- [Narrator] Coming up on a caregiving themed episode of "One Detroit," we'll see the challenges faced by a Northville couple as a wife takes on the difficult task of caregiving for her disabled husband.

Plus, we'll hear from community leaders about meeting the needs of older adults and their caregivers.

Also ahead in our "Destination Detroit" series, we'll hear from a Detroiter whose mother came here from the Philippines.

And we'll close the show with a performance by the Divine Divas Dance Troupe at the St.

Patrick Senior Center.

It's all coming up next on "One Detroit."

- [Announcer] Across our Masco family of companies, our goal is to deliver better living possibilities and make positive changes in the neighborhoods where we live, work, and do business.

Masco, a Michigan company since 1929.

Support also provided by the Cynthia and Edsel Ford Fund for Journalism at Detroit PBS.

- [Announcer] The DTE Foundation is a proud sponsor of Detroit PBS.

Through our giving, we are committed to meeting the needs of the communities we serve statewide to help ensure a bright and thriving future for all.

Learn more at dtefoundation.com.

- [Announcer] Nissan Foundation, and viewers like you.

(upbeat music) - [Narrator] Just ahead on "One Detroit," we'll have an important conversation about caring for caregivers and helping older adults age well.

Plus, our "Destination Detroit" series looks at how a Detroit man's mother came to the United States from the Philippines to pursue a nursing career.

And we'll show you one of the fun activities for seniors and caregivers at the St.

Patrick Senior Center.

But first up, a study by AARP and the National Alliance for Caregiving estimates 63 million Americans are caregivers.

Over the coming months, Detroit PBS is focusing on the challenges and triumphs of caregiving in a series of special reports.

Today, we have the story of a Northville couple navigating the caregiving system.

Linda Cline takes care of her husband, Randy, who was paralyzed after a bicycle accident.

"One Detroit's" Bill Kubota visited the Clines and talked with them about the issues and decisions they're facing.

(upbeat music) - [Linda] We're just going through the motions every day.

We're not really living, we're just going through the motions every day.

- I watch her push the lawnmower.

Makes me want to cry, quite honestly.

- [Bill] Randy and Linda Cline, they're in Northville.

- Twice a day, she has to change my colostomy bag.

Every time I see her bend over to empty my urine bag, you know, that pinches my heart a little bit every time these things occur.

And she's wore out because she's doing what I used to do and taking care of me when the caregivers are not here.

- [Bill] Other caregivers are on the schedule to help Randy, but his wife Linda is the main one.

Linda, age 74, Randy, 69.

- You're trapped in that body sort of thing, I am.

Considering what I used to do.

- I can't imagine.

- I love playing guitar.

I love building them.

- [Bill] Randy had a band called Busted by Nine that ended for him in 2021 after a bicycle accident.

- I hit an orange barrel that I did not see.

I went over the handlebars.

The bike is fine, by the way, not a scratch on it, but I went right over the barrel and hit head first.

I had my helmet on and I skidded for a little away and I thought, "Oh, this is really gonna hurt," and I didn't feel anything and it was hard to breathe.

- Yeah, but now you're in pain 24/7.

- [Bill] Randy was a union electrician.

Linda worked in IT with a major bank.

They retired five years before the accident.

- Every day you were there, every day.

And that was during COVID.

We had that all mess to deal with.

And then my recovery was really slow in the beginning, but she would come see me every day.

And at that time, I could not feed myself.

I could only move a little bit of one hand and a foot.

- [Bill] A typical Tuesday breakfast time.

Linda's got the system down.

- He just had his pills.

Can't really get him up for a few minutes because of the blood pressure thing.

So I have to, you know, it's just easier to feed him.

And then I have to eat too, so it's just easier.

I've worked it out that way.

I don't mind the breakfast thing.

Caregivers don't get here till nine.

I don't want caregivers in the house right when I first get out of bed, I could have them do it.

Randy tells me to have them do it, but I don't just don't want people in the house.

That's so hard when you have people in your house all the time.

You know, you don't get any privacy, so I hate it.

I absolutely hate it, but there's nothing I can do.

I need the help.

- [Bill] And this is called a Hoyer lift?

It's Wednesday.

The visiting caregiver's running late.

Randy needs to get out of bed.

Linda operates the lift by herself.

- See, and it's broken, so I gotta, I'm trying to get it fixed, but is waiting for the doctor and insurance they tell me.

- Watch yourself.

- [Bill] Randy weighs over 200 pounds.

Wednesday is a shower day.

Getting him to the bathroom is a process.

This is covered by Medicare, right?

- Medicare covers the Hoyer and the wheelchair and the bed frame.

We bought the mattress.

So yeah.

- That was what, 3,000?

- Yeah, it was over three, yep, because we wanted a mattress that moved around.

So this is, how would I- - This is this little girl.

90 pound.

- Yeah, I'm losing weight some more.

- 96 pound.

- Did I get you right?

- Yep.

- The motorized wheelchair needs work too.

It's expensive and nearly five years old.

Linda spends a lot of time on the phone.

- If they would just repair it, I'd be happy with that.

But it's very hard to get anything repaired.

They're busy, I guess, you know, shorthanded probably, busy.

I don't know.

It's very, very difficult getting him over this bump, for me anyhow.

- [Bill] The Clines get advice from Carl Simcox.

He's with the Senior Care Network sorting out services for people like the Clines.

Simcox has been at it for 30 years.

- No one, if they have free time, is thinking about, what do I do if I need intense medical care?

They don't think about understanding what Medicare Medicaid is or how to make sure they don't become financially destitute.

Families aren't trained to provide that kind of level of care.

So it's really hard for them to do that.

And if family is doing it 24 hours a day, I can't tell you how many times I've seen caregiver burnout.

- I feel like I'm failing sometimes.

And emotionally, I take it out on him.

Physically, I take care of him perfectly, but emotionally, I'm a mess.

So I take it out on him.

I lose my temper, I lose my patience.

I don't feel like I'm cut out for this job.

- [Bill] One visiting caregiver, Kathy, she comes three mornings a week helping Randy with a stretching regimen which allows him to walk short distances with assistance.

Kathy is paid out of pocket, along with a few other caregivers who drop by here and there.

And the Clines get some help they don't have to pay for.

- Yeah, and this is from AgeWays.

Look at this.

I have to read through this.

- [Bill] AgeWays serving Southeastern Michigan provides caregivers two full days a week.

- It looks like I have to sign it.

- [Bill] What is that?

Hours or something?

- I have no idea.

I mean, look, I just got it today.

But on this book, I have everybody in here that's a caregiver, and I have every year they've been here, and how much I paid them.

Caregiving last year was $35,000 in cash.

- [Bill] This is out of pocket, then?

- Out of pocket, and caregiving here, I spent 30, does that say 36?

Yeah, 36.

I don't know sometimes, I don't know.

You know, I get worried because, you know, it's everything that we worked our lives for.

I worked all my life to be here, and here it goes all to caregiving and medical bills.

So I don't know where I'd be if we owed money, you know, for car payments and house payments.

So, yeah.

- [Bill] The Clines used to spend time in Florida, had a second home there, but that was sold so they could redo their Northville house to make it wheelchair-friendly.

- Right here?

- Yep.

- [Bill] Lunchtime.

With the visiting caregiver on duty with Randy, Linda can leave the house.

She usually gets some short daytime interludes to do yoga, play pickleball, and get some shopping done.

Another Monday afternoon.

- Do you wanna leave it like that?

- I'll leave it like that.

- [Bill] Another caregiver takes Randy to physical therapy paid for by Medicare.

That happens twice a week.

- [Doctor] One, two, and up.

Up up up up up, good.

- We're managing financially because of me, because I do a majority of the caregiving and the rest of it is covered by our pension checks and our social security.

- Lined up?

- You're perfect.

- [Bill] Generally speaking, it's more cost-effective if people like Randy can live at home and be cared for there.

- Right there, is you a good dog?

- [Bill] But as Linda gets older and needs more help, the question arises.

- [Linda] You know, why don't you bring in more caregivers?

And so he doesn't have to go into a home, but, you know.

- It's a money thing.

- Well, and plus, you know, sometimes they don't show up.

It's like, and so it's all on me if they don't show up, so people don't understand.

And then I said, if I have caregivers in this house round the clock, except for when he's sleeping, where am I gonna go?

It's a small house.

I mean, I'm thankful for it, but I have to go sit in the basement.

I don't know what I would do with myself because I can't go spending money.

I can't, you know, I can't, it's like I'm so limited on what I can do.

- [Bill] Support from Medicare, not Medicaid, has been good, the Clines say, but Medicare only goes so far.

- Most people think that Medicare covers more than it really does.

Medicare is designed to help in the acute stage, whether it's the hospitalization, short-term rehabilitation in a skilled nursing setting, - [Caregiver] Two, three.

- [Carl] It doesn't cover the custodial care of caring for somebody, which is very intense.

- [Bill] Much of Randy's care falls in the custodial category, based on their finances, the Clines see a Medicaid nursing home in their future, but they'll have to spend down their savings to qualify.

- So Medicaid is designed for people who have no financial resources.

So you have to meet a certain income requirement as well as a certain medical need.

But you have to have less than $2,000 in savings.

So you have to spend your money and then apply for Medicaid.

And that's primarily in a nursing home.

- But he doesn't wanna go into a home, so.

- When you're ready, I'll go.

- I mean, we're trying to hold off, I don't know.

I'm just, but I'm start, like right now, I have a pain in my leg.

I know it's stress because I don't know how to, I don't know how to let go of things either.

If I see something that needs, I think we're the generation that if I see something that needs to be done, I do it, whether it's taking a toll on me or not.

- [Bill] What's next?

Perhaps when Randy has another hospital visit, like when he had pneumonia a few months ago, the Clines might be able to make a move.

- You have to have three days in a hospital before they'll transfer you to a- - If you go three days in a hospital, you can then get like six weeks of inpatient rehab.

And so Carl, who is my advisor on this, he said, don't just go into a nursing home and, you know, they're gonna know you're gonna go on Medicaid.

He said to get the better nursing home, go into the hospital for three days, and then you can go into a nursing home, then start paying cash and then go on Medicaid.

But it's something you don't tell anybody going in.

- [Bill] Linda said a nursing home they'd want costs $15,000 a month, but also has to accept Medicaid.

There, they'd spend out of pocket until Randy's assets are depleted.

But then how many months can you afford 15,000 a month?

- We only have maybe five, five months.

He's got an OT guy coming at 3:00 today.

Mentally, I'm starting to talk to someone, a therapist, and see if that helps, you know, my mental state.

I mean this is not a life, but I got a dog and I have a son, otherwise I wouldn't be here, truthfully.

Sorry, Randy.

- [Narrator] Recently, Detroit PBS partnered with the St.

Patrick Senior Center in Detroit for a public event about caregiving.

It was titled "Caring for Caregivers: The Art of Aging Well."

A panel of local agency and nonprofit leaders discuss the needs of older adults and their caregivers.

Here's a portion of that conversation, which was moderated by "American Black Journal" contributor Judy Gallant-Stokes.

- I saw the entire thing.

(upbeat music) - My mother had Alzheimer's for 10 years, and my brother who's in the audience and I were caregivers, and she used to say to me sometimes, "You're really good at this, you know, you should go into business."

I said, "No mom, this is because I love you.

I enjoy doing this for you.

I don't know if I'd be able to do this as a job."

But it's very important to have.

And that's what you see in the audience here tonight, people who raise their hands said they're caregivers because those are people that are in their lives and people that they love.

And so you step up, you do what you have to do.

Satrice, tell me a little bit more about St.

Patrick and some of the history.

It's a rich history here in the services today.

- Definitely.

St.

Patrick Senior Center, we're over 50 years old.

It was started by Sister Mary Watson.

We have a variety of program.

We're one of the larger health and wellness centers with the support of Detroit Area Agency on Aging of course.

(group laughing) (audience applauding) They do a lot for us.

We wouldn't be who we are without them.

So we have a number of programs.

Our congregate meal program where we cook food from scratch.

We have bunches of exercise, dance classes.

We even are teaching older adults digital literacy.

So I have digital navigators who are seniors trained and we're teaching VR, we're doing AI, we're in the community.

We also have started with workforce development training because we know that many older adults are being forced to get back into the workforce for whether it's self-fulfillment or just needing that extra money, even if it's to pay for your healthcare.

So we are training older adults to be entrepreneurs and community health workers.

- Okay, so Ron, since you're right next to Satrice, talk about that, you know, the interaction, and how you, DAAA as they say, how you're able to help others in the community.

- Yeah, DAAA and it is easy to help a entity such as St.

Pat's because of the commitment and the heart and just the love in which Satrice pours out in which you could tell carries down to the rest of her team and to the services in which they provide and how they connect to the community.

So it makes it very easy.

But at DAAA, we've been around for 45 years, and it's been our mission to try to do what we can to allow individuals to age in the community with age, I mean with grace and dignity.

And we've done that by creating a system as far as a network of partners that allow us to provide what I say as a continuum of care.

And that continuum of care essentially allows individuals to come to facilities like St.

Pat's in which you can do, I recall one of the first times I got to Detroit, I came here and tried to do a line dancing.

And so that's part of what Satrice has on me.

She shows that video every now and then when she comes with asks, and so, but, you know, you could come in and do line dance and you could participate in the VR programs.

You could participate and play some pool, get a haircut.

I mean, you could really do things as far as socialization.

But then the continuum of care that we provide goes all the way to if you're homebound, if you need assistance in the home, in which we can send someone into your home to allow you to avoid going into a nursing facility and to receive care there.

- I think a lot of caregivers feel invisible because they are so involved and so wrapped up in trying to take care of that loved one.

But what are some ways or organizations that can help them feel seen and feel supported?

Anybody can answer that.

- One of the things that we like to do is really talk around advocacy.

And we can use that word in a number of ways.

So we really encourage caregivers that come to us to be their own self-advocate.

And we really go through workshops.

We partner with a number of organizations.

But the other part of that is also being an advocate on various levels on the state level, on a political level, on a policy level.

So also giving those skills out to the community at large, really to have conversations, really to get out and to tell your story.

It is so important to tell your story as a caregiver because that's where change happens.

And so, not to be afraid of telling that story, but just making sure when you get out there, tell your story, keep telling your story, say it over and over again.

Write it down, email it, do all those things because that's really what we really press for change to happen.

- Ron, do you have- - I would say that it's this multi-pronged approach, in advocacy, it has to occur because again, caregivers are the backbone of our healthcare system.

And the appropriate resources need to be directed to caregivers.

And I say it as far as whether it's with the employer as far as EAP programs or if it's with the ability to reimburse or to provide payments to caregivers if it's increasing the rate of payment to direct care workers.

And, you know, there's a number of policy considerations.

And the other one I would say is like a tax credit for caregivers.

And so there's a number of policy considerations that should be promoted and needs to be advocated for.

And the greatest voice is your voice.

And it's, you know, and you have to speak to your legislators and talk to those that can influence policy.

But I would also say to recognize the realities of what's occurring in the real world and what's happening is that we work with a number of partners and we also have, one of our team members is here today as far as Crystal White, as far as providing caregiving services.

And those caregiver services are allowed to help educate and to train caregivers through programs such as Trualta.

And then it's also where we can do intensive assessments to help caregivers understand where they're at and what their needs may be.

And also we can help direct them and to connect them to the appropriate resources.

And then also we just try to provide support to support groups.

And so I would say that as a caregiver, that you really need to make certain that you take care of yourself and that you spend time for yourself.

And that also, one of the things I continue to hear is that you don't beat up on yourself or don't feel guilty about if there's a bad day, or if there's a bad moment, because we all have those in life and we will experience them.

- Satrice, if you could just wave a magic wand and change one thing about how we support caregivers, what would you do?

- I would say just trying to find ways to make it easier.

You know, here at St Pat's, I'm really into technology, but also finding ways that you can use technology to simplify your life.

So ways to stay connected.

Maybe you can't get out, but you can get on Zoom and be in the support group or get in a class.

Maybe you're having trouble trying to get your groceries and you don't have time to leave and, you know, you can't take groceries to your mother because you're still at work.

But maybe we can use something like Kroger Boost and have our groceries delivered to make it easier.

So there's ways that we can do it, and it is the wave that's coming.

- [Narrator] Let's turn now to "Destination Detroit," our new series that explores the region's rich history and the people who helped shape it.

We hear from Detroit resident John Galvan.

He shares a story of how his mother came to the states from the Philippines to work as a nurse.

- There was a shortage of nurses, and the Philippines happened to have a program that imitated the nursing program in the United States.

(gentle music) My mother was recruited by Henry Ford Hospital to basically work her way through nursing at Henry Ford Hospital in the United States while my father and me and my siblings waited in the Philippines.

There was a shortage of nurses, and the Philippines happened to have a program that imitated the nursing program in the United States.

The official language in the Philippines was both Filipino and English, so it was easier for them to find nurses in the Philippines that could pass the nursing examinations.

I believe she had worked a few years and she was able to get a visa to allow my father and the rest of the family come on that visa.

(gentle music) - [Narrator] For more "Destination Detroit" stories, go to onedetroitpbs.org/destinationde.

That'll do it for this week's "One Detroit."

Thank you for watching.

We leave you now with a performance by the Divine Divas Dance Troupe at the St.

Patrick Senior Center.

(upbeat music) (upbeat music continues) (upbeat music continues) - [Announcer] This program was made possible in part by Ralph C. Wilson Junior Foundation, Michigan Health Endowment Fund.

Across our Masco family of companies, our goal is to deliver better living possibilities and make positive changes in the neighborhoods where we live, work, and do business.

Masco, a Michigan company since 1929.

Support also provided by the Cynthia and Edsel Ford Fund for Journalism at Detroit PBS.

- [Announcer] The DTE Foundation is a proud sponsor of Detroit PBS.

Through our giving, we are committed to meeting the needs of the communities we serve statewide to help ensure a bright and thriving future for all.

Learn more at dtefoundation.com.

- [Announcer] Nissan Foundation, Michigan Central, and viewers like you.

(upbeat music) (bright music)