Episode 190 – Nancy Picard: Caregiving in a Crisis

 

Like many adult children, psychologist Nancy Picard is determined to prevent her aging parents from contracting COVID-19.  But Nancy and her parents live in separate states.  So she’s in daily communication with them, and has wired up their house with cameras placed at strategic locations – at foot level, to give her parents some privacy.  A returned Peace Corps volunteer who has supported people from age four to 94 as a clinician and researcher, Nancy also focuses on supporting people’s needs for reminders through her health care startup, MemoryBeach.

As a psychologist and as a daughter who has cared for her elderly parents, Nancy understand the stresses of the moment and how everyday can feel incredibly long.  She’s here to offer comfort and advice to caregivers, for surviving as individuals with their own needs, and as sons and daughters  tasked with filling the needs of family members and friends.

 

 

Connect with Nancy on LinkedIn

Learn more about Life Stories for the Ages: Capture a Story. Connect the Generations.

 

INTERVIEW TRANSCRIPT:

JANA PANARITES (HOST) – In 2009, three hours after speaking with him on the phone, my father died of a heart attack. Prior to his death, Dad was asymptomatic, meaning he neither felt nor displayed any outward sign of illness. One minute he was here, the next he was gone. My father’s sudden death left me feeling completely unmoored.  For several weeks afterwards, I crawled into bed every night hoping that when I woke up in the morning, life would be back to normal, as if it were all just a bad dream, and dad was still alive. But of course, he wasn’t. Never in my life had I felt so anxious, not only about my future, but about the future of my widowed mother, who was then 80 years old.

The global pandemic we’re now all experiencing has brought back all those uncomfortable feelings. I’m anxious about the future and I feel vulnerable. And I know many of you are feeling the same. We don’t know how this is all going to pan out.  What’s worse is that as caregivers, we already operate at high levels of stress, because we routinely carry out difficult health care tasks without adequate training, all the while wondering if we’re going to lose our jobs – if we still have them – because we’ve taken so much time off to care for aging and Ill family members.  Now we’re not only combating that stress, but the stress of COVID-19 and the fear, anxiety and isolation that comes with it.

On today’s show, we’re going to talk about caregiving during this unprecedented pandemic and hopefully offer you some comfort and advice for surviving as individuals with your own needs, and as caregivers tasked with filling the needs of family members and friends. Here to help us with that is Nancy Picard, Nancy’s a psychologist and a returned Peace Corps volunteer who has supported people from age four to 94 as a clinician and researcher.  She also focuses on supporting people’s needs for reminders through her health care startup Memory Beach.

In her day job, Nancy’s a management consultant who’s worked with some of the largest companies in the US and abroad, plus federal and state governments and multiple financial and private equity firms. Her health care and retail startup MemoryBeach was chosen among a field of hundreds last year for Chicago’s 1871 Women in Science and Tech accelerator. Nancy has also cared for her own elderly parents, so she can relate to you in more ways than one. Nancy joins us from Chicago. Nancy, welcome to The Agewyz Podcast.

NANCY PICARD – Thank you. Thanks for having me. I look forward to sharing some thoughts today.

JANA –  Great. So I always like to start these conversations with some background information on the folks I interview. So I guess my first question is, did you grow up in Chicago? And what was your upbringing like?

NANCY  – Thank you. My upbringing was actually in Pennsylvania, in a rural community where we grew up among  the fields and the cows, and not too many people. I think our town had one stoplight – eventually.

JANA – Wow.  Eventually.

NANCY – Yeah… eventually.  And we never got a chance to see that community change. I’ve been back to it now, and of course, there are subdivisions and lots of houses. But when I grew up there, there was not very much. And so I spent a lot of my time on my bicycle, and with my brothers running around and playing sports and doing things like that, and I also grew up seeing how people dealt with issues – community, what community meant. And so living in a big urban environment was actually something I always longed for and yearned for. And that eventually, over the course of many, many years, led me to Chicago.

JANA – Okay, now, are your parents still alive, both of them?

NANCY – Yeah, my parents are both alive. They’re actually currently in California. It’s interesting because we seemed to pick two out of the three big cities right now that are shutting things down, or have shut things down. So they are now in Orange County. But I took care of them for the last nine months here in Chicago, where they lived in a back apartment that’s attached to our house, that we actually specifically designed in a universal design way to care for elderly parents living at home. So that project was many years in the making. And they were able to benefit from that.

JANA – And how did they end up going out in California?

NANCY – So sometime around… well, I suppose somewhere around in December, we realized they were getting too sedentary. And by that, I guess one of the things people can probably relate to in terms of caregiving is you’re always trying to find the balance between gentle encouragement, meaning you want to create kind of a shining moment to draw someone towards like, Let’s talk about the benefits of what you’re about to engage in, and it’s going to be wonderful, and you’re going to be more healthy. And so you’re trying to kind of set up some rewards, but those rewards are fairly far out there.

And so, in Chicago, it gets very grim and very dark. And I found that my parents were not moving a lot and encouragement was starting to turn into – I try to stay very far away from anything fear-based. So, like, if you know, “if you don’t do it, then this terrible thing is going to befall you.” So that’s not an effective technique, although one’s mind naturally kind of goes there. So what we decided was, since we had this tiny little house that we had kept, because we had actually been also caring for our father-in-law out there many years ago, before he passed. We had hung on to this tiny little place, and we were debating what to do with it.

And then when we discussed it with my parents, we said, Why don’t you take advantage of living in California? The weather’s warm, and at least with warmer weather – and we have a few friends out there we could lean on – maybe that would be a better environment for you, to get out and get some walks in and get some fresh air, and not be really stuck inside here in Chicago. So we flew out together, and I spent a week out there setting them up and setting up a lot of long-distance caregiving options for them and figuring out which ones they would accept, and then came back here and, you know, within a couple of months there was – maybe within a month even – there was the shutdown.

JANA – How old are they? And are they in good health?

NANCY – My mother is going to turn 80 next year.  My father is 87.  And they’re, they’re moving toward what we call the cliff of good health. So my dad, technically, is kind of on the edge of that cliff. I know many people are probably wondering what that means. It’s just, for every single person, and what the World Health Organization (WHO) would say is, you know, the optimum way to age is to be really healthy until you kind of move into the later part of your living experience. But that happens fairly quickly, because you’ve been, you know, healthy your whole life and then your lifespan starts to complete its journey.

And you kind of peacefully move on, but you move on with some rapidity. There’s kind of this, toward the end of life, there’s kind of a fall off.  And you don’t want that to be disease, and you don’t want that to be – and I’m sorry, very sorry to hear about your dad – you don’t want that to be a shock. But you do, you do recognize that the end of life is real. And that the WHO says, you know, our best guess, is somewhere around 115 years, maybe 120. So as you get into – I mean, that’s really pushing it.  So most people are gonna, around 100, kind of say goodbye to us.  And so around 85, 90, that’s when the goodbye is more likely.

JANA – Mm-hmm.  That’s the cliff you’re talking about.

NANCY – That’s the cliff.  And so you don’t want it to be falling off that cliff, you kind of want to, kind of walk down the other side.  But it happens more rapidly, then, of course, you know, developmentally as we grow up.  So that’s where he is.  So he’s in good health, but I’m always watching him because there tends to be less and less recovery between, you know, him falling down or him getting a head cold or him, you know, obviously, taking on some of the immunity problems now we’re all very good concerned about. So he’s in that space.

And my mother, she’s probably had every kind of medical condition and recovered from it, that I can’t – I mean, I can list – and I think she’s a, she’s a real example of somebody who’s benefited from being able to access the health care system in a way that’s brought her back to better and better states of health. So she just got over the flu in January. I mean, I won’t get into any medical details for her, but I mean, she’s, she’s pretty tough.

JANA – Wow.  And now are they in a care facility, or what’s their setup?

NANCY -No, they’re set up is they’re still living independently.  They support each other in a small house.  They have access to whatever Orange County now is providing, which isn’t an awful lot. But we traveled a lot when I was a kid, and so my dad has a civilian pension from the government that he lives off of – they live off of – so, they have a pretty modest existence, but it gives them just enough, you know, to take care of themselves now.  And they’ve talked about moving next to my brother who lives in Washington State, and moving into a cottage where they would have, hopefully have some personal care in the home. That would be their desired state of living: in a small cottage near my brother, with someone coming to the house to help them. That’s their dream.

JANA  – So where they are now is kind of a way station it sounds like.

NANCY – Yeah, it is. And if anybody’s listening and is curious about the technology that kind of makes that work – and this is maybe a little bit about the MemoryBeach link back to the company – we set up a system of monitoring them that they were comfortable with, around a certain staircase. So we have a camera setup at their feet. And so we never actually see their faces. But we – I mean, unless they want to.

They can pick up the camera, like last night we played Scattegories online, which was kind of fun. So we figured out how to use the internet basically to maintain our social contact. And I insist that we do have some kind of either voice communication every day, or we get to see their feet. I shared our security camera with them, so they can peek in on us if they want to. But the idea is to, like, create this sense of seamlessness between our two homes.

JANA -Uh-huh.  And they’re comfortable with technology, to the extent that you’ve kind of introduced them to it? Or what’s their mindset towards technology?

NANCY – So, their mindset is generally one of acceptance, but of course, they like to have the support. They’re generally safe with it. But they require monitoring, because they’ve been victims of multiple scam attempts and actually one successful scam, so – that got past me, which is unusual because I’m, I’ve got them layered up with all kinds of security, but – and I talk to them regularly enough that I ask about their online behavior, and what’s happening.  You know, and sometimes I’ll just– when I was living with them I would say, Can I look at your internet browsing history so I can see, you know, if we could just clear your cache, because a lot of times their phones freeze and stuff like that.

But generally, what I try to do, my attitude or my parents is what I give advice to other people to do, which is give options – always give options you can live with in terms of monitoring and help, try to only give limited explanations but lots of practical support, so that the person still feels as if their attempts at mastery have meaning. Because what I typically see happen in these kinds of interactions where people who are slow to technology, for whatever reason, and sometimes it’s, honestly, it’s just temporal lobes.

A lot of what we need to take in information and to process it and absorb it in our executive function, you know, using our judgment, our capacity to judgment, a lot of that slows as we age.  It starts about middle life and starts to slow. So when people have to keep working and working and working to acquire information, understand something, like my parents, I find the most helpful thing to do is just wait ’em out. Just wait and repeat and wait and repeat, because I know at some point is going to click. But for them, I’m trying to keep them cheered` up so they don’t get so frustrated that they just drop it and walk away.

JANA – Right.  Now, does either one of them have cognitive impairment, like dementia?

NANCY – They definitely have not been diagnosed. So they haven’t reached a point where I felt like it was necessary to ask them to get a psychological assessment. One of the things that I’ve learned not just clinically but also as a daughter is, the periods of recovery in caregiving can be really quite miraculous. So you can see somebody look like they have a cognitive impairment and you can get very nervous and you can wonder, and then you have to cover your bases and fix all the things you can fix in the immediate environment. And if those are fixed, and the impairment is still there, then you obviously have to seek support.

But there are a lot of causes of cognitive impairment. There are many causes of memory loss that are actually in the environment. And so when you go to a clinician, like when I used to be doing clinical assessments all the time, or memory assessments or even IQ assessments, someone would come in presenting an issue and they’d say, Here’s my dad, or Here’s my mom, or Here’s my child… and they aren’t like they used to be. And, in addition, here’s all the things that they’re doing wrong. Like, here’s what I’m noticing. And I would take that very seriously. I mean, families who report a change need to be respected, because many times what they’re reporting doesn’t rise to the level of clinical significance. It’s a subtle change. It’s something they really feel, right? And so that’s important.

Having said that, when you inquire a few things like, Well, what has changed in the environment? That’s when people pause.  What’s changed that would cause that person to change?  Because the person is relating to their environment. So, did the food change? Did the exercise level change?  Are they hiding something? Did you find something under the bed that they might be drinking or eating?

So before we start talking about cognitive impairment as it relates to what’s going on in a person’s state, we also have to just kind of try to figure out what’s going on in the environment. And then if they say, Well, nothing really has changed, you know, they eat the same, they drink the same or there’s not any big stressors, or there’s nothing that would cause this, then you kind of say, Okay, let’s hit some questionnaires, then and let’s get a full medical workup and let’s see what’s going on.

And with my parents, I’ve seen so many rollercoasters, from impairment to wellness to impairment to wellness, I thought, you know what, this is environmental. And that’s also part of why we made the decision to move them into a warmer environment. And sure enough – not strangely enough, now that I’m watching my dad’s feet, this occurred to me because I’m watching his feet all the time – I said, Hey, Dad, you’re walking better. Your gait is better. And gait is (laughter) – you know, it just came out a couple weeks ago that gait and dementia, you know, of course, right? It’s the same central nervous system. You’re gonna see gait changes. You obviously see them in Parkinson’s, so I’m like, This is so funny that now I’ve got cameras on his feet, as well.

JANA – Right.  That is wild.

NANCY – I know.  So, anyway.

JANA – Well, okay, since we’re on the subject of dementia, I’m gonna raise this obvious issue of how you explain to someone with dementia who forgets things every day, why they can’t, for instance, go to church or dine with friends or do some other activity they normally enjoy because of Covid-19.  Is it okay to come up with an excuse that has nothing to do with Covid-19? How do you suggest people approach that?

NANCY – Yeah, I think there’s two levels to answer. One is just, the caregiver needs to be respected for wanting to be attached to reality. I mean, as you or I know, or anybody who’s done caregiving… we, too, require engagement.  We, too, require love.  We, too, require a sense of self and permanence. And so sometimes, when we’re working with somebody who has a cognitive impairment, we want to tell them the truth.

Because we need to hear it coming out of our own mouth.  We need to say, I feel scared, or I’m worried or I need support, or I need love. I mean, these are normal ways to attach and they’re totally legitimate. So you stop there, and you say, Okay, I want to do it. And now you have to pause and wonder, should I?  Even if I want to and I respect it and it’s honorable, and it’s meaningful, and it’s healthy, and it’s wise, on so many levels, under what conditions am I allowed to ask for it?  And under what conditions should I get my needs met elsewhere?

And when you think about someone with a cognitive impairment, as they take in information, and they’re trying as best as they can to use whatever they’ve got to create their own psychological stability, the last thing you want to do is rock it, or rock their world, or introduce something new to which they’re going to have to adapt.  And If you are asking for an adaptation by way of restructuring their environment, or giving them a new reality, you have to understand that they’re working with less flexibility.  They’re more likely to be rigid, they’re more likely to be reactive, they’re more likely to experience those changes in the environment as extremely disruptive.

So you have to be careful as to mixing up your needs as a person with a whole lot of resources and flexibility, hopefully mentally flexible, and somebody who’s now constrained. And as you think about that interchange, ultimately, I mean, I can’t tell people what to say, but I can ask them to take a look. So if, if I can call a friend and talk about how scared I am, and that friend’s going to relate to me and we’re going to have this, we call “contingent relationship,” like, you’re going to talk to me and I’m going to talk to you and we’re going to find some source of comfort. And now I’m going to talk to my mom who doesn’t understand any of this and all she knows is that usually on this day, this thing happens and now it can’t, what  am I going to be able to say to comfort her?

And if I’m making up some wild excuse, or I’m generating something that is truly comforting, it’s okay not to have that represent what’s on the evening news. It’s okay for it to be something different. Again, you’re gonna have to wrestle with yourself a bit, because some people are really committed – for their own psychological stability – they’re really committed to doing things a certain way. They’re really committed to wanting to be in a certain way. And I certainly don’t want to rock any caregivers world.

But I will say that for the recipient of the information, the person who can’t process as quickly, who can’t understand it all, who doesn’t necessarily even want to know maybe, sharing information with them on their terms, to get them to a place of stillness or quiet… that’s, I think, where most caregivers end up.  They begin to accept that their loved one or the person they’re caring for, has a certain range and if they stay within that range, it’s good. And if they move out of that range of information or behavior, then it’s bad.

So if I had somebody who had really fallen in love with a particular idea, and it was creating a lot of stability, like, for example, they couldn’t maintain a schedule, or they couldn’t do something or, you know, was kind of living day-to-day because every day was very chaotic, I would try to rely on a different memory system, maybe an implicit memory system, something not conscious.  So set up a routine, that even if the person wasn’t entirely aware of the routine, I would go through the routine in the same way, and I would try to create a rhythm and a pattern, and have that be what keeps them still and psychologically stable.

So if that pattern used to be, we would get to go to this place, we would get to meet these people, this is the pattern of our lives and now our pattern has changed?  I would move to the new pattern and I would start repeating it, and have that be the structure. So maybe it’s not going to bingo, maybe you walk around the house five times. Maybe it’s not getting to go to your favorites store, maybe it’s pretending the favorite store is in the garage.

I mean, whatever it is, you want to set up a rhythm and set up a routine that keeps you sane and keeps them sane. And then say whatever you need to say to get everybody through it that’s going to create sense of psychological stability. But saying anything that relates to the word “catastrophe” or “damage” or any of those trigger words that are very upsetting, you may want to hold off on that for people who could actually handle it.

JANA – Yeah. So let’s move into the scenario where the caregiver is cut off from seeing and helping our charges. You know, now hospitals have visitor restrictions, most facilities have implemented “no visitor” rules or restricted access. How can caregivers create a sense of their presence if they can’t visit their loved ones?

NANCY – I love this. I love this question because I’ve been thinking about this for about 15 years. I really have.  And not that there would be a pandemic, but how do you access the visual system and the auditory system of a person, and try to connect to them emotionally in a way that is really a strong and deep and rich experience for both people?  Because sometimes with cognitive impairment, just like sometimes with any disease, you can feel like you’re in a jail and you can’t get out.  Or the person is in a jail and you can’t reach them.

So now we have a situation where people are actually in situations where they can’t get out and they can’t be reached, and they can’t be held. So how is it that we can use some of these other senses of the person to create a connection?  And it isn’t possible to replicate hugging someone.  So, I want to say to everybody out there who’s listening, I understand that. I can’t get to my parents now.

And in the Wall Street Journal today, I did read that all domestic flights in the US are now going to be really severely affected by air traffic controllers who may have fallen ill. So we’re all going to feel this now. It’s not just going to be, we can’t get to our parents in nursing homes, and our loved ones in nursing homes.  We may not be able to get to each other across state boundaries through airplane travel.

So this is not only a message to people who are trying to visit loved ones in nursing homes, its people trying to visit loved ones. And obviously, if the facility was set up for video links and video communication and cell phones, I think people have probably already figured that out. And so, you know, as much as you can, the visuals – if the person is obviously sighted – you know, you want to maximize all the different avenues of having someone see your face, see your facial expressions, and get a sense of, you know, how you’re feeling and cheering them up, and giving them a sense of hope through your facial expressions.

This is the most powerful way to do it.  And through your voice, through being on the phone as much as possible. Again, there’s going to be limitations, but we’re just going to start with the basics here that most people have figured out.

And then if you cannot reach them that way, you can reach them through the mail still. And one of the best things that you could possibly do is to send them pictures.  Any kind of pictures of you.  Again, your family, what’s going on, you can print them out on your printer at home if you can, black and white, you can turn those pictures into coloring pages if you’d like. And you can send a box of crayons, or some colored pencils, so that they can have an activity.  They’ll actually be coloring pictures of family life, of your kids or your dog or their house.

Or, you know, I was talking with a woman a couple of months ago, and she shared with me a story of her father who had Alzheimer’s, and he was living with her. And she was kicking around looking for new activities. And I said, Have you ever considered making an adult coloring book of all of his favorite images? And, Will he color?  Because coloring is quite calming and it’s quite soothing. And adult coloring books are just – they came out about a decade ago, and everybody loved them, right?  And so I said, Why don’t you make an adult coloring book of your family images, and the images that might remind him of his life?  So we did that of his house that he had left.

So the idea is to not work incredibly hard, but to think about what’s resonant in that person’s happy memories of you and them together or your life together, and send them things.  Write them a letter every day, post a letter every day, so they have something to open. You write it, they read it, they come right back. The act of writing letters is actually fantastic for one’s memory. It’s fantastic for interpersonal connection. We’ve lost that art with email and texting. But when you generate a letter a day – write two a day, write 10, who cares? – and put ’em on a stamp, put ’em in the mail and sit back down and write another one.

When I was working in the VA, in the PTSD clinic in North Hampton, in Massachusetts, and I was in my late 20s, I dealt with men who had been in World War II, men and women who had been in World War II and men and women who had served in Vietnam, and to a person, the things they kept with them when they were in battle or in recovery in a hospital were letters.

And they would read them and reread them and reread them. And we have a long history of letter writing, and a long history of how all those letters have created a deep history for us.  I mean, about all of our famous figures, and about people who’ve journaled about the history of the United States, right? I mean, we know all of these things because of writing. So my suggestion is, get back to the art of when we couldn’t see each other.  You know, back in the days when somebody would live on the other side of the world and have to take a ship to go see them, and letters still made it back and forth, you know?

So, some of this would be to soothe yourself, reopening those kinds of communication channels, when the technological ones might not be available to you.  But even if they are, sitting down and writing letters, and thinking and thinking deeply about your relationship, is very comforting and soothing. And then finally, I would say, the last piece is if you’re going to be in a position where you would like to have information from the staff, who’s caring for your family, I think respecting how they’ve set up their communication channels and recognizing the incredible feelings of loss and anxiety and the stress that you’re feeling, if you pick up the phone and you decide to call, recognize that you’re going to be transferring that feeling to the caregiving staff, and they may not be able to absorb it. So if you can get calm on your side, if you can get it together on your end, you’ll be able to decide if you really need to pick up the phone and call.

JANA – Some of the things you just said, address this issue, but I’m gonna raise it because it was raised by someone who belongs to the closed Facebook group I belong to called Working Daughter. She said that her issue is being overwhelmed by not only being the sole caregiver for her elderly, disabled mother but also her only social friend/therapist outlet. She had a friend that used to visit a couple of times a month, but now that’s gone.

She says, I’m desperate for my mom to make social connections. She’s had some difficulty with the computer, so it has to be simple. She finds Facebook to be complicated when she’s using it to communicate or find a previously viewed post. She says she was sorry that we didn’t grab the opening for an assisted living apartment when it became available in December, and she’s worried that her mother won’t even qualify due to her declining ability to walk and mild cognitive impairment. But I guess the issue here is one of concern for her mother being socially isolated, because she does live on her own and she’s not great with computers. Now, some of what you just said, might provide some solutions for this caregiver, but maybe you have other thoughts about that scenario.

NANCY – I do.  So when the issue of trying to interact with somebody who is not able to generate social connection on their own, and may be impaired and not able to use technology to join online with any kind of virtual social connection – I have thought about that a lot. And I’ve also thought about all of my years as a therapist, in one-to-one interactions with people. And what is the scientific and neurological basis for that mutuality? And why does it work? And how does it work?  How does it work at all kinds of levels – interpersonally as well as in a transfer of healing. So your friend, and the issue that she’s raising is something I’ve thought a great deal about, thought really deeply about, and also thought about it in terms of protection.

How do we protect people who in essence, can’t protect themselves? And how do we do that when we’re not right in front of them? What are the kinds of things we can do to help protect them from loneliness, as well? So we know the situation is complicated, and we know we don’t have all the information about your friend and what resources she has. So we’re gonna have to give some really generic advice. And hopefully some of these principles can kick off her creativity. And, of course, she can always call me. So – because you have to know more about the situation to actually be helpful. So I don’t want to give, you know, shoot from the hip advice.

But here’s what I’ll say: when you have a situation where you’re looking for a solution and you can’t generate it, then the first thing you know – we’re just going to square the puzzle here.  We’re going to find the four things that we know, and then we’re going to deal with the messy middle of our puzzle. So the one thing you know, is that you’re not there. So if you’re going to show up, it’s probably going to be in an emergency or it’s going to show up in a way that has to be healthy, and if it’s going to be healthy for you, like I said before, make sure it’s structured and there’s a pattern to it, for your own mental health.

The other corner that you go to is, this person can’t do anything for themselves. So that means that the resource is going to come from outside of them. And that’s a really important thing to accept.  If it’s been a long time, and she hasn’t sought social interaction, and she hasn’t been able to figure out Facebook, and she hasn’t done all these things, it’s time to say, And she’s not gonna.

So that was a good instinct to say we should have been in an assisted living arrangement, because now we’re going to really fundamentally accept.  It sounds like maybe there wasn’t acceptance before, in December, but now there’s acceptance. So, again, you’ve got to accept what you got. So the resource has to come from the outside. So we know two things, we need a resource from the outside. And we know that that resource has to be trusted. And we know the person is not going to do it themselves.

So what are the other two parts of the puzzle? Probably one is financial. How can you, you know, afford then to bring in an outside resource? And the last one is probably safety. What would you do in a difficult situation like that? So if you look at the puzzle, and you say, Okay, this is what I’m dealing with.  What’s in the messy middle?  Like, where are the all those puzzle pieces now?  We don’t have the straight edges anymore. We can’t deal with all those easy things. Now, we’re going have to deal with all these complicated things and try to put the puzzle together, like, piece by piece.

And I thought about that 20 years ago.  That actually occurred to me when I was in my graduate studies, and I thought, We’re going to have way too many people who are elderly.  We’re going to have a workforce that is going to be the sandwich workforce.  They’re going to be caring for younger people and older people. All of these older people are going to be living longer. That means they’re going to have 2, 3, 4 or five conditions that have to be dealt with. So I get it. I didn’t see the internet coming – I have to say, I didn’t see that one – but, I did, you know, we didn’t even have email when I was started talking about this. Maybe rudimentary, but… so I was thinking about that and thinking about this.

 And then I went through my clinical studies and I came to the following conclusion about four years ago, when we started to do the health care startup. I said, We’re going to need social chat. We don’t need therapy. We need social chat. And we need a social chatting system that people can trust. So we’re going to have to record the calls.  And we’re going to have to record the calls, and send them to the caregiver and send them to the parent. And we need a system to be able to do that, that’s going to record the call and not just record it, but transcribe it. 

So that if I were a daughter, and I knew my mom was lonely, and I could only provide so much social support, I wonder if someone would be willing to call her inexpensively, however, many times I wish – per day or per week or per month – or I could set the limits, I could set the terms, but I could know what was going on in that conversation. And all they would talk about is stuff my mom likes, and I would share that with them in advance.  Like, gardening, or the weather, or maybe sports, or my mom likes to sew. So they’d talk about sewing, or whatever.

And so the idea would be, I’d see the transcript, so that if I, as the caregiver, noticed anything in the transcript that maybe concerned me, I could pick up the phone and call my mom. And I would have that follow up and I would have however many recordings that I had wished for, to kind of go back and see had there been any change?  And now with artificial intelligence, if I wanted to run all those conversations through some kind of algorithm to detect change, I could potentially do that. And that would be like another level of getting permission from my mom. So both parties give permission.

And that startup idea of social chat we floated that last year. We said, Can we get any interest in it? And I asked all these rehabilitation and occupational therapists, do you want to try this out? Do you think this might be a good idea? And so we got a little bit of uptake. But I think the idea still needs to be fleshed out. But we offer that.  In MemoryBeach, we offer that.  And all the calls, we don’t ask for medical information. We don’t want medical information. This is just social, but it’s still on a HIPAA-secured platform, so that if inadvertently any information gets shared, then it’s still not going to be hacked. It’s still gonna be safe.  But the people who see it are the people who gave permission to see it.

JANA – Mm hmm.  Nancy, before we go to MemoryBeach, I just want to talk about uncertainty and coming to terms with it. I mean, we all crave stability and predictability. We know this is a dangerous virus, but fixating on the worst possible outcome isn’t really healthy. So I guess my question is, what should folks do if they have dark thoughts? And beyond that, how can they manage those dark thoughts if they’re living with a parent who has a chronic disease or an underlying condition, and they’re really concerned about themselves getting sick and infecting their parent?

NANCY – The first thing to think about when you have these dark thoughts is to actually accept them. And the human mind is great at generating them.  We’re designed to do it, because we need to think in catastrophic ways in order to survive. And so one of the things that I always recommend if someone is at first feeling something very deeply, and again, I want to say to everybody out there, Me too.

I understand it and I feel it and I feel the anxiety. I think the thing that helps the most, after you accept, Okay, this is what’s going on for me right now, is that there have been many, many proven studies, and hundreds of years of history to help us all figure out how to deal with these, and how to not let them overwhelm us to the point where we can’t function. Because we still need to function. And in fact, we need to function really well.

So here’s what you’re going to hear from many, many walks of life, because it’s not just psychology, but anthropology and sociology and, gosh, I guess just about every kind of science has taken a look at how do we help people deal with stress?  And I mean, if you bring it back down to its fundamentals, how are you dealing with strong feelings of unease and discomfort?  The outcome you’re looking for is compassion.  But how do we get there? 

Compassion for ourselves, compassion for other people who are suffering, compassion for the health care workers, and the research scientists who are now scrambling to communicate with each other to try to find a solution.  And even compassion for people on LinkedIn who are just honking off and irritated, more so than they used to be, right?

So there’s friction in relationships and, I mean we have to get back to compassion. But how do you get there when you’re so stressed, and you have these very, very dark and catastrophic thoughts?  And even knowing that you’re tilted that way, you’re tilted toward the negative for your own survival, so you’re gonna have to swim upstream a little bit on this one. And the first thing you need to think about is just, how does it feel when you’re not so stressed? Recall that feeling.  Something peaceful.  Because that’s going to be your shining moment. This is what you’re heading toward.

So even just invoking Gosh, I remember a time when I felt better, and now I’m going to try to access that. I’m going to try to go back to that state. And I’m going to try to recruit it inside of myself. And you’re going to hear the same exact advice from me and anyone else, which is always going to be meditation, and deep breathing, and removing yourself from the stressor at least temporarily, even your own thoughts.  Just quiet contemplative thinking, or focusing on things that are outside of you.

And we certainly have lots and lots of online resources. But if you can’t access those, I mean, I think probably your listeners are listening to this through some kind of technological device, so there’s no end to supports  out there for meditation on a lot of the social channels.

But even if you don’t have that, the way the human mind works, is it creates a its own background narrative of chatter. And it actually – the mind listens to itself. So if you’re having negative thoughts, if you’re saying negative things, that creates a kind of self-fulfilling spiral.  So what you want to do is you want to get out of it by taking a lot of deep breaths, you can find a visual outside of you, or a thought you want to meditate on.  Anything that, again, brings back that feeling of peace and wellness. And you want to stay there with a breath as long as you can, until the next breath, and you want to kind of go back to it.

And for some people, they can maintain this for a moment or two. And then maybe it’s three moments. And your work yourself up to a minute. And for some people, they can, with a lot of practice – this is why it’s called a meditative practice – they really do better with a nice, soft, gentle voice taking them through it. And again, there’s multiple, multiple online resources for that. But what people have to understand is, it’s necessary.

In fact, I would say that if I were prescribing a behavior, that this would be the number one prescriptive behavior for managing any kind of environmental or interpersonal or – so, any kind of stress generated from your own thoughts – is by calming and focusing on something beautiful and peaceful, and really paying attention to your internal state and your breathing and your body. And you’ll begin to feel yourself relax.

Now, if you’re a skeptic, and you need to understand how this works biologically, what I’ll say is, when you draw energy toward a particular kind of thinking, so you’re basically asking your body to generate all that energy now, and instead of paying attention to this thought that makes you scared, now we’re going to pay attention to a thought or a moment that actually makes you feel peaceful. You’re going to be redirecting how you think. And the more redirecting you do, the more you strengthen those kind of connections that are internal to you and how your mind works. So what I want to say is, the more you practice peace and peaceful thinking, the more it will be readily available to you when you need it. Like any exercise.

So the practice and the practice and the practice, the slowing down, the calming, the breathing – at first, it might feel a bit forced. But if you practice it throughout the day, there’s one psychologist that I follow, who suggests a few minutes a day five times a day is better than nothing. And rather than trying to see it as a workout, it’s actually pulling aside and focusing on what’s good.  What’s a good thought, what’s going to image, what’s something that brings you peace.  And that is actually as deeply meditative as listening to something online.  You know, because it’s the same neural system.

What we’re doing is creating a flexible response. And so that means that as the stressors come in, instead of you feeling like you’re a tennis racket and you’ve got to whack it back, now you’re more like a volleyball net.  You know, it kind of comes in, you catch it, and you just kind of bounce it off. It’s that flexible neuronal response that you’re really going for. And that’s what generates the sense of peace. That’s what generates the sense of coping.

You know, people have said to me, especially when I worked in the VA, we would always have people on this state of ready high alert. And of course, there were lots of reasons for that, that related to, you know, brain morphology and how it changed under stress. I get it.  But even so, they’d say, if I don’t have this armor up, then when something bad happens, I won’t be ready. And we would say again and again and again to them, That’s only under the conditions of a battle.  When you’re not in battle, when you’re now in your life and you’re still having the same response, we now need to heal from that.

And the way that we heal from that is we create this more neuronal flexibility.  We start to rebuild, slowly and slowly and slowly, with a lot of practice, we start to rebuild the peaceful you.  The you that can cope with things. And I mean, meditation is the way to go.  It’s – you know, again, without knowing a person, they may need some medical intervention. But even if they had it, they’d still need to meditate.

JANA – So as the skeptic at the microphone, I would argue that we are in a battle of sorts right now, just to kind of, you know, play devil’s advocate here. And that perhaps one of the things we can also do is to be putting limits on how much news we watch and that sort of thing. Checking the news all the time can feel like you’re, you know, kind of getting control on it, but it can also increase anxiety. So, to the extent that we’re looking at this as a different kind of battle, how does meditation and that sort of, what you’ve just described, how can we sort of use those methods in battle against COVID-19?

NANCY – Yeah,  no, I think that’s right. Yeah, absolutely. And I really like your question, and I think it’s spot on.  It’s valid. So for anybody who’s trying to figure out how much they want to stay informed, in a kind of a paradoxical way, it may feel calming to always be checking the news, and there’s an unintended consequence then of always feeling stressed. So that’s an unintended consequence.

That’s where the cure kind of creates a different set of problems. And so I would not stand in that person’s way. What I would say is, when you pay attention deeply to how you’re reacting, one of the things that you’ll understand is, you’re in a particular physical, state and mental state, you get a good handle on that.  Like, I’m ramped up or I’m anxious or I’m feeling this. And what we want to do is make sure that the person has an alternative to go to.

So if you don’t want to go to that, if you’re seeking something else, if you want to actually feel differently, remember, it still has to be in the person’s desirable state. You know, some people may want to stay amped up.  They may want to –  and I would never tell them to do otherwise. But if you have a desire to not be there, then the avenue to do it is free. And that means, I’m going to try to limit what frightens me. And I’m now going to introduce a balance. I’m going to introduce balance to that, so that I can go and check the news every hour. That’s fine. Or I could check it every 15 minutes. It doesn’t give me a lot of time to balance.

So it’s not about removing or substituting, it’s just about balance.  And your physiology isn’t really designed to be in a high stress state 24/7, because then it will begin to destroy itself. So as a survival mechanism, you actually do have to introduce rest and relaxations.  Marathoners know this, triathletes know this, mountain climbers know this.  People who push themselves to extreme physical limits know this, because as hardy and as resilient as your body can be, there’s a situation called active resting, where during that time, you might not be moving but your body is working hugely, behind the scenes, to repair. And so you may say, Okay, well, I’m gonna watch a lot of news. But one of the things you have to remember is, and I’m gonna have to repair from that.  You know what I mean?

JANA – I better allocate some time to repair as well.

NANCY – Yeah, exactly. I mean, think about it. So like, here my hormones are going ba-dang, ba-dang, ba-dang…  and my nerves are just, like, firing and I’m coming up with all these scenarios as to what am I going to do. And I think those are smart. You know, I’m not going to tell you not to plan how you eat, not to plan how you keep yourself clean, not to plan now you’re going to be doing more laundry, or now you’re going to be coming up with more creative ideas to keep the kids busy.

Now you’re gonna have to come up with all these fantastic ideas to help your family, or your older parents or your relatives, understand that their routines change like we talked about with dementia.  You’re just like, 24/7 bam, bam, bam. And what you’ll hear in the general world out there, people will say, well, self-care and self-love. And you’ll say, That’s not for me, I got to keep going, you know? Bam bam bam.  We have to respect the cell, you know?

JANA – You have to respect what?

NANCY – The cell.  Our cellular bodies.  As much as our minds are there to help us understand our relationship to the world – that’s the job of the mind, is our relationship to the world, right?   But the job of the brain, is to run the whole system, right?  And the brain is only a bunch of cells. So if you don’t respect the cell, then the cell itself, not respected, not cared for, not nurtured, will stop working.

JANA – That’s deep.

NANCY – Yeah. So you have to respect the cell. And how do you respect the cell?  You have to you have to water it, right?  You have to let it rest. I mean, every single cell in the body has, I don’t know, somewhere around 10,000 moving parts and you’ve got 11 trillion cells. So some of them are going to have to rest. If you want to get down to biological essentialism, I’m not great here because I’m a psychologist, but I can give you lots of references.

And the idea is, like, if you want to be overwhelmed with references, you have to respect the cells. And by the way, the cellular bodies that occupy, that make us us, they talk to us. And it’s up to us to pay attention, right?  And so the mind can be very powerful. But the mind is only about 100 billion cells. I’m not sure we should let the mind run the show all the time.

JANA – Well said.  OK, let’s talk about MemoryBeach, because this is a great, great startup I want folks to know about.  Tell us about its evolution and what it’s all about.

NANCY – So MemoryBeach is really just a big answer to the question, So what?  When I was a clinician, and I wanted to be helpful to people who were aging, I started out my doctoral studies in long-term care and personal care. I did my dissertation in personal care, and I was committed to the times we’re living in now, way back in the 90s, in the early 2000s. Like I said, I saw this coming.

I thought, if I have enough time to think about it with a bunch of smart people, we’ll be able to figure this out. Some of the people I worked for at the state of Wisconsin went on to run the Centers for Medicaid and Medicare. At that time, they had some radical ideas about paying for personal care at home. You know, rather than putting people in nursing homes, why don’t we just pay relatives to take care of our family members? And that was really interesting. There were a bunch of sociologists and PhDs studying that.  It was called the Wisconsin Partnership Program.

JANA – Talk about prescient.

NANCY – And I just happen to – yeah – I just happened to be a graduate student who needed to eat. And I ended up as a researcher on that project, and then later on, turned it into my dissertation and a focus of a lot of what I wanted to think about. So MemoryBeach was a long way away from me, which I didn’t know at that point because I ended up in management psychology and working in corporations. And I still consult there.

But MemoryBeach was a way for me to now take the accumulated wisdom of the past 20 years, and match that with consumer psychology.  Because I had been a consultant for a lot of consumer product companies, and also had worked and lived abroad for many years, about seven or eight years, I had lived abroad through the Peace Corps and other experiences.

And so I thought, Okay, well, there’s a couple things I know to be true. This is universal.  People caring for their parents is universal.  Relationships are universal.  People wanting a better – life that’s universal. But there’s going to be some major sociological, psychological, environmental changes in our society because of aging. And I wonder how we can help people. And in addition, there was a lot of consumer fraud because of the internet. So people in the aging categories, like we talked about, were being defrauded all the time. And I was concerned, because, again, we’re talking about resources. You know, we need resources to care for everybody.

So, MemoryBeach was an attempt – and it’s still an attempt because it’s still a startup – to start to explore some ideas.  If you could figure out why people, ultimately at the end of the day, when you offer them something good to help them with their memory, why they feel some aversion. Had we shamed people so much, that they would hide their memory deficits?  That they would hide them to the point where they would be vulnerable, and they would now become targets for fraud and abuse and neglect. And I had seen that cross other domains of mental illness. And I had seen the devastating effects.

NANCY – My own brother experienced that. I have a brother who died recently, and he had severe schizophrenia his whole life.

JANA – Oh, I’m so sorry. I didn’t know that.

NANCY – Yeah, thank you. Yeah. So we lived it. I actually lived it. And it wasn’t for that reason alone, but it certainly made me hyper aware, to have somebody who is struggling, could then, you know, feel so ashamed of their struggles that they wouldn’t reach out.  And during my years consulting in business, I had met this amazing guy, who was so confident that he used to put his medication on the edge of his desk. 

And this was in a corporate setting. And he openly talked about his struggles with mental illness. And he had risen through the ranks. And one of the things that had made him so attractive as a leader to people was his authenticity. And he had gotten there through a complete and utter lack of shame. And he saw the properties of his mental tissue as he saw the properties of any other part of his organs. He said, You know, on most days I’m good.  And on the days that I’m not, I need these guys.  You know, plunk plunk.  Here’s two yellow bottles, and this is what I do.  And this is how I roll.

JANA – Deal with it.

NANCY – Yeah.  And I’m good with it. You know, I’m so glad I figured it out.  And here I go. And I remember there were some executive stories that were popping up here and there about people who had figured it out. And I thought, Okay, well, I know they can do it. So what was it that MemoryBeach could be? It could be a way to try to attract people to talk about memory because I’d go and curate products that would actually help you out.

And you could find them in a Kmart or a Target. These are products that were so well designed, that if you were forgetful a little bit or forgetful a lot, you could slide these into your lifestyle and they would provide some kind of functional boost.

Like when you break your leg and you use a crutch. This would be, you know, I’m having some memory loss.  And so the common forms of memory loss show up anyway for us, like when we travel we all forget our phones and our chargers, and our laptops and our phone. And we, you know, we don’t feel that embarrassed. But that, in fact, is memory loss. And if we could create a conversation around common kinds of memory loss, would it be okay, if we could start tiptoeing toward, Now I’m more concerned.  Now I’m more willing to talk about it earlier upstream, maybe I’d go see a psychologist or another health care provider a bit sooner. And maybe I could get help a bit sooner, and maybe I could stop being so afraid.

I mean, MemoryBeach was really a way for me to try to change the conversation around memory and say, like any other organ, brains aren’t going to function perfectly. We’re going to forget stuff.  And look, look at all these cool products that we’ve designed to kind of accommodate that. I mean, they’re everywhere, and they’re really clever and some of them are actually kind of hip.  I mean, you kind of carry this thing around, you feel good.  You feel, like, Hey, I’m part of the “in” crowd.  I look good, right?

JANA – Stylish.

NANCY – Right, I’m stylish.  So, could I curate that for people? And I’m not saying, you know, Hi, this is Nancy Picard.  If you buy this you’ll never forget. It’s not that.  It was to use psychological science, what we know about cognition and say, All right, I’m going to create kind of my own algorithm, my own screen. I’m going to put some of these products through it, and see if they can pass the test. Yes, they can.  Check.  And then I’m also going to add in what I mentioned before, another aspect of, say, embarrassed about using something is, if you’re really not interested in products, I mean, a lot of older people aren’t. In fact, they’re less and less interested in material things, and more and more interested in relationship.

You know, when we’re younger, in our 20s, 30s and 40s, we do a lot of social comparison. And, Hey, there’s Instagram. We do a lot of comparing our children – Hey, there’s Facebook.  Or whatever we’re comparing. But as we age, we’re not so interested in comparison. We’re actually more interested in connection. So that’s where we also built this platform for social chat, where I said, you know, it can be product support, I guess, if you forget how to use your product, but really more, the other aspect of MemoryBeach is just social chat. And that connection to people.

And I wanted to provide social chat based on the premise that if a family member or a relative or a loved one wanted the person they’re caring for to have a social connection that they could trust, that they felt like was authentic and reliable, and they could actually see the conversation, and see what occurred in the conversation and have visibility to it, then we would provide that, too, as a service because the technology was there.  So MemoryBeach is kind of two things right now.

The last thing I’ll mentioned is, it’s also an assessment platform, because the last aspect of memory is that as clinician, I used to do many memory assessments, not just for the elderly, but also for kids, like, for IEP.

JANA – Like for what?

NANCY – IEPs.  Individual Education Plans.  So when a child might come in and be struggling academically, and might need some extra support in a behavioral health setting, the person who is tasked with doing this cognitive assessment piece is typically the psychologist, because of licensure rules. So you can have, you know, a great team of some health care professionals, and then when it turns to assessment, the psychologists kind of carved out this piece for themselves.

So in doing these Individual Education Plans and sitting on teams, one of the things I noticed with the children, and then I felt with the elderly, too, and I saw even in corporate life, is that when you introduce the idea of an assessment, you can create some stereotype threat, and see underperformance.

So the underperformance was related to anxiety and the feeling of being watched. And if you could create an environment that was safe and warm and friendly, and even kind of funny, and get the person in a good mood, you’d get a more authentic read of how they’re functioning. However –

JANA- that makes sense.

NANCY – Makes sense, right? But, however, as a clinician, if you keep changing the setting, then you don’t have really good standardized results. So at least you have stereotyped results, right?

JANA  OK, so that’s really interesting. OK. Yeah.

NANCY – Yeah.  So for example, this happens to me still, to this day: a woman who’s about my age talked to me about her mom, and she was telling me about her mom’s lack of willingness to go get an assessment. And should she be concerned?  And all those kinds of things.  Like, is there something going on? So what we’ve set up a MemoryBeach, we have – one test out of four is an assessment you can take with your loved one, not alone.

So you two can sit down side by side, and you can play a game. And the game is just based on puns, because puns tap into several different kinds of memory. There’s only 10, and they change.  And they’re puns from grade one to grade six. So they don’t require a college education in terms of vocabulary. So these are simple puns.

And you basically get the stem of the pun and you have to answer it, like a joke – like any other joke or riddle.  So, if you got through 10 of those and the person that you’re playing with or you, yourself, you feel like OK, this is good, we got most of them right, then there’s no problem. And if you kept playing it, and you noticed that the person was really struggling, and again that concerns you, then you should pick up the phone and maybe seek some advice from a health care professional.  What we recognized on MemoryBeach was that whether or not that person did anything, we wouldn’t know.

Because first of all, we wouldn’t save the score. We weren’t going to track anybody. So for privacy reasons, anybody can play at any time, and they can do whatever they like with the information. And we also know that since they’re not likely to get an assessment, they just want a solution, that if they played the game and wanted to be directed to a suite of products that match their memory, then they could do that, too.

JANA – Mm-hmm. Sounds like a more fun version of the mini-mental exam that so many of us have taken our parents to.

NANCY – That’s right.  It’s absolutely right.  It’s a variant of that. And so that’s how it works.  And so the other three games that we have in process right now, are really designed to round out that picture, so that ultimately, if someone wanted to move forward after playing some games and having some fun, if they felt like something clicked for them – that now they were in a new space, this was different with their loved one or their relative, then they should certainly seek a resource.  You know, again, seek an outside resource like a psychologist.  Do an assessment.

But if they weren’t going to do it, if they decided that that wasn’t going to happen, and they just wanted to try to come home and get some products and change the environment, and maybe reinforce it or strengthen it, or make it an environment that reminded you or tapped you on the shoulder, or maybe there were some products that could help you, like for example, I’ll just mention one and I’m not plugging this. But I think it’s fantastic.

Like if you’re buying a lot of fruits and vegetables and you don’t want them to go rotten on you, you don’t like a lot of food waste, because you’re buying for someone with a cognitive impairment.  And you know that the food tends to go rotten and it’s such a heartache, because you can only shop, like, for them once a month. Could there be a way to keep these fruits and vegetables fresher longer? So we have a way to deal with that on MemoryBeach. 

But again, I’m very cautious of trying to use this in a persuasive way. It’s actually more like an informative and helpful way, to try to get the information out to deal with the struggles of caregiving, as opposed to saying this is the only solution, because it certainly isn’t.

JANA – Yeah. Well, Nancy, tell folks where they can learn more about MemoryBeach.

NANCY – It’s MemoryBeach.com.

JANA – Straight up.

NANCY – It’s very simple.  Yeah, straight up. And you can find the first game there, and you won’t be tracked. We don’t put any cookies on the game, so that we know what you played or we know what your score was.  It’s actually more like a public service. And there’s a handful of products there that really, now, we’ve limited them now, because we are in a locked-in environment in Illinois, and we’re unable to get to our offices. So they’re really now more for illustrative purposes, of the kinds of things that you could potentially benefit from using.  And then we have a couple of proprietary things that we’re trying to develop for the environment, that have been shown to increase attention. So that maybe that helps your memory a little bit better.

I mean, memory is not helped by one thing. So if you pay attention to your physical health, if you pay attention to your mental health, if you pay attention to your nutrition, if you pay attention to your stress levels, all of these things contribute to better memory. So in trying to address little tiny touches around the whole person, including social isolation or social connection – maybe we could phrase it that way – MemoryBeach is really a way to try to get the word out about memory and destigmatize memory loss, so that we can help more people, and they’re less likely to hide it.

JANA – That sounds great. And, you know, for listeners, I should say, full disclosure, I am very familiar with Nancy’s startup MemoryBeach because a couple of her products are featured rewards on my IFundWomen crowdfunding campaign. I have no financial stake in this, but just to say, you know, full disclosure, that is how I became connected with MemoryBeach.  So Nancy, I wondered if you have any last thoughts.  I  thought maybe we would wrap it up.  Do you have any last thoughts?

NANCY – I think maybe a thought connected to a feeling. I feel so deeply what we’re all going through.  I can see it when I’m on the sidewalk here in Chicago. I can read it in the posts that people are posting. And I can really feel it for myself, too, with my own parents and my kids. And for those of you who are right on the front lines, a deep, deep sense of gratitude, and thanks to all the health care workers and all the medical professionals who are right on the front lines, who are doing direct service, I just want to say thank you so much.

And for those of you who aren’t in that space, who are feeling like it may be so far away from you, all the sacrifices that you’re making, I saw something really powerful today. I read something very powerful today from the state of Illinois, from our medical directors about how our actions in the next couple of weeks are going to benefit us for months and even years to come. And I understand the stresses of the moment, and the stresses of caregiving and how everyday can feel so incredibly long.

So the fact that it matters, and I don’t know that it does, but there are those of us out here who are going through it as deeply as anyone else, and in addition, we are out here feeling your discomfort and your pain.

So as you think about rallying, and you think about the courage that you need, and you think about the patience that you need to get through this, I think the thing I want to say is that we who are in, at least the psychological profession, we know you’ve got it in you. We know that because when you come to us, that’s what we look for. We don’t look for where you’re broken, only in the sense that we’re trying to heal.

We don’t look for where you feel ashamed, only in the sense that we want to help you step away from it. But what we’re looking for is, where is your courage?  OK, let’s encourage that. And where is your spirit, your fighting spirit?  OK, let’s wake that up again. We know it’s in there. We know it’s in you.  We believe in you. And we know we’re going to win against this. And we’re all in this together.

JANA – We’ve been speaking with Nancy Picard, Nancy’s a psychologist, and as I mentioned a returned Peace Corps volunteer. She has supported people from a very young age, age four to 94, as a clinician and a researcher, and she’s got a great health care and retail startup called MemoryBeach, which I encourage everyone to visit.

And the only thing I want to say is that as terrified and stressed out as we all may be about this awful contagion, I just want to remind folks that kindness is contagious, too. So I don’t want people to lose hope. I want us to all try and be kind to each other. I’ve seen some amazing displays of it, and it is contagious. So let’s all try to be kind to each other and I know we will get through it. Nancy, thank you so much for being on the show. I really appreciate your incredibly thoughtful responses and your expertise.

NANCY – Thank you.