Book Chat: The Value of Wrinkles

By 11  am On


Hosted by Patricia Dubroff, the director of community relations for Assisting Hands Home Care. The elderly have a myriad of health issues from Alzheimer’s to being frail and unable to care for themselves.

Patricia Dubroff: For those of you who don’t know me, I’m Patricia Dubroff. I’m the director of community relations for Assisting Hands Home Care, and we are all about educating our families and our colleagues about what’s new in the planet, how we can make it better for elders because as Tyler so wisely said, you can be 75 years old and you can be hale and hearty, or you can have Alzheimer’s or be dealing with challenges of cognitive powers, you can be frail and vulnerable in your physical body. It’s just such a wide-open territory. Age has nothing to do with your health, in some ways.

So we’re going to talk to Isabel, and Isabel comes from the world of home caregiving because she grew up with her grandparents in her home, and that is not so usual. I was going to do a poll, actually, but I forgot to put it out there, of how many people grew up with grandparents, period, how many people grew up with grandparents in their home. I think it would be kind of small. So if you want to put that in the chat, I’d be happy to tally it up. Just tell me whether you were raised with grandparents in your lives and if they lived with you.

So, she comes to this work in a very unique way. She kind of developed into her career by default, it sounds like a little bit, as most of us have … you kind of flow with what seems to be a parent. She’ll tell you a little more. But she ended up working with Erickson and the whole concept of senior community living and then got involved in hospice. She’s quite remarkable in that she realized that one of the things that is holding back the whole process of helping elders is that a lot of young people don’t get involved in that as a career choice until they’re already in their 40s or 50s. And so you’re missing that intergenerational piece that is so sweet and powerful. She writes about that, too, in her book. So, Isabel, welcome to our book event of the day, and-

Isabel Tom: Hi. Thanks for having me.

Patricia: It’s great to have you. I’ve shared hosting with her, so it should be able to … If you put it on speaker view, you should see both of us and not just me speaking. I’m not sure, but we can figure that out. So Isabel, tell us a little bit about you growing up and where that little nutshell came from.

Isabel: Sure. I’m actually from Montgomery County. I grew up here, and I grew up in a multi-generational household. So it was my parents, I have two older sisters, and then myself. I think what made my story unique is that my grandparents lived for a really long time. I know people who have grown up with their grandparents, but their grandparents may have passed away. Or I think it was Rachel who said her grandma got moved into an assisted living. But I lived with my grandparents until I was 26, so I literally … I think it’s kind of a cultural thing. It was unspoken, but I wasn’t allowed to move out until I got married, so literally, I lived with my grandparents until I got married.

Even after that, I still was really close to them and helped care for them and just support them. My grandpa passed away at 98, my grandma passed away at 102, so basically I started writing my book after my grandma passed away. She was my last living grandparent, and so I like to say I have over 35 years of experience working and serving and being around older adults both personally and professionally. People always give me funny looks like, “What?” But yeah, I mean, there’s a lot to say in that. I’ll let you just go on with your questions because otherwise, I’ll just talk on and on and on.

Patricia: That’s okay. It’s a good story. One of the pieces that I like a lot in your book is … And I thought maybe you could read a little bit of it if you don’t mind. But I thought this part about that elders have time to encourage us, that you gleaned that because you were around them. It’s on page 39. Do you want to read that? Just that first paragraph is just so sweet.

Isabel: All right. “Sometimes we underestimate older adults and give them seemingly unimportant tasks so they can feel helpful. But oftentimes, older adults have the time and willingness to make a real impact on our lives. They can offer a helping hand, and like this older woman” … and I tell a story about an older woman who makes an impact … “They can relieve a busy mom of six from one of her many jobs. As you go about your day, look around at how older adults are already contributing in simple yet powerful ways. They are one of society’s most underutilized assets.”

Basically, I would say as a kid, I had my grandparents around and I like to say that they were like this extra layer of love and attention that I got. I mean, my parents were good parents, but then I also had my grandparents around, so I was able to get, I would say, more attention and support to help me … I feel like it built resilience for life and the tough things in life, because I knew that somebody always cared. The chapter title is called I’ve Got Time for You, because I feel like we live in a society, especially all of you, if you’re from this area, then you know this is a busy … you’re always busy and people are rushing in and out of their houses or checking their phones, they’re, “I’ve got to get here, I’ve got to go here,” and I experience myself with my own kids. But it was like my grandparents were just there, and so they were just this stable presence that always had time for me.

That’s great. I want to just share a little bit about what’s in the chat. Let’s see. “Yes, my grandma lived next door and I was very close growing up.” Tyler’s maternal grandparents had passed before he was born, but he had paternal grandparents’ two doors down. Wow, that’s amazing. “Profound influence on growing up. They never got called Grandma and Grandpa. They were always Stan and Annie.” I think that’s really interesting, too. Sylvia says two grandfathers, grandmothers died when she was six and one step-grandmother, but nobody lived with them. Deb says she lived with her grandfather. Hard to get to know him, he spoke Lithuanian and two other languages, but English was not their best choice.

And I’m the youngest of 10 grandchildren, and so I got sort of the last of the … because people weren’t living that long anyway. But I was really close to my mom’s parents, and my dad’s parents didn’t speak English, so I had that same problem. I think my dad used to pay us a penny a map. We’d look through an encyclopedia. As long as we were quiet on the floor while they visited, it was okay. But they died when I was very young, so very interesting.

At home, my grandparents, they spoke Cantonese, Chinese, and so that’s something I realized as I lived with them longer. I couldn’t get to know them as well because I didn’t speak Cantonese as well. I mean, when you have a limited vocabulary, you can only get into so much. So actually, when I was in college, I studied abroad for a semester in Hong Kong to try and sharpen up my Cantonese skills, and it actually did help a lot. That’s a whole other story, but …

Patrica: Yeah, but language is such a barrier. And even now with Google Translate, which is wonderful, it’s not always … It makes the conversation very jilted. You’re struggling. So that’s a huge piece.

Another thing then that dovetails really well is about including them in the conversation. The name of this chapter is Your Invitation Speaks Volumes, and it’s on page 59.

Isabel: So include them in the conversation. Well, basically, at the end of every chapter, I have something called “take notes,” and it includes practical ideas. Because I work personally and professionally with older adults, there are a lot of things that I’ve noticed that we can do. I think a lot of times as a grandchild or as an adult child, we care but we don’t know how to help, so these are just some ways. “Include them in the conversation. Ask if they can hear you. Speak louder if needed. Hold their hand or place your hand on their arm as a way to acknowledge them. Explain terms, places, gadgets, technology, and programs to ensure older adults can engage in the conversation. Help them understand what you’re talking about. Ask, ‘How are you?’ or, “What have you been doing lately?” or, “What do you think?” to show that you are interested in them and to engage in more conversation.

Patricia: One of the things that often happens with elders is that we just assume that if they’re sitting in the corner, then that’s enough. But there are really great ways to engage, and that’s what I like about the practical side of Isabel’s book. Some people have that gene in their systems already and they know how to just snuggle up and sit down next to their grandma and start talking. My kids do that all the time. But not everybody’s comfortable with that, and it’s interesting … I don’t know, it’s a phenomenon to me to watch that.

Isabel: Yeah. I would say, actually, I don’t consider myself somebody who’s natural. I am really intentional about it, actually, and I think it’s because I realize how powerful it can be when a younger person reaches out to an older person, and especially for my grandparents. I would try to think of things to talk to them about. I just want to encourage those of you who may find it awkward to make conversation with somebody older than you, I really believe that it’s the effort … not the effort, but the thought, and that when you take that step to reach out to somebody older than you, whether it’s just acknowledging them or asking how they’re doing. I think they notice it and they see it and it blesses them. Because if you think about as people age, especially; if they’re more isolated, they live maybe alone … Even now during this time, when I call up somebody I used to work with, an older person, I’m probably one of the only people who called them that day, and so I think it makes a difference just that you take that intentional effort to reach out to them.

Patricia: Very wise. I worked for a number of years in the long-term care facilities as an art and healing person and we would often bring in folks of varying ages. So we had the little toddlers with their moms, we had the teenagers. We’d set up these one-on-one relationships so that every week, the same person would be visited by the same youngsters, and those relationships were super powerful. People who wouldn’t come out for events were now out for events. Really, even some that weren’t even able to vocalize were vocalizing. They had a reason. They were being asked to help, and it’s just so powerful to witness that, so that’s lovely.

Let’s step aside a little bit. We know the book is fabulous and has lots of information in it, but what possessed you to actually launch this concept of writing a book? I mean, you got a master’s in public health. You were in the world of aging and supporting that. How did you find time or effort to do that?

Isabel: That’s a good question. Since I graduated from college, I started working in the aging field serving older adults, and actually, ever since I started working in this field, I started learning things about how we can care for older people or gaining different insights. I feel like this gap kept widening. I would talk to my peers and they would say, “Oh, you work with older people? That’s so depressing.” And in my opinion, I was like, “Oh, I love my job. I’m learning new things and there’s so much we can do to bless older adults.” I was seeing a lot of things that they … the ways that they just blessed me in return as I served them, so this gap kept widening. And so I think it was probably five or six years later, I started a blog and it was called About Being Old then, and it was basically a place where I could write to try and share with my peers’ different things, insights that I learned about caring for older adults or just interacting with them and things that encouraged me.

So I did that for probably about seven, eight years, and I don’t think anybody really read my blog. You probably have never heard of it. But my grandparents were still living and I kept on learning. I started working in the hospice care field, and again, my mind was blown away. Initially, I thought working in a field related to dying would be depressing, but I kept learning new things from a professional perspective that I could use personally as my grandparents were aging. I shared before they lived … this is my paternal grandparents … they lived until 98 and 102. So when I was working in the hospice care field, I learned about the decline and I learned about pain and how that can affect an older person [inaudible 00:15:51].

So basically, about two years ago, my grandma passed away. She was my last living grandparent. And I had put in a lot of time and effort to just make sure that she knew she was loved. I have three kids, they’re … three kids within four years, and so that’s a lot of work. It’s very tiring. I was working part-time and I was visiting my grandma to keep her company or help anywhere from three days a week to six or seven days a week, so I was tired. But when she passed, I had a lot more time. This just opened up space, and I thought, “Let me blog more because now I have time to do it.” But as I was reflecting, I realized I had so much to write. The other thing that I realized is my grandma had just such a beautiful ending, and I realized it was a culmination of all the things that our family had learned and things that I had learned that I feel we’re able to help her have a beautiful ending.

And I just started to wonder, “What about the other older people in the world? Who is going to care for them? Who’s going to be a voice for them?” I also looked out there and I was like, “There are no books out there for grandchildren or a younger audience,” and there really wasn’t. Usually, when you write a book proposal, there are books that you’re supposed to compare your book idea to other books that are already out there. I couldn’t even find an Amazon category for what would have been beneficial to me as a grandchild. Because I cared for my grandparents, I just didn’t always know how to help. And so I realized that the reason why you don’t have a category or books out there written by a younger person is that, as a young adult, I haven’t gone through aging. How can I write about it?

But then I realized like I was saying before, I have 35 years of experience working and serving and living with older adults. And because I lived with my grandparents, I lived literally in the room next door … I mean, I heard their conversations at night. I was woken up by their shuffling to the bathroom. I had to wake up when we had to go to the emergency room because there was bleeding, there was this, different things like that. I feel like it gave me an inside perspective, as close as you can get for somebody who’s younger, into what aging is like, and it helped me gain greater compassion for them.

So even though my kids were one, three, and five at the time, I was like, “I’m going to do this,” because in our society, I think we praise the voices of the youth more. I know that if I wrote this book in five years … If I wrote this book after I turned 40, I don’t think it would have an impact. If I wrote it at 50 or 60, I don’t think it would have the same impact, and I don’t think it would reach the younger audience and meet that need of trying to engage younger people to take a greater part in loving the elders in their life, or even in their community.

Patricia: Yeah. I think that’s a beautiful honoring of your grandparents to have written the book. In my faith, we do a year of blessings for the family member who’s passed, and as an artist, I took on doing a blog, a drawing a day for my dad, and that’s drawing a day spells “dad.” So it’s like you want to focus on what you’ve experienced in a way that other people will understand, and I know that you’re a faith-based person as well, so it’s like a bigger picture of what’s going on. I think it’s a great way to attract younger career thinkers about going into this field and making the field even that much more valued.

Yeah. I think the other thing, too, that I realize is that whatever job that you have, whether you’re working in a senior living or whatever field you’re in, the number of older adults is growing rapidly. So you could work at a bank, you could work in finance, you can work in pretty much … The majority of careers are going to be working with somebody who’s older, and I think if we have the right attitude as we interact with your customers or clients in whatever field you’re in, that’s going to make a huge difference. It’s going to make your job easier, it’s going to make your customers happier, and it’s going to allow you to have a meaningful impact in relationships with the people that you interact with.

I think the other thing, too, is everybody has parents or grandparents. Maybe they don’t have living grandparents anymore, but we’re all going to be caring for somebody older than us. Over the years, I’ve had a lot of peers or even their parents come to talk to me and ask me for advice when their loved one fell or went to the hospital, and I can help them and give them practical help like how to choose a short-term rehab, how to find home care, all of that, but I often have this burden because I wish I could share with them … I wish I could say 10 years ago, I wish they came to talk to me and I could share with them everything in my book. Because there are so many things … Once you work in the field of aging, there are so many things that you realize that you can do to provide a better quality of health for the seniors in our lives. Often people don’t start reading or learning until their loved one already has a health issue, and-

One of the things that make that even more exciting is when you talk about how to get your parent or your grandparent to have uncomfortable conversations. This is something that advanced care plan managers are brilliant at, and it’s one of the things that we talk a lot about in-home care because we want to get to know our families really well and really know what the preferences are. So because I come from the arts and healing world, we’ve set up a protocol of preferences for creative engagement because creative engagement is a great tool to use with elders as a way to support healing and open those communication dialogues.

So you have a piece in here where it says, “If your parent is uncomfortable talking about the future directly, consider yourself an investigator.” At that moment, I had this picture of you … because I had met you once before … with your little Sherlock Holmes outfit on, and I was like, “Oh, you should have put a little Sherlock Holmes in here.” Because that’s kind of what it’s about. You don’t talk to your parents and grandparents about the things that you need to talk to them about at this stage when they need help. Like, what is their preference for whatever? And I think that that was a really cute way to talk about it, to put on your investigator hat.

Isabel: Well, I think you have to be creative about it because the closer that you get to the end of life for somebody … and this is from my experience working in the hospice care, the end-of-life care field … the closer somebody gets to end of life where they … Yeah, the closer they get, the more intense the conversation gets, the harder it is to talk about these things, and it’s like you need to talk about them because if you don’t … It sounds so harsh, but bad things can happen. A lot of suffering that older adults have near the end of life, it doesn’t have to happen if there were conversations that were had earlier. Even now, I think about … This is something that’s really been in my heart, is with COVID, people are talking about ventilators and how the elderly are the ones who are vulnerable. Well, let’s say a lot of people sign their advanced directives and they say they want everything, but they don’t really understand what’s involved.

For example, a ventilator. I think if the elderly actually looked and realized … if it was explained to them what was involved in terms of getting a ventilator, they may not want to have that. And so I feel for the healthcare workers who have people coming in who need a ventilator, but they know that for an older person, they may not fare well on a ventilator. And so yeah, those conversations are so important. And for me, even during this time, it’s been a good time for me to even re-talk these things with the older people in my life that I want to make sure that if anything happens to them, that they get the best care possible. So it’s been an opportunity to bring up that subject and say, “Hypothetically, COVID’s affecting all these different people, but what would you want if this happened to you?” And so yeah, being an investigator, just being creative in the way that you bring up those conversations is important.

Patricia: I think one of the nice pieces, too, that’s throughout this book is that you don’t say, “You have to do this.” It’s like, if they don’t want to talk to you about it, then just wait until the next time you go and chisel away at it. Ask it a different way. Ask it from a different perspective. Have a story about somebody that you even made up about what happened to them. Not in a shocking way, but just in a way to open that conversation.

I’ve been doing these conversations once a month with folks around the issues of death and dying. It’s called Death Café, and it’s an international organization that our local village in Rockville and I sponsor. And it’s fascinating getting people talking about how they feel about death and dying, whether it’s for themselves or a family member or a friend. And just having those words in the conversation, it’s incredible. Some people haven’t uttered that word, “death,” in decades, because they are just afraid of it. It’s almost like the way we used to think about cancer, that you couldn’t say the C-word in front of people, that that was too scary.

So without getting too … I thought that would be a good segue into your chapter about What an Honor. I think the-

Isabel: I chose something from there that I thought I could read if I-

Patricia: Oh, sure. That would be great. I didn’t know if you had already prepped.

Isabel: Well, I feel like a lot of people don’t ever get to the end of the book, and so I figured I’d read from literally the last page.

Patricia: Oh, that’s great, because I got a couple of pages before that. But go ahead, let’s hear what you got.

Isabel: I’m just going to read the last page. It’s called A Noble Calling. “When I reflect on my journey of living, loving, and serving the old, I laugh at how far I’ve come, from grumbling about why I had to grow up living with grandparents, to clocking in over a decade of experience working professionally in the field of aging. I now have this special place in my heart for older people. Looking back, I’ve had quite a journey, one where every drop of mine mirrored the needs of my family to their very end. From working in fitness to assisted living and rehab to hospice, I see that my professional experience allowed me to bless my elders in extremely meaningful ways when Mama” … and that’s my paternal grandma … “When Mama passed away, she was my last grandparent, and I thought for sure I had now completed my job of caring for the elderly.

But it was in the weeks after Mama’s death, as my body rested, that my mind went into overdrive, and that’s when I started to wonder. What about the rest of the elderly? Who will speak for them when their health is failing? Who will sit with them and defend their pains? Do they have anyone who will be with them when they need a hand? Who in the world is going to be their voice? In our prime younger years, we set off into the world, motivated more than ever to make a difference. We sign up for the Peace Corps, we serve at soup kitchens, we travel overseas to care for orphans, we engage in political change. Yet somehow in our effort to change the world, we have missed the fact that in addition to reducing poverty, pollution, crime, and evil in the world, in our very own neighborhoods and family, there is life-changing work to be done. In our midst is a generation full of rich stories, wisdom, knowledge, perseverance, personality, and love waiting to be discovered.”

Patricia: Thank you. It is a beautiful sendoff, and I relished every page of this book. And not because it was the only book that I had that was fresh here where I’m caring for my mom. But actually, the part that I wanted to go back to, just a few pages before that. You talk about the beauty of good sendoffs. And like I said before, since I work with folks talking about death and dying, I love the way you wrote this. It’s almost like a poem about … to get the proper sendoff. It says, “Every single white-haired and wrinkled adult needs a sendoff.” I just think that was such a sweet way to say it. “They need a sendoff to remind them that they are loved. They need a sendoff where their life can be celebrated. They need a sendoff to commemorate their time here on Earth. They need a sendoff where they can share their worries and concerns. They need a sendoff where they can reminisce. They need a sendoff so they can say goodbye. And they need a sendoff to see everyone who loves them and to be reminded how pretty darn special they are.”

Honestly, I couldn’t think of a better little poem to engage both sides, the elders and the family members, into a discussion about what it is that you want? It doesn’t have to be this heavy list of medicines and not medicines and interventions and not interventions. It can be really from your heart. I just thought that was lovely that you put that in there.

Isabel: Thank you, yeah. I mean, I think a lot of times, we think that to care for the older people in our lives, we have to understand all these different things about senior care, and it’s helpful to understand those things. But from all the older people that I’ve served and I know, the sense I get is they just want to be loved and they want to know that they have people around them that support them. Yeah, a proper sendoff is basically … That came from, I think, when I was 27 and I was attending a lot of sendoffs and it just hit me and I realized, “My grandparents need a sendoff,” and it just completely changed the way that I interacted with them. Because I think sometimes if you are a caregiver, then you understand it’s hard. It’s a lot of hard work. It is exhausting mentally, emotionally, physically. So sometimes that perspective can really help you to have that perseverance to keep on going and not just to do it out of obligation, but to do it because you care for the older people in your life.

Patricia: Great. I’m going to open it up to questions, and then I want to save five minutes, in the end, to ask you about what’s next, so be thinking about that. But does anybody have a question? You can unmute yourself or raise your hand. There’s not that many of us. I don’t think we’ll be interrupting each other. Tyler?

Tyler: I don’t have a question, but when you were talking about the uncomfortable conversation or having the conversation, it also works in reverse. I mean, I’m the elder part of the conversation. I find it hard with my younger family members. They don’t seem to want to have that conversation with me because I’m blunt about it and upfront because-

Patricia: So you need to buy them each this book and have them read it, and then they’ll come clamoring to you and say, “I get it now. I get it now.” That’s what I’m thinking. This book is so useful for sending to the adult grandchildren and saying, “You don’t have to go into a career in this field, but read this with me in mind. How can we open this dialogue?” So that’s a great perception.

Isabel: Yeah, I don’t know the book at all, so I will take your suggestion.

Isabel: I’ll tell you a really funny story from working in hospice. A lot of times, adult children will tell … When I was still working in hospice care, they would tell us, “Don’t say that you work in hospice care. Just don’t talk about death or anything.” One of the funniest stories is when one of the potential patients, when the nurse went to visit her, she said, “When my kids come to visit, don’t say ‘hospice.’ Don’t tell them that I’m dying, because I know that my health is really failing right now and I don’t think I have very much time left, but don’t tell them because I don’t think they can handle it.” So it’s just really funny. I mean, every family is different. But yeah, that’s definitely a dynamic that does happen.

Patricia: Did we have any other questions? I’m going to check the chat and see if anybody’s written clandestinely.

Oh, I think Mary. Oh, Mary, go ahead. Let’s unmute you. Hang on. You’re muted still. Let’s see if I can unmute you from here. Yes.

Mary: Yeah. My husband has Alzheimer’s, and so it has kind of turned my life upside down and I’m trying to deal with it. I do a lot of reading and it sounds as if your book may be very helpful. We’re both in our 80s, so we could well be very close to the end of life, and I feel I need to do as much planning as possible for that. We have one daughter and we have had some conversations with her, but probably not as many as perhaps we should have had.

Patricia: Well, there’s time to have more conversations. Thank you …

Well-… for being so open and sharing. I introduced myself before as the director of community relations for Assisting Hands Home Care Potomac, so if there’s something I can help you with offscreen, I’d be happy to have a conversation with you. We have a lot of information and support for families all over Montgomery County. Sylvia, did you want to ask a question? I see you’re unmuted. I thought maybe you were …


Oh, okay. Sorry. Anybody have a comment or a discussion point they’d like to venture out with Isabel?

Isabel: I was going to make one comment based on what Mary had said. One thing about my book and the reason that I wrote my book, too, is because there are a lot of guidebooks out there that kind of give you the technicals of what to do. One book you might be interested in is … It’s by Dr. Gary Chapman. It’s called Keeping Love Alive While Memory Fades. But one of the reasons why I wrote my book is because I feel like as caregivers, you get very tired and emotionally it’s hard, and there are a lot of decisions you have to make that I feel are difficult and sometimes you are very uncertain. And so I wrote this book as more of a book about the heart that really, I think, can encourage people who are caring for their loved ones, whether it’s a spouse or a grandparent or an adult child. So I hope it does encourage you.

Also, I’m going to be doing these book events every month. I decided it would be fun to do. My next book is actually called Life-Ku, so something a little more fun and humorous. And then the next book is going to be Being My Mom’s Mom. This may also be a great book for you, Mary, because it’s written from that caregiver perspective, one on one, where her mother had severe cognitive challenges and she needed to take on a much more profound role as a caregiver than just companion care. She needed to be everything for her mom.

Great. Thank you for suggesting that. I will look into it.

Patricia: Yeah. Those are good ones. So Isabel, tell me what’s next for Isabel Tom. You’ve had this great book adventure. Obviously, you’re doing interviews still. What would you like to have happened next?

Isabel: That’s such a tough question. I think there are a lot of directions that I could go to. I truly enjoy working with older adults, and since my grandparents have passed, that’s a part of me that’s missing. I have my mom and my mother-in-law, and they’re in their lower 70s, but I miss working with the older adult population, so I hope one day that I will … when I get back into working, I’ll be able to do that. My kids are really young still, so right now, I’m actually staying at home. I’m doing a lot of interviews, I’m doing a lot of writing, just spreading the word because I think for me, what I write in this book, I feel like it can make a difference in people’s lives. And I want grandchildren and adult children and spouses and older people just to see the value that older people have. I think that’s counter-cultural to where we are at right now, so just to be a voice for the older generation.

So wherever God leads me in that area, we’ll see. I mean, right now, I’m pretty busy doing different interviews. So if any of you are ever interested, you can follow me on my … My website is and you can also find different interviews I’ve done on podcasts and just to listen more about my work. And especially if it helps you as a caregiver.

Patricia: There’s definitely a link on her website to buy the book and ship it to all of your grandchildren and loved ones. I wanted to mention there was a chat from Deb saying the mention of a ventilator perhaps not be appropriate for elders in ICU, and I wonder about your thoughts on placement of pacemakers in later years of life that might end up extending life unnecessarily beyond what they would want. Again, those are such personal choices, the quality of care that one is experiencing.

I’m going to tell a quick story. My mom was 92 years old and she had a pacemaker put in when she was 85 and it had a five-year warranty on it, says it’s going to last five years. So, of course, she beats the five years and her cardiologist says to her, “Listen, you got six years out of this unit and now it’s sending out signs to us that it’s time to replace it.” And she goes, “Oh, why would I replace it?” He goes, “Because look at you. You’re fantastic. You drive at night, you’re very independent.” I mean, he said, “And the new ones, they’re warrantied for 10 years.” And she said, “Okay, you’re on.” And actually, the second installation was much easier than the first and she’s hardy and hale and ready to get back out to not social isolating. She misses all her buddies.

But those kinds of questions about whether to intervene or not are so much like … Getting back to what Tyler said at the beginning. You could be 75 and frail and really at death’s door, or you could be 75 and looking 40, right Tyler?

Isabel: One thing that this made me think about is I have a YouTube channel. It’s not that active. But what I’ve been doing starting two weeks ago is I have a video series about how to help advocate for your loved one when it comes to medical decisions and how to make decisions. I think there are certain questions … Like Patricia was saying, I wouldn’t be able to answer your situation. I would have to understand everything, and ultimately, the decision would be up to your loved one or whoever is the decision-maker. But I think there are questions that you can ask that help you make a more informed decision. That’s something on YouTube if you look for The Value of Wrinkles, that I’ll be … Or you can actually subscribe to my newsletter and I’m sending out those different videos. Because I think knowing what questions to ask can help provide you so much more peace when you’re making difficult decisions like that.

It’s all part of that be the investigator. I love that. I want somebody to draw a little cartoon of you with a Sherlock Holmes hat. The other chat that I must share is that Elizabeth said that she’s the co-chair for the nonprofit Mastermind and the young professionals’ Mastermind for the Rockville Chamber of Commerce, and the young professional group is hosting a great fun event on June 22nd. If you go to the, you can find those events listed and sign up. You don’t have to be a member to come to an event or two. They usually don’t push you to become a member until the third event you show up at. But I’d be happy to help you guys do that. I love the Rockville Chamber and they’ve been so supportive over the years, so good people, and I highly recommend visiting their website as well.

Patricia: I want to thank you guys for joining us today and thank you, especially to Isabel for allowing us time to have a nice chat in our …… wherever we are. Someday, we’ll do this life, I hope, and she’ll have a stack of books that she can sign for you. But in the meantime, read and educate and stay safe and stay sane.

Thank you for coming.

Isabel: Thank you.

Patricia: Feel free to reach out to me if you ever see me on the street or email me. I’ll be glad to hear from you. So thank you. Thanks, Patricia.

If you would like to schedule an appointment to discuss your senior loved one’s care needs or to set up a free in-home evaluation with one of our nurses, call us today in MD at (301) 363-2580, or in VA at (703) 556-8983. We are located in Bethesda, MD, (301) 363-2580, and Reston, VA, (703) 556-8983.