Hi, I'm Megan, and I've got a new podcast I think you're going to love. It's called Confessions of a Female Founder, a show where I chat with female entrepreneurs and friends about the sleepless nights, the lessons learned, and the laser focus that got them to where they are today. And through it all, I'm building a business of my own and getting all sorts of practical advice along the way that I'm so excited to share with you.
Confessions of a Female Founder is out now. Listen wherever you get your podcasts. This show is presented by the Commonwealth Fund, a nonprofit foundation whose mission is to promote a high-performing, equitable healthcare system.
The Commonwealth Fund supports research to improve health care policy and practice and has a long history of exploring what the U.S. can learn from the best health care around the world to do better here at home, especially for people of color, people with low income, and those who are uninsured. To learn more, visit CommonwealthFund.org. It's time-consuming caring for my father and caring for my daughter at the same exact time.
My kids are five and seven years old. My parents are in their late 60s. Some of my biggest struggles is just balancing everything on my plate. This sandwich generation, no one prepared us for it. No one prepared me for it. I feel exactly the same way. All of a sudden you hit your 40s and nobody's told you that you're going to have to raise children and take care of your parents at the exact same time.
30% of family caregivers in this country are part of the sandwich generation. People caring for both young children and elderly loved ones. And many of us also balance work on top of it all. Even when there are good days, where everything is running smoothly, no one is sick, there's no emergency to take care of, there's still this constant feeling of stress. It's always there.
sandwich generation. I mean, it's such a cute way to describe a time that for many of us might actually be the hardest years of our life. Being stuck in the middle, being pulled in a million directions, often feeling very overwhelmed and very alone. This is Uncared For. I'm your host, Sujan Pak.
Today, I'm talking with Robert Ingenito, who is part of the sandwich generation of caregivers. For several years, Robert's dad lived with him and his wife as they raised their daughter. Robert worked part-time as he juggled family life and being the primary caregiver for his dad.
Robert's father died in February. He was 93. I spoke with Robert about one month later. He was grieving, of course, but he still wanted to talk about his experience, to put words to some of the things he had gone through. Caring for his father had been such a big part of his life. Their relationship in general was so strong, though Robert says they weren't always close. What was he like as a dad?
He was quiet. I don't have many of your typical father-son memories. We didn't do things like play catch or go to baseball games.
He wasn't the more, let's say, hands-on parent as my mom. He really focused on his career as attending a physician at a couple of different local hospitals before going into private practice. But he was definitely present and around and just loved being with me and with our family and family.
going on vacations and all those things. When my mom passed away, when I was 19 years old, I have this very strong memory of my dad and I in the basement of our house and we're doing the laundry. And, you know, there were two things he said. One was that it wasn't supposed to happen this way because my mom was so much more younger than my dad.
But two, he acknowledged the fact that he wasn't the more hands-on parent with me and that he hoped that the years ahead would bring us closer together. And he did. It was 25 wonderful years of some great father-son time.
When Robert was in his late 30s, living in New York City and just starting a new family, his dad was approaching his late 80s. After his dad had a heart attack, Robert took on some caregiving duties, like preparing meals and going to medical appointments. But things really changed when he and his family moved to the suburbs with their toddler and Robert's dad moved in with them.
So all of this is happening. You're starting a family. Your dad is moving in. I mean, this is why we're sitting down with you. There's so many books and conversations and TV shows around like becoming a new parent, you know, and the joy of bringing a life. This whole kind of...
of your life that so many of us find ourselves in, where we're raising our own family and then taking care of aging parents. That part is like a black box. Right, right. I was not expecting him to live up to 93 years of age, right? Like, we are in a world today where people's lifespans are going much further beyond where they used to be.
And so I think the fact that I was in this, you know, what's called the sandwich generation where, you know, I have a little one and then also a geriatric one that I'm now taking care of at the same exact time was just, you know, crazy. Yeah. Yeah.
Yeah, no, it is. It's a whirlwind. Like there'll be a moment where the wind dies down. I'm like holding my breath and then something kicks it up again. And this juggling of these two phases in your life that are so different, but also weirdly similar. Yes. And then you're both the child and the parent in both situations. Yeah, yeah.
You know, it was funny. In September of 2020, you know, we're in the midst of COVID, right? And our daughter is now, I think she's probably about, you know, two or three years old. And we're like, you know, in the middle of potty training. But at that same time, my father had a very mild stroke and he fractured his hip.
And so after he went to the hospital and came back home, we had to do things like install chairlifts and we bought walkers and a bed cane and a commode to go over the toilet. And this is kind of a funny little story that my wife and I would talk about. But as I said, it's around this time that we're potty training our little daughter and
And she has a special potty seat, right, that goes over the regular toilet seat. However, whenever she needed to go to the bathroom, we had to swap out my dad's commode with her potty seat. And whenever my dad had to use the bathroom, we would swap out her potty seat with his commode.
And my wife and I would say, these potty seats and commode manufacturers need to get together and like build a device that can accommodate sandwich generation households. I mean, I just, I love it. It's, you know, you got to just like look at those moments and it's the absurdity of like, hold on, wait, which, wait, who has to pee? Hold on, I got to get the right toilet. Yeah.
I just, I love it. I know I'm in that phase where my dad just doesn't want to eat what he used to eat. And so I'm like, am I cooking 48 chicken nuggets right now? Like frozen chicken nuggets for my kids? And then my dad, that's all he wants to eat.
And my dad was never that person. And it's just also a weird, like, changing of identity. The parent becomes the child, and the child becomes the parent. And you're making decisions, you're, you know, you're cooking meals, you're doing tasks that you'd normally associate with, you know, changing of a diaper on a baby table. Yeah.
When, no, you're actually doing that for your loved one, for your parent or for, you know, somebody who you need to take care of. And it's hard. It's really, really tough to kind of put your brain and your whole being into that new role with this person.
When we come back, Robert talks about how this new role became all-consuming and when he got to his breaking point.
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I'm Hasan Minhaj, and I have been lying to you. I only pretended to be a comedian so I could trick important people into coming on my podcast, Hasan Minhaj Doesn't Know, to ask them the tough questions that real journalists are way too afraid to ask. People like Senator Elizabeth Warren. Is America too dumb for democracy? Outrageous. Parenting expert Dr. Becky.
How do you skip consequences without raising a psychopath? It's a good question. Listen to Hasan Minhaj Doesn't Know from Lemonada Media, wherever you get your podcasts. Talk to me about what that care looked like for you. You know, describe a typical day for me, you know, when he was living in your home and what you were doing for him on a day-to-day basis. A typical day was usually getting up, getting our daughter to school, you
Maybe I would put in a couple of hours of work for my part-time job. And then I would come back to the house, get him out of bed, usually around like 11 o'clock in the morning, help him change out of his pajamas into some day clothes, get him downstairs, give him a cup of coffee, set him on the couch, maybe turn on the TV or give him a book or a crossword puzzle to do.
And then I could kind of leave him out to himself for the day. You know, he would be able, with his walker, to get up, go to the bathroom on his own. And that was pretty good. I would go back to work and pick up my daughter from school, bring her to her swim lesson or whatever. And then we'd come back home and I'd make dinner. And that would be, you know, kind of the highlight of his day, being with everyone around the dinner table.
And then after a couple of hours, usually around 9, 10 o'clock, I'd help him up the stairs with the stair chair, help change him into his pajamas, get him back into bed, and wish him good night. And that was kind of like the routine of doing that while at the same time raising our little daughter. It was kind of like a day-in, day-out routine that...
you get caught up in and you don't realize that so much of this, these small but important tasks are becoming so much a part of who you are. And when it's over, you just feel like, what happened? Where did that piece of me go? And it's taken quite a while for me to, I'm still kind of coming to terms with that.
I mean, I don't think I've ever heard anyone say it that way. And it's so true that these small tasks become who you are when you're a caregiver. Yeah. Wow. I would shave him. You know, I would shave him usually like once a week on the weekends. And my dad, he, you know, while he was up there in the years, he had a pretty good, you know, faculties.
But his hearing was really bad. And so when a person's hearing is bad, communication, right, starts to become a thing. And once a week when I would shave him, you know, and I'd put the shaving cream on his face and I'd take the razor and carefully, you know, shave whatever stubble he had there. Yeah.
It became such an incredibly intimate and personal form of communication between me and my dad. And, you know, it wasn't, it's not like the most favorite task that I had to do, right? But I kind of liked it and I miss it now because it was just a way for me to show him that I loved him. Yeah. Yeah.
I mean, I feel the same way when I am like coloring my mom's hair. She's just all and she refuses to just accept that her hair is gray. She won't let that go. And I think also, too, it's the touch. You know what I mean? Because it's like so much of of of caregiving becomes like a.
like a obligatory or like, you know, a touch that it, that has to lead somewhere or do something. And then when you're in those intimate moments and you're holding your father's head or I'm holding my mom's neck to make sure that, you know, I'm getting her hair just right. That touches. I mean, it, it says it. Yeah. It's everything. It's, it's all about mother and daughter. It's all about father and son. It's just like,
you know, that bond and you don't need words at that moment. You just, you just rely on touch and care. And, you know, as I'm shaving him, I'm thinking, oh, I don't, you know, I don't want to nick him. I don't want to cut him. And, you know, you're, you're doing it carefully and you're just so present in that moment. Yeah. Yeah.
But it wasn't always easy to savor the time together, especially as Robert's caregiving responsibilities became more intense. At night, he would have to get up from bed to go to the bathroom. And I tied this bell around his walker. And whenever I would hear it ring, I would spring out of bed and run over and be with him just to make sure that he wouldn't fall.
And I wasn't getting sleep. And my wife said, you can't keep this up. You just, you can't keep doing this, you know, to yourself. And that was the straw that broke the camel's back for me. You're thinking, well, I can do these small incremental things. I can do things like shaving and that stuff like that. But when it was coming to the point where I was just
physically tied to the house because I was so afraid for him and his health and safety and well-being or worrying about a fall. That was the piece that I just knew I can't keep this up. Robert did have a home health aide help out at the house some days, but he desperately needed some deeper breaks from caregiving.
There would be on occasion, maybe like two or three times where we would do this thing called respite care. And, you know, I'd explain to my dad that he's going to have to go into a place for like two weeks where I know he's going to be, you know, taken care of, you know, in a safe environment.
And he'd say to me, no, I don't need to do that. Right. Like, why are you doing this? And I would have to each time remind him, like, you're not doing this for you. You're doing this for me.
I need to take a break from this caregiving. I need to focus on my family. And when I would say those things to him, he kind of understood where I was coming from and agreed to doing the respite care. It's so important for caregivers to ask for help and take a break when we need it,
Respite care provides short-term relief from a few hours to a few weeks, giving primary caregivers time to rest, travel, or spend time with other family and friends. You can look for providers through a home health agency or your local department on aging. But as Robert learned, sometimes respite care just isn't an option. Were there moments when you were taking care of your father regularly?
that you felt that it was pulling you away from being a father? Oh, yeah. Absolutely. The one memory that really rises to my mind is in August of last year, last summer, my family and I were planning to go away on vacation, and I had signed up my dad to do this respite care so that we could go away, and he got sick.
And, you know, when you do sign up for respite care, you have to go through this process of being evaluated. And when he got ill, well, the evaluation that had been conducted no longer applies. And so the respite care had to be canceled. And I had to stay home with him. And my wife and our daughter went away on this trip. And it was hard. It was really, really hard. Yeah.
Leading up to this moment, I was realizing that this was becoming a bigger and bigger part of my identity. And I would remark to my wife, you know, how long can I keep this up? But after that trip, after that experience, my wife and I, we kind of came to this conclusion that
This is just not sustainable and that we needed to find a way for him to get the care that he needed that wasn't going to be as taxing on me or on our family. And that's when we moved him into assisted living where he stayed for the next about five months of his life.
Moving a parent into assisted living isn't an easy decision for a lot of people. For Robert, though, something happened decades earlier in his life that made it particularly difficult. So I'm 19 years old. I'm a sophomore in college. My mom, who had been battling colon cancer, died.
was basically at the end of her rope, and they had told us that we needed to pursue hospice care for her. And we brought her home, we gave her everything that we could, and she, from her deathbed, she says to me, you know, don't put your father in a nursing home. And for a 19-year-old sophomore, you know, it had an incredibly huge impact on
and something that I carried with me for the past, my gosh, I'm now 44 years old, so you do the math, right? Like every single decision that I made about my dad's care was colored by that promise. And I can still remember it so vividly. And so when she made this request of me, I just said, yeah, I'll do it. You're my mom, you're dying.
I want to do whatever it is you want me to do because I love you. She was in so much pain and she was coming to the end of her life. I wanted to do whatever I could to be a good son for her. When you tell me that story, just like how much love that your mother had. You know, in her last moment, she was like,
take care of this person that I love. So there is some poetry, some beautiful. It's both. It's the hardest and it's the most beautiful. So I have to imagine, since this promise you made to your mom, that moving him into this assisted facility, how hard that decision was. It was the worst decision I had to make. I just felt awful.
I remember the day my wife and I were driving to this facility to sign the lease. You know, we're heading down the Hutchinson River Parkway, and I say to my wife, "I feel like I'm throwing in the towel." I really thought that I could keep this promise, that I could, you know, I would be able to keep him at home, and that he would spend his, you know, final days in our house.
And it just, it wasn't realistic. It wasn't possible. I couldn't keep it up. There was a small pang of guilt. Well, let's not call it small. There was a big pang of guilt there. You know, I don't want to necessarily pigeonhole, you know, cultural stereotypes, but, you know, I grew up, you know, in this Catholic, Italian, Filipino household where guilt is a big thing. And, you know,
This was a promise that I had made to my mom on her deathbed, right? If that isn't the most Catholic, Filipino, you know, immigrant mom thing to do, right? It's like out of a movie, yeah. But I just, I had to come to terms for myself. I had to come to terms, you know, understand like, I'm a dad, I'm a husband, right?
And there's so much more going on here that I have to be aware of that's beyond just being a good son. It was hard. It was really, really hard. But amazingly, after he moved in, after a good week or so, I was really impressed by the socialization he was getting and the engagement he was getting from the staff and from the other residents.
Yeah.
I feel like as a caregiver, it's so hard to ever make the right decision. Everything always feels like you didn't do enough. The second guessing and the guilt, it just weighs you down. And it doesn't help that we have so few real options for care in this country, especially when you factor in the cost of care. And then on top of that, the stigma many people feel around nursing homes.
But Robert was able to move beyond that and realize that he wasn't throwing in the towel. He was doing what he thought was best for his whole family. There's something to be said for having the courage to make a change, even if it's one you hadn't planned on. After this short break, Robert talks about how his six-year-old is dealing with all the change. Hello, I'm Joel Breveld, medical myth buster and host of The Dose, a health policy podcast from the Commonwealth Fund.
Each season, I sit down with a leading health policy expert and medical professionals to have real conversations about the issues that keep them up at night. We talk about breakthroughs in their research and their new ideas to make our health care system work better for all Americans. This idea of equity needs to be taken up by everyone.
And wherever you are in your work, whatever sector that you're in, we need to have conversations about what tomorrow looks like. I hope you'll check out The Dose and enjoy listening to our interviews. You can find us at thedose.show or by searching your podcast app for The Dose from the Commonwealth Fund.
An Australian hiker travels to the American West to walk a wilderness trail. Wasn't afraid to be out on his own. But Eric Robinson vanished in the Hiawinta Mountains. I remember thinking, "Eric, what were you thinking, mate?"
I'm Dave Colley. Join me on my podcast, Uinta Triangle, where I travel the world to answer the question, what happened to Eric Robinson? Follow Uinta Triangle, that's U-I-N-T-A Triangle, on Apple Podcasts or wherever you listen. Welcome back. After Robert moved his dad to an assisted living facility, he said the house felt empty at first, but the transition ended up being good for the family dynamic as a whole.
It improved. It definitely improved. I think if you were to ask my wife and our daughter, I was a more present father and husband for them. And I think in the times that I would visit with my dad or take him out to a restaurant or to our house for dinner, I was in a better place. I was better able to take on whatever the challenge was because I had that
rest and that respite and I can come at things in a much you know refreshed way but holy cow the price tag on that is huge yeah for the five months that he was there he was paying around eleven twelve thousand dollars a month um to be in that facility and you know he was a doctor he had fortunately the savings to do it but it was expensive and you know medicare's not paying for this
And you have to know, right, it's only going to get more expensive. So all of that was paid out of pocket? Like none of that was covered by insurance at all? No. I mean, his doctor's visits, the trip to the emergency room when he fell...
the medications that he was on, you know, that's covered by Medicare. And he had a, he had a good supplemental insurance that also, um, would take care of, you know, whatever wasn't covered by Medicare, but yeah, the assisted living facility, the rent that he was paying there, the fees that he was paying for medication review for, uh, diapers for, um,
This is something we heard from a lot of caregivers. Medicare just doesn't cover so many of these costs.
Medicare is a federal health insurance program for Americans 65 and older. It covers things like routine doctor visits, preventative care, and hospital stays. But like we've mentioned in previous episodes, it does not cover assisted living facilities or other long-term residential care, such as nursing homes or memory care facilities. ♪
Medicaid, a joint federal and state program, may cover long-term care, usually in a nursing home, but only for low-income seniors. And the demand is high. But despite the big price tag of the assisted living facility, Robert was grateful for the care his dad received. His dad stayed there for five months until he had an incident. He fell. He fractured his pelvis.
We had to go to the emergency room at our local hospital. And after about four or five days, I could see, you know, this is not something that you can do surgery on. This is not something that he would be, you know, bouncing back from the way he bounced back from his other falls. And I talked to the doctors. I talked to the palliative care team. I talked to the social workers. And I said, look,
I just want him to be as comfortable as possible. I want him to, you know, whatever we could do to mitigate the pain, let's do it. And if we can get him into a hospice hospital, I would appreciate it. For people nearing the end of life, hospice provides compassionate care focused on pain relief and providing comfort. Hospice also gives emotional support for the family.
He was moved that evening. And I remember following the ambulant from the regular hospital to the hospice hospital, and it felt like, again, you know, this throwing in of the towel, and it was like this last trip for him that I just felt awful about, and I felt, my God, I'm making these decisions for him, and I'm basically, you know...
giving him a death sentence, right? Like when you say hospice care, you know, this is what it means. And when we got there, I remember meeting with the doctor, talking about the medications that he was on. He was on, you know, different heart medicines. And I said, look, I know where this is heading. Do we need to be on this heart medicine? And it was, again, another difficult decision that I had to make. And we took him off those medicines and...
About two and a half weeks later, he was gone. Robert's dad died at 93 years old. When we talked about a month after his dad died, Robert was understandably tender. I could hear him contemplating the decisions he made in real time. I was so grateful he was open with me because so many of us will someday be faced with very similar decisions. And they're hard to make and talk about.
But Robert says he doesn't regret anything about the care he gave his dad, including moving him to assisted living. Kids can be a great medicine through grief, and Robert's daughter is no exception. She's six years old now. She grew up knowing that this grandpa, who was in his 80s and 90s, was not the same grandpa as my wife's parents, who are now in their 60s.
And so, you know, she couldn't like play with him the way she plays with my in-laws. You know, he wasn't the kind of grandpa that could just, you know, get up and run around the house with her or play, you know, make-believe games with her. Or for that matter, as I said, his hearing was really bad, could hear her the same way, you know, that, you know, I could hear her
And so that was a major stumbling block, I would say. But there were small moments where I felt we could bridge that gap. And so sitting in his lap while he's in the wheelchair and we're, you know, going across to the church garden across the street from our house or riding in his lap as he's going down the stair chairs. You know, she would love that.
Just a couple weeks ago, we had the stair chairs removed from our house. And I had huge emotional reactions to that. And I learned from our daughter's teacher that she too was crying in school because she knew that they were being removed. And they were just this piece of equipment in our house that really...
made it so possible for him to live with us and to be part of us. And to like, for her to share this memory with him, right? That when we had to get them removed, it really like hit us in ways that we didn't realize that, you know, it would be like that. Have you thought about what you will say or maybe you've already had conversations with her about this time?
With a six-year-old, right, you got to think about what is understandable for somebody this age. A couple weeks ago, she and I went to the cemetery. They had put up the stone. My dad's buried or entombed, rather, next to my mother in a mausoleum.
And we found the two of them next to each other. And, you know, when you go to a cemetery, right, it's a sad time. But when you go with a six-year-old, like...
There's a certain levity to the situation. Like, we were taking pictures of the stone, and my daughter's, like, kneeling next to her grandma and grandpa, their names, and she's smiling and kind of being a silly, you know, little six-year-old. And I don't know, I felt like, this is nice. You know, this is actually...
a really nice experience to be having instead of like coming to the person's grave and, you know, you're going to feel sad, of course, right? Like that's a given. But to go to the grave and be with someone who is just have such a light heart and a light, you know, spirit, it's a great learning experience for me. Yeah. Yeah.
Robert's story reminds me that when they say caregiving is a journey, it's really true. You can go from helping your parents here and there to moving them in, and then eventually you come to lose your loved one. And that will continue the journey in a whole different way. Feeling that loss, but also feeling lost yourself. I was imagining all these things sitting with Robert and seeing his grief.
I think in the end, when you're caring for a loved one, you just want to know that you did all that you could. You loved as well as you could, and that those last years were met with dignity and care. There's more Uncared For with Lemonada Premium. Subscribers get exclusive access to bonus content like unaired interview clips from caregivers across the country. Subscribe now in Apple Podcasts.
Uncared for is a production of Lemonada Media. I'm your host, Sujan Pak. Muna Danish is our supervising producer. Lisa Fu and Hannah Boomerschein are our producers. Our mix is by Ivan Kurayev. Music is by Andrea, Kristen's daughter. Our associate producer is Isaura Aceves. Jackie Danziger is our VP of narrative content. Executive producers are Jessica Cordova-Kramer and Stephanie Whittleswax.
This season of Uncared For is presented by the Commonwealth Fund, a nonprofit foundation making grants to promote an equitable, high-performing healthcare system. Help others find our show by leaving us a rating and writing a review. You can follow me on Instagram at sujinpah and Lemonada at Lemonada Media across all social platforms. Follow Uncared For wherever you get your podcasts and listen ad-free on Amazon Music with your Prime membership.
Thanks so much for listening. See you next week. This show is presented by the Commonwealth Fund, a nonprofit foundation whose mission is to promote a high-performing, equitable healthcare system.
The Commonwealth Fund supports research to improve health care policy and practice and has a long history of exploring what the U.S. can learn from the best health care around the world to do better here at home, especially for people of color, people with low income, and those who are uninsured. To learn more, visit CommonwealthFund.org. ♪
Hey, I'm Nicole Norfleet. And I'm Aaron Brown. And we work at the Minnesota Star Tribune. And we've got a brand new show called Worth It. Every week, we get together with a group of people who know Minnesota inside and out. We skip the Minnesota nights and get right to the good stuff. We share the stories and the happenings around the state worth your time and your money. Worth It from the Minnesota Star Tribune and Lemonada Media. Every Friday, wherever you get your podcasts.