Yasmin Nguyen: 0:00

Are you taking care of an aging parent or family member? As you approach the later years in life, chances are you or someone you love may be experiencing a health challenge or facing a serious illness. Navigating the journey of being a caregiver can often lead to feelings like overwhelm, frustration, fear, sadness, guilt, anger, exhaustion and loneliness. How do we take care of our loved ones when we are barely taking care of ourselves? The reality is that many of us either avoid having deep, open conversations about this journey, carry everything on our shoulders or simply don't know how to deal with the challenges. Welcome to the Real Retirement Show. My name is Yasmin and I'm Kathleen.

Yasmin Nguyen: 0:51

In this show, we delve into the multifaceted world of retirement beyond the finances. It isn't your typical retirement discussion. It's a vibrant journey into what retirement truly means in today's world. We bring you real stories from real retirees and experts discussing real challenges surprises, joys, heartaches and the myriad of emotions that come with retirement. From addressing family dynamics to mental and physical health, to finding purpose. We tackle the issues that truly matter to retirees and those thinking about retirement.

Yasmin Nguyen: 1:30

In today's episode, our special guest, Dr Delia Caramante, will share specific strategies and tips to care for a loved one's illness without losing ourselves. Dr Caramante is an integrative palliative medicine physician. She is the founder of the Integrative Palliative Institute and host of the Integrative Palliative Podcast. She is board certified in family medicine and palliative medicine, certified by the American Board of Integrative Holistic Medicine. She is an adjunct assistant professor at the University of Maryland, where she teaches both palliative care and integrative medicine. Dr Caramante has been voted a top doctor by her position peers and has published textbook chapters in the fields of integrative and palliative medicine. She is the author of the book Coping Courageously a heart-centered guide for navigating a loved one's illness without losing yourself. Let's join our conversation with Dr Caramante.

Kathleen Mundy: 2:34

I had an opportunity yesterday to immediately download your book and committed to making sure that I had finished the book before this interview. It highlights so many things that so many people need to live, jump in and embrace. One very impressed. Wow, the book is amazing, I'm telling you. I couldn't put it down. In fact, I fell asleep with it in my hand. I read it all evening. Then I said, oh my gosh, okay, I'm going to go to bed, I'll read another chapter too. I'll finish it while I'm. That didn't happen, it wasn't boring, it was just a late night. So it's amazing, it's profound, it's powerful.

Dr. Delia Chiaramonte: 3:15

Well, thank you so much. Thank you for reading it, and I appreciate those kind words very much.

Kathleen Mundy: 3:19

I want you just to give us a little bit of an overview of what happens when end of life becomes a reality for many people, and the differences that they have in our healthcare system, the options that they have.

Dr. Delia Chiaramonte: 3:33

I think one of the big misconceptions, to start with, is around the whole term palliative care. People, even other physicians, often think that palliative care means end of life care, but it truly does not. End of life care is a little part of palliative care, but palliative care just means the care, full person care of families facing serious illness with a focus on reducing suffering, reducing physical suffering, reducing emotional suffering. And a serious illness is something like cancer. If you have cancer and you're trying to be cured or you're trying to have your life markedly prolonged, but you're nauseous from chemo, you're tired from chemo, you're anxious, you're depressed, you're having stress, talking to your family, your family is a mess. All of that is suffering. Palliative care is appropriate in that space, even if the person is hoping to markedly prolong their life. It's really about serious illness, reducing suffering. The other thing that I think is so important about palliative care is that it includes as the unit of care, the whole family, recognizing that if there's something serious going on, it's not just about the patient, it's about the whole unit.

Kathleen Mundy: 4:51

I experienced this when my father became ill. This was some 20 odd years ago, which is, in fact, why I said I wish I did this book then. But I will tell you, the advantage that I had during that process was the fact that I'm an only child, so I didn't have all of that disruptive emotional baggage that comes, as you've described it so eloquently, with the turmoil that can exist when family members don't have a control point. I could relate so much to what you outlined in your book.

Dr. Delia Chiaramonte: 5:22

Yeah, there's no question that families can break apart just when it's most important to be together. That's actually why I called the book Coping Pharegiously, because I think it takes bravery courage to be open, to looking at these things and talking with your family and not just being in a hole and pretending maybe it'll just go if we don't think about it.

Yasmin Nguyen: 5:46

And certainly when we have these experiences in our life, especially when we've got loved ones that we are caring for, that are going on this journey, and we're joining them on this journey. So many of us don't necessarily have the roadmap, the training, the skills to navigate it, and what you have shared with us through your book, through your wisdom, is so important, especially during this time, this chapter of our lives, when we do have these health challenges that do come up. And, dillie, I'm curious for those that are either going through it or caring for others, that are navigating various different illnesses. What are they facing? What are some of the things that they're struggling with as this comes up?

Dr. Delia Chiaramonte: 6:30

Yeah, you're so right, because none of us have a roadmap, because usually we haven't been here before, and so not only do we not have a roadmap, but no one's ever really talked about it for our whole life, because it's kind of the last thing that we don't talk about. We can say cancer now, we can say pregnancy once, a part of time, that wasn't a thing we can say erection. We can say menstruation right, we can say all those things, but don't talk about death. People have this kind of magical thinking sometimes, like if I say death, someone's going to die, but that's of course not how it works. It's not how it works, but we don't have experience in our life with how to deal with it.

Dr. Delia Chiaramonte: 7:08

So the things that often come up are a few. One is the most basic and practical, which is how do you even manage the medical system? Right? The medical system is chaos. You wait seven hours in the emergency room. You don't even know who's the doctor anyway. Who's there like who's that guy? Then there's another guy, then there's another person comes in. Who are all these people and who am I supposed to listen to and who's in charge?

Dr. Delia Chiaramonte: 7:36

People say the physicians or other clinicians will say words and maybe the family doesn't totally understand what they're trying to say. And sometimes even physicians will couch hard things because we're afraid to say it. The physician might say something well, things aren't going that well. What does that mean? It means that the family just makes up in their head what that means. Who knows what that could mean. Sometimes a physician says that, and what they mean is it's time for hospice, that nothing is working, the end is near. But the family may not hear it that way. So there's tons of miscommunication just in the healthcare system. That's one piece. That's hard.

Dr. Delia Chiaramonte: 8:14

Then there are some other things that are kind of more personal that are hard. One is that because we don't have experience talking about progressive illness and death, the family members often will go to their own corners and not talk to each other about it. And if one person even says, what will we do if the chemo doesn't work? Sometimes the family members jump on them and say don't say that. You kids, you have to be positive, we're not going to talk like that around here. And that makes the person retreat. Right, they just got the whoop. That's not okay for me to say so now if they were worrying about their own death. Now they're worrying all by themselves, maybe in a room filled with family members, and having to carry that all alone because the family wasn't comfortable allowing that conversation into the room. So that is the part that breaks my heart, because just at the time when maybe, time is getting shorter and connection with the family is most important, sometimes people kind of break apart and become lonely within their family, and that is heartbreaking.

Kathleen Mundy: 9:21

I wonder if I'm unique in this. I remember a time when my dad was going through this end of life and I asked him what's it like for you?

Yasmin Nguyen: 9:34

I'm so sorry.

Kathleen Mundy: 9:41

Sorry, don't be sorry. He said something so profound. He said to me it's like being encased in cement. I got it. I really that changed.

Dr. Delia Chiaramonte: 10:02

So sorry, please don't be sorry. This is exactly what we should be doing, which is feel the real feelings when things are hard.

Kathleen Mundy: 10:11

Well, it changed our conversations from that point forward because all of a sudden I really understood he was feeling no one was trying to interpret.

Yasmin Nguyen: 10:25

I know it was raw, it was real.

Kathleen Mundy: 10:29

Yeah, I think that, oh, pardon me, sorry, please I think that we should allow ourselves the opportunity to ask these hard questions to them so we have an understanding. Wow, oh, please, it's OK. Yeah, I guess I'm not over it.

Dr. Delia Chiaramonte: 10:55

I'm so sorry for your loss. Losing a parent, no matter how long it's been, is just a life-changing experience.

Kathleen Mundy: 11:02

In your book you mentioned how it's important to accept things and how some people don't do it and they don't allow them to speak about their oncoming death, and that's what spoke to me. I was grateful for anything during those months. I was grateful that I actually had the courage to ask them that question.

Dr. Delia Chiaramonte: 11:25

I'm so proud of you that you did that.

Yasmin Nguyen: 11:28

Delia, the work that you have shared is so powerful. It touches us to our core, some places that women have known has healed, and you're really helping us share and express the real experiences in our lives. And that's what this conversation, this show, is about is really tapping into the realities with love, with kindness, with generosity, with wisdom, so that we can all experience a better place together.

Dr. Delia Chiaramonte: 11:59

Absolutely, and I'm really touched by that story that you told us, kathleen, because you allowed him to share something that before he may not have been sharing, but he was certainly feeling it and he was feeling it all alone, and anytime we're going through something tough, it's better to share it with somebody who cares about us than to go through it all alone. You have such a great example of how having that connected moment even though you couldn't make it, not feel that way to him, but just having that connected moment was so powerful for you and I have no doubt it was powerful for him. And that's exactly the point honestly, that's why I wrote this book is for exactly what you just described. Because if we're afraid to ask those questions, how are you doing? What does it feel like? Are you afraid? What can I do for you?

Dr. Delia Chiaramonte: 12:52

The thing I think is important to say is we don't have to know how to do it. Well, there's no right words. You can just come in someone's presence and say I literally don't know what to say. I have no idea what to say. I wish I could fix this, but I know I can't and I don't know what to say. I just want you to know that I love you and I'm here. That's all I've got. That's amazing, right? You don't have to have the perfect words.

Yasmin Nguyen: 13:15

Right Dilya. I'm curious, aside from courage that Kathleen exhibited, to ask for those who may not be in that place. Where they have that courage, how do you approach or how do you ask those questions, or how do you initiate a conversation that feels so scary?

Dr. Delia Chiaramonte: 13:38

No one has to have the courage first. Really, it's an act as if kind of thing. You can be shaky and crying and a mess or have no idea what you're about to say, but just bring your wholehearted open self to the other person's presence. And you can even do it with silence. If you really come to someone's bedside and you bring your open self and you allow tears to form in your eyes. If that's what you're feeling and you hold their hand and you squeeze it, that counts. You don't even need words.

Kathleen Mundy: 14:09

When I was reading your book, that became almost a mantra. It's silence is a language that we don't often use, and I think that was very profound, that you mentioned that several times throughout, and you're absolutely right.

Dr. Delia Chiaramonte: 14:26

Thank you for highlighting that. It is so important. And what I find that sometimes people do instead is things they do things like well, I'm going to go clean the kitchen, dad and I put all the things away and I'm now I'm going to go to the store and I'll make us some dinner and, yes, everybody has to eat. But you know you can order. Like, don't do that. How about just sit quietly by their bedside or read them the newspaper or watch a movie together, even if they're sleeping through half of it?

Dr. Delia Chiaramonte: 14:54

We sometimes do when we're anxious because it feels safer, like I know how I can do something. I could do the laundry, I'll go do the laundry, but we really want to not do that, if possible, and just leave some of that and just be present with either the person who's ill or with another family member, just be present in the scary stuff. And that's really the acceptance part, I think, is not that you accept that someone's dying, as though you like it, and of course you don't like it, but just things are what they are, right and pretending is worse. When we're pretending, we can't be real and part of what we want to do and we have limited time with someone is to be in their presence and to be real.

Yasmin Nguyen: 15:38

Speaking of presence during your book launch, you had talked about the 10 different experiences that I think you went through. I'm curious if you would share what were some of those other ones and expand a little bit more on what do you mean by being present to the suffering?

Dr. Delia Chiaramonte: 15:55

Sure. Let me just share briefly the background to that conversation. So one of my children had an injury, a pretty significant injury, when she was a middle schooler and there was a very long recovery and there were times when we didn't know if it was ultimately going to be okay and there was a ton of physical suffering and emotional suffering involved in that. And so the first part that was hard for us and I found the same things that were hard for me and my family were the same things I find in my patients and their families, and the first one was just to be in the presence of someone else who's suffering. So when someone is suffering, it feels easier to go downstairs and do the laundry than to be with them.

Dr. Delia Chiaramonte: 16:46

It's hard to be with someone that you care about who's suffering when you can't fix it. If you could fix it it would be easy, but if you can't fix it, it's hard in so many ways. It's hard because you love them, it's hard because you feel that you get guilty or broken, sort of that. You can't make it go away. And it's physically hard.

Dr. Delia Chiaramonte: 17:06

Even the way human beings are, we often take on what other people are feeling and you may feel headache or tightness in your chest or tense in your body, when you see someone else suffering and it's hard to stay, it's hard to be in their presence, but also it's important because they feel it anyway. They can't run away from it, and so there's really like they're suffering alone or they're suffering with company, and it is almost always better to have somebody who cares about you, who at least sees you, and it's important to be seen. And so the image that I find helpful, that was helpful for me and is helpful for the patients and families that I've cared for, is to walk beside someone. So when we feel like I have to fix this and I can't, it's unbearable. But when we see like you are walking up a very tall hill here, I can't make the hill be smaller, but I can walk beside you and then at least you're not walking up that hill yourself.

Kathleen Mundy: 18:09

I think the one of the things that sometimes families try and do is just control the situation. Yes, and when you take that time to be present in that suffering, you have to accept that you can't control it. It is an uncontrollable circumstance and for a control-free it's really difficult. I wouldn't have the skill set to do so, and I think that one of the things that you mentioned in your book is that some of the practices that you're going to talk about of course I've interrupted you twice now, but of the 10 points you mentioned how often you need to practice these so that you become really good at it, so that you can utilize it when it's necessary.

Dr. Delia Chiaramonte: 18:57

Correct, and I do want to speak, since you mentioned it, about control for a moment. What people tend to do because it makes them feel better, they're not being bad people, they're just trying to survive a difficult situation is it feels good to control something, even if the something is kind of irrelevant. So that's what makes people go downstairs to do the dishes when their loved one is suffering. I can't fix this, but I couldn't do the dishes. But we have to check ourselves for that and make sure we're not trying to control something that is irrelevant to the story and instead let that go and be present, even if it doesn't feel like we're doing anything. But we are doing something because what we're doing is presence with another person and that counts. So I do think that's an important thing to look at, because people often think they're doing a good job by all the controlling that they're doing, and this comes up very often with aging parents.

Dr. Delia Chiaramonte: 19:50

So let's say, aging parents who are still cognitively intact, so they should be making their own decisions, right, boy? The kids want to control everything that their aging parents are doing. You need to stop eating Snickers bars, and you have to exercise and you have to be better about writing down your medicines and you have to go to the day program, you have to do all these things and they can create conflict with their parent just when they're not going to have that much time left with their parent. And this idea of people who are cognitively intact are allowed to make their own bad decisions is really important, right? Yeah, sure, maybe they should eat more vegetables, but probably you should have when you were a teenager too, and you didn't. And people are allowed to make their own bad decisions, so we should prioritize the relationship.

Yasmin Nguyen: 20:40

Oh, that really hits home. I found myself Mom, you need to stop eating that sugar stuff, Dad, we need it. And then of course, I feel bad after I've kind of shamed or judged them. I feel like the roles were kind of reversed, like back in the day they were telling me this stuff and now it's my turn. But now I realize I have to take a moment and pause and catch myself and notice that, oh, am I more committed to being right or am I more committed to be loving?

Kathleen Mundy: 21:10

There you go, that's true.

Yasmin Nguyen: 21:12

And it's that moment of pause that, okay, it doesn't need to be this way, the thing doesn't need to be over here, it's okay, I'll just move it later. I don't need to yell at them for it or anything like that.

Dr. Delia Chiaramonte: 21:25

Good for you for having that realization. It's really important. It's hard, it's hard but it's important. But you can say your thing once or twice, maybe three times max. Maybe they don't know sugar is bad for you, whatever. Just in pace you can say it once or twice, but if you've said it a few times and they're not listening to you, you know, stop. They're allowed to make a decision that you think is wrong, Even if you are legitimately correct. It would be better to do it your way. They're allowed to make a decision that's different than what you think and what matters more? The relationship, or them eating more vegetables, right? So if you could say well, before they died, they ate a lot of vegetables.

Kathleen Mundy: 22:05

We hate each other now, but they sure ate vegetables, and I want to just ask what does it matter at that point in their life if they eat vegetables or candy bars every day? It's not life changing.

Dr. Delia Chiaramonte: 22:16

But it is the urge we were talking about before to control something controllable when you can't control the uncontrollable. So my parents are aging and that breaks my heart and I'm not going to have them forever and oh my gosh, that's terrifying. So I'll focus on this other thing instead. But really, the acceptance part is wow, life is finite and for my parents it is potentially particularly finite. Oh, we never know that, but potentially, and that's hard. Let me be with that. Instead of trying to control other things to make myself feel better in the moment, let me think well, wow, how, how, what do we need to repair with each other? How can we just spend some fun time together? What would be a new experience that we could have together? Focus on the relationship, prioritize the relationship.

Yasmin Nguyen: 23:03

Speaking of control, there's a lot of emotions that go with that, and one of the ones that that typically accompany controlling is anger, and I remember you mentioning something about being the brunt of their anger. Can you talk a little bit about that?

Dr. Delia Chiaramonte: 23:17

That's a great question. So when someone is suffering, they often feel angry because their life got messed up. That was the case for my daughter. But people who have cancer that's not fixable people whose life didn't turn out how they wanted even if they're, they have normal aging but they're looking back at their life and they didn't do the things they wish they done or they missed opportunities that they can't give back now. People feel angry sometimes and that's legitimate that they feel angry. But they also sometimes share that anger with the people in their life and that can be hard.

Dr. Delia Chiaramonte: 23:55

Now it's better if we can see it kind of from the up high, like, wow, that person, my loved one, is feeling legitimately angry about this thing that is happening to them. They're sharing it with me because they feel safe with me, but that's hard for me. So, seeing it in that way, you can make a plan, like sometimes you can set boundaries and say I need you to stop yelling at me, please. I hear how much you're suffering, I hear that you are so suffering, but it hurts me when you yell. So if you could yell less, that would be better. You can do that. You could just find other ways to fill up your cup to experience for yourself like, wow, that was a hard interaction.

Dr. Delia Chiaramonte: 24:31

I feel kind of stressed out about it. I'm not going to yell back at my loved one because that's only going to fracture a relationship. It won't help anything. But I've been kind of wounded a little bit. So let me go for a run, let me take a shower, let me call my therapist, let me talk to a friend, let me write in my journal, let me go cook, let me go create something, whatever it is that is in our own fill up, our cup plan. So I think not being reactive and seeing the big picture makes it much easier to tolerate, as opposed to if you're just in it and they yell at you and you yell back. Then your relationship is fractured again and nothing good came to that.

Kathleen Mundy: 25:09

You know, this brings up a question that I have now Is that, if you're a caregiver, how can you deal with the frustration and the resentment when you're trying so hard and yet it seems sometimes like they don't appreciate what you're doing or the sacrifices that you might be making? How would you advise a caregiver to deal with something like that?

Dr. Delia Chiaramonte: 25:31

It's such a great question. That happens all the time. So in the fantasy world we would be loving and we would show up with our presence, and then the other people would be so appreciative and they would tell us how wonderful we are in a relationship with each other. Sometimes that happens, but often it doesn't happen quite that way, because both people are suffering. Plus, we bring our own personalities to our circumstance and there may have been conflict between the people before. It may be that the person, the patient themselves, is so angry that they can't feel grateful. So the first thing I would say is we have to be realistic about what we can offer without depleting ourselves too much, and that it's okay to do less. And this may sound harsh, but that's the way it is. So we shouldn't give so much that we're hanging on by our fingernails, dusted, depleted, sick, resentful People do that, but that's not the best approach.

Dr. Delia Chiaramonte: 26:33

In the book there's a chapter called you Song Creating an Imperfect Plan which counts, even if there's just one child. The idea that it's true, it's not going to be perfect, this fantasy, if I'll just give up everything and care for my parent and then they'll be so loving. Yeah, it sometimes doesn't work that way at all. So the idea really in the Imperfect Plan is let me self-reflect what can I do without feeling completely depleted? So maybe I can come over twice a week, but if I come over seven days a week I'm going to lose it. So you don't do seven days a week.

Dr. Delia Chiaramonte: 27:06

So the first thing is what can I do without feeling totally depleted? Who can I get to help me? Who else can help me? And the obvious people if there are siblings or other immediate family. But how about the next level out? How about friends? How about neighbors? How about the next level out? How about people at religious organizations or in your book club or at work? And how can people help? So sometimes people can help by showing up and actually doing things. Sometimes they help by sending food, but sometimes they can help with money. Some people can help with money. They might be like I'm not coming over and I'm not wiping any butts, but I'd pay for some things. And they might pay for some home health care, right, so that you can have a break. So I really think the central core in your question is to only give what you can give and then be creative about getting help for all the other stuff.

Kathleen Mundy: 28:05

That's a really good point. I know that oftentimes you feel obligated to do absolutely everything, but the point that you make that some people who can't spend time might have the resource to get a cleaning help or something or have someone come in and do the laundry I think that's really, really relevant because it gives you an opportunity to step back a little bit, and in your book you mentioned that you know removing yourself and kind of stepping back and letting go a little bit.

Dr. Delia Chiaramonte: 28:34

Yep, right, exactly. And so that concept of I feel obligated. If you're running on obligation and you're pushing yourself so much that you're depleted, you're not a very good caregiver anymore and your person probably is not feeling better that you're there, because you're probably crabby and annoyed and they might feel afraid to ask for anything. They will feel your negative energy. So it's much better to give what you can give and still keep positive energy and get help for the rest of the stuff than to be like, no, it's fine, I'll do it, and you show up with that energy.

Yasmin Nguyen: 29:09

That's actually not great, even for the person you're trying to help. That's such an important distinction. Delia, the energy of obligation and a conversation with mentors in the past. They've helped me notice the difference between when you make a decision to do something out of obligation, rather out of excitement or love, what bounce back is resentment.

Dr. Delia Chiaramonte: 29:36

Yep, they will feel that, and I think that avoiding regret is a pretty important piece of this whole thing, because when you're in it you can be like, fine, I'm here, I'm annoyed, and they can tell I'm annoyed, but whatever, at least I'm here. But then at some point they will be gone and you don't want to be stuck with that thinking gosh, the whole last year I was just annoyed and that's not how I want to end my relationship with this person. So the other piece to this, I think, is that when we ourselves are depleted, hard things are harder. So part of the answer to your question that's maybe one step back is that we actually really need to work on filling up our own cup so that we are as filled up as we can be, because we probably can help more than, and we can help in a more loving attached way than that. If we're just like I'm working like a dog, I'm volunteering, I'm doing these extra things, I'm cleaning my house myself, I'm making dinners every day, I'm driving the kids all by myself to all the things and I'm just white, that person trying to provide caregiving is really hampered, whereas if they could do some things to lighten their own load, like.

Dr. Delia Chiaramonte: 30:51

Maybe someone else can drive my kids to some other things and maybe I can order in healthy food sometimes and maybe I can get somebody else to clean the house now and then.

Dr. Delia Chiaramonte: 30:58

Maybe I can lower my standards a little bit and just let it be a little messier, for right now it's kind of a crisis time. Maybe I can work a little bit less at work or do a day at home, I can ask anyway. So what are the ways that we can reduce the things that empty our cup and add more things that fill up our cup? Maybe I really need an hour or two alone every weekend. I can pick the place in my house and put a note on the door and say nobody bother me unless there's blood. This is my time. Maybe I need to join a running club, or maybe I need to have a book club, or maybe I need to go get a massage every other week. What are the things that I need to fill up my cup so that I'm in a better space and from there, the person who is ill will get the very best of me.

Kathleen Mundy: 31:47

I was really inspired by your concept and how you deal with what you call toxic positivity. That struck me as a concept I never, ever thought about before. But I know many people go into this positivity lane and almost push away reality, thinking that they're doing the right thing. And just explain your concept a little bit for us, sure.

Dr. Delia Chiaramonte: 32:12

Thank you for allowing me to speak on this because I think it's really important. Actually, people get confused about gratitude and toxic positivity. So gratitude meaning looking for the things in your life for which you are grateful is generally a healthy psychological thing to do. It reduces anxiety, it reduces pain, improves sleep, depression et cetera. But toxic positivity is really brutal. The concept there is whitewashing all the bad things away. No, it's fine, everything's great, it's going to be fine. So if someone says, gosh, the doctor said the chemo might not work, a loved one this happens all the time will jump in and say don't you say that? That's not true. We have to be positive. If you're not positive, it's not going to work and all that does is shut down the person who was having some realistic concerns about how things are going to go. So toxic positivity is like white paint over the moldy wall it looks good for a second and you might think that it's good, but it is covering up some difficult stuff underneath and it's not psychologically good for anybody. So the trick that I like to use that allows space for both the hard parts and also the grateful parts is this sentence of I don't like or I hate, if you want that.

Dr. Delia Chiaramonte: 33:39

I don't like blank, but at least blank. So I don't like that. I have cancer, but at least my family lives in town. I don't like that. My headaches won't go away, but at least the snow stopped. I don't like that. My child's not doing well in school, but at least we got this great dog and it's brought the mood up in the house. They don't even have to be related, so I don't like that. I have to go get a mammogram today, but at least I had a great breakfast. The point is it makes space for the thing I really don't like. It doesn't say I don't hate cancer. It allows space for it. Hate that. But then it just gives you the space to turn your head of your attention a little bit and say but here's something I could show, a moment of gratitude. That's so powerful, dilya.

Yasmin Nguyen: 34:37

And the distinction with that particular phrase is that you're acknowledging what's there. You're saying that, hey, here it is, but I don't have to like it. But then I appreciate something else. It's not, like you said, whitewashing and saying no, no, no, it's not there, I don't see you, I don't see you. But it's just saying, hey, it's there and I'm focused on something more positive, exactly.

Kathleen Mundy: 35:00

But this skill set could be used absolutely every day, whether you're in a crisis or not.

Dr. Delia Chiaramonte: 35:07

It should be. I do that all day long. It changes the way you carry yourself through the day. Any time I go gosh, whatever it now it pops to my mind and most of the time, most of the time, I'm able to say, yeah, I don't like that thing, but at least this other thing, and it just lightens the heavy a little bit. It just reminds you that, yeah, that stinks, but look, there's other stuff too, and it's a wonderful psychological tool. Here's what I love at the book launch party last week I shared that, and since then people have been texting me their phrases that they did that day, and it makes me so happy. It makes me think, oh, we all should be doing this all the time. We should be texting our friends. Oh, I don't like blank, but at least blank.

Kathleen Mundy: 35:49

It's a great size I'm going to share with you. I used it immediately because it's knowing like crazy here and I said I don't like cold, snowy days, but I get a chance to look at the forest behind where we live.

Dr. Delia Chiaramonte: 36:03

So I love that I was able to use that. Perfect, exactly perfect. That's great Thanks for sharing that.

Yasmin Nguyen: 36:11

Delia, you had mentioned earlier about navigating some of the health care system and the challenges that are out there, and, kathleen, in one of our conversations we talked about some of the delays that we experience in getting news about various different diagnoses or perhaps even being heard by our professional caregivers too. And so, deely, I'm just curious what's your experience been like and what are some thoughts that you have around navigating some of those particular challenges as a caregiver with the health care system?

Dr. Delia Chiaramonte: 36:46

Yeah, boy, the health care system is kind of a mess, I'm sorry to say, and so because of that, I would say that being organized and vigilant and a really good communicator, those are probably the key things. So, organized, I give an example in the book of how you might organize your medical records, and actually on my website too is something people can download about how they should set up their notebook. This is important because you might assume that if you go to two doctors, that they both know what medicines you're taking. Or if the new guy changed your medicine, he told the old guy, no, he didn't. So nobody knows what you're taking except you. You go to a hospital, they'll pull up the medical record from when you were there two years ago. They might write down those medicines as though those are your current medicines and they may not be your current medicine. So you as the patient and family are the source of truth, and so you have to have a notebook that has all the stuff and carry it around with you so that the source of truth is with you and you share it, so that in terms of organization, I think is really important. Related maybe to that one is write down your questions before you go into the office, because you'll think you'll remember. And then, as soon as you go into the office you forget all the questions, the doctors rushing around, then they leave and you go oh, we didn't ask about that thing. So write down your questions, have them open and then write down the answers. And if you're not able to write down the answer because you don't totally understand, ask again so they totally understand. So organize all the information from all your medical experiences in one place.

Dr. Delia Chiaramonte: 38:17

Vigilance, unfortunately, is very important. There are tons of medical errors every year. It's nobody's fault per se. Doctors and nurses are doing the best they can. The system is chaotic. It'll blame anybody, but it's a fact there are errors.

Dr. Delia Chiaramonte: 38:30

So if I have a loved one who's in the hospital, as much as possible I would try to have somebody there. So that's an example of how you could bring in other helpers. You don't have to be there every minute. Maybe there's a neighbor who could come for a few hours, or people from church or synagogue or your mosque could come for a while. Maybe someone from work could come for a while. But as much as possible it's good to have somebody there and watch what's happening. So if they give pills and there's a blue one, and there wasn't a blue one there before say whoa, hang on one second, what's that blue pill and why are they taking it? And if the nurse isn't sure, say wait, don't take that yet. Go, please call the doctor and ask them what that pill is for, because there's a possibility it could be for somebody else.

Kathleen Mundy: 39:18

You know I keep relating this story about the experience I had with my father, but when he was hospitalized for a few months actually near the end I had a notebook that I asked people when if you visit Lyle, would you please give me a description of what you find? It was a huge advantage and I would leave a note for the next person who might be in it and it really helped reduce my anxiety and it was a nice thread throughout his time that he was with us.

Dr. Delia Chiaramonte: 39:51

That's a great example and a really important thing to do. Thank you for that.

Yasmin Nguyen: 39:57

That's so powerful. Wow, delia. We're so grateful that you bring such richness in experience and experience and wisdom. And for those interested in learning more about Dr Caramonte's work and her amazing book, visit wwwcopingcouragiouslycom. We'll also include the links to her website, book and resources in our show notes at wwwrealretirementshowcom.

Kathleen Mundy: 40:25

Well, you've opened my eyes to a lot of things today and yesterday, and that was the best 24 hours to spend with the book.

Dr. Delia Chiaramonte: 40:32

Well, thank you so much. Thank you for reading it, and I appreciate those kind words very much.

Yasmin Nguyen: 40:36

Thank you, Delia. We're so blessed and grateful that you hear that your mission is helping so many people, not only within this retirement conversation, but so many others as well, and this is an important topic that I think we just don't have an opportunity to really explore much, and that your book is a gift that allows us to do so.

Kathleen Mundy: 40:58

Absolutely.

Yasmin Nguyen: 40:59

Kathleen, anything else?

Kathleen Mundy: 41:00

Well, this has been an emotional journey for me. For sure. We are blessed to have someone like you, who takes this journey to help others, because it will be life changing for them. The memories that they will create, the legacy that they will leave, will be something that they can be incredibly proud of, with your help. I think the lessons we learned from each other are lessons that we absolutely hold as gold, and when we have like-minded people that are open, open hearts, open mind, come together and share those experiences that actually will help someone else in their journey is why I think people are put on this earth. Just in closing, I just want to say I have a 95-year-old mother-in-law that I don't have a lot of experience dealing with this up until I am now dealing with it, and the information that you provided really is going to give me insight into how I can make the relationship better and her experience here better. I'm looking forward to our blossoming new relationship.

Yasmin Nguyen: 42:06

Thank you for taking the time to join us today. If you enjoyed this episode or found it valuable, please subscribe, follow and leave a comment or a view on your favorite platform. If you have friends, clients or loved ones who are retired or thinking about retirement, we invite you to share this show with them. Check out the show notes with links to resources mentioned in this episode at realretirementshowcom. Remember, retirement is a joyful journey we get to experience together. Join us next week for another real retirement conversation.