When Children Become the Parents…Navigating Aging Parents with Shivan Sarna

For this deep dive conversation, we're going to be talking about a very interesting topic here. We're going to be talking about dealing with raising, taking care of elderly parents, which is really hot topic in our generation, especially with midlife right now. A lot of us are navigating that, and if we're not yet, we might be soon. I've got Siobhan Sarno here now. She is actually an author. She is a top summit host. She is very well known in the gut healing space. She wrote a book, Healing Sibo. Am I pronouncing that right? Sibo.

Yeah, you got it.

We could do a whole topic around this. She is a go to expert when it comes to gut health and even food poisoning. All the things that are happening internally there. But that is not what we're going to talk about today. But you might want to follow her for and read her book on those topics because she's an expert there. I wanted to talk to her about this very specific topic because she is right in the thick of it. And this is a hot topic with midlife. We don't have enough resources on how to handle it. So thanks so much for jumping into this deep dive conversation with me, Siobhan.

Oh, my pleasure. I, you know, usually was planning on talking to you about gut, but then when I saw the list of interests, I was like, wait a minute. Yeah, this is important. And not enough people are talking about it to your point. So. They are not. They're not. Hi, I am Siobhan Sarna, and I was a TV host for 24 years as well, on a home shopping network. But we were cool. So it's hsn. So I, you know, I have a lot of experience with another generation as well. My cat's gonna walk by. You're gonna see her tail in just two seconds. There you go. So. So here's a little bit of background on why this is actually relevant. And not everyone's going to have the situation, but we all are going to have aging parents unless they are deceased. Okay. Pretty much. So I was born when my father was 69 years old. I'll show you a picture of him.

Oh, my goodness. I didn't know this. Siobhan, 16.

Yep. He was from India. My mom was 30 years his junior. She was from upstate New York. They met in New York City. Where else could these two people. He was from India, she was from upstate New York. They met in New York City and he wanted to hire her. This was back in the 50s. He wouldn't pay her enough so she didn't go to work for him, but he did start to court her. And lo and behold, they ended up getting married. And it's a beautiful story. He took her around the world and just opened up the whole world to her. She was very savvy and very sophisticated, and it was a beautiful thing. I have two older sisters, eight and nine years older. My father died when I was 13. When he was 82, I was a surprise, by the way, obviously. And my mother passed away at 70, back in 97. And she had lymphoma. And really was one of those scenarios where it was like someone once said, she should have just crawled in the grave right after your dad, because she kind of gave up. It's very sad. It's very heartbreaking. I'm so glad they're together in the heavens right now. So this gets more interesting because when my mom was dying, and by the way, I did take care of her for the last 10 years of her life. So she had lymphoma for a long time. It was really interesting. It was very brutal, because in the 90s, chemotherapy police, you barely knew what the lymph system was. I did a whole summit on it to educate people. So what happened was when mother was dying, Bunny was dying, she asked my friend, who's an older generation, Linda, if Linda would watch out for me. It was very, very sweet. Linda is of another generation. She's older, and she's now in her 70s, and she now lives with me and my husband. So I've known Linda for 30 years, and what's happened is, is that now I'm her primary caregiver.

Yeah, she became sort of like your adoptive mom in. In a lot of ways.

In actuality, I did get adopted by her. It was more of, like, a love gesture, and it was very sweet. And it wasn't like, about assets or anything. It was just like, let's make this a fit. It was so sweet. And so here we are. And I have seen her lose 30 pounds over the course of about two years, just like this wasting. And she's still as feisty as ever, and she has hearing loss and doesn't want to admit it. So we had to go to the audiologist and. And she looked at the report, and she felt that the lady was really, really nice, but that she wanted to see another audiologist because she isn't having a hearing problem. But I had explained to her that we're actually a very polite family and that we don't constantly say to her, you can't hear. And you're asking me to say what? Oh, my gosh, what? Like, almost constantly.

So she's thinking, this lady's wrong. And it's just. You're just being very nice.

Yes, yes, yes, yes. And there's a lot to. So this is a little example. So I've watched her go from this robust human being to wasting. And you know, it's going to happen to all of us. Right. So here we are. We're trying to, like, make the most out of every day. We're living our best lives to the best of our ability. But most people don't plan on their own death. They don't plan on taking care of the next generation. Right, right. The older generation, the previous generation. And that's why we're having an elder care crisis in this country. And so what do you do and why assisted living facilities and memory care facilities are just so valuable when they're great and when they're horrible. It's horrible. The guilt of sending someone to a nursing home can be so overwhelming and devastating. And it's something that I'm like trying to ring the bell really loud so we all start thinking about it. My par were amazing. Bigger than life in Life magazine, literally at inaugurations. They were amazing human beings. There are two things I wish they had taught me, Natalie. I wish they had taught me to exercise regularly. I wish that was a value system we had and I wish that they had taken better care of their end of life plans.

Yeah.

Right. So. And I think part of it was that my dad was so much older. Like there was a little bit of denial that he was going to pass, you know, anyway.

Were you an only child? I'm taking as Siobhan.

No, I have those two older sisters.

Okay. Got it.

Right. And though I was an anniversary baby, a big surprise and the light of their lives, no doubt. Anyway, so, you know, we need to do a reality check about what we're going to do for ourselves and what are we doing for our parents and is there enough money and. And this is your to do list, everybody. And don't hate me for it, but the back of your mind, do you know about Medicare and Medicaid? Do you have an elder care lawyer? Are your wills in good shape? Are their wills in good shape? Do you have a power of attorney who is going to have that last, you know, sign off on health proxies? These are all really, really important and they are neglected because no one wants to deal with it. Why would we? Yeah.

And I can say right Now, I don't think I've dealt with any of these. And as you're speaking, what's coming up for me is this isn't. Not. This is so much bigger than just us dealing with elderly parents. This is what are we leaving our kids to deal with.

Right on. Right.

Because a lot of this. Yeah.

I don't have kids, so.

I do. Yeah. So I'm. I do. And so I'm listening to your list and I'm like, you know, I don't know any of this. And is that fair? Because then otherwise she's walking through the shoes that you're walking through right now. Later.

Right. So my father died. We had a hundred dollars in the bank. We had a very expensive home with a big mortgage. And he, he was an incredible businessman. Oh my gosh, this guy was incredible. But at the end he, we didn't have the things in place. And that was the only thing my parents thought about was his end of life plans. It was really interesting upon review. So my mom and I were like rich, poor people, like rich in assets of this home in Sarasota, Florida. But like we had an art collection that was not museum quality but was like designer grade of Indian artifacts back in the day. Sure. And so we, if dad died in the 70s, you know, we would have people come over to the house and like buy things off of our coffee table. She was hustling. This is doing a high side hustle.

And you're 13, so at the time, so you're right.

And I'm like, okay. You know, it really created this bizarre scarcity mentality that I've had to overcome. And also simultaneously, like super blessed to be living all the water in Sarasota, Florida. Growing up, I mean, it was just like so champagne problems in certain ways. But now fast forward, find that elder care lawyer. Make sure that your estate is in good shape. Make sure that your parents have it together. And also those healthcare proxies. Plus, does your parent want to be resuscitated? Do you have a DNR in place and a dnr? Do not resuscitate. It needs to be on the refrigerator if they're not doing well. It needs to also be in. In certain states. Depends on state. There are. It's a doctor's order. It's not just a legal document that you sign at the lawyer's office. It's. The doctor has to sign it as well. So it's two different things. Like if you're like, oh, she has a do not resuscitate and you're the emergency room. Unless you produce this one document from.

The doctor because they're going to say that legally they have to do it. Yeah.

You got a lot going on here. Oh, wow.

Okay. So this is. This is a pretty significant checklist. So I'm assuming you figured this out because you've had to navigate this.

I am in the process of navigating it. So mom did not need Medicaid, but Linda may. Right.

What's the difference between Medicare and Medicaid?

Medicare is when you still have money. And I way oversimplify it. Way. Like, this is not. I'm telling you, this is a rabbit hole.

Okay.

And Medicai is when you don't have any money and they do. So there's Medicaid fraud, where people will be like, I have $100,000. I'm going to give it to my kids. And now I don't have any money.

Oh, wow.

Right. But just so you know, they do a. I don't know, I think it's. Yeah, it's national. They do a five year look back. So they're going to look back over that person's five years of income. And if you've been giving it away just so it looks like you're finally below a certain threshold, that's gonna be a problem. There's also, you know, different situations where maybe someone falls, which is a huge issue. Falling risks are huge. And then they go into the hospital, then they go into rehab, then they can't be taken care of at home, and so they go into a facility. A lot of these facilities have three year wait lists.

Oh, my goodness.

Right. It depends on where you live. So this is so very important that you have it together. And what if you don't know what these facilities are and the nice ones don't have room? I would want to know what the setup is locally for these rehab places. So when the social worker is talking to you about, well, they only have room here, but get our waiting list here. Like you already know what your loved one is getting into. Now there's. I'm not even talking about, like, memory stuff, you guys, because it's just. It's so huge. As anyone who's dealing with an elder parent or even a reasonably young parent who has memory issues, that is a different animal in so many ways. And my heart goes out to you. Do they have life insurance? How. What is the relationship that they have with their doctor? So when my mother was dying, she was in Florida and it was in the 90s and her doctors were so used to dealing with dying people. And because it's Florida, it's elder elderly there, in many cases, they had such a different mindset. My sister got married in New Hampshire. My mother, through the will of my other sister, who came down and got her and flew with her, while my mother had hepatitis C because she had no immune system left. She lived through my sister's wedding. She told my sister on the. The day after she got married or a couple of days later, like, I think I'm going to go this weekend, meaning she was going to pass. Now, my sister in New Hampshire worked in Bristol Myers Squibb. So she had all of these doctors who are her friends. And my mother had heart failure. She went into the hospital. This is all like crazy, right? And my sister's friends, who were appropriate doctors were able to then not look upon my mother as this pain in the butt elder woman who was also dying, but instead were tremendously compassionate because she wasn't just a number. Yeah, they had a relationship to the doctor. So you really need to build these. It's not easy, by the way, because I get it. The relationships that you build with these people are going to make important decisions, are super important. So they were able to put my mother on a morphine drip and she drifted. And so she did pass. I mean, she was at the end, had no nose left from skin cancer. It was horrible. She had gangrene on her effing nightmare.

Awful.

So I do not wish that for anyone, obviously, but that was divine intervention as far as I was concerned, because if it was in Florida, who knows what would have happened. The other thing is, I think people at the end really played down or aren't aware of or ignorant of what hospice can do for you. So hospices are incredible resources for people's family as well as for the person who's at end of life. I didn't actually ever bring hospice in for my mother because I didn't understand what it was. I didn't have a reality check of what it was.

I've heard nothing but positive things about once people. Finally, people are so scared of it, they stay away from it. They don't understand it. But once they actually bring it into to it, people are usually very happy they did that.

Right Now I want to tell you another story, which is about someone dying at home. Make sure. So I. So Linda wants to donate her body to Harvard. So we. We laugh a little. Morbid laughter. I'm like, oh, finally someone in the family is going to Harvard. So anyway, oh, my gosh. So we made. She. She said, I don't want a T shirt. It's too soon. So. So we. I talked to the funeral home that Harvard referred me to, and they will take the body. I know this is all like really blunt, you guys. I'm so sorry. But they'll take the body and there's no fee that. That block, depending on where it's located at the time. Okay. So if you're going to have your. If this person who you love is going to be. You know, we're all dying and we. Us included. But do they want to be cremated? This is kind of more obvious. Do they want to be buried where. What do they want done? But there are prepaid cremation services that you can do whether you are traveling at the time and pass that. That. That organization guarantees that you will be cremated at the same price. Because to move a body is super duper expensive. Okay. The other thing is I talked to. I talked to some. I talked to a police officer about. And the mortuary about what happens if she dies at home. And this is what they said. And I think it's going to depend on the state. However, if she dies at home and hospice is not there, the police come and the ambulances come. And he said to me, it's. A lot of this is just full disclosure. I feel like I'm doing disclaimers because what I'm about to say feels really weird, is that it's a lot of attention to the home. Like your neighbors are going to know. It's like it's a thing. Like it's a public thing street. And you should be aware of that. That's going to be a ramification and that it's very, very uncomfortable. And the police go through the list. Did you kill this person? You know, it's really.

And it's not just that it even like. I mean, I'm thinking ahead to even like home resales and stuff or. Right. You have to discuss.

Right on. No, exactly, exactly. So, yeah. Oh, you don't want to be the. Do you want to. How do you feel about being the house that had someone dying? I mean. And it's also life and death.

I mean, it is like this happens in most homes at some point, but. But it's part of the cycle. But it's still something right now that it's. It's a whole. It's a deal. It makes a difference.

It's a thing. Yeah. So, yeah. So there was somebody who died at a hotel in my favorite Location where I like to go on vacation. I was like, oh, I don't know if I want to go back there. And my husband and Linda said to me, well, then you're never traveling to a hotel ever.

Yeah, because it happens all the time.

It happens all the time. So. So the police will come, the ambulance will come. It is uncomfortable. They ask you questions. Okay. If a hospice nurse is there, again, state by state, so please check, the hospice nurse can sign the death certificate, and then the police don't need to come.

Wow.

And they just call.

Makes a big difference.

Yeah, makes a big difference. Now what if the hospice nurse isn't there? Well, you can call the hospice nurse and they can come, I think, and they can, you know, do. Do the deal. But if she's not enrolled in hospice, it's not happening. Got it. The other thing, I heard a story about a hospice nurse that freaked out when the person died. She was new, I guess, and so it was very difficult on the family because it didn't go smoothly. So you need to build these relationships with your caregivers to the best of your ability, and you also need to vet them. I mean, if someone's not competent, you as the caregiver with the Carey and care, other carers really need to manage it. And that's a huge deal. The other thing I found was care.com. so care.com is a site where you can type in your zip code and people who work at hospitals, nurses aides, personal assistants, drivers, it all comes up. And these are all people that want to make extra money, either extra as a side gig or full time. And that lists their experiences. If you pay extra for care.com, like, they vet it. Vet them. And, you know, there's a, like, driving, you know, you know, test and things like that. I mean, so you get some. Some better data about these people. The other thing about Medicaid is that you can apply for it to get in home care. So. But there's a variety of different thresholds you need to be approved for and pass. So I just want to really bring all this up is like, yes, the fricking hornet's nest. And you're also dealing with the emotions. And also personalities change over time. Have they had a mini stroke? Has it affected part of their brain? Are they getting enough water? If they have a uti, they can totally have a personality change. And you're like, oh, my gosh, what happened to my favorite.

It's almost like this is going to sound really bad comparison, but I'm going to bring it up. It's kind of like when you're caring for a pet or maybe even caring for a baby. Like, they're not communicating and we don't know, and you're sort of doing a guessing work. I mean, there's a lot of that.

And they're scared and they're scared and they don't feel like themselves, and it's it. And they are not. They know that they're closer to the end than the beginning. So it's. It's in a very, very confrontational time of life for them and for you as the loved one who's caring. Add on that you don't live near them. Add on that they live in the house. Whatever it is, there's so many complications, and if you are prepared, it makes it better. That's all there is to it.

Yeah, that this makes sense. You gave us a pretty good list, too, of the things. My question for you is, how do you take care of yourself during this? Because this is right on a lot.

A thousand percent. I'm so glad you asked that. There are blogs and there are podcasts about caregiving for the caregivers that I definitely want you guys to go and search. There are great books out there. New York Times just did an excellent article about it. So, you know, do your typical Google search on all of that. But even if you take that care.com, you know, helper a couple of times a week, an hour, a week, whatever you can afford, you have got to take care of yourself. Because we all know when we get hangry, tired, we get impatient, for sure. And I absolutely adored my mother. Okay, she was astonishing. But I regret the way I spoke to her on occasion at the end of her life. And that is very difficult for me to say.

Yeah, I'm sure she understands it. Knows 100%, we're all human.

100%, 1,000%. I have no doubt. And, you know, I've definitely felt in meditation, I feel her all around me all the time. But. But. And I have. I'm happy to say I'm a person who doesn't have a lot of regrets because I really work my plan and I'm, you know, I'm really trying to be, like, meditate and, you know, be good. And I'm not perfect by any stretch. When I was in my, you know, 20s, when this was going on, but it. It. I don't want to have anyone else have that experience if possible. It sucks. It sucks.

Yeah.

And I have a very elaborate understanding of my version of the afterlife, so I'm very peaceful about it. But if I see these movies and stuff like, oh, I didn't get a chance to tell them I love them. Okay, well, in the astral plane and my understanding of the universe, they know. So it's not. The veil is so thin. It's not like you didn't say something on that last day and they're still mad at you over it.

Right.

Let yourself off the hook. But, you know, obviously we're human and stuff, so I just. I just want to make it as easy as possible for anyone because it's a. Yeah, no joke. It is not. And what if your husband or wife is not on the same page with you? What if you're. Here we go. What about the siblings who are now speculating about who's going to be in the will? Who gets that couch? Who gets the china?

This is why it's so important to have that communication ahead of time.

Gotta do it. Yeah. To do it.

Siobhan, this was super eye opening and so helpful. Thank you so much for this, for sharing.

My pleasure. And I wish everybody the. The best in these experiences and may. May we all be peaceful and be free around it. Thank you for having me.