents Are Hard To Raise®.
[00:26:58] Till next time... May forget everything you don't want to remember, and remember everything you don't want to forget.
[00:27:04] See you again next week.
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