エピソード

  • Connect, Don’t Correct: Handling Repetitive Questions and Behaviors in Dementia
    2026/09/20
    About this episode“I want to go home.”“Someone stole my purse.”“I don’t want to take a shower.”For families caring for someone living with dementia, the same questions, concerns, or behaviors may surface again and again. The instinct to explain, correct, or reason with someone is understandable—but it can often increase frustration for everyone involved.In this episode of The Care Conversations Podcast, Dr. Jeff LaFond and Ashleigh Davis, Administrator at Magnolia House by Physician Care Homes, discuss a different approach:Connect before you correct.They explore how caregivers can respond to repetitive questions, anxiety, resistance to care, and changes in behavior with greater empathy while also looking for the physical or medical issues that may be hiding underneath the behavior.In this conversation“I want to go home” may mean something deeperWhen someone with dementia says they need to go home, simply responding, “But you are home,” may not help.Ashleigh explains why “home” may represent safety, familiarity, or comfort rather than a literal address—and why validating that feeling can be more effective than trying to prove the person wrong.Behavior is communicationA sudden increase in agitation or repetitive behavior may be a clue that something else is happening.Jeff and Ashleigh discuss possible contributors such as:* Pain* Infection* Constipation* Medication effects* Hunger or thirst* Fatigue* An uncomfortable environment* Even something as simple as an object irritating someone’s foot inside a shoeThe lesson: when behavior changes, caregivers may need to become detectives.Timing mattersThe episode also explores why time of day can make a major difference.Fatigue and “sundowning” may worsen confusion or resistance later in the day. A task like showering may go much better when it matches the person’s lifelong routine rather than the caregiver’s schedule.Validate first, then redirectIf someone believes an item has been stolen, dismissing the concern may increase anxiety.Instead, caregivers can acknowledge the concern, offer to help look for the item, and use the interaction to build trust.As Ashleigh explains, the person may not remember exactly what you said—but they may remember how you made them feel.Key takeaways* Connect, don’t correct.You do not have to bring someone with dementia back into your version of reality in every moment.* Behavior often communicates an unmet need.Look for pain, illness, fatigue, discomfort, changes in routine, or environmental triggers.* Know what is normal for your loved one.A sudden increase in confusion, agitation, or repetitive behavior may warrant a call to their medical professional.* Work with lifelong habits instead of against them.Familiar routines can reduce resistance and anxiety.* Validation builds trust.That trust may make other parts of caregiving—such as medication, bathing, and daily care—easier.* Caregivers need grace too.Frustration is normal. The goal is not perfection, but learning how to respond more intentionally.Watch the videoPrefer watching rather than listening?Watch the full episode on the Physician Care Homes YouTube channel:About the hostsDr. Jeff LaFond is a gastroenterologist, healthcare leader, and co-founder of Physician Care Homes.Ashleigh Davis is the Administrator at Magnolia House by Physician Care Homes and has more than 13 years of experience in senior living, including recreation therapy and assisted-living administration.Stay connectedFollow Physician Care Homes on Facebook, YouTube, and LinkedIn.Subscribe to The Care Conversations Podcast and our newsletter for practical guidance on dementia, caregiving, memory care, assisted living, and aging:physiciancarehomes.comA note for familiesThis podcast is intended for general educational purposes and does not replace individualized medical advice. If you notice an acute or significant change in behavior, confusion, pain, or function, contact the person’s healthcare professional.Help another caregiverIf this episode helped you think differently about a difficult caregiving moment, please share it with someone who may need to hear it.Thanks for reading ! Subscribe to The Care Conversations Podcast for free to receive new posts like this one! This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit physiciancarehomes.substack.com
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    16 分
  • Planning Before the Crisis: The Conversations Every Family Should Have
    2026/09/13

    About this episode

    In this episode of The Care Conversations Podcast, Dr. Jeff LaFond and Ashleigh Davis, Administrator at Magnolia House by Physician Care Homes, discuss why some of the hardest conversations about aging are often best started while everyone is still doing well.

    We discuss:

    * Why families should talk about future care preferences before a medical crisis

    * How documenting healthcare wishes can reduce uncertainty, guilt, and family conflict

    * Tools such as Five Wishes that can help start conversations about future care

    * The role of healthcare powers of attorney, advance directives, financial planning, and elder-law attorneys

    * Why organizing and sharing important documents is just as important as creating them

    Our goal is to provide practical guidance, expert conversations, and compassionate support for families navigating aging, dementia, memory care, assisted living, and caregiving.

    In this conversation

    Have the conversation before you need the answerA stroke, advancing dementia, hospitalization, or other unexpected event can suddenly leave families making major decisions under tremendous pressure. Discussing wishes beforehand gives loved ones a roadmap rather than asking them to guess.

    Put wishes into words—and preferably into writingWe walk through the Five Wishes framework, including choosing someone to make healthcare decisions, discussing treatments you would or would not want, comfort and end-of-life preferences, and what matters personally to you.

    Planning goes beyond medical decisionsAdvance directives, healthcare and financial powers of attorney, elder-law planning, and knowing where important documents are stored can all become critical when someone can no longer manage these issues independently.

    Key takeaways

    * The best time to plan is often when nothing is wrong.Decisions are easier to discuss thoughtfully before a family is dealing with an emergency.

    * Clear wishes can be a gift to the people you love.Knowing what someone wanted can reduce guilt, disagreement, and the burden of making life-changing decisions on their behalf.

    * Creating documents is not enough—people need to know they exist.Make sure the appropriate family members or decision-makers know what documents you have, where they are located, and how to access them.

    Watch the video

    Prefer watching rather than listening?

    Watch the full episode on the Physician Care Homes YouTube channel:

    Resources mentioned

    * Five Wishes

    * Advance directives and healthcare power-of-attorney documents

    * Elder-law attorneys

    * Financial planning for future care needs

    * The Death Deck and Dementia Deck as conversation starters

    About the hosts

    Dr. Jeff LaFond is a practicing gastroenterologist, healthcare leader, and co-founder of Physician Care Homes.

    Ashleigh Davis is the Administrator at Magnolia House by Physician Care Homes and brings more than 13 years of experience in senior living and helping families navigate care decisions.

    Stay connected

    Follow Physician Care Homes on Facebook, YouTube, and LinkedIn.

    Learn more and sign up for our newsletter at:

    physiciancarehomes.com

    A note for families

    This podcast is intended for general educational purposes and does not replace individualized medical, legal, financial, or other professional advice. Families should consult the appropriate professionals regarding their specific circumstances.

    Thanks for reading! Subscribe for free to receive new posts and podcast episodes.



    This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit physiciancarehomes.substack.com
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    19 分
  • Falls in Older Adults: Prevention, Safety & When It’s Time for More Support
    2026/09/06
    About this episode“Mom fell again.”For many families, that sentence becomes a turning point.Sometimes the fall causes only a bruise. Other times it leads to a broken hip, hospitalization, surgery, rehabilitation, loss of independence, or a cascade of additional medical problems.And once someone falls, fear of falling again can create another problem: they move less.Less movement leads to weakness and deconditioning.That can make the next fall even more likely.In Episode 6 of The Care Conversations Podcast, Dr. Jeff LaFond and Ashleigh Davis discuss why falls become more common with age, what families can do to reduce the risk, and when repeated falls may be telling you something bigger about your loved one’s safety and support needs.In this episode, we discuss:* Why aging increases the risk of falls* Changes in strength, balance, vision, hearing and mobility* Common home hazards such as rugs, clutter and poor footwear* Why a hip fracture can become such a significant medical event* The cycle of falling, fear, inactivity and deconditioning* When physical and occupational therapy can help* Canes, walkers, rollators and other assistive devices* How an occupational therapist can evaluate the home before an injury occurs* Bathroom safety, grab bars and lighting* Why medications — and even the time of day they are taken — can increase fall risk* When increasing falls may mean living alone is becoming unsafe* Life Alert and other emergency-response tools* How assisted living can provide another layer of monitoring and support* How fall-detection technology can improve response after a fall* Why unwitnessed falls often lead to difficult emergency-room decisions* The dangers of being left on the floor for an extended period* Why better information can lead to better fall-prevention interventions* How to keep older adults active without “putting them in a bubble”Why do older adults fall more often?Falls usually are not caused by one single problem.As we age, several things may begin changing at the same time.Strength declines.Muscle mass decreases.Balance may become less reliable.Vision and hearing change.Reaction time may slow.And conditions that were once minor inconveniences — an area rug, cluttered walkway or poorly fitting shoes — can become meaningful hazards.That is why families sometimes struggle to understand why someone who seemed relatively independent suddenly begins falling.The world their loved one is navigating physically may feel very different from the world a younger person experiences.One fall can start a cycleAfter a fall, many older adults understandably become afraid of falling again.That fear may lead them to move less.But movement is one of the things that helps preserve strength, balance and mobility.The cycle can become:Fall → fear of falling → less activity → weakness and deconditioning → greater fall riskBreaking that cycle matters.Physical therapy can work on strength, gait and balance.Occupational therapy can help determine whether daily activities or the home environment can be modified to make them safer.And sometimes the answer is as simple as making sure someone has the right assistive device — and is actually using it correctly.Look at the home through a different lensFamilies do not necessarily need to wait until someone is injured to assess the home.Physical and occupational therapists — as well as other aging-in-place professionals — can help identify risks.Walk through the home and think about your loved one’s actual routine.Are there loose rugs?Is there clutter?Do they have to navigate stairs unnecessarily?Are frequently used items located where they can easily reach them?Does the shower have grab bars?Is the bathroom safe?What happens when they get out of bed during the night?Small changes can matter.Don’t overlook lightingGetting from the bed to the bathroom at 2:00 AM is very different from walking through the house in the middle of the afternoon.Nightlights or motion-activated lighting can create a safer path without requiring someone to search for a light switch in the dark.It is a relatively simple intervention that may reduce risk.Review the medicationsThe home itself is only part of the picture.Medications can contribute to falls as well.Older adults commonly take multiple medications, and those prescriptions may change frequently.Families should understand:* What medications their loved one is taking* Why they are taking them* Whether the medications may contribute to dizziness, sedation or instability* Whether they are being taken correctly* Whether the timing makes senseOne example we discuss in the episode is a diuretic — a medication that increases urination.If it is inadvertently scheduled in the evening rather than earlier in the day, an older adult may spend the night repeatedly getting out of bed to use the bathroom.Now combine:* darkness* sleepiness* impaired balance* urgency* and repeated nighttime walkingand fall ...
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    18 分
  • The Cost of Assisted Living & Memory Care: What Families Need to Know
    2026/08/30
    About this episodeFor many families, finances are one of the biggest sources of anxiety when considering assisted living or memory care.How much will it actually cost?What is included in the monthly rate?Could the price increase after move-in?Does Medicare pay for any of it?What about long-term-care insurance, veterans benefits, Medicaid, or selling a home?And how does the cost of a senior living community compare with trying to provide increasing amounts of care at home?In Episode 5 of The Care Conversations Podcast, Dr. Jeff LaFond and Ashleigh Davis, Administrator at Magnolia House by Physician Care Homes, walk through the financial questions families should be asking before choosing a community.The goal isn’t simply to find a price you can afford today.It is to understand how the pricing works, what could change over time, what resources may be available, and whether the plan remains financially realistic if your loved one’s needs increase.In this episode, we discuss:* The two common pricing approaches: level-of-care pricing and all-inclusive pricing* Why the advertised monthly rent may not be the final monthly cost* How care needs are assessed before move-in* Why that assessment may change after the community gets to know the resident* How activities of daily living can affect care levels and pricing* Why families should anticipate periodic reassessments and annual rate increases* Continuing Care Retirement Communities and large entrance-fee models* Community or move-in fees in traditional assisted living and memory care* Medicaid, auxiliary grants, and veterans benefits* Why Medicare generally does not pay the room-and-care costs of assisted living* How long-term-care insurance may help* Why financial advisors can be valuable before making a decision* Hidden and optional costs families should ask about* The financial, physical, and emotional costs of trying to provide extensive care at homeUnderstand the pricing model firstWhen families tour assisted living or memory care communities, one of the first financial questions should be:How exactly does your pricing work?Ashleigh explains that families commonly encounter two models.In a level-of-care model, there is typically a base rent plus an additional charge based on how much assistance the resident requires.The community assesses needs such as bathing, dressing, toileting, medications, grooming, and other activities of daily living. The resident then falls into a care category or level that carries an additional monthly charge.The challenge is that these systems are not standardized.One community may use a point system. Another may base its calculation more heavily on the amount of staff time required. That can make comparing two communities difficult even when both say someone is at a particular “level.”The other common approach is all-inclusive pricing, particularly in memory care.In that model, housing and care are combined into one monthly rate rather than having a separate care-level charge.Magnolia House uses this all-inclusive approach.Neither structure automatically makes one community better than another.What matters is understanding exactly what the quoted price includes and what could cause it to change.Expect the care assessment to evolveBefore someone moves into assisted living or memory care, the community generally performs an assessment.Ashleigh describes a thorough initial assessment as approximately a 20- to 30-minute conversation, supplemented by information gathered during the tour process, conversations with the family, direct observation of the prospective resident, and required physician paperwork.But there is an obvious limitation:A short assessment cannot perfectly reproduce someone’s daily routine.A person may report that they bathe independently, for example, but the community may discover after move-in that this is not consistently happening.That is why communities commonly reassess residents after they have actually lived there.In the episode, Ashleigh describes a 30-day reassessment, when staff have now observed the resident morning, noon, and night and have a much better understanding of what assistance they really need.Sometimes the resident needs more care than initially estimated.But sometimes the opposite happens—the original assessment was conservative and the care level can actually decrease.For families, the important lesson is to ask:When will my loved one be reassessed, and what could that do to the monthly cost?Plan for change—not just today’s priceAging is progressive.Someone may be relatively independent today and later experience a fall, stroke, hospitalization, cognitive decline, or another significant change.Care plans and care levels therefore cannot remain static indefinitely.In the episode, Ashleigh explains that formal reassessments are commonly performed periodically and also when there is a significant change in condition.Families should therefore ask what the highest realistic ...
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    22 分
  • Touring Assisted Living or Memory Care? What Families Should Look For
    2026/08/23
    About this episodeTouring an assisted living or memory care community can be overwhelming.Families may visit several communities in a short period of time, hear unfamiliar terminology, compare different levels of care, and try to make an incredibly important decision for someone they love.And it is easy to get distracted by beautiful buildings, impressive amenities, activity calendars, and polished sales presentations.But the building isn’t going to care for your loved one.The people inside it will.In Episode 4 of The Care Conversations Podcast, Dr. Jeff LaFond and Ashleigh Davis, Administrator at Magnolia House by Physician Care Homes, discuss how families can approach a senior living tour differently — asking better questions, paying attention to what is happening around them, and looking beyond the “shiny objects” to understand how a community actually provides care.Think of yourself as an informed detective.You are not trying to find a perfect community. You are trying to determine whether this community is the right fit for the person you love.In this episode, we discuss:* How to prepare before touring assisted living or memory care* Why families should bring a written list of questions* What to ask about care plans and family communication* Why staffing ratios can be misleading without the right follow-up questions* How resident acuity changes what a staffing number really means* Who actually counts as a direct caregiver* What staff and resident interactions can tell you about a community* Why staff turnover and tenure are worth asking about* What call-bell response times may reveal about staffing* How a community responds after a fall or other medical event* How physician and clinical support can affect emergency-room transfers* What technology may be available for safety and family communication* How to interpret state inspection reports and violations* Why families should meet the administrator and nursing leadership before making a final decision* Why food deserves more attention than families sometimes give it* Why the goal isn’t the “perfect” community — it’s the right community for your loved oneStart with what matters to your loved oneBefore scheduling tours, spend some time thinking about what really matters to your family and, most importantly, to the person who may be moving.Then write those priorities down.Walking into a senior living community for the first time can be sensory overload. There may be beautiful common areas, activities, amenities, staff introductions, and a great deal of information coming at you all at once.It is surprisingly easy to leave and realize you forgot to ask half of the questions that actually mattered.A written list helps keep the tour centered on your loved one rather than the sales presentation.Don’t get distracted by the shiny objectsAmenities and aesthetics matter. People deserve to live somewhere that is attractive, clean, comfortable, and well maintained.But ask yourself whether the features being highlighted actually matter to the person who will be living there.An impressive amenity may appeal to an adult child making the decision without providing much value to Mom, Dad, a spouse, or another loved one.Instead, spend at least as much time watching the people.Are staff interacting with residents?Do those interactions seem warm and genuine?Do employees acknowledge residents as they pass?Do they seem happy to be there?Do residents appear well groomed, engaged, and comfortable?And if a resident approaches you and voluntarily tells you what they think about living there — listen.Those unscripted moments can be far more informative than a brochure.Ask better questions about staffingOne of the most common questions families ask is:“What is your staff-to-resident ratio?”That is a reasonable place to start, but it should not be where the conversation ends.A staffing number needs context.Ask:* Who is actually included in that number?* Are these direct-care caregivers?* Are administrators, kitchen staff, housekeeping, or other employees being counted?* What are those caregivers responsible for?* What is the acuity of the residents they are caring for?* How many residents need significant help with bathing, dressing, toileting, medications, grooming, or other daily needs?Three caregivers caring for relatively independent residents is very different from three caregivers caring for residents who require substantial hands-on assistance.The ratio matters. The workload behind the ratio matters even more.Also ask about turnover.How long have caregivers been working there?Does the community have experienced staff with good tenure, or is there constant turnover?Continuity matters when people are providing intimate, personal care every day.Ask about response times — not just staffing numbersAnother practical question families may not think to ask is:How quickly do staff respond when a resident requests help?Many communities use call systems...
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    24 分
  • Memory Care vs. Assisted Living: What’s the Difference?
    2026/08/16
    About this episodeWhen a loved one is diagnosed with dementia, families often face an immediate question:Does Mom need assisted living, or does she need memory care?The answer is not always as simple as the diagnosis itself.In this episode of The Care Conversations Podcast, Dr. Jeff LaFond and Ashleigh Davis, Administrator at Magnolia House by Physician Care Homes, discuss the practical differences between assisted living and memory care—and the factors families should consider when deciding which environment may provide the right balance of independence, support, dignity, and safety.Rather than assuming that every person with dementia automatically needs memory care, Jeff and Ashleigh discuss the importance of looking at the individual: Are they wandering? Are they becoming isolated? Can they safely navigate meals and daily routines? Are their care needs beginning to exceed what a traditional assisted living environment is designed to provide?In this episode, we discuss:* Why a dementia diagnosis alone does not necessarily answer the assisted living vs. memory care question* Wandering and other safety concerns that may point toward a secured memory care environment* How memory loss can affect meals, activities, socialization, and daily routines* Why dignity and independence should remain central to care decisions* Differences in staffing and support between assisted living and memory care* How seemingly ordinary household items can become safety concerns as dementia progresses* Why some traditional memory care units can feel institutional—and how Magnolia House is being designed differently* The value of secure outdoor spaces, natural light, and freedom of movement* How technology such as SafelyYou may help caregivers better understand falls and potentially avoid unnecessary emergency-room visits* Why families should involve healthcare providers and experienced senior-care professionals when choosing a level of careIn this conversationAssisted living vs. memory care is about more than a diagnosisA dementia diagnosis does not automatically mean someone needs a secured memory care environment.Ashleigh explains that the goal should be to find the most supportive but least restrictive environment appropriate for that individual. Someone with dementia who remains safe, does not wander, and can still navigate much of daily life may be able to live successfully in assisted living.As dementia progresses, however, additional concerns may emerge that change that equation.Look beyond wanderingWandering is an obvious safety concern, but it is only one part of the picture.Families should also pay attention to whether their loved one can independently participate in daily routines. Can they remember when meals occur? Can they follow an activity schedule? Are they beginning to withdraw because participation has become confusing or overwhelming?Changes during meals can also be significant. Forgetting how to use utensils or requiring more hands-on guidance may signal the need for an environment designed specifically around cognitive impairment.Memory care can offer greater structure, closer support, and—in many settings—a higher staff-to-resident ratio to help residents navigate these challenges while protecting their dignity.Safety without creating an institutional environmentJeff and Ashleigh also discuss the challenge of making memory care secure without making residents feel confined.That philosophy has influenced the design of Magnolia House.Residents need protection from hazards that may no longer be obvious to them. Something as ordinary as shampoo or mouthwash, for example, can become unsafe if dementia changes a person’s ability to recognize what something is or how it should be used.At the same time, safety does not have to mean creating an environment that feels like a locked hospital unit.Magnolia House is being designed to allow residents to move naturally throughout the home while incorporating safeguards into the environment. Medication storage, bathrooms, household products, doors, and other features are being intentionally designed around the needs of people living with dementia.Creating freedom within a secure environmentOutdoor access is another important part of that philosophy.Rather than residents repeatedly encountering locked doors, Magnolia House is being designed with a secure memory care garden where residents can spend time outside safely.A resident may want to sit on the porch, enjoy morning coffee, walk outside, experience natural light, or simply follow a familiar routine.Those ordinary experiences can matter tremendously.Someone living with dementia may not always be able to explain that they feel restless, confined, or disconnected from their normal routines. Creating an environment that supports movement, nature, and familiar daily rhythms may help preserve both independence and quality of life.Using technology thoughtfullyThe conversation also explores Magnolia House’s ...
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    14 分
  • When Is It Time for Assisted Living or Memory Care?
    2026/08/09

    About this episode

    In this episode of The Care Conversations Podcast by Physician Care Homes, Dr. Jeff LaFond and Ashleigh Davis, Administrator at Magnolia House by Physician Care Homes, discuss one of the most difficult questions families face: How do you know when someone you love needs more care?

    We discuss:

    * The safety, cognitive, and daily-living changes that may signal a need for more support

    * How caregiver stress and exhaustion should factor into the decision

    * The tension between honoring a loved one’s desire to remain independent and protecting their safety and quality of life

    * Why planning for assisted living or memory care before a crisis can give families more choices

    Our goal is to provide practical guidance, expert conversations, and compassionate support for families navigating aging, dementia, memory care, assisted living, and caregiving.

    In this conversation

    Recognizing when the current situation is no longer workingThere is rarely one single event that tells a family it is time for more care. We discuss changes in safety, daily functioning, memory, judgment, and the increasing amount of help a loved one may need.

    Looking at the caregiver, tooThe needs of the person receiving care are only part of the picture. We talk about caregiver exhaustion, guilt, decision fatigue, and the importance of asking whether the current arrangement is sustainable for a spouse, partner, adult child, or other caregiver.

    Making decisions before a crisisFamilies often wait for a hospitalization, fall, driving incident, or other crisis before making a change. Starting the conversation earlier can create more time to explore options, involve your loved one, and make a thoughtful decision rather than an emergency one.

    Key takeaways

    * Safety is often the best place to start.Ask yourself what concerns you most when you are not there and what keeps you up at night.

    * Caregiver well-being matters, too.A plan that keeps one person at home but leaves another person physically or emotionally overwhelmed may not be sustainable.

    * Moving to a higher level of care can be an act of love.Choosing assisted living or memory care does not mean giving up on someone. In the right circumstances, it can improve safety, quality of life, and the relationship between the person receiving care and the people who love them.

    Watch the video

    Prefer watching rather than listening?

    Watch the full episode on the Physician Care Homes YouTube channel:

    Resources mentioned

    * Physician Care Homes: physiciancarehomes.com

    * The Care Conversations Podcast on YouTube: Physician Care Homes

    * For help navigating local senior-care options and resources, contact the Physician Care Homes team through our website.

    About the hosts

    Dr. Jeff LaFond is a gastroenterologist, President of Gastrointestinal Specialists Inc., and co-founder of Physician Care Homes.

    Ashleigh Davis is the Administrator at Magnolia House by Physician Care Homes and brings extensive experience helping families navigate senior care and placement decisions.

    Stay connected

    Follow Physician Care Homes on:

    * Facebook

    * YouTube

    * LinkedIn

    Learn more and sign up for our newsletter at:

    physiciancarehomes.com

    A note for families

    This podcast is intended for general educational purposes and does not replace individualized medical, legal, or financial advice. Families should consult the appropriate professionals regarding their specific circumstances.

    Help another family

    If this episode was helpful, please share it with someone who may be wondering whether an aging loved one needs more support.

    And if there is a question about aging, caregiving, assisted living, or memory care that you would like us to discuss in a future episode, leave us a comment.

    Thanks for reading this installment of The Care Conversations Podcast by Physician Care Homes! Subscribe for free to receive new episodes, practical guidance, and resources for navigating aging with confidence.



    This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit physiciancarehomes.substack.com
    続きを読む 一部表示
    16 分