Crisis Mode with Lindsay Steele and Chelsea Gerena

In Episode 7 of the Caring Table Podcast, host Dianne Frana sits down with Chelsea Gerena and Lindsay Steele for a real, honest, and deeply helpful conversation about senior care, caregiving, family decision-making, and why waiting until crisis mode can make everything harder.

Chelsea brings years of experience as a licensed practical nurse across post-acute care, skilled nursing, home health, personal care, long-term care, and hospice navigation. Lindsay Steele, a certified dementia practitioner and senior real estate sales specialist with Care Connect Senior Living, shares how she helps families connect with the right community resources, including home care, senior living placement, skilled nursing, and other care options. 

Together, they discuss one of the hardest realities families face: aging can feel scary, and losing independence often brings fear, defensiveness, and resistance. Instead of forcing decisions, Chelsea and Lindsay explain why families need to meet loved ones where they are, validate their feelings, and begin conversations before a hospitalization, fall, injury, or sudden decline forces urgent decisions. 

Dianne also shares from her own personal experience caring for her father, including the importance of validating anger, grief, and fear when a loved one is facing major health changes. The episode reminds listeners that being proactive does not mean having every detail figured out, it means opening the conversation early so families are not scrambling later.

This episode covers:

• How to start difficult conversations with aging parents
 • Why “I’m fine” often means fear, grief, or loss of control
 • Caregiver burnout and why families need support
 • Senior living placement, home care, skilled nursing, rehab, and hospice navigation
 • Why crisis decisions often lead to fewer options
 • How siblings can begin getting on the same page
 • The importance of respecting a parent’s wishes
 • POST forms, living wills, DNRs, CPR, hospice, and goals of care
 • Why quality of life matters just as much as safety

If you are helping an aging parent, caring for a loved one, or wondering when it is time to bring in support, this conversation offers guidance, clarity, and reassurance that you do not have to figure it all out alone.

Lindsay Steele
Care Connect Senior Living
Lindsay@CareConnectSeniorLiving.com
Cell: (484) 951-4647

Chelsea Gerena
ChelseaGerena@gmail.com

Episode Sponsored by:

LIFESTYLES Over 50 Northeastern Pennsylvania is a print magazine that is distributed for FREE 6x annually and connects seniors and their families with senior housing, assisted living, wellness centers, local health care providers, healthy living activities, and community events.

Our Mission encourages vibrant, healthy, and productive living through stories about people we meet and serve.

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Transcript

00:00:01:16 - 00:00:35:20

Welcome to the Caring Table. I am your host, Dianne Frana, where we gather for meaningful conversations and the life experiences that connect us all throughout the Lehigh Valley and beyond. At Caring Table, we believe every story matters and no one should navigate life's transitions alone. Each episode brings real conversations, encouragement, compassion, and practical insights for families, seniors, caregivers, and communities that support them.

00:00:35:22 - 00:01:08:08

Thank you for joining us today. Pull up a chair. Take your seat at the Caring Table. Every voice matters and everyone has a place at the table. I'm joined here with two guests, Chelsea Gerena and Lindsay Steele, which both bring more than 15 years experience in the senior care field. We're going to talk about their experience and what they can share with you, your loved ones, to help make the decision when is right to make different changes.

00:01:08:09 - 00:01:32:02

So we'll first start off. I would like them to each introduce themselves. And then we go into why you're in the field. I'm Chelsea, I'm a licensed practical nurse. I've been a nurse for ten years, working across the post-acute space and long term care, short term rehab, home health and personal care. I'm actually in the middle of a transition to a local skilled nursing facility.

00:01:32:04 - 00:01:53:15

To be their transitions nurse. So I'm super excited, but I've been in health care for a little over 13 years, ten years as an LPN. And have worked across post acute care, skilled nursing, personal care, home health, long term care. And I think that really stems from I was really close with my grandparents when I was young.

00:01:53:15 - 00:02:21:02

And so growing up, they got older, you know, helping them and ultimately ended up needing to help navigate them through, you know, the hospice continuum, which was a lot. But also in high school I did volunteer hospice work. So I think just the senior care arena has always kind of tugged at me. And then after having been in it for so long, you really see how complex our health care system is and how overwhelmed they are.

00:02:21:02 - 00:02:43:16

There's so much information, there's so many different people. There's just so much information. And so my experience kind of working through that continuum and also being a nurse kind of gives me a little bit of a different lens that can help navigate them through that system. My name is Lindsay Steele. I'm a certified dementia practitioner and a senior real estate sales specialist.

00:02:43:18 - 00:03:16:08

I work for Care Connect and have been in senior living space for the last 20 years, and we help put folks together with resources that they need out in the community, whether that be home care or placement at communities, skilled nursing, all of those things, we really help them navigate that at no cost to them. And the reason that I got into senior care and why I've been in it for over 20 years is and I'm a little bit older than Chelsea, so I'll say that senior care has really been in my blood ever since I've been a kid.

00:03:16:11 - 00:03:48:07

So at 14, I was volunteering at Phoebe and spending my summers there and working with the residents there. I became a CNA when I was 17 and so really had that boots on the ground kind of work ethic and really understanding truly what it's like to do the hardest part of the job, no doubt, hands down. So then from there went into skilled nursing and into, assisted living and independent living and did that for, for many years.

00:03:48:11 - 00:04:15:18

And I continued to stay in it because people need the knowledge that we have. People need the time to talk about what's going on for them. They're not able to get that in the health care systems or time with their doctor. We all know that those providers are completely pressed for time. If you get ten, 15 minutes and, a head nod of yes, I understand that you're speaking to me, that's you're lucky.

00:04:16:00 - 00:04:42:12

That's why I stay in it, so that we can really give them that information and that time that they deserve and that selfishly, for the, the, and the thank you at the end where people say, oh my gosh, just by talking to you for an hour made me feel so much better about this situation. So, some of it's a little bit selfish because I really I love that, appreciation.

00:04:42:12 - 00:05:08:18

There are many in this industry and in your care that have had the same, and you find those are the ones that are here to truly help the residents, patients, clients, whatever terminology we want to use. And like you said, Lindsay, when they you can take an hour to talk to them and they're really like, oh, now I understand, you know, and a lot of reasons myself personally is getting involved in I don't want people to experience what I experienced.

00:05:08:18 - 00:05:29:03

So I look at what I need, what was missing in the experience I went through. That's one reason why I'm here doing this podcast, because there's so much information to always be sharing, and how can I be the most effective and what knowledge I have. Plus all the people that I do know in the network to bring and share with others.

00:05:29:08 - 00:05:49:03

And that's the purpose of this podcast, knowing that we have working with the seniors, it gives you that that they're aging and about caregiving and what the families truly need. So with that in mind, what are the realities of aging and senior care for you when you see it? How do you address it? Do they may come to you?

00:05:49:03 - 00:06:08:21

Or if you see someone that you personally know? And I never want somebody to feel like I immediately know best, or I'm telling you what to do, I just kind of want to get an understanding of what's happening. What do you need? Because pushing people to do things they're not ready for is just going to backfire. And probably delay the necessary course that they have to take.

00:06:08:21 - 00:06:45:21

So just meeting people where they are, a lot of caregivers are burnt out. Some caregivers may not be aware that there is something happening. You might be seeing something that's brand new and that makes that conversation a little bit more difficult. So just kind of meeting them where they are and seeing, you know, what the needs are and then offering to, you know, help them, whether that's calling up somebody like Lindsay and saying, hey, I think this would be a really good fit or they really need help, or coordinating some medical pieces that need to be set up for them, whether that's home health or getting them in to see a specialist, something like that,

00:06:45:21 - 00:07:10:01

but just kind of being that guide. And then, Lindsay, that's your part, coming in and guiding them through the system, through what's out there. I would agree 100% with what Chelsea saying, you know, there's two folds to this, right? You have your caregiver and the family and you have mom or dad that is in this space that quite honestly, aging is scary.

00:07:10:03 - 00:07:38:04

It's a scary place to be, and it's a loss of a lot of independence. We might have some memory loss happening in there, and when people are in that space where they know something's not quite right, they become defensive and just very, very fearful. And so then you have a family that is trying to do everything that they can to make it right for mom or dad, and they really don't know how to navigate it.

00:07:38:04 - 00:08:04:00

It's like being a parent for the first time. We all say, I wish there was a book. No kidding. Truly. And so Chelsea hit it right on the head. It's meeting them where they're at, letting them talk, letting them just say the ugly thing. I think everybody is afraid to say, this is this is hard, or I can't handle it, or I'm mad at the situation.

00:08:04:00 - 00:08:29:13

Yes, you can be mad at this situation. You absolutely can. And what I tell family is, is when you have a family, when you have a parent that doesn't want to talk about it, because a lot of times we get that straight arm, I'm fine, everything's fine. We don't need to talk about this. Positioning it as we want you to be in the driver's seat of your life.

00:08:29:18 - 00:08:50:02

We are not here to have this conversation, to say, we're doing this to you, because that's the immediate fear, right? This immediate feel of the whole thing. I've spoken to some people, and there's things can go sideways pretty quickly. And, mom, we don't want that for you. We want to be able to put you in the driver's seat of your life.

00:08:50:04 - 00:09:19:08

And I know this feels uncomfortable, but can we at least start that conversation? Lean on people like ourselves? To bring that health care professional in that, you know, like, and trust in on those conversations. That's what we're here for, really to to lean on. And you're validating their feelings. That is so important to validate their feelings. I mean, I personally experienced my father being face at age 75.

00:09:19:13 - 00:09:40:19

He has three months to live because of congestive heart failure. He was so angry, so angry. But with the support, he moved in with me. That gave him 18 months of his life instead of three months. But you have to validate their feelings. I had hard conversations with my father because the one time he was angry, his older brother was there and he just wanted to spend time with them.

00:09:40:19 - 00:10:05:01

And I said, so you have to decide what memory do you want? Even whether they're not, maybe they're facing to move into selling their home, moving into a community, and they don't want to do that. But what memory do you want to have? What memory? How long you know, because you don't want it to go sideways. I'm a proactive versus reactive, where a lot of people, they do not have a plan.

00:10:05:01 - 00:10:27:15

And getting the plan and starting that conversation without the parents being defensive because they are, because they that you have to validate the fact that they're losing their independence. Patients, residents who come across frustrated or maybe a little bit aggressive, you know, most people, right, get that kind of confrontational energy and they're like, okay, we'll give you some more time.

00:10:27:15 - 00:10:50:17

Or they kind of they kind of go away. I think more health care professionals need to recognize that there's like a primary underlying emotion there. And it's not anger, it's fear. It's you know, sadness, it's depression. There's something else going on. And you really have to address that first before you can make headway with somebody to have a difficult conversation.

00:10:50:22 - 00:11:12:21

And you will see the conversation with them will also change, and how they will interact with you will change when you do validate it in a not a direct form, but a roundabout way. And they feel comfortable and they start coming to you with more personal situations that they're facing, which I again experienced with my mom, with her all timers.

00:11:12:23 - 00:11:33:04

I started acknowledging it, but the way I presented it to her, she feels comfortable to tell me I forgot how to drive to your house. And I said, that's okay, I'll just come and pick you up then, you know? So those are things that you you want to make them feel comfortable and then they're more relaxed with that, which is very important.

00:11:33:09 - 00:12:03:12

That's really scary. And that stinks, doesn't it, mom, I get that, you know, I get it. And and it's just like all of us, it's no different. I think sometimes people put our seniors into this, this box that magically at some stage of their life, they just became different than all of us, and they really didn't. It's no different, you know, why do you have the the friends that you have and the people that you know, like and trust because they validate you, right?

00:12:03:12 - 00:12:21:17

You know, yes, they do. And you're having a hard time with something or, or whatever. What do you do? You pick up your your phone, you call your friend and you say, I got to tell you about my day up, up, up, up, x, Y and Z and you've solved nothing. Probably at the end of the conversation. Right?

00:12:21:19 - 00:12:52:05

But but I feel better. And my friend feels good about making me feel better. And that's no different whether you're 41 or you're 85. Right. We all need that validation. That is the cornerstone of building relationships. And I think, like I say it, at some point, we've we've decided collectively, at a certain age that that doesn't need to happen, that we now need to revert back to telling people what to do.

00:12:52:05 - 00:13:14:14

And you're correct, we can also learn from them. They have so much knowledge. And if you put them in a situation where they can start sharing about their information and sharing about their past, they just want to share with people and talk and b socialization is huge to keep them intertwined with other people with the connection, for sure it is.

00:13:14:14 - 00:13:33:21

I mean, we've we've seen it at the communities that we've worked at. Yeah. And I think people forget to like I'm only in my 30s, but I have moments where I'm like, man, I it just feels like yesterday I was in my 20s and imagine that feeling like I still feel internally like I'm 20 something year old Chelsea.

00:13:33:21 - 00:13:52:15

And so I think that people forget that, like when you get older, you're still going to feel like you're you doesn't change your soul the way that you are, your personality, it doesn't change, your body changes. And internally, you know, you're still like there are seniors are looking in the mirror like, man, I still feel like I'm 40 year old.

00:13:52:15 - 00:14:14:20

Whatever. And that is I would assume a struggle when you start getting up there and, and, and things start happening and life starts changing faster than you can keep up with. So having a little bit of emotional intelligence is key. And I think back just to my experiences being in different communities or where I work, and one of the complaint would be the food.

00:14:14:20 - 00:14:37:03

So really, are they unhappy about the food or are they just unhappy they're not cooking it anymore and they used to enjoy cooking. So there's always, again, that underlining issue of why. And we need to sit back and come to them where they're at and meet them there and discuss with them what is reality and what are the choices and decisions that need to be made to be able to have a plan in place?

00:14:37:07 - 00:15:02:23

What's the other choice is not having a plan? And then what happens? Every decision is a race. So maybe let's discuss that. When they are forced to make a fast decision, you're limited to the resources and having a plan in place and being ready. What happens is, is when we wait for crisis mode, that becomes a hospitalization, and hospitalization turns into rehab.

00:15:03:01 - 00:15:32:21

And there's we could do a whole other podcast on on all of that, but it's this snowball effect, right? And now we're operating out of fear and anxiety. And that's never a good time to be making a big decision. Right? I think everybody can agree on that. Making a huge life decision is never best done when it's forced or just in a crisis mode kind of situation.

00:15:32:21 - 00:15:58:04

And so then when we wait to get to that point and there's been no plan, no conversation, and I'm not saying that having a plan, every single detail needs to be nailed out. You couldn't possibly do that. You couldn't possibly account for everything that could happen. But when there's been no conversation, oftentimes I'm having conversations with people that are saying, okay, mom's at rehab.

00:15:58:09 - 00:16:16:10

She needs to leave next week. She's not going to be able to go back home. And what do we do? Okay, so there's a lot of questions. First of all, how did we get here? Right. That's that is a really great framework of how I guess I'm laughing at it for, you know, I know it's a podcast. You can't see me.

00:16:16:10 - 00:16:41:10

Chelsea and I are, you know, looking at each other and shaking our heads. Yeah. So how did we get here? What do the finances look like? Where does everybody live? Who are the key players as far as decision makers? And when there's blank spots in those questions, it makes it very difficult because now we're scrambling. We don't even know what finances are.

00:16:41:15 - 00:17:07:12

I don't know if my sister's going to agree with me on this. And it's always the sister in California. Yeah. You know, and the both of you said California. Yeah. The one that's not present, the one that's not here. And and so I say to families, when, when we're talking about a plan, like I said before, it doesn't have to be nailed down to the tee, but let's open up that conversation.

00:17:07:12 - 00:17:40:22

If Mom or dad doesn't want to be a part of that conversation, let's have a conversation offline from from the family perspective so that we're all on the same page clinically. That conversation needs to be happening. Also, what are your goals of care? What do you want your life to look like? And I think we typically see these conversations happening, you know, after your first few hospitalizations, we're very much in a in a fix it, always fix it kind of holding pattern.

00:17:40:23 - 00:17:57:15

And there really is an art to like learning when it's time to not fix it and focus on quality and not only our providers and our health system, but even in our community. Those are the conversations that people don't want to have or don't want to have with mom and dad because they don't want to talk about it.

00:17:57:15 - 00:18:18:22

And so being proactive in that route, too, because sometimes those two things, or I would say almost always those two things align because depending on what's going on with you medically, may or may not change your options of where you can go if you're not safe to be at home anymore. And so it's kind of getting that full circle picture of where are we right now and where do we want to be?

00:18:18:23 - 00:18:29:16

How did the parents address it to their children that this is what I want, or this is what I need when they're denying themselves of what the real situation is?

00:18:29:18 - 00:18:53:23

I think that's taken best from the parents. I think it hits harder sometimes. Right? When mom or dad is like, you know, I'm ready. This is where I'm at and I'm good. I've had a happy life, you know, I did X, Y, and Z. This is what I want to do next. Sometimes it requires multiple conversations and, you know, just having the patience to like to do that because they're actively processing.

00:18:53:23 - 00:19:19:12

It's not a conversation where you have and they're like, okay, yeah. You're you're absolutely right. And I agree with everything. And I'm totally fine with all of the change. You know, it's your it's your mom, it's your dad. It's the person who took care of you. And that's a hard change to endure. So just having patience and supporting whatever mom and dad wants, because ultimately it's about what they want and and supporting them regardless.

00:19:19:12 - 00:19:43:03

For clarity of our listeners, we're speaking in terms of from a clinical perspective, what kind of interventions do we want and what we don't want, right? We're talking about CPR, we're talking about hospice. There are forms called post forms, Pennsylvania Orders for Life Sustaining treatment. And a lot of people don't know about those. No. Right. They really don't.

00:19:43:05 - 00:20:00:11

Out of hospital, DNR, all of these things, these are part of the education that we're giving to people all the time. And I'll sort of back up and I'll go down that rabbit hole for just a quick second. People have things in place power of attorney, living well, insurance, all that stuff. And they think, okay, great, now I'm done.

00:20:00:12 - 00:20:28:13

Right. But the reality is, when we started talking about the post form and a living will, the living Will is a 12 to 15 page document that's made by an attorney. Right? An attorney is not a doctor. He's not a nurse. He's not anything. He's just somebody that is making a formal document, legal document to give guidance to the families in terms of what should we do if we're in some sort of a terminal type of state?

00:20:28:13 - 00:20:52:04

You can't go to the hospital and hand a doctor that that living will and say, okay, our job here is done. That's where the post form comes in. And that's where Michelle says, referring to those, those difficult conversations, because really, it lays it right out. I do or do not want to be in the Bay to write, you know, a peg tube or new or artificial feeding or artificial hydration.

00:20:52:04 - 00:21:13:09

It's very specific. Yeah. And we do see that a lot. Right. Where the, the patient themselves is saying, I don't want to live that way. So I am opting out of these things. And to your point, and families are on the other side of that table, and they're really grappling with that. They're like, oh my gosh, what do you mean you don't want that?

00:21:13:09 - 00:21:39:14

Because I'm not ready to let go. So it is it's a very, very sticky conversation to have. But the fact of the matter is, is that it's your parent's life. And, and I think we all want that respect. Right. We go back to the validation principle. Right. And if I want CPR but you don't we have to respect each other's opinion.

00:21:39:14 - 00:22:02:16

Yes. Where things get messy is when we bring in emotion and guilt and all of those things. But putting your parents first and what they want, regardless of how hard it is on you, you need to honor that. And, and if there's, you know, some therapy and things that you need to talk to you for with some other people to get right with that, then then I encourage you to do that.

00:22:02:16 - 00:22:26:19

That's I think people don't utilize that enough. If they do go on hospice. This is you do have a social worker that comes in. But then there's also in the community, if you reach out to someone, there may be support groups or if you're living at home, you reach out to your doctor, or if there was someone like you, Lindsay, that would navigating and helping them with the services that they need, that they can reach out, that you may know someone else to refer them to.

00:22:26:19 - 00:23:02:02

It's important. Very much so. And you have to, like you said, respect what their wishes are and what your wishes are not. You know, it's quality versus quantity. Everybody's different. And that's what makes the world go round. But we have to honor that. And that's important. With this, we're getting near the end. And I want to know each of you what you think the most important takeaway is for our guests to know from this conversation, though this is in our last podcast, we will have them back to because there's a lot to share with you and coming with your the experiences that both of you bring, it's important for people to understand and that's

00:23:02:02 - 00:23:30:02

the goal of Caring Table. So what is the takeaway for you today? Don't wait to get help to look into resources. Caregiving is literally a it's a team effort. Even when nothing is happening. That's the time to getting plans in place and starting to think about, you know, what you want the future to look like. There's so many resources and people like Lindsay and I that are able and willing to help and help you navigate.

00:23:30:02 - 00:23:53:00

And oftentimes, families wait until that hospitalization that fall with an injury, that sharp decline, because maybe there were signs happening before that we met. So don't wait. I would say cut yourself some slack. You know, we don't have this figured out. And as I mentioned before, we wish that there was a book for parenting. There is no magic wand.

00:23:53:04 - 00:24:17:10

Feel like you can lean on us because every situation is different. Give yourself some grace and know that it's okay to ask for help. It really is. And you're going to feel so much better once you have that initial conversation with somebody. You rip off that Band-Aid. I know it's uncomfortable, but have that initial conversation and just have that next step in your mind.

00:24:17:10 - 00:24:38:21

And I encourage you that if you can't even get your parents together, then start having those offline conversations with siblings so that everybody can get on the same page. And it's important to respect each other and know you're not may not always be on the same page, but you could compromise. And to put your parents first and to do what is most important for your parents.

00:24:38:23 - 00:25:05:08

I thank you for coming on. This was a great conversation, I appreciate it. I would like you both to share your contact information, if you can. How they can reach out to you, and we will also have it underneath in script as well. Lindsay Steele with Care Connect. My email is Lindsay at Care Connect Senior living dot com. My cell phone number (484) 951-4647.

00:25:05:08 - 00:25:29:23

You can always feel free to call text. We're here to help Chelsea Gerena at gmail. C h e l s e a g e r e n a@gmail.com. Thank you for coming. This was exciting and we will be back at Caring Table to share with you how and what is out there for you, and to let you know you are not alone.

00:25:30:01 - 00:25:44:12

Until next time, take care of yourself and those around you. There is always a seat for you at hearing table podcasts. Please let me know your thoughts and any changes we should make. Thank you for listening. Talk to you next time.