How to Stay Out of a Nursing Home – The Caring Generation®

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The Caring Generation® – Episode 90 June 16, 2021. On this caregiver program, expert Pamela D Wilson shares tips for Staying Out of a Nursing Home and remaining active into your nineties. Guest David Frost, an NFPT Certified Master Fitness Trainer, shares tips for nutrition, endurance, and strength training to support an active lifestyle in retirement.

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How to Stay Out of a Nursing Home

0:00:04.0 Announcer: Caregiving can sometimes feel like an impossible struggle. Caregivers may be torn between taking care of loved ones and trying to maintain balance in life. The good news is that it doesn’t have to be that way. The Caring Generation, with host Pamela D. Wilson, is here to focus on the conversation of caring. You’re not alone. In fact, you’re in exactly the right place to share stories and learn tips and resources to help you and your loved ones. So now, please welcome the host of The Caring Generation, Pamela D. Wilson.

Watch More Videos About Caregiving and Aging on Pamela’s YouTube Channel

0:00:37:49 Pamela D Wilson: This is Pamela D. Wilson, caregiving expert, speaker, consultant, and guardian of The Caring Generation. The Caring Generation focuses on the conversation of caring, giving us permission to talk about aging, the challenges of caregiving, and everything in between.  It’s no surprise that needing care or becoming a caregiver changes everything. The Caring Generation is here to guide you along the journey to let you know that you’re not alone.

0:1:05:56 Pamela D Wilson: You’re in exactly the right place to share stories, learn tips and resources to help you and your loved ones plan for what’s ahead. Invite your aging parents, spouses, family, and friends to listen to the show each week. This week we are talking about how to stay out of a nursing home and be active into your nineties. Six actions to consider regardless of your age today that can make a difference.

01:35:66 Pamela D Wilson: Nursing homes are not only for the elderly. Sometimes unexpected events happen that result in middle-aged adults living in nursing homes for the rest of their lives.  Our guest for this program, David E. Frost, is an NFPT certified master fitness trainer, rowing coach, Adjunct Professor, and Navy Veteran. His company Well Past Forty focuses on nutrition, endurance, and strength training for adults who want to remain active and healthy.

02:13:01 Pamela D Wilson: To begin our discussion about how to stay out of a nursing home, I want to start with why elderly parents or middle-aged adults live in nursing homes. Let’s start with younger adults. In middle age, anywhere between 40 to 60, the main reason adults live in a nursing home is a health issue or an accident that results in a disability—physical or mental. Women, more than men, become physically disabled in middle age.  To learn why, listen to The Caring Generation podcast, Managing Work-Life Balance for Working Caregivers, and my interview with Dr. Carrie Karvonen-Gutierrez.

02:56:75 Pamela D Wilson: During the years that my primary work was serving as a care manager, a power of attorney, or a guardian for clients, I was responsible for caring for middle-aged adults who experienced severe strokes or were in serious car accidents. The stroke or car accident resulted in a permanent brain injury that had cognitive effects on memory, speech, decision-making, and physical impact—resulting in some of these clients having to use a wheelchair permanently.

03:31:03 Pamela D Wilson: Imagine being forty years young with a severe physical disability or brain injury and having life as you knew it yesterday suddenly and permanently taken away from you in the blink of an eye. These clients participated in physical therapy and rehabilitation at hospitals and care centers. Unfortunately for the majority, the ability to recover—to be fully active—was not possible because of different degrees depending on the severity and background of the stroke. Some clients had early diagnoses of chronic diseases like heart disease that resulted in a stroke.

04:17:23 Pamela D Wilson: Other clients were steady drug users—alcohol, cocaine, marijuana, or others and had a stroke due to drug use. Some were mentally ill and did not take care of their health. Clients without health issues were involved in deadly car accidents or experienced another type of accident. One example is a man in his thirties who lived in Denver—a bodybuilder. This man was sitting on a retaining wall and fell backward and hit his head.

04:52:17 Pamela D Wilson: The head injury he suffered was so severe that he was paralyzed from the neck down. I will share a link to his story in this transcript and a video he made to educate the public about the importance of having a living will and not being placed on life support indefinitely. (Warning: This video depicts a real-life situation and may be disturbing.) This man was not my client. I came to know of his story through a colleague who shared his story.  Some of my clients could not use their hands to brush their teeth or hold a fork and feed themselves. Others regained a moderate level of physical ability but not to the degree that he or she could live alone by themselves anymore. All were frustrated about not being able to live a normal life.

05:42:28 Pamela D Wilson: It’s a sobering thought to be forty years old and realize that you will live in a nursing home for the rest of your life—another 40 to 50 years. That this place, this nursing home is you’ll spend every day, holidays, birthdays in a shared room with another resident and very few belongings. In addition to health issues, there are more challenges related to being in a nursing home when you are young that might not immediately come to mind.

06:16:31 Pamela D Wilson: The first challenge is finding a nursing home with residents similar to the age of yourself or a younger permanently disabled family member. Depending on where you live, finding a nursing home with a younger population may or may not be possible. I live and work in the Denver metro area. Even a metropolitan area of this size, the number of nursing homes with concentrated residents in their middle-age is few.

06:46:66 Pamela D Wilson: The average age of a nursing home resident is 82. How would you feel being forty living with individuals twice your age? What would you have in common except health issues? Waitlists may exist in these communities with younger adults, meaning that if you are advocating for a family member you may place a brother or sister in one nursing home and have him or her on the waitlist for another nursing home that has younger residents.

07:18:53 Pamela D Wilson: The other issue that families face is relying on Medicaid for the payor source. A forty-year-old may have some money to pay for care privately, but savings or money from the sale of a home will not last long at an average cost of $8,000 a month. Socializing and making friends, which we will talk about later, is an essential aspect of health. Imagine being a 40-year-old living in a nursing home with some younger adults but most people in their 80’s or 90’s. How would this affect you mentally?

07:56:13 Pamela D Wilson: Living with older people who need more physical care and many of whom have dementia, can have a significant effect mentally and physically on a younger person. For all adults, actions for how to stay out of a nursing home begin years earlier. In fact, aspects of health begin as early as the teens and the twenties. But no one tells you this. Which is why we are talking about how to stay out of a nursing home from the perspective of actions we can take every day of our lives, no matter our present age.

08:33:13 Pamela D Wilson: One result of COVID that I view as positive—even though the effect can be viewed negatively—is that many twenty, thirty, and some forty-year-olds returned to “wait out COVID” by living with their parents. What do you think happened? Young adults became more aware of the health issues of their Baby Boomer parents or grandparents.

08:56:84 Pamela D Wilson: Children may have been the ones to go out and grocery shop and pick up prescriptions so that parents with health issues were not potentially exposed to COVID. The downside of COVID is that young adults became caregivers before their time and realized that their parents might die from COVID if exposed because of having multiple chronic diseases. COVID has brought attention to healthcare

9:24:12 Pamela D Wilson: For better or worse, consumers are more aware today that having a chronic disease can make one more susceptible to viruses like COVID. Even still, some consumers living in the United States believe that COVID is a manufactured concern by governments to scare people and limit their activities. Looking for a bright spot in all of the challenges brought forth by COVID, my hope is that consumers will realize the importance of being proactive about health beginning early in life.

9:55:84 Pamela D Wilson: Only one person can make how to stay out of a nursing home a reality—and that’s you. It’s me. It’s your parents and your grandparents through their daily activities. Let’s talk about why some older adults end up living in nursing homes. Because knowing the why can us help avoid this concern. The reason is similar to middle-aged adults with some type of disability. Although for older adults, the disabilities happen incrementally over time.

10:27:18 Pamela D Wilson: It’s thinking, wow, I can remember when I used to be able to do X. Times when I had all of this energy, and now I seem to be tired all the time. How many of you remember when you were young, and you could stay up all night and go to work the next day? That was me in my twenties. A little nap here and there kept me going. The first action you can take for how to stay out of a nursing home is to avoid being diagnosed with a chronic disease.

10:54:61 Pamela D Wilson: How do you do this? The number one action is to take an interest in health. To seek information and establish regular medical care. It’s unfortunate, but detailed information about preventing diseases or delaying disability from a disease diagnosis remains scarce. Primary care physicians fail to make recommendations for preventative screenings and immunizations because they focus on treating what ails you today.

11:22:89 Pamela D Wilson: Persons who ask questions and who are proactive get better healthcare treatment. It’s all up to you. No one is going to take the initiative for you, your parent, or other family members. So, how do we communicate the importance of health to our families and others we know. We can start by setting a good example and talking about health in our families and to our children after becoming a little more educated.

11:50:38 Pamela D Wilson: Making friends who are interested in their health and who are physically active can be a great way of learning new information and putting that information into action. You benefit from the wisdom of others who have committed time and effort to learn about health. When I was in my early twenties, I joined a gym, I made friends at the gym, and when we hung out we were active. Playing volleyball, racquetball, running, hiking, biking. These sporting activities became social activities that supported good health.

12:25:09 Pamela D Wilson: What does it take to get started to become more educated about health? If you have not taken this action, the first step is to establish regular medical care with a primary care physician. Even if you believe there is nothing wrong with your health. Get an annual check-up and have bloodwork done. You might be surprised. Having a doctor of record offers a backup plan if you get sick and need to see a doctor as soon as possible. I realize that the doc in a box or that medical clinic at the grocery store corner may seem more attractive or convenient.

0:13:02:52 Pamela D Wilson: It can be in a pinch. But having a doctor who you establish a relationship with and who gets to know you can be vital first step for planning how to stay out of a nursing home.  We are off to a break.  If this is the first time you are joining the show, thank you for being here. The Caring Generation is not limited by time zone or location—caregivers worldwide listen. The show and the transcript for you to read are on my website at Click on the Media Tab and then The Caring Generation. This is Pamela Wilson, caregiving expert, author, and speaker on The Caring Generation. Stay with me; I’ll be right back.


0:14:09:16 Pamela D Wilson: This is Pamela D Wilson, caregiving expert, consultant, and speaker on The Caring Generation. Helpful information for caregivers and aging adults are in my book: The Caregiving Trap: Solutions for Life’s Unexpected Changes, available on my website Click on Library in the top banner and then book. You can also purchase my caregiver course, Taking Care of Elderly Parents: Stay at Home and Beyond,

0:14:36:26 Pamela D Wilson: featuring 30 hours of webinars featuring practical steps for how to take care of elderly parents, make a plan for aging and health, and things you should know for how to stay out of a nursing home. It’s never too early to make a plan to live the best life possible today and in your later years. In the first segment of the show, we talked about the number one action for how to stay out of a nursing home—establish regular care with a primary care physician.

0:15:05:93 Pamela D Wilson: If your aging parent is not participating in regular medical care, set this up for mom or dad and then do the same for yourself. Learn about your health and research activities to reduce chronic disease. Action number two for how to stay out of a nursing home is to become and remain physically strong and active. The benefit is better overall health and avoiding accidents due to physical weakness or balance issues that result in nursing home stays.

0:15:38:92 Pamela D Wilson: We don’t learn about the true benefits of physical activity in school—even though we may have had to participate in gym class or try out for another sport. Our parents probably don’t teach us about the benefits of physical activity because no one taught them. The only way to learn about physical health is by being curious and taking action. For some, the motivation is watching an elderly parent or a grandparent suffer or struggle with health issues.

0:16:09:041 Pamela D Wilson: Watching my mother suffer from one health issue after another—beginning in her forties—was the wake-up call that I needed to pay serious attention to my health. I didn’t want to live my life worrying about my health every day. My mother died at age 69 after years of suffering from multiple health issues. I watched my aunts and uncles, her sister, and brothers suffer from a similar fate. Suffering and the potential of an early death were my motivation to join a gym, take vitamins, and eat healthily.

0:16:49:50 Pamela D Wilson: All habits that I continue to this day because I don’t want to end up in a nursing home. Unfortunately, living in a nursing home at the end of life is the fate for many women after a husband or a partner dies. If a woman is never married or is divorced, it can be a similar story. I was blessed to care for amazing women who never married or had children. These women became role models during the years I managed care for clients.

0:17:18:12 Pamela D Wilson: They had active careers and lifestyles. But when the time came for them to need care, their estate planning attorneys introduced them to me to manage their healthcare needs and finances. One of these clients walked two miles every morning—rain, shine, or snow—well into her nineties. If you don’t know much about physical health or the benefits of exercise, join a gym. Hire a personal trainer for one or two sessions and then follow their recommendations.

0:17:53:11 Pamela D Wilson: Of course, after getting clearance from your doctor. If you can’t afford or don’t want to spend money on a gym or trainer, watch exercise videos on YouTube. You can find just about anything there – including several hundred caregiver videos on my YouTube channel. Walking is free, and you don’t have to buy weight equipment as many of the trainer videos on YouTube use furniture or other things you have in your home to support a daily exercise plan.

0:18:25:54 Pamela D Wilson: The hard part—and I’ll be honest about this—is establishing a routine where you exercise no matter your mood or how you feel. Embracing discipline and persistence contributes to staying out of a nursing home. There are many times when I can find some reason or excuse not to go to the gym or exercise outside, but I’m at a point in my life where I’ve been doing this so long.

0:18:54:45 Pamela D Wilson: Thirty 30 years—that I no longer allow myself to make an excuse. Because I know that I will feel mentally and physically better after an hour hike or going to the gym or lifting weights, and I’ll be glad I exercised. Fortunately, I’ve also created relationships with friends with similar health habits. We talk about being active. We socialize through activity. There are no quick fixes for many actions for how to stay out of a nursing home.

0:19:24:73 Pamela D Wilson: Many of these activities are lifelong habits that you can create today and continue to perform. Consistent action and routines make a significant difference in many aspects of life. This discussion goes beyond health and well-being. We’ll talk about number three for how to stay out of a nursing home. In looking at the lives of my elderly clients, those who remained healthy and active into their nineties who were single women had interesting careers.

0:19:57:76 Pamela D Wilson: These careers spanned from being an editor at a national magazine, a secretary for a broadcast company, working in public health, a teacher, a paralegal. These women were independent and self-sufficient. I mention this because being healthy and learning how to stay out of a nursing home requires independent thinking, interest in learning, and self-sufficiency.

0:20:24:28 Pamela D Wilson: Married couples and partners can achieve similar goals if you both have the same interest in health. You probably know couples—or you might be one—where one partner is interested in being healthy, and the other is not.  These partnerships can be challenging but not impossible if you commit to good health. Indeed, the people we spend time with, our spouses, families, friends, and colleagues at work, become our herd or our comfort zone.

0:20:54:55 Pamela D Wilson:  It’s not until we venture outside of this comfort zone to meet people with other interests and beliefs that we can change the longstanding habits we inherited from our herd or family and learn things that our herd has no interest in learning. Being self-sufficient and making a plan for education and ongoing employment supports self-sufficiency at any age. I have three college degrees.

0:21:23:55 Pamela D Wilson: The first degree was from a technical college where I learned secretarial skills because I wanted to improve my job prospects. Society tempts consumers to want everything now rather than talking about incremental progress one step at a time. One step at a time is the way to establish habits that stick. My next degree was an undergraduate degree in business and marketing. I needed that to get promoted.

0:21:51:29 Pamela D Wilson: Then completing a master’s degree in organizational behavior to further advance my career and become an entrepreneur. I completed all of this education part-time while working full time. In those classes were adults much older than I – in their 40’s, 50’s and 60’s who wanted to improve their lives. Education is never wasted. Becoming educated supports self-sufficiency and many of the skills beneficial for how to stay out of a nursing home.

0:22:27:25 Pamela D Wilson: Figure out your interests and move ahead. You may be interested in a trade like plumbing or being an electrician—go for it. Whatever interests you, you’ll be happier and healthier if you find a job or a specialty work that you love. We’ll talk more about how the benefits of education provide skills to navigate the healthcare system and be a better caregiver for yourself, aging parents, or a spouse later in the show.

0:22:56:69 Pamela D Wilson: Up next, an example for all of us. David E. Frost, an NFPT certified master fitness trainer, rowing coach, Adjunct Professor, and Navy Veteran. His company Well Past Forty focuses on nutrition, endurance, and strength training for adults wishing to live life to the fullest, including persons suffering from chronic diseases like MS, cancer, Parkinson’s Disease, cerebral palsy, diabetes, and metabolic syndrome. It’s never too late to consider becoming more active.

0:23:32:56 Pamela D Wilson: If you are interested in making a plan to support the care of an aging parent or spouse or interested in creating a care plan for yourself, visit my website to schedule an eldercare consultation. Click on How I Help, Family Caregivers, and then complete the form to schedule a telephone or video call with me. This is Pamela D Wilson, caregiving expert, caregiving speaker, and eldercare consultant on The Caring Generation. Stay with me; I’ll be right back.


0:24:31:69: Pamela D Wilson: This is Pamela D Wilson, caregiving speaker, expert, and advocate on The Caring Generation program for caregivers and aging adults. Whether you are twenty or 100 years old, you’re in exactly the right place to learn tips to help you and your loved ones plan for what’s ahead. If you’re not sure how to talk to your children about caregiving issues or if you’ve tried to talk to your aging parents. Let me start the conversation for you. Share The Caring Generation Podcasts and my website with spouses, parents, brother, sister, family, and friends.

0:25:04:30   Pamela D Wilson: Welcome back to more tips for how to stay out of a nursing home and steps you can take today. Let’s meet David E. Frost.

0:25:10:05 Pamela D Wilson: David, thank you so much for joining me today.

0:25:14:87 David E Frost: What a pleasure to be with you, Pamela, thank you.

0:25:18:15 Pamela D Wilson: So I want to talk about aging, and health, and chronic disease. Aging is associated with chronic disease and pain, and instead of being more active because of pain, many adults become less active. You’re a trainer. You’re a fitness coach, is there a way to be active and manage or reduce pain?

0:25:37:85 David E Frost: Yes, Pamela, that’s a simple yet a hard answer. When you stop, you drop.  Pain, can, it’s a good news bad news story, isn’t it. It’s a wonderful sensing signal that something isn’t quite right. And isn’t it interesting that motion may cause discomfort, but the more you do something, the less uncomfortable it and the more you’re able to have that lotion working your skeletal muscles, your connective tissue, and your joints.

0:26:07:46 David E Frost: We do want to deal with pain but believe me, that motion is a great tonic when done correctly. Now a person may not be able to do it on his or her own, yet the journey is worth it to live maybe not free of pain or discomfort but to minimize it. To mitigate it, to modify it, and to keep smiling. So you may not be able to avoid it. Pain is part of life. Pain is part of aging so let’s try to manage it.

0:26:38:10 Pamela D Wilson: And your website, it’s you really focus on health and activity and positive aging for older adults but many older adults because of pain and health diagnoses, their bodies suffer from inflammation and stress. Can you talk about the effects of that on the body?

0:26:55:29 David E Frost: Yes, and if I may kind of put a fork in the road between episodic or acute inflammation and then chronic inflammation. And it’s the chronic inflammation where we get—our cortisol pumps. Our wonderful adrenal and endocrine system that’s pumping out a chemical, cortisol, which is great in a fight or flight sense. But most of us, as we get older, want to spend more time feeding and frolicking—not fighting and flighting or fleeing.

0:27:26:48  David E Frost: So we want to manage cortisol, and the way to do that is several ways. One is breathing. One is being mindful. One is exercising. But inflammation is a necessary—if you will—evil. When we exercise, we do want to create tiny, manageable inflammation so that our bodies sense and respond to restore, rebuild, refresh, and that wonderful term which is confusing to a lot of people. Autophagy where our bodies actually rebuild themselves.

0:28:01:13 David E Frost: Almost all of our body is rebuilt over months or years, and inflammation is a key part of the sensory response to make us regenerate. So it’s good news, bad news. We do want to manage it, and we do want to experience exercise or activity-induced inflammation that’s manageable. We don’t want the drip, drip, drip of chronic inflammation, which decays and prohibits our ability to live long and live well. So those two types of inflammation are to be kept in mind.

0:28:35:13 David E Frost: One is kind of good, and one is definitely not good. And chronic stress can lead to central obesity. It can lead to metabolic syndrome, hypertension. Lots of bad things. We really want people to breathe, to hug, hum. Really important to hum to link our mind and our gut via that wonderful vagus nerve system. We can do better, and I’d rather folks take steps two at a time than take two drugs at a time to try to manage stress.

0:29:04:65 Pamela D Wilson: A lot of clients I work with they’re over the age of sixty, and there are some statistics out there that say that about 30% of adults over age 60 will fall at some point and break a hip. How can adults build stability in the body to reduce the risk of accidents and injuries like a hip fracture?

0:29:23:53 David E Frost: What a sad, sad, realistic yet sad comment on our society. Hip replacements, knee replacements, even wrist fractures are expensive. And oftentimes, there’s very little good that comes from it. So, stability is accident insurance, I believe. And the insurance is to try to minimize falling. And if you have been moving and strengthening yourself, if you fall, you’ll bend, not break. So, the answer is bottom to top. The great toes are ultra-important for balance. If we think about some of the longevity tests, one is standing on one leg with your eyes closed.

0:30:08:70 David E Frost: How long can you do that? [chuckle] Someone else will have to time you, of course, unless you count to yourself. But that’s a great test. Getting up from the ground without using your hands like we did as kids. The sit-to-rise test are a very important indicator of how well our—fancy word—proprioception for spatial awareness. We all trip. Kids trip as much as we do over the age of sixty. But the kids recover, and if we don’t work stability and don’t work, our neuromuscular system to respond to a stubbed toe or an imbalance. Bad things can happen.

0:30:47:40 David E Frost: So start with your great toe. Spend time on one leg. We have a progression in training to go from bi-lateral symmetrical things where you’re on both legs, say for a weight exercise activity. Then you’ll go to maybe a foam cushiony unstable platform. And then you’ll go to one leg—a unilateral thing so that your body remembers how to be kid-like. So keep the faith. It’s a journey but stability comes much quicker than strength or stamina.

0:31:20:45 David E Frost: So there’s almost no excuse for not improving one’s stability as accident insurance. It does not take a lot of time. A few minutes a day is a wonderful investment in your physical bank to avoid something with very little upside—falling and breaking something. So start with the great toes, close your eyes safely, and progress to where you can be more kid-like. It’s simple yet hard, Pamela, but that really is it. There’s no magic ingredients, there’s no elixirs. You have to do the work. You have to challenge your system to become more stable like you were when you were a young one.

0:31:59:54 Pamela D Wilson: Let’s say there’s somebody listening and they’re thinking, hey, this sounds like maybe something I can do, but they’ve been relatively inactive. Let’s say they’ve never gone to a gym. They’ve never been an exerciser. If you were going to talk to this person, how would you talk to them about safe ways to get started so that they don’t overdo it or don’t injure themselves.

0:32:17:59 David E Frost: Yes, and keeping in mind that we do want them to generate a little bit of inflammation and a little bit of post-exercise soreness because that’s what our bodies crave because we’re mammals. But start slowly. First, please get a physical aptitude readiness questionnaire completed.  We advocate that folks over the age of sixty get doctor’s approval before elevating their heart rate in case they might have hypertension or have a condition.

0:32:47:42 David E Frost: We trainers think we’re pretty good, but we’re certainly not medically trained unless a trainer is an M.D. or a registered nurse. So we definitely want the physician’s or medical professional’s approval to sweat, to move, and to lift heavy things. Appropriate heavy things. But the answer is start slowly. Motion is medicine. It’s proven that resistance training can build results even for folks into their eighties. This is fairly new. Twenty years ago, folks thought we were put out to pasture with a gold watch in our sixties.

0:33:23:31 David E Frost: New studies both for the mind and body say that we can regenerate skeletal muscle as well as neuroplasticity for our wonderful brains well into our eighties. So why give up on that? Why concede to senescence? The answer is start slowly. If you don’t feel comfortable, there are amazing online resources for many folks that are comfortable going online for things like Silver Sneaker programs for elders. There are hopefully trainers that will help, or buddies, or siblings, or younger ones that can help you get started.

0:34:02:15 David E Frost: The first steps are the hardest we know that. But you can’t take the first step if you don’t lace up your shoes and move. So please start. It’s never too early. It’s never too late. But the journey is worth your physical bank—as Muddy Waters said years ago, that great Chicago blues singer, “you can’t take out what you haven’t put in.” So let’s start putting reserves into our amazing bodies for balance, for strength, for stability.

0:34:29:20 David E Frost: And just be really positive about it. It’s a journey. There’s no elixirs, as I mentioned. No matter what you hear on the news or Madison Avenue, you have to do the work. Start, be positive, get help professionally, Get a doctor’s approval. It’s doable. Let’s encourage everyone that get up from a chair or even those folks that may not be able to get up from a chair but who can move—you’re an athlete. So let’s applaud athletes and get them moving.

0:34:57:54 Pamela D Wilson: You work with people that have chronic diseases like Parkinson’s or MS or cerebral palsy that might not think that they can do anything to improve their physical condition. How do you adapt workouts for people that have certain conditions?

0:35:12:13 David E Frost: Listening a lot is an early and kind of—and I don’t mean that in a simple way because it’s hard. Each athlete is different. Every case of Parkinson’s is different, for you know, depending on how the dopamine is or isn’t working in an individual. So it’s really important to assess what the mental approach is of the athlete—of the client. And what he or she can currently do as well as what he or she wants to do. We certainly don’t want them to give up on the things that they enjoyed. If it’s golf. we want to adapt. If it’s pickleball, we want them to somehow be engaged for both the social and physical aspects.

0:35:56:64 David E Frost: But the point is we have to tailor a focused program for each and every client whether they’re able-bodied or whether they have a challenge like MS, PD, cancer, or obesity. We just have to make sure the mind and bodies are aligned. You know that old platitude about attitude determines your altitude. I believe it. And if a client is ready, willing, and able, and the trainer or a professional is able to establish a program. A success-oriented program, good things can happen regardless of the conditions that you mentioned.

0:36:34:03 Pamela D Wilson: David, I thank you so much for joining me today.

0:36:37:16 David E Frost: Thanks so much, Pamela. What a great chat, thank you.

0:36:40:28 Pamela D Wilson: Up next, more thoughts about how to stay out of a nursing home. Share this week’s show and all of The Caring Generation podcasts with your family, friends, and colleagues. You can find the Caring Generation on all of your favorite podcast and music apps, including Apple, Google, I Heart Radio, JioSaavn, Spreaker, Amazon Music, Breaker, Deezer, Listen Notes, Pandora, Player FM, Pocket Casts, Podcast Addict, Podchaser, Stitcher, Spotify, Tune In and Vurbl. This is Pamela D. Wilson, caregiving expert, speaker, and consultant on The Caring Generation.  Stay with me. I’ll be right back.


0:37:47:00 Pamela D Wilson: This is Pamela D. Wilson, caregiving expert, speaker, and consultant on The Caring Generation. If you are an aging adult or a caregiver not sure what to do or how to plan for care, my website offers resources for caregivers. Check out my caregiving library, my Caring for Aging Parents blog, listen to all of The Caring Generation podcasts, read the show transcripts, watch videos on my YouTube channel, register for my online webinar caregiver courses, or join my caregiver support group on Facebook. There’s something for everyone at

0:38:27:42 Pamela D Wilson: Let’s continue our conversation about the value of education and continuous employment for how to stay out of a nursing home.  Attending classes whenever you find something of interest supports learning and, more importantly, supports curiosity. If you have been a caregiver for some time, you know that it’s the questions you don’t know to ask or those you don’t ask result in problems or making mistakes in caring for aging parents or a loved one.

0:38:59:43 Pamela D Wilson: It’s the challenge of not knowing what information you need that someone isn’t telling you. My goal with this podcast, The Caring Generation, and all of my work is to educate caregivers to be more aware of the unexpected things that happen in care situations and to support learning advocacy skills. If you are a caregiver, one day, you may be the person who needs care.

0:39:24:85 Pamela D Wilson: These tips for how to stay out of a nursing home are for your parents, a spouse, you, and your children, who may one day be your caregivers and need care. Number four on the list that follows education and steady employment is to create a plan for aging and the potential of needing care. If you follow this suggestion for how to stay out of a nursing home, you’ll be less likely to need care even though we know that unexpected and crazy things happen like turning, falling, and breaking a hip.

0:40:00:00 Pamela D Wilson: —a diagnosis of dementia or Alzheimer’s because of a family history. Included in this plan, if you already have a chronic diagnosis, is learning more about the disease, treatment, and preventing the disease from advancing. Adults who have illnesses that affect daily functioning and make performing daily activities difficult often do less instead of doing more because of feeling depressed or hopeless.

0:40:29:26 Pamela D Wilson: Depression is one of the most common mental health issues in aging adults. Symptoms of depression include less interest in activities, too much sleep, too little sleep, overeating, not eating enough, self-isolating, and a lack of self-care. As if we haven’t already done enough of this as the result of COVID. Even if you already have a chronic disease, as discussed with David E Frost, physical activity offers benefits.

0:41:00:90 Pamela D Wilson: If your body is feeling sore or painful, is that pain may be a result of being inactive, sitting too much, watching too much television. In the elderly during the pandemic, those who watched more television, especially the news, felt more anxious and worried. How many times do you watch a program on television, go to bed, and have stressful dreams or nightmares about what you saw on the news? This happens to me.

0:41:27:80 Pamela D Wilson: During sleep, the brain attempts to clear out stress. Watching the news or programs that can be upsetting right before going to sleep or at any time during the day can result in more work for our brains and greater mental distractions. Create a 30-minute pre-sleep routine where you don’t watch the news or play with any technology before bed. Do a relaxing activity to help you fall asleep, like meditation, reading, or listening to soft music.

0:42:01:73 Pamela D Wilson: When you think about your plan for aging, this also involves saving money to pay for care. Maybe purchasing a long-term care insurance plan if you are still healthy enough to qualify at a good rate. Look at your home. Is it the right home to live in when you are in your 70’s or 80’s? If not, think about downsizing and simplifying.

0:42:25:62 Pamela D Wilson: Parents who have lived in their homes for 30 or 40 years can collect a lot of stuff. My parents did. Start a routine of cleaning out one drawer each week and giving items to charity, family members, or friends. Buy fewer things. Does your home feature steps or other potential hazards that might result in a fall. What type of safety equipment might you have installed? For example, grab bars in the bathroom or a hand-held shower or shower or tub seat.

0:42:58:56 Pamela D Wilson: If you have not, consider getting your legal matters in order. Contact an elder law, probate, or estate planning attorney and designate an agent under medical and financial power of attorney. Create your living will, a will, or a trust. Prepare for aging before actually getting there. It’s is a positive step for how to stay out of a nursing home. Be as realistic and practical as possible before you need care so that you have a clear plan for what happens if the unexpected happens.

0:43:32:94 Pamela D Wilson: Think about scheduling or creating a monitoring plan for tracking important activities. If you have high blood pressure, buy a home blood pressure monitor and track your blood pressure. Monitor your weight several times a week or every day to make sure you are not unexpectedly gaining or losing weight. Schedule physical activity and socialization into your daily calendar.

0:44:00:01 Pamela D Wilson: I know many retired adults who say that they are busier in retirement than during their working years. Being busy is a positive aspect of life. Research confirms that staying physically active, gaining new interests, and socializing have significant and positive health benefits.  Number five for how to stay out of a nursing home includes identifying leisure time activities that you enjoy and do. My father, well into his 80’s enjoyed gardening, walking, and traveling with my brother when he was available.

0:44:34:98 Pamela D Wilson: There’s no reason you can’t take the time to do all of the things you dreamed about during your working years. If you have embraced the habit of being physically active, you will be in a better position to have the physical strength and endurance to walk, to be active, and travel if this is your desire.  Take a class at a local community college or community center. Find new interests to keep your brain, your mind, and your body active.

0:45:07:72 Pamela D Wilson: If you have always wanted to learn technology but you’ve been hesitant or intimidated to learn how to use apps on a cellphone or a tablet computer, there’s no time like the present. While this may be initially be an intimidating thought, the use of technology opens up a new world for many aging adults. During COVID, Zoom calls became more popular. Family members and friends who had not “seen” each other in years began scheduling regular video calls.

0:45:40:53 Pamela D Wilson: Health apps for all types of activities are available, many for free. If you enjoy walking, find an app that can track your distance and time. There are apps for calendars, scheduling, medication reminding. If you can think of something, you want to monitor or track, there’s probably an app for that. Learning to use technology supports virtual medical appointments.

0:46:06:93 Pamela D Wilson: There’s no need to drive to see the doctor for a routine issue if you can accomplish the same via a video call or email through the doctor’s office medical portal. This easy access supports better and regular healthcare. The opportunities for participation in leisure time activities are limited only by your interest, your curiosity, your effort, and your time. This leads us to number six for how to stay out of a nursing home. Maintain current friendships and learn to make new friends.

0:46:41:24 Pamela D Wilson: Most of us have already experienced the loss of friends to a health concern. If you don’t live near family, your circle of friends and acquaintances can dwindle with age and time. Remaining healthy and out of a nursing home is supported by frequent contact with friends and family. If you are short on friends, pursuing leisure time activities can be a good way to meet others with similar interests. Don’t wait for others to invite or ask you for coffee. Be the person who invites and makes the request.

0:47:17:73 Pamela D Wilson: As we discussed in a prior interview with Dr. Jeffrey Hall that I’ll put in the show transcript, turning a casual acquaintance into a good friend takes time—anywhere between 50 to 200 hours. Assess your social situation. Are there things you would like to do that current friends aren’t interested in doing? If so, join a social group to meet others who might enjoy going to a play or a movie or taking a weekend trip to a nearby city. There also may be things you are interested in doing that you don’t even know about—

0:47:57:63 Pamela D Wilson: that other people are participating in. All of the activities we’ve discussed can support being active rather than isolating at home, which is not good for you physically or mentally. However, if you’re already past the point of being able to be physically active, what do you do? Learning technology, as we discussed, can open new doors for friendships. There also may be opportunities for you to volunteer from your home. Senior groups often have opportunities to establish regular calls to isolated older adults—of which you may be one.

0:48:32:27 Pamela D Wilson: If you have a crafting talent, maybe you do some woodworking, knit or crochet for a charity that creates bonnets for newborn babies or lap blankets. I had a client who made birdhouses and gave them away. No matter your situation, if you are interested, there are options to explore. Everyone’s life situation and preferences are different, and I smile when I say this. Even among middle-aged adults—my friends—patterns and routines of behavior can become ingrained.

0:49:07:17 Pamela D Wilson: Activities you did five or ten years ago may be off your list for one reason or another. Health or dietary concerns may mean that you no longer go to restaurants but prefer to have all your meals at home. Maybe you are concerned about driving and depend on others for transportation. There are so many changes that come with aging that present an opportunity to adapt. Accepting change and looking for options or alternatives is a positive coping mechanism and supports how to stay out of a nursing home.

0:49:38:94 Pamela D Wilson: If you’d like to learn more about the experiences and interests of other caregivers, follow me on social media. Many of my posts and the videos I create respond to caregivers who complete the caregiver survey on my website. Go to the Contact Me button, scroll down to the caregiver survey and send me your thoughts. On Facebook, follow me at @pameladwilsoncaregivingexpert, where you can join my online caregiver support group, The Caregiving Trap. Follow me on Twitter @caregivingspeak, Instagram @wilsonpamelad, and Linked In pameladwilsoncaregiverexpert. I’m Pamela D Wilson, caregiving expert, advocate, and speaker on The Caring Generation. Stay with me. I’ll be right back.


0:50:49:70 Pamela D Wilson: This is Pamela D Wilson, caregiving speaker, author, and expert on The Caring Generation. Are you struggling to balance work and caregiving responsibilities? Does your company or group offer caregiver support programs or education? If not, share my website with the human resources manager or decision-maker in your company. I’ll be happy to talk with them. Let’s return to how to stay out of a nursing home.

0:51:16:26 Pamela D Wilson: Let’s say you are a single person either through a divorce or losing a spouse or a partner, and you are faced with having to care for yourself and make decisions related to aging. What is your plan for success? There are times when consulting an expert in any area, law, financial planning, care planning, or caregiving, can help you create a success plan.

0:51:44:22 Pamela D Wilson: If you are getting a late start specific to planning for care because you didn’t realize you needed a plan, ask your friends if they have made plans and then compare the information. If you don’t have a caregiver and need one, what will you do? Do you have the funds to hire someone to come into the home?  Does it make sense to consider moving in with a friend or having a friend move in with you so that you can look after each other and share expenses?

0:52:13:52 Pamela D Wilson: Do you have family or others who can and will help out when you need care—and have you asked them? Have you had that conversation? Older adults who live alone are at greater risk of needing help navigating situations and making decisions if a plan is not in place. This can feel like a scary position to be in because of feeling vulnerable. Rather than waiting for something to happen, make something happen. Regardless of where you live, there are resources for seniors available.

0:52:49:11 Pamela D Wilson: Begin by asking the staff at your doctor’s office, call a local senior or community center, call the local center on aging. It is important to learn about options before a need arises. The more prepared you can be, the more confident you will be that you can manage whatever happens. The reality is that we will all be in this stage of life if we live long enough. If you are a younger adult. What do you want your life to look like at 60, 70, 80, or 90?

0:53:25:14 Pamela D Wilson: While I realize it may be difficult to imagine the future because we can’t predict everything. The actions that we take today—the activities we do every day that are part of a positive routine can significantly contribute to the quality of our life in life in our later years. How do you want to live in retirement? Think of the positive role models you have today. Perhaps a grandparent or an older friend. Ask them what they did to prepare for life.

0:53:58:78 Pamela D Wilson: Ask them what things they didn’t plan for. Ask them what surprised them—and learn from that. It is through sharing and coming together with others that we have the greatest opportunity to learn if we are open-minded and interested in creating a future that includes good health, opportunities to participate in activities we enjoy with friends and family we love. Life is short. The years pass by more quickly with age.  Let’s make the best of life and make plans today for how to stay out of a nursing home and help our loved ones, aging parents, and our children do the same

0:54:39:63 Pamela D Wilson: If you are an older adult seeking to make a plan for yourself and you’re not sure what to do or if you are a caregiver for an aging parent looking for support, visit my website Pamela D and schedule a telephone or video eldercare consultation. Click on the How I help button, then family caregiver, and then eldercare consultation. It would be my pleasure and an honor to support you.

0:55:02:54 Pamela D Wilson: Pamela D Wilson: Thank you for joining me the week on The Caring Generation – the only program of its kind connecting caregivers and aging adults worldwide to talk about caregiving, health, and everything in between. Invite your family and friends to listen each week. This is Pamela D. Wilson, caregiving expert, advocate, and speaker. I look forward to being with you again soon. God bless you all. Sleep well tonight. Have a fabulous day tomorrow and a great week until we are here together again.

0:55:33:71 Announcer: Tune in each week for The Caring Generation with host Pamela D Wilson. Come join the conversation and see how Pamela can provide solutions and peace of mind for everyone here on Pamela D Wilson’s The Caring Generation.



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About Pamela Wilson

PAMELA D. WILSON, MS, BS/BA, NCG, CSA helps caregivers and aging adults solve caregiving problems and manage caregiving needs through online programs, live support groups, and an extensive caregiving library that includes articles, podcasts, videos, and webinars.

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