Summary
In this episode of CareLab, hosts Emilia Bourland and Brandy Archie welcome Dr. Brittany Lamb, an ER physician and advocate for dementia family caregivers. The discussion navigates the dual nature of smartphones and dives into the complexities of advanced care planning for dementia patients. Dr. Lamb shares her personal experiences and insights on improving healthcare systems and supporting caregivers through education and structured decision-making processes.
Key Takeaways
- Smartphone Debate: Smartphones are powerful tools offering significant benefits but also pose challenges like addiction and information overload.
- Personal Responsibility: Effective smartphone use requires self-discipline and personal responsibility to balance benefits and potential harm.
- Advanced Care Planning: Conversations about advanced care planning are often lacking in primary care due to time constraints and need for better integration.
- Healthcare System Reform: Ideal healthcare would separate financial interests from care, with more support for those on the ground, like physicians and caregivers.
- Educational Resources: Dr. Lamb emphasizes the importance of providing educational resources and structured programs for caregivers to make informed decisions.
Transcript
Emilia Bourland, OTR, ECHM, CFPS: Welcome to Care Lab, it's Care Lab Day!
Brandy Archie, OTD, OTR/L, CLIPP: Care Lab Day. I'm so glad to be here and to have this conversation today. And you know, it's Friday, so it's best day of the week.
Emilia Bourland, OTR, ECHM, CFPS: Yeah, I feel like it's been like a hot minute since we've had a Care Lab Day for some reason.
Brandy Archie, OTD, OTR/L, CLIPP: Yeah, I don't know why, but hopefully everybody who's listening has had a Care Lab Day every Friday because that's when we'll release episodes.
Emilia Bourland, OTR, ECHM, CFPS: Yes, indeed. So don't forget that. Mark your calendar. Make it a recurring event to listen to CareLab. We have a really, really awesome guest as if you are watching this, you can see already. We have with us Dr. Brittany Lamb. So Brittany has the best bio, I think ever. She's an ER physician by night and a dementia family caregiver, decision maker, educator, and advocate by day. And we're going to talk about all that.
Brandy Archie, OTD, OTR/L, CLIPP: Exactly.
Emilia Bourland, OTR, ECHM, CFPS: with Brittany here today. But first, we have a serious question that we have to answer.
Brandy Archie, OTD, OTR/L, CLIPP: How serious can this be? I doubt it. But we're ready.
Emilia Bourland, OTR, ECHM, CFPS: You know, actually, most of my icebreakers are like not serious at all. This is a more serious one. This might be a more controversial one. So smartphones, are they good or are they evil? This is a complicated question.
Brandy Archie, OTD, OTR/L, CLIPP: Is it complicated? Do you have an answer right now?
Brittany Lamb, MD: Hmmmm
Brittany Lamb, MD: I'm going to say they're good. I mean, think about all the things that you can do with your smartphone that you couldn't do before. I just, I think it's a good tool. I see the other side though.
Brandy Archie, OTD, OTR/L, CLIPP: The evil side is not that far away. It's in the horizon. You can see it.
I think with most things, one, that I answer, and two, that happen in life, there is no one right way. And I think it's very great. And I think they can be used for good, a lot of good. It creates internet access for people who haven't been able to have it because they can't access a desktop. So it makes it more affordable to do that. And it just gives a lot of ability to do a lot of things. Also, I think a smartphone is a really great accessibility tool because it's got all this stuff in your pocket already to help with low vision, to help with memory reminders and all that. So that's all great. However, it also opens you up to the world all the time and you can be summoned at any moment. There's no like, unless you put your phone away, there's no like time where you can't be gotten to. And don't let me get started on the kids on the phones. So yeah, I think it's great.
Brittany Lamb, MD: Hmm.
Brittany Lamb, MD: Yeah.
Emilia Bourland, OTR, ECHM, CFPS: Okay, so I would agree that it's neither 100% good nor 100% evil. Most days I feel like it's more evil, I won't lie, in my own life and the way that I see it affecting the world around me. But I also, I mean, I think that's a great point that it has given people access to knowledge in the internet who would otherwise not be able to access that. And that's a really important thing to kind of democratize knowledge.
I mean, that's part of what we tried to do here at CareLab. I have to recognize that probably podcasts wouldn't exist if smartphones didn't exist. So there's that. And it does make it very convenient to accomplish lots of different things in a short amount of time. I think that the problem that we all struggle with is one, like you said, there's never a time when you can't be gotten to.
Brandy Archie, OTD, OTR/L, CLIPP: was that.
Brittany Lamb, MD: Mmm, yes.
Emilia Bourland, OTR, ECHM, CFPS: Also, it kind of ends up resulting, the ability to do so much ends up resulting in this kind of information and task overload that I don't think, you know, our brains really aren't built to manage that. There's this like idea of like multitasking, right? But we know really and truly that brains actually don't do that. It's what we technically call like attention switching. And when you're constantly attention switching,
Brittany Lamb, MD: Hmm.
Brittany Lamb, MD: Mm -hmm.
Emilia Bourland, OTR, ECHM, CFPS: It makes it very hard to have sustained attention and actually do anything well. And so, like, why do we all feel so frazzled? Well, there's lots of reasons, but the smartphone probably doesn't help with that. And and yet don't even get me started on kids with the phones. Don't even get me started on on kids with the phones like and all all of the stuff. I think the other evil is that I think there's a lack of awareness that a lot of the technology is built to keep you.
Brandy Archie, OTD, OTR/L, CLIPP: Mm -hmm.
Brittany Lamb, MD: So true.
Emilia Bourland, OTR, ECHM, CFPS: in it and keep you using it. So it's literally built to be addictive and to tell you what you want to hear. And I think unless you can put some really firm guidelines on yourself and how you're using it, there's a potential for a lot of harm to happen both on an individual level and then, you know, that takes a toll on our society as well. So but on the other hand, so many amazing things have come out of this technology. So.
Brandy Archie, OTD, OTR/L, CLIPP: on it. Yeah.
Brittany Lamb, MD: using it. Yeah.
Emilia Bourland, OTR, ECHM, CFPS: I don't know, like I said, most days I feel like it's more evil, but I have to acknowledge that you're probably right, Brandy, it is closer to gray and there are a lot of really good things that you can do too.
Brittany Lamb, MD: Yeah, and it's a way to teach you how to critically think and use it as a tool and maybe to manage your time a bit better and to self -discipline, you know, and to take care of yourself and realize that this thing may be causing you harm. So I'm going to put it away. I'm going to use my do not disturb. There's, that's a balance.
Emilia Bourland, OTR, ECHM, CFPS: Mm -hmm.
Brandy Archie, OTD, OTR/L, CLIPP: Mm -hmm.
Emilia Bourland, OTR, ECHM, CFPS: Yeah, yeah, I think ultimately it really comes down to us all having like taking the personal responsibility to make sure that we are managing ourselves with it, right? And, you know, part of that comes from the understanding and the awareness that it is something that needs to be managed. But but yeah, we all have to at the end of the day, no one's forcing you to keep your face on the screen, right?
Brittany Lamb, MD: Mm -hmm.
Brittany Lamb, MD: Hehehe
Yeah.
Brandy Archie, OTD, OTR/L, CLIPP: I think that's mostly true. Yeah.
Emilia Bourland, OTR, ECHM, CFPS: Mostly, yeah.
Brandy Archie, OTD, OTR/L, CLIPP: I was trying to come up with an example of a place where you are forced to keep your phone on your face and there probably are some jobs that you have to do it. But either way, you still have some self -discipline at home when you are not at work or whatever the case may be.
Emilia Bourland, OTR, ECHM, CFPS: So, okay, well, I don't know. That was a little bit of a diversion, but thanks for humoring me. But now, now we get to get into the meat of the matter here, Brittany. And I mean, Brandy and I were talking about, you know, you before you came on the show and just how cool we think your work is and how important it is. So would you mind sharing with the audience, you know, more about your work and your background?
Brittany Lamb, MD: Yes, absolutely. So I have been practicing emergency medicine for nine years and became passionate about decision making and advanced care planning, which led me to create an online course and now a group program for dementia family caregivers to help educate them and navigate the journey of dementia and become a better decision maker and advocate for their loved one. And really it's, it's my personal experiences that drove me towards this work. And those personal experiences were the catalyst to the passion that I have now, which I won't get too much into right now, but
I think that if we can create more awareness and education around advanced care planning for chronic illnesses, specifically dementia, we can, we can see, you know, improved outcomes and better decision making from families and then also an improvement in healthcare delivery because people will have this done before they reach crisis. So
I'm very, very excited about this new work that I'm doing, and it's been a fun journey over the past, let's say year or so.
Brandy Archie, OTD, OTR/L, CLIPP: That is amazing. And I think that it's really needed because like you said, there's not a lot of information that people have prior to it being an emergency. And that's never the time to make decisions about care or, you know, any of the things that have to happen after a certain diagnosis. And I think the hard part is that a lot of those conversations should be happening in primary care, but primary care doctors don't have enough time in the day to do all the things that they need to do, and that doesn't come up until later when it really is a lot harder to get a plan in place.
So what does your program really consist of when you start working with these families?
Brittany Lamb, MD: Yeah, so I have one-on-one options and a group option now. And really, the group option, I just launched that this year. So that's very exciting. And we meet for six weeks and we go through what advanced care planning is, because most people, like you said, aren't introduced to the concept and don't really know what it means. I take the foundation of the Respecting Choices Advanced Care Planning Certification Program and give people the very basic introductory information and apply that to their specific situation. And we talk about how to, how to engage and have these conversations with your loved one, how to talk to the medical team, what questions to ask, how to communicate well. Because I think we do a terrible job in medicine with, with our communication with families. And really like I do think it's a lot of it is because we're just kind of overwhelmed in the system and
we need more physicians and more advanced practice practitioners and really more, more team members like Brandy and other OTs to, to help out. So it is, it is, it is a journey to like shift the system and get people more time with their primary care physician. So that's why I created this because it's just a supplement to the care that they're receiving and they can just spend an hour a week learning a little bit more about how to best navigate this disease and help their loved one. So we talk about disease progression, we talk about things like, you know, when, when you are, when you're declining and your disease is progressing and you reach a stage of like a severe dementia, what does it look like at the end stage of dementia? And a lot of people don't understand what that looks like and so they end up making decisions based on things like,
they want, they want the very best for their loved one, right? And they want to do everything they can, but they don't understand that doing things like tube feeding and antibiotics and you know, bringing them into the hospital at the very end of life, it isn't going to change the outcome. And so what we want to do is provide comfort and we want to provide comfort and help them be as pain free as possible and as peaceful as possible at that stage. So we talk about, you know, where, where should your loved one be living? What does that transition look like? I talk about things like, you know, long term care planning, estate planning. I encourage people to make sure that they get with an elder law attorney, financial advisor to make sure they're navigating those things appropriately and putting a plan in place so that they have, they have that peace of mind going into those stages of disease. So
I just like to think of it as kind of a, I don't know, we talk about everything. We talk about it all.
Brandy Archie, OTD, OTR/L, CLIPP: That's amazing. And I think that it's just such a good service to provide because like you said, there is no one that I think that is really providing that level of education and to kind of make it normal, right? To make it normal to have the conversation because it has to happen at some point in time. And it is interesting because I've been a part of several advanced care planning conversations as the occupational therapist working with different kinds of patients, some of whom had dementia, some of whom had other illnesses that were going to be more progressive. And I've noticed, and I'd love to hear what you have to say about it. It seems that a lot of times the family, like you said, does want to do everything they possibly can, but it's really for their own peace of mind and not because it's actually what's best for the patient.
Brittany Lamb, MD: Yes. Yes, absolutely. And it's heartbreaking because, like I said, they want the best for their loved one. And because of the lack of education and information that they're receiving, they're just being reactive instead of being proactive. And so really the goal is to shift them to be a little bit more proactive. But you're right, you know, people are afraid of being judged. They're afraid of, you know, if I don't do everything, I'm going to be judged by my siblings or my aunt and uncle and my, you know, whomever. And, and there's all this pressure to do everything, even if it's going to cause their loved one more suffering.
Brandy Archie, OTD, OTR/L, CLIPP: Exactly.
Brittany Lamb, MD: Yeah. And I think that it's just, it's just lack of awareness and education.
Brandy Archie, OTD, OTR/L, CLIPP: And then they also don't realize that, like you said, the best thing you can do is to be comfortable and have peace and that suffering really isn't in the equation. But that's something that's going to get left out and instead it's just do everything.
Emilia Bourland, OTR, ECHM, CFPS: I just think your program is so incredible because, you know, I think from a, from a family member's perspective, it's often very hard to hear some of these things from a medical professional, like right in the moment, right in the middle of a crisis. I think it is much more palatable to hear it in a structured educational setting, like what you're talking about, where you're teaching people, here's what to expect, here's how to prepare. And I think if you can separate it from the crisis moment, people will have a much easier time understanding that really they're doing this to reduce suffering and increase comfort and that actually they are doing everything for their loved one. And it's, it's a much more comforting thought when it's separated from that, that immediacy of crisis. But I mean, that's, that's just a hypothesis on my part. What, what do you think?
Brittany Lamb, MD: Yeah. Yeah, absolutely. And also, you know, for me personally, having been through some medical crises in my family, there was a time where the doctor told me that I couldn't speak to my loved one because they were intubated and I wouldn't be able to communicate with them. And I didn't believe it because I had had a prior experience with an intubated patient and we did communicate. And so I said, okay, well, I am going to go to the bedside and I am going to talk to them. And sure enough, we were able to communicate, you know, despite them being intubated. And so I was able to kind of guide them through and provide comfort and say, you know, I'm here and you know, I'm here and I love you. And I think that, you know, when people are afraid and in crisis, they need to have the right tools and the right information and they need to understand what's happening and
that's going to help them make the right decisions. So absolutely, I think that this type of program is helpful in that way. And also, you know, the reality is there are lots of different perspectives out there and some people want to do everything. They want to do everything. They want their loved one to get all the treatments, get all the antibiotics, and that's okay. That's okay. If that's your choice and you feel like that's going to help you sleep better at night, I will support you in that. But the reality is for a lot of people, that isn't the right thing to do for their loved one. And so we really need to educate people and guide them to make the right decisions for them personally and for their family member. So.
Emilia Bourland, OTR, ECHM, CFPS: Well, and I think it's so important that people have access to you. You're coming at this from a place of having had the experience both in your personal life and in your professional life. And then, you know, there really is no substitute for someone who has lived that themselves and has also been in the medical field and seen it from the professional side as well. So I think you bring such a valuable perspective to it. How can people access you? How can they find out more about your program?
Brittany Lamb, MD: Yeah. So my website is www.BrittanyLambMD.com and I have information on there about the program. You can schedule a free consultation call with me to see if the program is a good fit. And then I am on social media. So I have a YouTube channel with educational videos, Brittany Lamb, MD:. I'm on Instagram, Facebook, LinkedIn, Twitter, all the social media platforms, but mostly YouTube and Instagram.
Brandy Archie, OTD, OTR/L, CLIPP: Perfect. And we'll put those links in the show notes too, so people can find you.
Brittany Lamb, MD: Awesome. Thank you.
Emilia Bourland, OTR, ECHM, CFPS: So Brittany, I want to talk to you a little bit more about your personal experiences and how they have driven you to become so passionate about this work. I know that your mom had early onset Alzheimer's disease. And can you talk a little bit about how that has influenced your work?
Brittany Lamb, MD: Yes. So my mom was diagnosed with early onset Alzheimer's disease in 2014. And at that time I was just finishing up residency and beginning my career in emergency medicine. And it was just a really, really difficult time. I was trying to manage my new career and also support my mom and my dad who were trying to navigate this disease. And I think the hardest part was just not knowing what to expect and not having the right information. So we were just kind of fumbling through the dark and trying to figure it out as we went. And it was just a really, really challenging time. And I think that if we had had more education and more information, it would have been a lot easier for us to navigate. And I think that the reason that I became so passionate about this work is because I don't want other families to have to go through what we went through. I want to provide them with the information and the tools and the resources that we didn't have so that they can have a better experience and provide better care for their loved one. So that's really what drives me and what motivates me to do this work.
Emilia Bourland, OTR, ECHM, CFPS: That's amazing. And I think that it's so important for people to hear that because a lot of times, you know, when you're going through something like that, you feel very alone and you feel like you're the only one that's experiencing it. But the reality is that there are so many people out there who are going through the same thing. And I think that your work is really helping to bring people together and provide that support and that community that is so important.
Brittany Lamb, MD: Yes, absolutely. And I think that, you know, one of the things that I love about the group program is that it does provide that sense of community and that sense of support. And people are able to share their experiences and learn from each other. And I think that that's just so valuable. And it's something that, you know, I wish that we had had when we were going through it with my mom. So I'm really, really happy to be able to provide that for other families.
Brandy Archie, OTD, OTR/L, CLIPP: Yeah, I think that's such a good point because that really is the power of community is to be able to learn from other people who've gone through the same thing and to be able to support each other. And, you know, when you're in it, it can be really hard to see the light at the end of the tunnel, but to know that other people have gone through it and come out the other side and are able to support you is really, really powerful.
Emilia Bourland, OTR, ECHM, CFPS: Absolutely. And I think that, you know, one of the things that I love about what you're doing is that you're not just providing information, but you're providing a framework for people to make decisions and to really think through what is best for their loved one and for their family. And I think that that's just so valuable because a lot of times, you know, we don't know what we don't know. And so to have someone who has been through it and who has the expertise to guide you through that process is just so valuable.
Brittany Lamb, MD: Yes, absolutely. And I think that, you know, one of the things that I really try to emphasize is that there is no one right way to do this. You know, every family is different, every situation is different. And so it's really about providing people with the information and the tools and the resources to make the best decision for their loved one and for their family. And I think that that's just so important.
Brandy Archie, OTD, OTR/L, CLIPP: Absolutely. And I think that it's just such a good point to make that there is no one right way to do this. And, you know, every family is different, every situation is different. And so it's really about providing people with the information and the tools and the resources to make the best decision for their loved one and for their family. And I think that that's just so important.
Emilia Bourland, OTR, ECHM, CFPS: Well, Brittany, thank you so much for being here today and for sharing your story and your work with us. I think that it's just so valuable and so important. And I really appreciate you taking the time to be here.
Brittany Lamb, MD: Thank you so much for having me. It's been a pleasure.
Brandy Archie, OTD, OTR/L, CLIPP: Thank you so much, Brittany. And we will make sure to put all of the links to your website and your social media in the show notes so people can find you and learn more about your program. And thank you again for being here.
Brittany Lamb, MD: Thank you.
Emilia Bourland, OTR, ECHM, CFPS: And thank you to our listeners for joining us today. Don't forget to subscribe to CareLab on YouTube or your favorite podcast platform so you never miss an episode. And we'll see you next time on CareLab.
Brandy Archie, OTD, OTR/L, CLIPP: Bye, everyone.
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