Good morning, Dr. Rebecca Starr. Thank you so much for joining us at the Amherst Senior Center. Oh, sure. Thank you. Thank you for having me. I'm excited to be able to have this time to talk. Yeah, great. Well, welcome to the community. I had the opportunity to meet you when you first arrived to Cooley Dickinson Hospital, and you have been a really wonderful community partner and a source of wisdom and advice, certainly for me and my position as director of services throughout the pandemic. I'd like people to know that you phoned me, you contacted me, emailed me, just asking, do we need support? Do we have questions? So first of all, I just want to thank you for your presence in the community. My prior practice was around the field, the intersection of medicine and law around geriatrics. And so the fact that we have a geriatrician at Cooley Dickinson Hospital, I just want to say, like, hooray, we are so very lucky to have you. So with that said, I thought it would be helpful for people to kind of get to know you a bit. And if you could just tell us a little bit about your professional background, your education, and sort of what brought you to this position. Sure. So I'm a geriatrician and most people know, but in case that means I take care of people who are older than 65. And I always say, you know, that is your age, but not by how you feel inside. And I always joke that I will always feel 29. So people shouldn't get, you know, scared of that. It just is what it is. And I've had known that I want to be a geriatrician from the moment I thought about going to medical school. So this has always been something I wanted to do. And I feel so lucky to be able to practice geriatrics. And actually, I feel tremendously lucky to be able to practice geriatrics in this community, in this area. I started off at Downstate, SUNY Downstate in Brooklyn, and spent a summer at Mount Sinai. They had a great geriatric program, and I had a great mentor there who brought a tremendous amount of enthusiasm in. I then went to Brown, and there was a very strong geriatric practice and a gerontology, and we'll talk about the difference there. Also a strong research program there. With that work, then I went to Cambridge Health Alliance, that's in Cambridge, Mass. There, the goal was to take care of the underserved, if you will. And I worked at a PEACE program, which stands for Program for All-Inclusive Care of the Elderly. And that's a program for 55 and up who are duly eligible on Medicare and Mass Health. And who have a good amount of chronic conditions or mental health conditions that they could actually be in the nursing home, but the goal is to keep them living in the community with a really lovely wrap-around care supports. So I did that for some time, and then sort of felt the pull to this area, and went to work at Bay State. And there I had some amazing opportunities. I did geriatric consultations, primary care, and actually started the ACE unit at Bay State. It's acute care for elderly, where we made a designated floor in the hospital, and we showed that providing really great care, basic care, and I think fancy, we were able to really reduce what we call hazards of hospitalization. So more people on this unit went back home, there was less complications, and people really seemed to like that. From there, I've now been at Cooley Dickinson now for a year. July 22nd was my first year anniversary, and have really been welcomed here. Again, I think there was a strong need for this, working the Cooley Dickinson Health System. I've really been supported and able to build a great geriatric practice in the outpatient setting. I also see some inpatients and have started a program within the community as well that I can talk about later. Great. So you mentioned that there is a difference between geriatrics and gerontology. Could you explain what that is? Because I'm not sure I even understand that. Gerontology has been talked about even as far back in the age of Aristotle, where he called, used this word, Eugiria, and I'm just looking at my notes, but he meant successful aging, a long and happy life in which independence was maintained and there was no pain or suffering. So that continued on for a while. Dr. Mechnikov coined the word gerontology, and that was over 100 years ago, and that's the study of the biological, behavioral, and social sciences of old age. So gerontology is the study of aging. In 1909, Dr. Nasher first used the word geriatrics to describe the medicine, and they called it of old age. So geriatrics is the medicine of taking care of older adults. And gerontology is the study of that. And there's a lot of intersection as well. Yeah, yeah. Fascinating. So what drew you to this specialty in terms of treating older adults medically? I just think that that's always so interesting among the fields. I know that there's a dearth of practitioners. You know, they have some things that I think pull people's attention. This may not necessarily be among those, particularly for young people who are training as a physician. So I'm always curious why this field for you. Sure. And I think to your point, there's maybe 6,500 geriatricians when there's the need for over 30,000. So I always try to encourage everybody to go into the practice. And as geriatricians, I think we're some of the happiest, you know, physicians in the field of medicine. I was blessed to have four amazing grandparents. And I think many geriatricians go in have had grandparents that were these great role models. So I was able to grow up with four grandparents, each one tremendously different from the other. I had a grandfather that loved to go dancing. And his wife, my grandmother wore leather pants into her 90s. She did shrink a little bit and just made sure that they were always hemmed perfectly.  Who they were in their 20s and 30s and 40s was that same person in their 60s, 70s, 80s and 90s and 100s. And they changed along with it. But they kept that spirit. They had a real zest for life and continually learning. My grandmother would read the New York Times, for example, from cover to cover every single morning, and stayed up on all the politics and everything going on in the world. So they showed me how important it was to have that continual desire to know what's going on. My other grandparents, my dad's parents were also equally amazing. My grandfather was a lawyer and hated it and went back to work in his 40s, which was unheard of at that time, went back to school, became a patent lawyer. He worked in New York City on the 27th floor and he walked up and down the flights of stairs twice a day. I don't know how he did it, but I really think that that contributed to his overall well-being. My grandmother was an opera singer and then an interior designer, and they remained very active going into to classes all the time. They traveled the country back and forth throughout their years, and they really tried to travel internationally. They were lucky that they had the health and the financial resources to do that, but again, this great curiosity. As they got older, I was able to see again how they adapted to that, their resilience, their struggles, and their losses as well, too. I thought if I can help other people, having them as my role models in mind, then I feel really blessed to be able to do that. What an amazing imprint and role model for that term of a successful aging, right? Yes, very much so. You are the medical director of geriatrics at Cooley Dickinson Hospital, and so you have this imprint or role model around successful aging times four, which is like, and those stories are so rich and dynamic. What do you see in your practice around aging and how sort of people in the valley are aging? How would you contrast that to what you grew up seeing? Sure. I think there's, you know, everybody's different, right? So I'm gonna, but I do see a tremendous amount of that as well, too, that need for learning and to continually be interested in what's going on in the world around them, to really, many people are very into both mental and physical exercise, and they read a lot, and they know what they can do to help them. So in those ways, there is that similarity. And in terms of the practice for your field, how or why would somebody come to see a geriatrician? In other words, if I was one of those robust, physically active, I'm 65, I'm doing crossword puzzles and, you know, going for walks and I feel fine. Would I see a specialist such as yourself? So sort of the question of like, when and why would somebody seek a consultation with a geriatrician and get that sort of input? Great, great question. And I'm gonna back up what I see myself doing is really focusing on someone's overall well-being, right? And I don't think of geriatrics as just the medical management of disease, but again, focusing on sort of the full frame, the full picture of somebody and seeing the whole person. So generally, I think if somebody is very robust and active and everything is going fine, they generally don't need to see me at that point. But if they have questions on what I can do to what do you know that can help with successful aging, then that might be worth a visit to talk about those things. And then they've sort of established themselves with me. And then we can check in whenever needed. And that could be every year or every couple of years. But you have a sense of, All right, this is working really well. These are some things you might want to change. And then let's check in. That's for the healthy, robust person. Yeah. Some people start to have concerns about their memory, perhaps, or they they've had some chronic conditions and they they're wondering if a geriatrician can look at it from a geriatric point of view. Are the medications that worked beautifully in their 40s and 50s and 60s? Are those the medications that they should still be on now? Or are there any changes that we can make to make sure that they again continue to successfully age? And with that term, I think it's an important term, but I don't want anybody to ever think that they found if there's any. So so some people come in, people come in for a variety of reasons. I'm always happy to see everybody. I think there's people that want to check in and make sure that they're feeling great and want to continue to do so. Some people come in because they want to start planning for what could happen in the future. And they want to make sure that they have those plans in place. And I think that's important in a similar way to estate planning or, you know, advanced care planning. I'm certainly happy to help with that.  They're having more pains from arthritis. They're having more trouble with things like perhaps urinary incontinence, or they can't do what they wanted to do. And we try to look at the whole picture and come up with creative and out of the box ways to think, how can we help improve this? What would be a creative or out of the box way? So I just, I'm fascinated by this concept of sort of a holistic assessment and not just looking at a condition or a particular problem, but really looking at, can we enhance other things even as you have that chronic condition. That's really fascinating. Well, I think that there's so much that we can think of that can help somebody in small ways. Some of the basic things is sometimes it's hard to do laundry. Maybe the laundry is downstairs in the basement and the stairs might be a little treacherous. And knowing what places in the area will pick up your laundry and bring it back all washed and folded in a not expensive way. And so it's something that you don't even have to worry about anymore. So what are the concerns and what are the possible options? Knowing the community resources is huge. Our community centers are such a great resource. And knowing what they offer, knowing what Amherst Senior Center offers, for example, knowing what's available, I think is really important. And I think working to say, you know what, this doesn't exist. Have you guys thought about doing this? So it could even be help walking a dog on a hot day. You know, anything that we think of, if somebody is having difficulty sleeping because of arthritis, what can we come up with that can help with that pain? Is it special mattresses? Is it working with occupational therapy? So really thinking, what's the problem? How can we find a solution to it and make it so that you can get the best quality? Does that help answer that a little bit? Yeah, no, that's so and it's very interesting. And I think probably unusual in the practice of medicine overall, to be so global in your sort of outreach and the way that you conceive of problems and sort of troubleshoot beyond just here's a pain, here's a pill. And that's all that you're looking at. Yeah, one of the other things that's important that we I have here at Cooley Dickinson is time.  Some people aren't always quite prepared for that. But we really want to get to know the whole person, and they can really think through the solutions. So because we have more time, that's really helpful. And then we work closely with their primary care provider to, to make sure that our notes are sent and understood. And we really try to think of that as a partnership. Yeah, so that actually was one of the questions. So before we had this presentation, an opportunity to talk, folks did send me some questions that they had. And that was, I think that there was a lot of questions around, do you replace a primary care physician? Do you work with that primary care physician? And, and sort of like walking through, what is it like if I came to see you? What is an appointment like? And how is that different from the PCP visit where it tends to be limited in time and, and then availability? Yeah. So in this role, some geriatricians are primary care providers, some are consultants. In this role, I'm a consultant. And so that gives me the opportunity to see, you know, more people and really work with them through things. So people can either get a referral from their PCP or self refer. That depends on insurance, what their insurance allows. But we welcome that or referrals from the community as well, if there's concerns. Again, we do our best to partner with PCPs. And really try not to take over, but perhaps suggest or try to highlight things that again, can help with aging in a way that that keeps people as vibrant and healthy as possible. So I think that answered part of your question remind me of the other part. What would a first visit be like? You mentioned that more time that you can spend with a patient when they first come in. So what would, what would it be like? What would somebody expect? Sure. So we send out a packet of information prior that asks a good deal of questions. And they're really important questions. And so it's not just asking what are your chronic conditions? What are your medications? But you know, how do you take your medications? How do you get them? How do you use pillboxes? Really understanding how that happens. We act to ask about activities of daily living. Those are what we take for granted, but it's important. It's if you think about everything you do from when you're in bed, to getting up to having breakfast.  Can you get to the bathroom? Okay. Can you get yourself in the shower? Can you get yourself dressed? Can you eat? These are basic things. But again, we don't ever want to assume that anybody can do these. We want to be aware of difficulties. We look at IADL, so independent activities of daily living, or there's sort of a higher level. Who does your finances? Do you do your finances? Food shopping, driving? So we really want to know what areas are going well, and what areas might be a little more difficult. And again, try to work with that. We ask about people's sleep, because we know that sleeping is so important to how you feel during the day, how your brain functions. Some people get concerned that their memory, they're having concerns about their memory, when really, it's actually that they're not sleeping well, or maybe there's some undiagnosed sleep apnea. So we'll ask questions. What is your exercise tolerance? How far can you walk? Can you walk upstairs? Again, we want to know everything and not take anything for granted. Try to figure out what might be something holding you back from continuing to live independently. We ask about advanced care planning. We really want to know what are your thoughts about this? What do you have completed? Do you have a health care proxy? Make sure everybody has a health care proxy. And if somebody doesn't, we, we work to make sure that that happens. And by we I want to call out I have the great fortune to work with an amazing nurse, Sharon Asher. She's a huge piece of this. It's a partnership. I think it always takes a team or a village. And she innately understand so much about a person and their family caregivers. And I think add such a strength and robustness to the geriatric practice as well. Yeah, yeah. So that that was a really wonderful explanation of really what that visit was like. One of the questions I had been sent was, you know, how would you help with everyday living? And I think that you covered that so remarkably well, because it is the struggle of the everyday tasks. And if there are some small modifications that perhaps an older adult can't think of, it's fantastic that in that medical model, you take into account all of that about quality of life. I just, that's really wonderful. You are indeed lucky to have you. Well, thank you. Yeah. One of the things that you just talked about really reflected to me that this concept that we talk about, and I hear about often in senior centers about the importance of being able to age in place. And I have certainly seen that during the time of COVID, the ability to age in place in your own home has really taken on a new urgency. People not wanting to go to long term care facilities or other congregate settings and really doing an all out muscular effort to keep people with robust services in their home for helping them for those things around toileting, or whether it's, you know, getting groceries or navigating areas where there might be a stair and how can we modify your house with some, you know, quick either installation of stairs, the elevator thing, and also ramp. So we've been involved in a lot of requests around that to help people to age in place. And I'm wondering if you could speak to from your perspective, what's your opinion about aging in place, you know, the impact on a person's mental, emotional, spiritual and physical being? And do you have an opinion about the importance of that and the appropriateness of it? Absolutely. I think everybody's different in everybody's case is different. But that being said, I think many people want to age in place, right? But it's important to really think about what does that mean? What are the things that enable you to age in place? Is it being able to drive? Is it being able to drive to go get your groceries? In the age of COVID, if you can't get groceries, who could get you those groceries? If you have an animal, who's going to help if the animal needs to get to the vet in a in a timeframe, navigating your house, you might live in a beautiful three story house. But if it's hard for you to navigate those stairs, that's really something to think about. Thinking about bathrooms. Again, some people say, Well, I'll move my bedroom downstairs to the main floor. But you also want to make sure you have a bathroom on that floor that's accessible and set up to help you wash your baby. So these are all things to really think about. Think about what you do every day that keeps you this way, handling your finances. Many people are moving to electronic finances, you know, doing it online. My mother is still going to the bank. So thinking about what that can look like, what help you might need. Using a computer and having internet. Those can be complicated things to set up, but can really be, especially now, a window into telemedicine visits, a window into zoom meetings with family and friends. And so thinking about what you might need there, and who can help you with that. Do you have family or friends that can help you? There's great movements that are starting. Amherst Neighbors is starting in North Hampton Neighbors. And before COVID, they were able to get into the house. Now, I'm not sure where that stands, but we've been partnering with Cooley Dickinson V&A. And they've been amazing partners. And they're going into homes now using all the protective equipment. They have appropriate PPE. And they're doing it in a safe way to say, doing home safety evaluations, recommending modifications, physical therapy to make sure you have exercises to do, and occupational therapy to make sure, for example, your stove is accessible. And whatever you're doing, you're able to do. And are there any modifications that can be made? So thinking through all those things really helps. We know that people have these beautiful family homes that are on many acres. I hear this. And that can be really something to think about. And it might be a place where you need to think, who's going to manage all of this? And what are you getting from it? And does it still make sense, I think, to stay there? Or might it make sense to think of alternative places? Even in this age of COVID, I think we know that assisted livings, independent livings are doing tremendous things to stay as safe as possible. And I think there's still very good options as well. And so if you had advice based on what you see about older adults, planning and foresight, what would be your message to our community around planning as we look at aging? Great question. We all have our wishes. We want to stay in our homes, right? We want to maintain the level of independence that we have had all of our lives. But we also have to face the fact that unfortunately things happen and it might not continue. And just as we have life insurance and hope that we never have to use it, it's equally important to have plans in place for what happens if or when I can't drive. What's going to happen then? What are my resources around? What do I have family or friends that are around and that can help me if I need to get some urgent medical care, for example? Or if I have to go somewhere, who can help take care of my pets? I think it's really important to plan out these, I always say you hope for the best, you plan for the worst and then you're always prepared. And one of the things that I see, unfortunately, is that people haven't really planned it out. They have their wish, I'm going to stay in my home. But that's a wish and it's important to separate that out from a plan. I want to stay in my home and here's how I'm going to make it happen. Right? Here are the things that I'm going to do. This is how I'm going to get groceries if I can't drive. If I can't cook, this is how I'm going to get meals made. If I can't bathe on my own, this is how I'm going to get help. And I think it's important to think about, do you have the resources to be able to do that? What are alternative options are out there and really think about this? If I have a big yard, who's going to take care of this if I can't take care of it? These are things that I see that haven't been done. In many ways, not to blame anybody, it's just not how we're set up as a society to think about. And so I think those are important things to really think through. Sit down with your family if they're there. Sit down with your friends or community. Many people have a church or a place that they can talk with and really think these things through. I'm certainly open to your suggestions on it as well. You have a wealth of experience that way too. Well I think we both, well I know from our perspective at the Senior Center, we are often called in as a resource but often at the tail end. So something has already happened or there's an emergency need that needs to be resolved or quickly handled without that kind of foresight. So when do you think people should begin this conversation? Because I think that when we talk about planning the more concrete for anybody who might be listening to this, we can share with them when they should begin this discussion. And are there any tools that you would recommend or that you are aware of that might help someone to sort of triage and think ahead about all of these kinds of details other than seeing you where we know that those conversations will happen and then they can see us at the Amherst Senior Center and we have resources and we can talk to people about that. But are there any other resources or tools and then the timing of it? What would you suggest? I think you're so right. Often we see people in a time of crisis and unfortunately when you're in crisis you don't have those same choices and options and things are being done in often in ways that down the line you wish hadn't been done if you don't think things through. I would say you know while you're still in good health is the time to start maybe putting it in even on the age of retirement whatever that is. What is it going to look like now right? What is it going to look like if my partner or I become ill? How are we going to manage that? What are the options? And then really visiting that as time goes on. But I still I and you asked about tools I'm honestly not aware we're actually trying to build them now as we speak to say what happens if you can't drive? What are you know your resources? Can you still realistically live in your house if you can't drive? What what will that look like? What what family is around we know nowadays everybody moves so far and I told my kids they can't. And I don't think I'll have luck with that but the reality is that people live in many places families too now we know you know with divorce and remarriages things can become more complicated and so I think it's really important to start having these conversations early on before there's any changes in mobility or there's changes in your cognitive function if somebody starts forgetting things and then there's concerns that there there's memory issues I think it's important to have these conversations really starting and I could say say say it is at 65 it's just an age but it's important to start to plan that way along with that planning it's important to do advanced care planning as well too. And what do you mean by advanced care planning because that's a term a lot of people have different ideas around what what do you mean by that? Sure so again I always say it's um you wear your planning for the worst uh you know I'm hoping for the best but everybody over the age of 18 should have a healthcare proxy and I this is my biggest thing you know I'll I'll have parents I'll see a patient and there's their their kids will come in the kids don't have a healthcare proxy so we actually have healthcare proxies and we hand them out to everybody and they can even fill them in in the office and get them witness just so you start with something. People will say well it's at my lawyers and I say well that's I'm glad it's there but you need it in the hands of your healthcare proxy you need it in the hands of your PCP or anybody that's caring for you and if you're traveling or you know depends where you're going but it's good to have that as well too. Yeah so healthcare proxies again everybody over the age of 18 should have one you can go to Massachusetts has a website on it it's sometimes it can be difficult to come up with these honoring choices is a great website started by a lawyer and that's in Massachusetts and it's really great about running you through questions so that's the start and then talking about what can be hard but what we might say is end of life care and it's really thinking about but at every age and stage in your life you want to think about the care you want the care you don't want and really having these conversations with your families so that they're aware of your wishes having these conversations with your PCPs so they're aware of your wishes and completing a most form if it's getting to a point where you're developing a good amount of chronic conditions and but always having this conversation it can be scary for some people some people don't want to talk about it my mom will say not this again but I think it's really important so that I know what her wishes are so that I can honor her if it comes to that and I think it helps everybody be prepared so that there is no crisis that's such an important piece of it yeah and the most one just to to distinguish the health care proxy from the most form for people who are listening so the health care proxy designates a person to make medical decisions if you are you lack capacity to do that most form is a medical order form that you complete with a doctor is that correct so I just want to make sure people think oh i'm going to sign a most myself that would be a conversation that somebody would have with someone like yourself or another provider is that right that's right exactly thank you for making that clarification a health care proxy designate someone to make decisions that you would make for yourself if you couldn't make it and I always make that distinction it's not the health care proxies uh decisions or wishes it's your wishes and that's why it's so important to have that conversation with your health care proxy and say these are is what I want this is what I don't want so that they're aware of that we find that some people appoint health care proxies and have never had that conversation with them that's the health care proxy the most is in order for life sustaining treatment and it really talks about things like if my heart was to stop beating what I want to have artificial resuscitation chest compressions in what I want to have a breathing tube or be intubated and then it actually on that's on one side it's a pink form on the other side it talks about what I want dialysis or what I want to feeding to or IV fluids different different options and you're absolutely right it is a medical order that should be signed by your doctor or advanced practitioner can do that the other thing that I that's important to say is these are not set in stone once you sign them they're not engraved somewhere they can be changed as you go through life and if you sign it one way in one situation you can change it always to another you know another time you don't want to be changing it every month but you want to think it through and take a look at it at least once a year if something changes does that help answer that question yes yes yes yes and I think particularly around the most in the healthcare proxy because we do receive I receive a lot of calls and people are confused they think they only need a most and they're not asking about the healthcare proxy so in that conversation for the reason I went so emphatic over your suggestion that everyone should have it is we are really going to be rolling out some more programming around the healthcare proxy in the most next week we're going to do a caring conversation on Zoom specifically about healthcare proxies and most so this is this is really apropos of that and sets the stage for that and and I really appreciate that from your perspective too it's really important that your patients have that conversation and and sort of leap over the cultural barriers to talking about end of life which which I think are so significant from my perspective even as an attorney I often had to deal with those situations where if somebody didn't have a healthcare proxy the hospital would hire me to appoint a guardian and then a stranger is trying to extract information about you to discern what would be your choice around end of life care and a judge another complete stranger is the person who's ultimately making that decision whether to intubate you or not or to pull life sustaining care and so to the extent that that we can have control in one of our themes of the senior center is empowerment and control and I think having a good end of life is as important as the whole stream that that aging and dying is also living so so I really I really appreciate your on that I completely agree I think we we want and should have as much control in all aspects of our life as possible and being prepared with this is important so I just want you because we only have probably a few more minutes and I want to get to a few more questions that have come in so because our topic was healthy aging healthy living and so folks were asking at a variety of different ways but what healthy habits would you recommend other than than living the lives of your four grandparents I think you give some great role models about how to live but are there any other health habits that you would recommend so that we can age in a way that is as healthy for us physically mentally and emotionally as possible and many people ask those questions and what can I do to maintain my memory in mind and we know that there's three things that have actually been shown to help one is physical activity so physical activity helps your body and your mind and by that we mean 30 minutes three to five times a week it doesn't have to be all at once don't go from zero to 100 if you haven't been working out but really any any type of exercise one point I want to make especially in and I don't want to talk much about but in the age of COVID if people have really been inside it's really thinking all right what can I do inside to get some exercise and I tell people stationary bikes it doesn't need to be the peloton but really anything even just getting up from your chair five times an hour with not trying not to use your arms as I'm trying not to use the arms of your chairs as long as you feel safe but standing up five times sitting down carefully making sure it's safe to do so but that can really strengthen your your quads and your buttocks and help maintain just so much so physical exercise and it's not just cardio it's also strength-based training always talk to your PCP first but our cardiologist here recommends strength-based training in addition to cardiovascular exercise I think those those two things are very important and we really know that they help they also give you serotonin that's that the neurotransmitter that makes you feel better inside so it can help your mood as well too so that's physical exercise mental exercise really important one of the things that I always tell my patients is we really have limits on how much television children should watch right and they recommend really not more than two hours a day but I find that many people as they get older maybe that you know it's a lack of things to do or a lack of company but the TV is on for long periods of time and we really know their studies show that that can actually decrease longevity wow really turning off the television putting on music whatever you like classical music we know can enhance your mind some people love music to dance to if you grew up in the you know dancing in the 50s turn it on and I think it can also lift your mood and help you exercise so limiting television so as part of the mental exercise there's some great classes that can be done online now I'm blanking on the site I can think about it and send it to you that people you can take classes like history in Spain and it can be as obscure or as interesting as you want it to be but something new we know creates that neuroplasticity that sort of the brain's an amazing organ and it actually can really grow so if you learn a new language or new instrument that can really do amazing things for your mind I'll hear people say well I'm not gonna be good at it and that what I tell them is it's not at all about being good at it don't worry about that maybe people around you might suffer from hearing the music but it's an act of learning something new that makes all the difference so even trying to learn a new language for just a short period of time a couple days a week can do amazing things making sure you're reading staying involved asking questions the what we've seen so far is that people that take a real active role in there what's going on around them reading their community generally have better physical and mental health than those that don't so that's physical mental activity meditation actually has been shown to actually help the mind and body and it can also decrease anxiety and depression and I know that sometimes there's that barrier that sort of poo poo I don't do that kind of stuff you know or I it never works for me I can't stay focused well that's the whole point of it right is that you shouldn't feel bad about it it's all about just trying to be present and bringing your mind back and they've actually done studies that shows that it can improve your sleep and so we recommend that for for helping the sleep improve your mood and really improve your mind so those three things are probably the biggest things that we look at we do also know that sleep is hugely important we know that sleep changes as you get older for a variety of reasons you might have arthritis and it might be more painful at night you might have urinary frequency you have to get up to go to the bathroom multiple times a night the quality of your sleep might not be good you might have undiagnosed sleep apnea so we ask a lot of questions around sleep and don't be afraid to talk about it with your doctors or your PCPs you know I'm getting up at night a lot to go to the bathroom there's things that we can suggest that can help with that so those are some of the big areas that I think can really help your whole, your mind, your body and just how you're going through the world those are tremendous thank you so much and I know that there's there's a lot of information about loneliness and depression in the community have you seen any sort of positive gains as a result of this time period for seniors are there any things that you're seeing that people are cultivating or doing that that is really working or successful it's a great question because it is a hard time for many one thing that I think helps is really trying to structure your day we know this works for anybody you know if you were tired you might have floated along a drift but having a structured day makes all the difference in the world so from eight to nine okay I can watch TV and drink my coffee whatever time you get up all right I'm going to get dressed and showered that's really important making you you don't want to stay in your pajamas all day long get yourself dressed and ready for the day it just can really change the mindset schedule out some exercise and then schedule some time that you're going to connect with somebody via phone via zoom I think everybody's feeling this way and would benefit from a call one of the things that that people have done is sometimes it can be hard to know what to talk about but sometimes you can do an activity together some people will um play games and they just move their other partners or components they can you can be really creative you can do a craft together I even have people who are fishing together they can set it up and so try to think about activities that you can do with somebody even though it's you know socially distanced that can make the difference so I think having a schedule making sure you've scheduled some activity in there and then thinking about things that maybe you didn't have time for going through those old photos that you wanted to go through organizing areas well this is a perfect time to get that stuff done make sure make a list of okay I need photo albums if I'm going to do this this is I need a table to do it what time of day we'll all do it and schedule that out so really scheduling that out thinking about your meals still trying to schedule and making sure you're getting outside for some fresh air in some sense you know while it's 95 be careful you don't want to go out in the hot part of the day but thinking about the earlier the later day and thinking about how you can see your family via zoom or maybe it's socially distanced outside you know in ways that can be done in a safe manner mm-hmm so I think people that have really stuck to a schedule have been able to get through this and and even thrive and you know depends what type of person you are if you're an extrovert or an introvert too that that makes yeah I have to say I feel better even hearing that that day that you just laid out than I think of the days I'm stuck around in pajamas yeah there is a noticeable difference just sort of in mood and attitude so I think I probably have time for one more question and I and looking at what we receive for for questions I think it there were a number around telehealth meetings with their positions and so do you have any tips for individuals who are accessing telehealth medical visits for the first time from your perspective as a caretaker to someone who's probably I imagine you're doing some telehealth visits yourself yes do you have any words of advice sure so it is a different form many people I think are used to what a visit means what a medical visit is you go in your weight room you wait there for a little bit you go get your vitals checked then you go in the exam room and you wait and this is a different forum and so just thinking that all right it is different but I do recommend if people can you know safely get on a scale have your weight ready if you have a blood pressure cuff and you're talking to your doctor advanced practitioner about blood pressure have a blood pressure ready having some of those basic things can really help give them the needed information write down your concerns again because you might not be used to this it might get you a little flustered so if you know your visit's coming in two weeks start writing down what your questions are or if you know what you talked about you know write down what you last did at Cooley Dickinson you can get on to my chart and look at your notes and so it might help to look at your prior note with all your newly learned technology skills or those that have had them kudos you know you're doing better than I am and then not getting flustered if things go wrong we're used to that as you know as we're learning and doing this too and things just aren't going to work you might not have the sound but I do think trying to practice ahead of time if possible is important we try to be as flexible as possible the zoom we know is HIPAA secure so we try to work with that but and the phone is also HIPAA secure so we try to make sure that those things are done but just knowing it's a different time you can always schedule another visit or ask a question if you forgot and I still think we can do a lot as far as the exam goes so I try to do as much of an exam as I possibly can I can't listen to the harder lungs yet that might change but not to be afraid of it just know that in some ways it's been great for me I get to see what people's houses look like that might scare others but I can see how they're walking and what they have to navigate in the house right yeah they can even pull out you know have your medication bottles that they're or whatever you're using it's a great way to do a medication reconciliation we can really see what you're taking so I actually think there's just some advantages to it as well yeah yeah well thank you so much because that that is helpful I think there's so much as you alluded to new space that we're all trying to broker and and I think not getting flustered and going with the flow generally serves all of us so and just to just sort of wrap it up I just wanted people to know who we're listening a couple of pieces of information so one when we're talking about telehealth visits or connecting with individuals the senior center we received a grant recently so we are purchasing and creating a technology loan library so any seniors out there who don't have the ability to access Zoom we will have nine tablets coming in soon and then I am doing fundraising to create a larger library so so that senior digital divide we're looking at and you know particularly people in terms of the loan we have some criteria and those who need it for medical visits is definitely a high priority for us to be able to help people to facilitate this even as a public health issue so one we will have that available so call us at 259-3060 secondly a follow-up that we will be doing a presentation on healthcare proxies and most forms next week so you can stay tuned to both the ads on our website and on our Facebook page so myself and another attorney Anita Sorrow who was in risk management as an attorney for base day are going to be doing that presentation and we'll have some more forms to follow up on your great recommendations for planning and then we're going to also have another conversation I believe it's August 20th with a palliative care physician around some more conversation for that advanced care conversations and how do you broker that space so we will we're going to follow many of the things that you raised and then I wanted people to know that certainly one hour is not enough to extract all of your wisdom and so we're really grateful for you sharing time but that we worked with the Amherst neighbors to to divide your time and attention for two different topics and I wanted folks to be aware that you will be speaking with and doing a presentation to the Amherst neighbors and that would be one that is focused we decided to have them they're going to do topics around COVID so we did receive a number of questions about COVID and we're going to save those for that conversation so if you want to share with folks that information the date and the time I can tell anybody that Amherst neighbors is a 501c3 if you're not familiar with them they're here in the community and it's a community-based and inspired group they're trying to serve neighbors simply helping neighbors there's no fee to join at this point in time and they have a website so if you just google Amherst neighbors it will come up I believe it's AmherstNeighbors.org and you can register so you do have to become a member and then they are doing programming for free so you are one of their highlights and if you could just do a little teaser about what you'll be discussing and when that would be that would be delightful sure thank you the talk is going to be August 6th from 4 to 5 p.m. again I'll talk a little bit about what I do and what it looks like in the age of COVID many people have questions about what they should or should not be taking or what are fair risks to take or not to take how to manage how to help with social isolation and how to maintain your the best possible successful aging and health during this time so those are some of the topics that I'll cover again it will be a question and answer so we'll see what other questions come in if there's anything that you're thinking about feel free to to bring those questions forward as well too that's fantastic and could you just share with people and closing if somebody watching this says geez I really would love to have an appointment with Dr. Rebecca Starr with two Rs at the hospital or from the medical the geriatric medical director how would they locate you and find you sure so on the Cooley Dickinson website we actually have a geriatric page with some resources are the name is called Cooley Dickinson medical group geriatrics if you have any questions or want to schedule a consultation you can call us at 585-0755 if you're interested in the consult you can also ask your PCP for a referral and again we have the web page on the Cooley Dickinson site that will give more information to great well thank you so much thank you for your time and your talent and thank you to Cooley Dickinson for bringing in someone who is so expert in the field of aging and aging well and in a way that comports with our values and with the community and you really are inspiring about what medical care can look like for older adults so thank you so much it was a pleasure always every time I interact with you it's a joy so thank you Dr. Starr and have a beautiful day thank you and the same to you as well okay bye bye


Rhaid i gwrth fy enw i am spiritog, when she was nine months old. Before she had a transpart, she lived in Mexico to become a home artist, she was born, we're up and down in the children's office, she spent her whole life attached to monitors, and themes, and grips, which just keep her alive. For the weeks before she had a transpart, she was having a date with me and tell of me and every day they tell each other, don't be bored with dating, that we're going to lose her. I can have to get her chance on in May 2009. My first one failed and she had to remember five days later. I'm incredibly lucky to get the first one. Let only the second one. Since then, she's absolutely thrived and came home just for her first birthday. She's seven now, she's a ghost of full-time school. She's a development teacher, fantastic. She runs around, she loves life.


First keynote address speaker. He joined the ABP group in January 2018. Prior to this, Shiv was chairman and CEO for PepsiCo for four years and before that with Nokia as CEO for India and later emerging markets for nearly a decade. Shiv has been a CEO for half his career and was one of the youngest CEOs in India. Shiv has worked in HUL for a number of years, mostly in marketing. He has also worked with over 50 brands in his career and seen many business transformations. Ladies and gentlemen, please put your hands together for Mr. Shiv Sivakumar, Group Executive President Corporate Strategy and Business Development Aditya Birla Group. He will be sharing his views on role of leaders in building trust. A very warm welcome to you, sir. Thank you very much. And let me start, guys. I know you're running behind schedule, so I'll jump straight in. Thank you very much for inviting me to do this session on trust. I remember I did something similar in Goa I think two years ago, but that was a different topic and a different audience. Okay, will you move my slides, please? Can you put on my slides? Okay. So the first slide is up. Okay, so the topic I've chosen is the role of leaders in building trust. Okay, so let me start by defining trust to you and then I'll give you my definition of trust. Next slide, please. Okay, trust. Trust is simply the firm belief in the reliability, truth, capability of someone or something. That's how, you know, most people define trust. So, you know, I did something interesting. I just Google trust, put on the word trust Google and see what happened. Next slide, please. So I typed in trust into a search engine, which was Google, and then see how many results I got in under one second. Next slide, please. I got 1.18 billion results in one second as the search engine signals to you. So after that, I sat back and said, let me take some of the big names and what's happened in the last one year and type in those names and see how many do I get. Trump had 733 million results in one second. Biden had 697. Merkel had 85. Boris Johnson at 234. Messi had 115. Roger Federer had 337. COVID had 5.64 billion. And Prime Minister Modi, every time I do this, somebody says, why don't you have an Indian example? Prime Minister Modi, I think, had some 234 million. So clearly, trust is very, very high on people in our radar. That's the simple message that I want to give you. Next slide, please. For me, however, especially in today's world, trust means that you will not hurt me when I am vulnerable. That's what it is. I think a lot of people in business, in society, are feeling vulnerable. And basically, they're saying, don't hurt me when I am at my lowest. Because normally, when you're doing well, you're moving ahead, you've got great tailwind, and that's when most people, most leaders and everybody is arrogant when they do well. The real challenge is when you're down, when you're not doing well, that's when you don't want people to hurt you. Next slide, please. Thanks to what we've gone through over the last 11 months, people are feeling vulnerable right now. If you look at citizens, they've cut back on their EMI repayments by 200 basis points. They're saving more. They're worried about their jobs. 63% of corporations and people believe they're going through a disruption and 40% more believe that, yes, it will impact them. Individuals are worried about whether they'll keep their jobs, they'll keep their jobs at the right salary. Citizens are feeling vulnerable. At a very basic level, citizens are saying, if I go out, what's the guarantee that I will not be impacted by COVID? Citizens are feeling vulnerable. Society is feeling vulnerable. Because societies are feeling vulnerable, we put barriers and said you can't travel. Even if you travel to my country, you need a seven day quarantine or a 14 day quarantine or whatever it is. So every gated community is putting barriers. Every city is putting barriers. If you want to come back to Bombay today and if you're traveling either from Delhi, Goa, Rajasthan, Gujarat or Kerala, you need a rapid test result which says that you haven't tested positive for COVID. So the state of Maharashtra has put that. The state of Singapore has put that. The state of Indonesia has put that. So everybody's feeling vulnerable at this point of time in terms of what's happening. Next slide please. If you go through the trust report which comes out every year, what's funny this year is that business is more trusted than government, NGOs and media. The word trust has appeared. I was counting 13 times in the last 21 years in the headline of the communication of the trust report. 13 times out of 20, that's 65%. So business today is more trusted than government, NGOs and media. And we need to ask ourselves why is that and what can leaders do about it. Next slide. The credibility of CEOs is actually the lowest all-time low in India, Brazil, France, Argentina, Russia and Japan. So you have Brazil, Russia, India, part of the BRICS. CEO credibility is of all-time low in these six countries at this point of time for various sets of reasons. Next slide please. So now you have a very strange situation where people don't trust business and the CEO though it's better than the others. People don't trust media at all and I think media needs to wake up someday or the other. They are like ostriches, they're just buried their heads in the sand and I think most PR professionals also have done the same and that's the reason you are in this very wrong log jab. So you have a very strange situation where CEOs are not trusted, media is not trusted then you have to ask yourself how the hell do I build trust? If two of the things which are in my command which is my CEO, my leader, his voice and the media which propagates that if both are not trusted then what do I do? And I think this is a serious issue. So it goes back to the question why aren't CEOs trusted? Next slide please. CEOs are not trusted because I think there's a bit of a history to it because they think he or she is all about money, is all about himself or herself, it's about inequality which is hurting. Remember go back to what I said people are worried about their jobs, people are worried about their salaries, people are worried about their EMI.  He doesn't you know really empathize with what I'm going through. And I think many past CEO actions whatever they are have hurt you know the trust in CEOs and I think CEOs themselves need a good hard look at themselves to say what can we do different? What should we do? Next slide please. Why don't people trust media? They don't trust media because they believe that media is biased. Their interest is about the person and not the issue. Okay a Burger King on whose board I am just released an ad talking about why media makes everything sensational. Okay we have lost the ability to be balanced in media and hence people don't trust you. Okay if people don't trust media, people don't trust CEOs for whatever set of reasons then I think we are in deep trouble. Next slide please. So whom do people trust? People feel they can trust someone like themselves, they can trust their employer. In fact post the pandemic trust in employer is one of the highest across the world. In India I think trust in employer is as high as 80% plus. Okay they can trust their employer and they can trust the employer's website for information. It's funny the reason they feel that they can trust the employer's website for information is because they believe that's better curated, better thought through and will not have a bias. That's the reason they actually trust the employer's website and maybe that's a place where you need to start to say put out authentic information but more important put the source down to say this is the reason why we are seeing this. Imagine like for example in all our products in all our advertising etc if you make a claim in advertising you say claim tested with so many consumers this is the research research done by Quantum or XYZ or Nielsen that's what we put out. Now what stops media from putting that out? Imagine somebody writing an article which says at the foot line we have talked to 30 people, we have researched 200 articles before we've written this. If they did that I believe those type of people will have higher credibility as journalists. If you just write your opinion which is biased favoring X over Y I think you are in serious trouble and I think you will see that more and more in the coming years. Next slide.  So all of you as people who are you know communicating the company messages the CEO messages down to the public down to society need to ask yourselves what can we do to signal that this is truthful information to the public what proof points can we give the consumer or what proof points can we give society that this is the truth till you find this holy grail I don't think people will trust either the CEO or the media. Next slide. This is compounded by another simple fact in the 1960s a CEO was measured on a maximum of three to five parameters. Today a CEO is measured on about 50 to 60 parameters okay there's reporting on every single measure by a company and a CEO and many of these 50 to 60 parameters are in conflict with each other. So this is a serious challenge this is actually a no win situation so hence as you report each of these key variables you have to be very very clear about the veracity and the truthfulness of what you're communicating. You cannot say one thing one quarter and something else the other quarter and that's the issue. You know many times when companies go for growth somebody asks them what's your profitability no no no we are not worried about profitability we are fine and they're bleeding like mad okay this is the reason and the Indian media is you know smart enough they pick up these they talk to various people etc so when companies themselves are fibbing about simple things they cannot be trust from media even on CEOs. Next slide. So I would say if you want to build trust back I would start with leadership let the media sort itself out that is their job but having been a CEO and having practiced what I'm going to tell you of the next three slides this is what I believe CEOs need to think about very seriously and many of them don't do that. If you open the newspaper pages the business pages today every CEO says the same thing every CEO says we are a you know growth company we are an innovative company we are a people-centered company okay and finally every CEO says we'll double turn over in four years. You can do a cut face job everybody's saying the same that's one of the reasons why people don't trust CEOs because this has become standard you know a typewriter language. So next slide please the first thing I believe CEOs need to do if they have to build trust is I think they need to reach out and build positive relationships in the company and outside. It's a sad fact today that CEOs don't know more than their direct reports they have not met the frontline they have not met the customers etc I've been traveling from August 17 trust me when I go and meet my customers in the textiles business or the cement business etc they haven't met anybody else so if the CEO does not know more than his direct reports 10-12 people how the hell does he expect people in the company to trust him equally if the CEO doesn't go and pump fist with the customers with stakeholders how does he expect to build trust with anybody. The worst thing about leadership is leadership cannot be from a closet leadership is not a discipline which you can practice in a vacuum leadership is practiced with people trust is when people say I trust you it is not when you say I've told you something you better trust me it doesn't work like that so trust is innate it's a soft value and you can only generate that when you go out and meet people look at them eye to eye resolve their issues show empathy both in the organization and outside the organization till you do that CEOs will not be trusted next slide a very important issue of trust always is competence you have to be competent at what you do okay and you have to be very very competent at it apart from being competent you have to be ethical in all your details you know a lot of CEOs forget they say different things in different meetings and they think they're extremely smart they've got away with it the challenges remember the subordinates and people in the company and the media are dissecting every single word you say very carefully it matters to them and if you tell the truth I always tell my people you don't need to remember it if you tell a lie you need to remember whom you told the lie to why you told the lie and what was the data and I've always believed and there are some people on this call who have worked with me I always tell people the media has a role tell the truth as it is it doesn't matter okay they might hammer you for a day but in the long term they will always support you so believe bloody good at your job your CEO has to be bloody good at his job but more importantly has to be ethical in all his dealings if he's not then you're not going to get trust that's the second one first is building positive relationships inside the company and outside the company second is being competent and ethical and the last one which is actually a very difficult one next slide please to be consistent and meeting all commitments I cannot tell you one of the things the media tells me regularly society tells me regularly is that CEO's fix appointments and cancel it the last minute they cancel a day before they cancel on the day that's what they do now that place is you as the intermediary between the CEO and the media or society or investors in very bad shape this is terrible so if the CEO does not have the consistency in meeting his commitments if he cannot manage his diary how can he manage his company I can understand sometimes they might be a sense of urgency but if you've given a date to somebody two weeks out three weeks out then it's a job to be there in all my 17 years as CEO I might have missed one or two appointments that I've given might be because of a delayed flight or something like that otherwise never for example this call I logged into this call at 1135 I've been struggling to get on to this network okay it was just not working I got the IT guy luckily the previous session kept going and finally we were able to get in just about five minutes before the session the previous session ended so I would say going back to what I started with I think the CEO must reach out and build positive relationships more than his direct reports it's not enough for the CEO to hobnob with his direct reports number two the CEO has to be competent you cannot have incompetent CEOs in the corner office anymore and third the CEO must keep his commitment especially time commitments to the stakeholders and therein you are compromised when your CEO keeps canceling next slide please I've just written a book on the dilemmas of a career from being a management trainee to a managing director these are 10 career dilemmas this book releases on 15th it's in pre-order right now and as I tell people I can guarantee you that your CV value will improve if you read this book and you just practice diligently some of the inputs which are given here okay so please do order the book and please do spread the word amongst your friends you're the best source that I could think of as ambassadors of the dilemmas that somebody faces next slide please so in summary the word trust if you type in under one second you get 1.18 billion search results except covid I haven't found any other word which generates a billion results President Trump gets 733 President Biden gets 697 Prime Minister Modi gets 234 it's like that so trust obviously is on top of everybody's mind trust has become even more of an important word post what we've gone through over the last you know 11 months for me trust is simply you will not hurt me when I'm feeling down when I'm vulnerable today I submit to you individuals are feeling vulnerable society is feeling vulnerable large communities are feeling vulnerable and countries are feeling vulnerable today we are in a situation where business is not trusted media is not trusted business is not trusted because people feel that the CEOs have been playing their own game they see high degree of inequality and when they go through hard pangs in terms of will I keep my job for them to see that their CEO or whoever it is you know is at an unequal level hurts them okay so when people don't trust CEOs and people don't trust the media what do they trust them they trust individuals like themselves they want authenticity okay people feel they can trust other kind of people the biggest challenge for us as professionals of this industry what I call the engagement industry or the positive communication industry whatever you want to call it I think our biggest challenge is to give people truthful information we give them information but we need to layer that saying this is the proof why this information is correct this is the proof why this information is truthful if we don't do that it's unlikely it's unlikely that we will be trusted in the 1960s a CEO was measured on three to five parameters today the street of the city of London or the large street or wall street measures a CEO on 50 to 60 parameters and some of those parameters are in conflict with each other and that's a real challenge so CEOs need to practice which is your leader because you represent him number one they need to have positive relationships in their organization and outside they need to go and meet the ecosystem partners they need to meet more people in their company it is not enough for CEOs to just meet their direct reports that is the sad truth today of 99% of CEOs second the CEO needs to be competent he needs to be relevant he needs to skill himself he needs to learn and unlearn to be relevant for the future world and finally the CEO has to meet his commitments when it comes to external engagement many a time CEOs are not doing that and when they don't know that they place you in a bad situation and as I've said in the 17 18 years that I've been a CEO I might have missed two or three not because I didn't want to do it but because of other reasons so once you're committed you must go through with that so that's all I had to say ladies and gentlemen thank you very much IPR CCC for inviting me for this session it's always a pleasure to do this for you guys I did this you know a few years ago in Goa it is a fantastic feeling and there were a number of you who have worked for me and a number of you helped build my particular and my personal reputation and I would always want to thank you guys wherever you are I can't list out everybody but I truly owe you a debt of gratitude for all that you've done for me and all the hard work you put in for me thank you very much thank you so much for sharing your insights on the topic I think your ending note shows what a leader should do the gratitude for the journey that you've just mentioned shows what a leadership should look at and how they should move forward thank you so much for your time and for sharing your insights with us thank you so much sir


Many times I experience imposter syndrome. When I have to do a job that I know the degree of difficulty that it takes, I get very worried and I say, who told you you can't do this? Why did you even propose this job? And you say yes, you know.  Maybe it was a trope of luck. Maybe I better go sell hamburgers and fried potatoes or something. That's good. When I was a kid, I didn't even know how to swim. I was like a cat. I learned to gather the knowledge along the way. My desire was bigger than my everything else. The sea was my calling.


Four people were killed and five were wounded in Russian shelling of Ukraine's southern region of Kursan on November 23. The regional prosecutor's office and a presidential official said, the office said on the Telegram messaging app that Russian forces shelled the town of Berislav, killing a man who was riding a bicycle.ina-separate massive shelling of several settlements in Kursan district. Three people, two men and a woman, were killed, it said. It is preliminarily known that the shelling was carried out with cluster munitions. Andrey Yermak, the head of Ukraine's presidential office, said on telegram video footage published by Kursan's regional administration showed empty cluster munition shells and police officers carrying a body bag. Reuters could not immediately identify the date or location the video was filmed. Reuters could not independently confirm the report.


Everybody for a steer ripping four boxes of 2023 Star Wars chrome black for Paul B. Here we go, Paul. Let's do it Super fractured time Super fractured time Sup Hobbs. Oh, yeah, I got you man You realize this market was so Hi for a defensive rookie Some defensive rookies are getting there these days though like Micah his rookie year saw slash year Let's go Paul. Let's go Paul. All right. Got plo koon to 199 on the refractor fantastic fights is Kylo Renna Praetorian guard and as I am first auto here is Officer Mkay. I'm good. I'm good. He's the next Aaron Donald's. No bias. No bias All right base ala Sakura That is Juku and Kenobi fantastic fights And page Tico no Way No way no way, dude. We did it, Paul. We did it, Paul Let's see a gigantic name here Yeah, Werner Herzog the client one-of-one superfactor auto Yes, dude, that is so sick Werner Herzog One-of-one the client auto that is the second Werner Herzog superfactor auto. I have pulled really dude. That is awesome Paul Go Paul dude. That is what is up right there Werner Herzog on the one-of-one autograph superfactor The other one I posed for illegal really yeah, that's so sick. That's awesome, man Purple Gore Koresh to 125 green and 99 Imperial Royal Guard and a Moma Nadon or Nadon Moma Nadon and a green auto here is of Koska Reeves to 99 That is Mercedes Varnado Also of the WWE Koska Reeves auto to 99 is that Bianca Belair? Is that who that is? All right, last box Paul.  You killed it Got Watto Refractor to 199 Lando Calrissian and Beaumont Kin and refractor auto here is of Captain Carson Tiva Sasha Banks, that's who it is. That's who it is. Captain Carson Tiva, Paul Sonhung Lee All right, Paul There it is again Werner Herzog one-of-one auto as the client On a real hit. Thanks again, buddy. Appreciate you as always. We'll get him out to you


what's going on guys welcome back welcome back to the channel i'm still here still alive still in ala springs for another couple of hours at least today um i want to come back to youtube i want to publish a video that is uh it's four months in the making i feel like it's probably being at least i don't know four four or five months since i published a video on this channel and that wasn't planned by any means but you know life life life goes on you know i've i've been playing dad for the last nine months and it's been nine of the most rewarding and enjoyable months of my life and unfortunately you know youtube and youtube videos and creating content just hasn't really come into the picture i haven't really posted on instagram or facebook um i think for a while there it was because i wasn't really proud of who i was or what i was doing and and i i was still still half in half out as far as wanting to live in ala springs again and and and you know the the draw uh for me coming back uh as my kids right they live here they were born here they still live here we have had plans of of moving um to the east coast of australia but for now they're they're staying here uh tate has started she's five years old she started transition which is basically transitioning it's a year that they do at school transitioning from preschool into actual primary school and that happens from the ages of five to six so she's halfway through her first her first year of transition and my youngest daughter tristan just turned well it's wednesday the second she turned four on saturday the 29th of july and so she well she she had to wait until she was four so she could get enrolled in preschool and she has indeed started preschool this is her third day and so both kids are at school both kids go to the same school both kids look cute as hell in their little school uniforms but they still don't like to put them on in the mornings they still don't like to get up and all those good things that you get with five and four year olds but i tell you what uh their development and their development personally and also my the development of my relationship with them over the last nine months has been so so incredible for me it's been really rewarding yeah there are hard times of course there are there's hard times in any family dynamic um but i am more confident than ever in my relationship with them and that confidence only was ever it was only ever gonna come if i really knuckled down and forgot about everything else and just focused on them and focused on try to be the best dad that i can and i'm still working on it it's still a work in progress there is no manual for being a parent um and especially no manual when it's it's it's unexpected and uh well here we are you know five five and a half years on and i am i'm probably i'm probably in the most content phase of my life that i have been in the last five or six years ever since you know my youtube channel the last time i can feel the last time i can remember feeling as content as i am now was just was at the start of 2018 when my daughter was first born um and we had a really uh large house to live in everyone had their own bedroom everyone had their own space um i was working earning quite a lot of money and things just felt right things just felt like they were falling in place you know and then the explosion of my youtube channel happened and that that that just threw everything on its head i my priorities i couldn't i couldn't decide what like i it was um it was an amazing time but it was a very confusing time because i i had this youtube channel that i that i had put so much effort into for so many years and finally i felt like i was seeing the success that i deserved and then i had this newborn baby um and a full-time job that was taking a lot of the time away from the channel and i had to try and navigate through that and share my time and in the end the family dynamic just completely broke apart my fault maybe but you know i've always stuck to my guns and i've always stuck to like trusted my gut and trusted my instinct and at that time that dynamic the way that it was just wasn't working and here we are five years later and i'm you know i'm so thankful so grateful that i'm still in their lives uh yes i have had periods of time where i have been out of their lives but that was always with the view to come back at the right time in the right place and um you know these last five years i've tried to portray through youtube and it's been it's been interesting it's been it's been fun but like i said over the last nine months i've really just put that to the wayside and um and worked on myself uh and worked on in many ways and and and worked on my relationship first and foremost with my kids and i'm sitting here right now two hours away from my flight back to christ church for a month um just feeling like i can i can go i can go on a holiday because because i i know that my kids love me and my kids know that i love them and that my friends is the most important thing in the fucking world so i'm here just to check in i'm here to tell you guys what to expect on the channel over the next uh couple of months at least uh the top 100 series is coming back for a sixth installment currently i have created the videos from number 100 down to number 67 so we're a third of the way through i've enjoyed it so far i've done that over two days i've done that over the previous two days yesterday and the day before um there's a couple of other videos that are going to be coming out in the channel prior to those the first of which is talking about my childhood talking about a collection that i've made of my all all of my most favorite and most treasured childhood toys i was able to find the majority of them on on ebay great condition decided to treat myself a bit of retail therapy and really connect with my childhood again so that is that's a that's a pretty epic video it's just going through everything that i bought and the reason for it and going back down memory lane and you know having a bit of fun with you guys so that's that's one video the second video is covering the new motorbike that i bought um don't go getting your hopes up it's a 125 but i just made a fun video just talking about it uh going out and taking it for a bit of a spin and yeah basically once i arrive in christ church i've got an all blacks match to go to this weekend which i cannot wait for a fucking oh it's going to be sick it's going to be the second ever all blacks match that i've ever been to i'm going to catch up with my mate tin we're going to go from christ church where i live down to deniden which is where the game is being played i've never been to that stadium before it's the only stadium in new zealand with the with the roof so it doesn't matter rain hail or shine the the game will go on and uh that's going to be a sick a sick time so that'll take me through to the end of next week or the end of this week sorry and then i'll be back up in christ church with you know three and a half weeks to focus on making content i mean that's that's that's that's what i want to do it's easy to say that you know i can't really predict exactly how that's going to go i hate pigeonholing myself into things i want to arrive there i want to have a really awesome weekend and i want to come back to christ church with with uh some some plans some goals you know because i'm away for a certain period of time i know what's going to be waiting for me when i get back here which is full-time work and you know playing dad again so i'm going to make the most of my holiday i'm going to really enjoy it one of the things that i'm looking forward to the most is is waking up on a cold christ church morning and stoking the fire uh that's that's just being in my mind the last few weeks and i can't wait to do it that's a really lovely way to wake up in the morning go and get some fire cut it up the axe put it in there get it going and sort of just keep that lovely ambience the entire day uh as far as content is concerned i i want to make some more content around rugby the rugby world cup is coming up i think i think it starts in september so i want to be covering a few games um through that but fundamentally the main goal is to fundamentally does it even make sense my main goal as far as content is concerned is to shoot edit and publish the top 100 videos so for anyone you know looking forward to those um stay tuned they will be coming they will be they will be published as members only videos for the first couple of weeks and then i will publish them as public videos we've got the NFL season coming up i'm going to do my very best to cover certain pre-season games it seems you know it seems i'm always really really keen to get back into creating content when the pre-season games start and then i go hard with the pre-season games and by the start of the regular season i've kind of burnt myself out so that's what i want to not do this year um i'd love nothing more than to feel really really motivated to make content as the regular season starts i'm going to follow the Jacksonville Jags once again um trevor lorence kelvin ridley etienne and the rest of the gang should be good unfortunately my fandom with the bucks is kind of i don't know it's just not what it was because tom brady's left and lennon fornette's left so it's like i don't think i'm going to rock with them anymore but a team that i am going to rock with this year is another Florida team and that's the miami dolphins so if i had two teams to follow this year it's going to be the Jacksonville Jags and the miami dolphins and i can't wait to watch some football but i also can't wait to watch some rugby the rugby world cup and i can't wait to watch the live game this weekend i keep forgetting that i'm going so that's going to be good this video was really always going to be off the cuff um each and every video that i make normally is there's two things that i want to mention that was four i mean two two things two things i want to mention before signing off uh and they are two uh two separate youtube channels that i've created over the last six months and i'm super proud to present them to you and uh some of you guys will have already subscribed but those for those who haven't for those who don't know what i'm talking about i've got one channel titled rugby player reacts and basically what i've done is you know there was a period of time there where i had a bit of copyright infringement on this main channel and there was a point there where i thought fuck i don't actually know whether my channel is going to be is going to be around for too much longer because i i kept getting these copyright not not only claims but strikes and i got two strikes and it got real dicey there for a moment and i thought fuck before my channel disappears i'm going to have to download every single rugby player reacts video and keep it in in you know on a hard drive and originally i was just going to keep it for myself but then i started uploading them to this new channel rugby player reacts and i've uploaded almost 500 videos on that channel now keeping them in chronological order and if nothing else it's been really fun for me actually to go back in time and and upload the videos in order and sort of i haven't watched any of the videos back but just seeing the titles and seeing the way that i work my way through um through the the videos over the years has been fun so if anyone wants to go and support that channel that channel is not going anywhere there will be over 1200 videos on that channel eventually i'm uploading them at two per day at the moment so for anyone who wants to go back in time and sort of relive a few of the the og moments please head over to rugby player reacts and subscribe the second channel that i want to talk about and it's been a bit of a a passion project for me it's called it's okay to talk and it's okay to talk is a platform for me to talk to talk about my problems to talk about my issues good bad and the ugly and that's exactly what i've done so for anyone who wants to um follow along for anyone who can relate to any of those videos about addiction for the most part then please head over to it's okay to talk it's my goal to get that to a thousand subscribers and monetize that channel because that is going to be my platform where i really can talk i can talk just openly and honestly and not so much to the masses you know it's a lot easier to talk like that to 200 people um than it is to talk like that to 157 thousand people and i know that 157 thousand people will not be watching this video but the ones that matter will and it's just been a it's been a real it's been an important outlet for me over the last nine months so by all means go and subscribe to those two channels i'll continue to be posting content on there as well as this channel uh major goal when i get back to New Zealand in that first week is to enjoy myself connect with everyone but also finish shooting the top 100 series i want to get that out on the channel for my members as soon as possible and it's going to be it's going to be fun you know it's going to be fun so thanks for listening guys as always and uh jeez it's it's not going to be easy leaving it really isn't even if i know that i am coming back it's never easy kids are at school at the moment they're coming back they're getting pulled out of school early to take me to the airport and say goodbye and uh i don't know whether they can really grasp the emotions around that i guess we'll see we'll see how it goes at the airport but um yeah i'm going to be sitting on that plane i already know i'm going to be sitting on that plane thinking fuck is this the right thing was this the right thing is this the right timing but you know to leave your kids for any period of time is never going to be the right time it's never going to be the right timing but it's necessary man i need some time away i've put in a fucking solid nine months and and i'm proud of myself for that and i've gotten to know myself a bit better and i've certainly got to know my kids and they're so important to me man so important to me i i love them dearly and i've had some of the best moments you know i've i'll i'll leave you with this the if you ask me when am i most happiest when am i the happiest like what is the most what is the the thing that i can see or hear or or feel that makes me the most happy and puts a massive smile on my face every single time and it is whenever my kids smile or laugh if i can make my kids laugh or if i can if i can hear them laughing it is it's the best nothing beats it nothing beats it and you know when they do want to cuddle up or whatever i'm very very conscious of the fact that they're never they're not going to be the small forever and so whenever they do want me to pick them up or put them on their shoulders a part of me says no like i might be busy at the time or i might not i might not feel like it but then i think fuck man they're not going to be like this forever take every opportunity you can to connect with them and and lift them up and make them smile so life's good there have been moments i've had my moments where life hasn't felt that good but as always guys thanks for watching you can expect those other videos to to drop um i feel like i've been doing a lot with my hands i don't know am i nervous not anymore i know every single person that clicks on this video is an actual a real supporter of mine and so what have i got to be scared of nothing so thanks for watching guys and i will see you in new zealand