March 31, 2025 • 27 mins
Sarah Gorenstein takes us on a journey through the evolving landscape of dementia care, sharing insights from her transition from the United Kingdom to becoming a pivotal figure in reimagining how we support families facing cognitive decline in America.
The conversation reveals how our understanding of dementia has transformed over generations. What was once dismissively labeled as "going senile" is now recognized as a complex condition requiring specialized, thoughtful approaches. Sarah explains how Lizzy Care was born from her own experience working with a family struggling to navigate care options during the pandemic, despite having significant resources at their disposal.
What sets Lizzy Care apart is their recognition that dementia affects the entire family ecosystem. Their innovative model creates personalized care plans factoring in family dynamics, financial realities, and the patient's evolving needs. Sarah emphasizes the value of early intervention through companion care – providing meaningful social interaction for those with early symptoms while offering essential respite for family caregivers before they reach burnout.
Technology emerges as a game-changer in their approach. Through a custom-built platform, family members scattered across different locations can stay connected to their loved one's daily care. Caregivers document observations that might signal changes requiring attention, while Lizzy Care's clinical team analyzes patterns to prevent potential crises before they occur. This proactive stance represents a fundamental shift from the traditional reactive approach to dementia care.
The discussion touches on practical considerations too – from navigating difficult family decisions when siblings have varying levels of involvement, to understanding payment options including long-term care insurance and upcoming Medicare coverage starting July. Sarah's insights offer a roadmap for families feeling overwhelmed by the complex terrain of cognitive decline.
Ready to explore how Lizzy Care might support your family's dementia journey? Reach out to Sarah directly at sarah@hilizzy.com, call 234-567-9449, or visit www.hilizzy.com to learn more about their services throughout the tri-state area.
Lizzy Care
Sarah Gorenstein
234-567-9449
info@hilizzy,com
Mark as Played
Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:00):
This is the Good Neighbor Podcast, the place
where local businesses andneighbors come together.
Here's your host, Doug Drohan.
Speaker 2 (00:11):
Hey everyone, welcome to another episode of the Good
Neighbor Podcast.
I am your host, doug Drohanfrom the Bergen Neighbors Media
Group.
Today we have a great guest.
We're going to talk aboutdementia care with Sarah
Gorenstein from Lizzy Care.
Welcome to the show.
Speaker 3 (00:25):
Hi everybody, Thanks for having me, Doug.
Speaker 2 (00:28):
Absolutely.
It's funny.
A guest I had earlier today isan estate attorney and elder law
attorney.
So we talked a lot aboutpreparing and planning for your
loved one's next phase in theirlife and how a lot of people
don't plan and then they findout that their mother or father
or their spouse has dementia andthey haven't fully, you know,
(00:52):
planned for it financially inprotecting their assets or
saving enough or how they'regoing to pay for it.
So you know, it's a nice kindof segue from that discussion to
talking with you.
So, sarah, tell us a little bitabout yourself first before we
even get into Lizzie Care, likewhere are you from and you know
(01:12):
what's your background.
Speaker 3 (01:14):
Yeah.
So some of your listeners maybe able to determine that I'm
not actually a Native American.
I grew up yeah, yeah, no Queens.
Speaker 2 (01:24):
Actually, people have said Queens Okay, all right,
yeah, yeah, the original Queens.
Speaker 3 (01:28):
The original Queens.
So I grew up over the pond inthe United Kingdom.
I grew up in Nottingham, I wentto university in Leeds and then
I was in London for about 20years and then I met my husband
and he lived over in the Statesand that's what brought me over.
(01:50):
So people often ask which isbetter London or New York, and
all I'll say is I was a singlewoman while I lived in London
and moved to New York, and I'm amarried woman with two teenage
sons now, so my lifestyle isvery different yeah, yeah, you
know, I've been to London manytimes, once as a student, and I
(02:12):
used to go back for work a lot,and I think if you like New York
, you like London.
Speaker 2 (02:17):
it's a similar.
Obviously they're differentcities, but there's a certain
vibe about the two of them thatI think you can compare.
Obviously, london is muchbigger and the nice thing about
the New York City subway systemis you pay one price to go all
the way from Coney Island to theBronx.
Or in London you have to paymore the further out you go.
But the tube system is a lotnicer and that's it, but
(02:39):
organized.
But that's me saying that.
Maybe someone who lives inLondon doesn't think that.
But it is funny.
Like, what do you like more inLondon or New York?
I mean it's, there's a lot ofdifferent things, but in some
ways it's a cosmopolitan city onboth sides.
Speaker 3 (02:53):
So it is, I feel, very fortunate to have had
living experience in both, and Ithink London is great, new York
is great.
They are very similar butthey're also very different,
very different characters.
Speaker 2 (03:12):
Yeah, yeah.
Speaker 3 (03:13):
But yeah, I love it over here.
You know, maybe one day I'll goback.
You never say never.
Speaker 2 (03:20):
Right right.
Yeah, my niece married someonefrom Birmingham and, going way
back, my uncle was stationed inthe Air Force Right right.
Yeah, my niece married someonefrom.
Speaker 3 (03:25):
Birmingham, uh-huh.
Speaker 2 (03:26):
And going way back.
My uncle was stationed in theAir Force in the 1950s in
England and married my auntDaphne, so oh, yeah, well, I
think the yeah.
Speaker 3 (03:36):
My grandmother, if she knew that I lived in America
, she would unfortunately shepassed away many years ago she
would be very excited because,uh, the American GI certainly
had a, a glamorous um maybe notso much anymore, but yeah so,
(03:56):
all right, so let's fast forward.
Speaker 2 (03:57):
So you moved to the States.
You're in the city.
How did you get involved withdementia care?
Speaker 3 (04:05):
Well, interesting, very circuitous route.
Actually, I don't have ahealthcare background.
I was working with a family whohad a family member who was
suffering from dementia andduring the pandemic prior to the
pandemic and during thepandemic they needed a lot of
assistance with her and reallymy role became finding care for
(04:31):
her and putting together aholistic care system for her to
age in place at home, and it wasa real journey.
It really became verymeaningful for me and
understanding that even peoplewho may have sizable assets and
(04:52):
access to a lot of resources,education found it incredibly
difficult to know how tonavigate this care landscape,
and you spoke a little bitearlier about estate planning
and having the money.
That is something that is veryimportant and I would urge
(05:12):
everybody at earlier stages oftheir life to start having those
conversations, particularlywith their parents, about what
their wishes would be shouldsomething happen in this
scenario.
You know, if something happens,what would you prefer?
Would you want to be aging inplace?
(05:34):
Would you be happy to move intoa community?
Let's talk about it in the coldlight of day, while we're not
in crisis, so that's, that'skind of.
I'm sure you had similar advicewith the estate attorneys.
Speaker 2 (05:47):
Yeah, and that's that's a tough thing, though is
a lot of people avoid it becauseit's a tough subject to to
really think about or discuss,and then there's an expense
involved, and I just find thatpeople keep putting it off and
putting it off and then all of asudden it's too late.
Speaker 3 (06:04):
But specifically with dementia.
Speaker 2 (06:07):
Now, that's something that you know.
It seems to me like autism,dementia.
These are things that didn'treally exist in our lexicon a
generation ago.
I mean, maybe we had differentwords for somebody with dementia
.
What's that?
Speaker 3 (06:23):
Yeah, I was going to say.
I remember growing up with agrandfather who I knew, even at
an early age.
There was something that was alittle bit unusual about the way
he behaved and I would ask myfamily you know what's wrong
with grandpa?
And I was always told, oh, he'sgoing senile.
Speaker 2 (06:49):
And I think that was the lexicon we used back in the
day, that kind of ageism.
Speaker 3 (06:51):
Yeah, he's going senile right Going senile.
I think the last, particularlythe last 20 years, maybe even
more accelerated over the lastfive to 10 years, there has been
much more awareness of, I think, any kind of cognitive
impairment, be that mentalillness, be that a
neurodegenerative disease.
I think the fact that peopleare talking about it and it is
(07:15):
being discussed is only good forall of us.
Speaker 2 (07:18):
Right, right, yeah.
And I know people whose parentsor grandparents are suffering
from dementia and it's kind ofsad for the whole family.
And I had someone on my show acouple of weeks back who's a
certified dementia carespecialist show a couple of
weeks back who's a certifieddementia care specialist.
(07:38):
But what I, you know, I noticedabout Lizzie Care is it's, you
know, your tagline isre-imagined dementia care for
the whole family, because I'dimagine, you know, once your
parent doesn't remember yourname and is kind of just, you
know, from one conversation tothe next doesn't remember what
they were talking about, it'sgot to be a really, you know,
debilitating for the entirefamily.
So tell me more about thisapproach where it's care for the
(08:01):
whole family.
Speaker 3 (08:02):
Yeah, I think it's really interesting.
You touch on a very importantpoint there.
I think what we know as expertsin this field is every family's
journey is going to be a littlebit different.
The presentation of the diseaseis going to be a little bit
different as well.
So forgetfulness, memory lossis certainly part of it.
(08:22):
But we have many families thatwe're working with where there's
full familial recognition,maybe two or three years into
the disease.
So it doesn't happen gradually,it does happen quite gradually.
A lot of these hallmarks of thedisease.
When somebody mentions the worddementia or one of its forms
(08:43):
Alzheimer's I think most peoplego to this memory loss thing and
, of course, for the familymembers, when they don't
remember who the family memberis, that's incredibly painful on
an emotional level.
So one of the things we leaninto with Lizzie Care is
understanding the individualfamily dynamics, and that can be
(09:07):
anything from financial torelationships, to situations, to
the support system, familysupport systems that are
available.
We really try to get close, orwe do get close and we
understand, we work alongsideall of what we call the
stakeholders.
Those stakeholders could befamily members, they could be
(09:29):
medical professionals, physicaltherapists, pcps, and also
understanding what a family's,what really what a patient's
desires were.
Maybe they did have thatconversation at an earlier time
(09:50):
and the family knows that theyare actually quite happy to move
into a senior living facilityand, trust me, there are many,
many gorgeous senior livingfacilities.
There's a.
I think there's also a mythabout what they look like, um,
and it's quite different intoday's.
Speaker 2 (10:08):
Yeah, yeah, many of them, and they look like you
know beautiful college campuses.
Some of them, that's rightthat's right.
Speaker 3 (10:16):
I mean, really what we're looking for is providing
the best level of care for thecare recipient and their family.
We include the family as partof that piece that needs
supporting and we reallysurround them with all of the
services they need, based onreally where they are in their
(10:36):
journey and what kind ofresources they have available to
spend on it.
Speaker 2 (10:41):
So that would be anywhere from home care right to
giving them guidance of whereto move and to say it's a memory
care facility, or I shouldn'tsay facility, community, or
maybe it's an assisted livingcommunity that has memory care.
Speaker 3 (10:58):
Yeah, and we're also very conscious of how people
want to spend their money orshould be spending their money.
And early on in the diseasethere are challenges that the
family faces, really, as thedisease is kind of kicking in,
where you aren't at that placewhere a family member forgets
(11:19):
who their loved ones are, but atthe earlier stages where you
understand there's something notquite right and you're noticing
maybe some forgetfulness orsome anger or some depression,
all of those signs.
(11:40):
We really believe and areproving out that people don't
need what we think oftraditionally as hands-on
dementia care at that point, butwhat they can really benefit
from is some socialisation andsome friendship and we lean very
heavily into providing bespokecompanions.
(12:03):
So people who will come in andif the family is the primary
caregivers they often are,especially in the early stages
maybe a husband and wife who'velived together for 50, 55, 60
years and the the wife isnoticing there is something not
quite the same with her husband,may talk to the family about it
(12:27):
.
The children will probably getinvolved.
Um, and there's a lot offrustration and a lot of
impatience with the patient whomay be displaying what other
people might see as signs ofdementia, but for that spouse
it's incredibly difficult tounderstand that that's happening
(12:49):
to this.
Speaker 2 (12:51):
The denial could be both the family and the actual
person who's starting to decline.
Speaker 3 (12:58):
Very much, very much.
And so we recognize that atthat point it can be extremely
beneficial for the spouse andthe care recipient to not be in
the same place all the time andto give permission really
permission to that spouse to saygo out, go do what you need to
(13:20):
do, have a little bit ofself-care for yourself and we'll
bring somebody in who canengage with your loved one and
really form a relationship.
Speaker 2 (13:29):
Is that the same person who's going to be doing
the in-home nursing, or is thata separate person?
Speaker 3 (13:34):
Occasionally it will be the same person, but quite
often, you know, we start withwhat we call companion care and
then we may transition over timeinto more hands-on care.
Sometimes that person will beable to perform those duties and
sometimes it will be somebodyelse.
It really depends on the case,and it may be that somebody
decides they they have it makessense for their family situation
(13:58):
, for them to be living inanother, in another community,
not living at home.
There is no right and no wrongand it definitely is not one
size fits all.
But, understanding and givingthat support to the family in
the earliest stages of thedisease can really help
everybody come to terms with thesituation and be making
(14:22):
decisions that are notcrisis-driven.
Speaker 2 (14:27):
So basically, the reason they they reach out is
when, at the first moment, theythink that their loved one is
starting to decline mentally andmay fear that they have
dementia.
Now shouldn't they go to thedoctor first to get a diagnosis?
Speaker 3 (14:42):
They should definitely, definitely speak
with their doctor and then theirdoctors may well recommend that
they get in touch with us,because the typical scenario at
the moment so we deal witheverybody at every stage of
dementia Typically somebody willreceive a diagnosis from their
PCP or their neurologist andthen they are said come back in
(15:05):
six months and if we need to putyou on medications, we will, or
we'll see how you are in sixmonths.
Meanwhile, the family goes backhome and things can decline
during those six months andthey're noticing things and
they're not really sure what todo.
Who can help?
How do we move through this?
How do we even tell my husbandthat we think he has dementia?
(15:31):
Because it's still got thatstigma, especially for the
generation that are beginning toreceive the diagnosis.
So, yeah, there's a lot ofparts to it, but we really try
to be there as a support systemfor the families.
So they have a resource, theyhave someone in their corner
(15:51):
that they can talk to and theycan plan and strategize with,
and then, as we create what wecall a care plan, we do that
together with the families andwe have everybody's.
Everybody is a stakeholder inthat.
Speaker 2 (16:07):
And is that, together with their doctors or you,
provide?
Speaker 3 (16:11):
We consult with their doctors, so we have a medical
team as well, and we do all ofthis through a platform, through
an app that's on people'sphones.
Through an app that's onpeople's phones, our caregivers,
our companions, our caregivers,whoever is part of what we call
that care circle will writenotes on the platform.
(16:33):
If there's a family memberwho's living on the other side
of the country or, as in my case, in another country, they can
see what's happening really inreal time and on a daily basis.
Oh, my dad went for a walk withthe caregiver today, but she
noticed that there was someunsteadiness with his walking.
The lizzie care team thenreviews those notes on on a
(16:57):
regular basis, talks to the pcps, we discuss what the best plan
is and we're trying to stay onestep ahead of a crisis by
working together with thefamilies.
And then, as we recognize thatmore care is needed, we do this
through.
You know we have.
We analyze the data, we look atit with our clinical teams.
(17:19):
Then we can step in and provideadditional services with the
agreement of the family.
Speaker 2 (17:28):
Right, okay, and then if they decide to go through a
senior living or memory care, dothey then employ the use of an
assisted living kind of locator,or is that where you would?
Somebody from Lizzie Care wouldtake them around to the
different communities for youknow to decide what the best
option is it's really up to them.
Speaker 3 (17:50):
It is a service we offer as part of our um you do
offer that we do yes, yes okayand we have done that quite
successfully with a with acouple of people recently, but
we're trying to maximizeeverybody has a finite budget at
the end of the day that thatfinite budget may be bigger and
(18:10):
for some people than it is forothers, but we are trying to
manage that money with them andmake sure that they're making
the right decisions for theirsituation so when did uh lizzie
care, like, where did it start?
Speaker 2 (18:23):
Where did the company start, in terms of what part of
the country, and why is itcalled Lizzie Care?
Speaker 3 (18:30):
Yeah, good question.
So we started in New York, justoutside of the city, and we
started two and a half years ago.
My background is really as ageriatric care manager.
As I mentioned, I startedworking with a family and, as a
result of the work I did withthem, I was recommended to
(18:51):
numerous neighbours and startedworking with them as well, and
then I was actually introducedto one of my co-founders, ollie,
through a New York Cityplayground convoluted connection
.
He and I got on a phone calltogether.
He had built a technologyplatform and one of the things
(19:13):
that I had understood when I wasbuilding out these systems in
the early days was how importantcommunication is between family
members, between care teammembers, providing that
consistency so that the the carethat the care recipient was
receiving was always consistentand based on what had happened
(19:34):
the day before.
For example, if she had eatensomething and had an upset tummy
, we would know not to give thatto her again or there would be
a reason why she had an upsettummy quite often carers,
caregivers are not given enoughsupport with the work that
they're doing and we're tryingto avoid always trying to avoid
(19:55):
hospital appointments andhospital admissions.
ollie had my, my co-founder,ollie fielding, had built a
technology platform based onat-home caregivers, trying to
connect them, because not onlydoes the care recipient
sometimes suffer from socialisolation, but their caregivers
can as well.
(20:16):
So, we came together and werealized there was some magic
that could happen together.
Realized there was some magicthat could happen together, and
a few months later we werefortunate enough to bring in our
CEO, who is Dr Mark Rothman,who has been a geriatrician for
the last 20, 30 years and iscompletely passionate about
(20:40):
dementia care and is able toprovide some clinical oversight.
That really differentiates usfrom other people.
Speaker 2 (20:49):
Wow, and then you know who's Lizzie.
Speaker 3 (20:53):
Lizzie.
So Lizzie was the first.
Lizzie is named in honor of DrElizabeth Blackwell.
Dr Elizabeth Blackwell forthose of you who may not have
studied the history at schoolwas the first female MD in the
United States and purelycoincidentally, she also was
(21:16):
born in England.
But I'm not, I'm not pretendingto be Lizzie.
Yes, yes.
She was the first female MD inthe USA.
Wow yeah, so we, we, we therehas been a tradition of women
being the primary caregiver inthis field, so we wanted to
honor that with our name yeah,that's great.
Speaker 2 (21:38):
And so how do people pay, like, how does it work?
Speaker 3 (21:54):
with with Lizzie Care .
Does insurance cover it?
Is it a monthly plan?
How does it work?
Paid?
We do have a monthlysubscription and that will
really depend on the level ofservice, and I'm happy to
discuss that with anybody thatwants to call us.
I'll give you those detailslater.
We are covered as well bylong-term care, so the Lizzie
(22:17):
Care component is often coveredby long-term care insurances,
depending on how the insurancepolicy is written.
And, most excitingly, come Julywe are going to be covered.
Some of our services will becovered by Medicare, so that is
going to be a big game changerfor people who are not able to
(22:44):
use our services as of today.
Speaker 2 (22:46):
Right, that's great.
Yeah, so I have, you know, acouple of other questions, and
you know these are things that Ithink people would you know,
and I guess you guys can answersome of these things right, but
you don't have to answer themnow, but you know it's.
I think the biggest thing thatfaces families is how do I know,
you know, if my mom's justforgetting things or if she's in
(23:09):
cognitive decline?
And then if you've determinedthat, like, how do I know if we
should bring her to a memorycare community or if she could
stay at home with home care,right?
And and I guess, as a family,like, how do you deal with it If
you have multiple siblings andyou have different relationships
and one's maybe caring more fortheir parent because they live
(23:29):
nearby, where the other oneshave moved away?
I'd imagine there's a lot ofthat that goes on, like who's
the main stakeholder whenthere's many kids and some of
them don't live here, and theseare all the types of questions
and, I guess, experiences thatyou can help with.
Is that true?
Speaker 3 (23:47):
That's, that's exactly why Lizzie Care was born
, because of all those variances.
So instead we are we, we care,we start with somebody wherever
they are on their journey and westay with them.
So we don't just come in and doa job and then move out.
(24:07):
We stay where we business modelis a subscription service, so we
help set up a care plan andthen, as I said, through the app
, we monitor that care plan and,as we're noticing changes, we
talk to the family members andwe help to make decisions.
It's also quite beneficial forfamilies, because having a third
(24:32):
party who is not emotionallyattached or involved with it is
really a very useful it.
It can help keep peopleaccountable.
We we employ people that we ascoaches, so they are social
workers and RNs and they do.
That's exactly the type of workthey do for us.
(24:54):
They speak with the families andhelp to make decisions together
.
Speaker 2 (25:01):
I mean, I think it's again I'm, I'm fortunate, my
parents are 90 years old andthey're okay, but my, my son's
godmother is, I mean godfather,his mother is.
He said yeah, she's, she's gone.
You know you go talk to her andshe has no memory recollection
of anything and it's and they'respending, uh I don't know, like
(25:23):
120 000 a year.
Yeah, um, you know they soldtheir house and all that is
going to her.
You know memory care.
So, um, you know it'sdefinitely a daunting, um, you
know experience to go through,but unfortunately it seems to be
more and more prevalent.
But, but fortunately there'speople like you and Lizzie Care
(25:44):
to help guide us.
So you're based or started inNew York City, but we're in
Bergen County in New Jersey.
If someone is in Bergen Countycan they call you for help?
Speaker 3 (25:54):
Absolutely.
Yes, we are fully all over thetri-state and we have a number
of clients that we're servicingat the moment in Bergen.
We have patients we've workedwith in Teaneck, in Tenafly, in
Florham Park, and we also coverMorris and other parts of and
(26:23):
Paramus.
Yes, we've got patients allover Bergen.
Speaker 2 (26:27):
I should have asked how do they get a hold of you?
What's the best way to reachyou?
Speaker 3 (26:30):
Okay, so they can call us on 234-567-9449.
That's 234-567-9449.
234-567-9449.
They can visit our website,which is www.
(26:52):
highlizzy.
com.
That's H-I-L-I-Z-Z-Ycom.
Speaker 2 (27:07):
Or you can email me directly if you would like to.
My email address is Sarah.
That's S-A-R-A-H athighlizziecom.
We're going to have that at thebottom of the podcast too, so
there'll be a summary with allof your contact details.
So, sarah, thank you very muchfor joining us.
This was great.
I think we could continue onwith maybe some specific
subjects and we could talk aboutthat.
Maybe we can have you back on.
Speaker 3 (27:24):
Thank you.
Thank you so much for having me.
I appreciate it.
Speaker 2 (27:27):
Absolutely All right, bear with me for a few seconds.
Chuck's just going to saygoodbye.
Speaker 1 (27:33):
Thank you for listening to the good neighbor
podcast.
To nominate your favorite localbusinesses to be featured on
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com.
That's GNP Bergen.
com, or call 201-298-8325.
This is the Good Neighbor Podcast, the place
where local businesses andneighbors come together.
Here's your host, Doug Drohan.
Speaker 2 (00:11):
Hey everyone, welcome to another episode of the Good
Neighbor Podcast.
I am your host, doug Drohanfrom the Bergen Neighbors Media
Group.
Today we have a great guest.
We're going to talk aboutdementia care with Sarah
Gorenstein from Lizzy Care.
Welcome to the show.
Speaker 3 (00:25):
Hi everybody, Thanks for having me, Doug.
Speaker 2 (00:28):
Absolutely.
It's funny.
A guest I had earlier today isan estate attorney and elder law
attorney.
So we talked a lot aboutpreparing and planning for your
loved one's next phase in theirlife and how a lot of people
don't plan and then they findout that their mother or father
or their spouse has dementia andthey haven't fully, you know,
(00:52):
planned for it financially inprotecting their assets or
saving enough or how they'regoing to pay for it.
So you know, it's a nice kindof segue from that discussion to
talking with you.
So, sarah, tell us a little bitabout yourself first before we
even get into Lizzie Care, likewhere are you from and you know
(01:12):
what's your background.
Speaker 3 (01:14):
Yeah.
So some of your listeners maybe able to determine that I'm
not actually a Native American.
I grew up yeah, yeah, no Queens.
Speaker 2 (01:24):
Actually, people have said Queens Okay, all right,
yeah, yeah, the original Queens.
Speaker 3 (01:28):
The original Queens.
So I grew up over the pond inthe United Kingdom.
I grew up in Nottingham, I wentto university in Leeds and then
I was in London for about 20years and then I met my husband
and he lived over in the Statesand that's what brought me over.
(01:50):
So people often ask which isbetter London or New York, and
all I'll say is I was a singlewoman while I lived in London
and moved to New York, and I'm amarried woman with two teenage
sons now, so my lifestyle isvery different yeah, yeah, you
know, I've been to London manytimes, once as a student, and I
(02:12):
used to go back for work a lot,and I think if you like New York
, you like London.
Speaker 2 (02:17):
it's a similar.
Obviously they're differentcities, but there's a certain
vibe about the two of them thatI think you can compare.
Obviously, london is muchbigger and the nice thing about
the New York City subway systemis you pay one price to go all
the way from Coney Island to theBronx.
Or in London you have to paymore the further out you go.
But the tube system is a lotnicer and that's it, but
(02:39):
organized.
But that's me saying that.
Maybe someone who lives inLondon doesn't think that.
But it is funny.
Like, what do you like more inLondon or New York?
I mean it's, there's a lot ofdifferent things, but in some
ways it's a cosmopolitan city onboth sides.
Speaker 3 (02:53):
So it is, I feel, very fortunate to have had
living experience in both, and Ithink London is great, new York
is great.
They are very similar butthey're also very different,
very different characters.
Speaker 2 (03:12):
Yeah, yeah.
Speaker 3 (03:13):
But yeah, I love it over here.
You know, maybe one day I'll goback.
You never say never.
Speaker 2 (03:20):
Right right.
Yeah, my niece married someonefrom Birmingham and, going way
back, my uncle was stationed inthe Air Force Right right.
Yeah, my niece married someonefrom.
Speaker 3 (03:25):
Birmingham, uh-huh.
Speaker 2 (03:26):
And going way back.
My uncle was stationed in theAir Force in the 1950s in
England and married my auntDaphne, so oh, yeah, well, I
think the yeah.
Speaker 3 (03:36):
My grandmother, if she knew that I lived in America
, she would unfortunately shepassed away many years ago she
would be very excited because,uh, the American GI certainly
had a, a glamorous um maybe notso much anymore, but yeah so,
(03:56):
all right, so let's fast forward.
Speaker 2 (03:57):
So you moved to the States.
You're in the city.
How did you get involved withdementia care?
Speaker 3 (04:05):
Well, interesting, very circuitous route.
Actually, I don't have ahealthcare background.
I was working with a family whohad a family member who was
suffering from dementia andduring the pandemic prior to the
pandemic and during thepandemic they needed a lot of
assistance with her and reallymy role became finding care for
(04:31):
her and putting together aholistic care system for her to
age in place at home, and it wasa real journey.
It really became verymeaningful for me and
understanding that even peoplewho may have sizable assets and
(04:52):
access to a lot of resources,education found it incredibly
difficult to know how tonavigate this care landscape,
and you spoke a little bitearlier about estate planning
and having the money.
That is something that is veryimportant and I would urge
(05:12):
everybody at earlier stages oftheir life to start having those
conversations, particularlywith their parents, about what
their wishes would be shouldsomething happen in this
scenario.
You know, if something happens,what would you prefer?
Would you want to be aging inplace?
(05:34):
Would you be happy to move intoa community?
Let's talk about it in the coldlight of day, while we're not
in crisis, so that's, that'skind of.
I'm sure you had similar advicewith the estate attorneys.
Speaker 2 (05:47):
Yeah, and that's that's a tough thing, though is
a lot of people avoid it becauseit's a tough subject to to
really think about or discuss,and then there's an expense
involved, and I just find thatpeople keep putting it off and
putting it off and then all of asudden it's too late.
Speaker 3 (06:04):
But specifically with dementia.
Speaker 2 (06:07):
Now, that's something that you know.
It seems to me like autism,dementia.
These are things that didn'treally exist in our lexicon a
generation ago.
I mean, maybe we had differentwords for somebody with dementia
.
What's that?
Speaker 3 (06:23):
Yeah, I was going to say.
I remember growing up with agrandfather who I knew, even at
an early age.
There was something that was alittle bit unusual about the way
he behaved and I would ask myfamily you know what's wrong
with grandpa?
And I was always told, oh, he'sgoing senile.
Speaker 2 (06:49):
And I think that was the lexicon we used back in the
day, that kind of ageism.
Speaker 3 (06:51):
Yeah, he's going senile right Going senile.
I think the last, particularlythe last 20 years, maybe even
more accelerated over the lastfive to 10 years, there has been
much more awareness of, I think, any kind of cognitive
impairment, be that mentalillness, be that a
neurodegenerative disease.
I think the fact that peopleare talking about it and it is
(07:15):
being discussed is only good forall of us.
Speaker 2 (07:18):
Right, right, yeah.
And I know people whose parentsor grandparents are suffering
from dementia and it's kind ofsad for the whole family.
And I had someone on my show acouple of weeks back who's a
certified dementia carespecialist show a couple of
weeks back who's a certifieddementia care specialist.
(07:38):
But what I, you know, I noticedabout Lizzie Care is it's, you
know, your tagline isre-imagined dementia care for
the whole family, because I'dimagine, you know, once your
parent doesn't remember yourname and is kind of just, you
know, from one conversation tothe next doesn't remember what
they were talking about, it'sgot to be a really, you know,
debilitating for the entirefamily.
So tell me more about thisapproach where it's care for the
(08:01):
whole family.
Speaker 3 (08:02):
Yeah, I think it's really interesting.
You touch on a very importantpoint there.
I think what we know as expertsin this field is every family's
journey is going to be a littlebit different.
The presentation of the diseaseis going to be a little bit
different as well.
So forgetfulness, memory lossis certainly part of it.
(08:22):
But we have many families thatwe're working with where there's
full familial recognition,maybe two or three years into
the disease.
So it doesn't happen gradually,it does happen quite gradually.
A lot of these hallmarks of thedisease.
When somebody mentions the worddementia or one of its forms
(08:43):
Alzheimer's I think most peoplego to this memory loss thing and
, of course, for the familymembers, when they don't
remember who the family memberis, that's incredibly painful on
an emotional level.
So one of the things we leaninto with Lizzie Care is
understanding the individualfamily dynamics, and that can be
(09:07):
anything from financial torelationships, to situations, to
the support system, familysupport systems that are
available.
We really try to get close, orwe do get close and we
understand, we work alongsideall of what we call the
stakeholders.
Those stakeholders could befamily members, they could be
(09:29):
medical professionals, physicaltherapists, pcps, and also
understanding what a family's,what really what a patient's
desires were.
Maybe they did have thatconversation at an earlier time
(09:50):
and the family knows that theyare actually quite happy to move
into a senior living facilityand, trust me, there are many,
many gorgeous senior livingfacilities.
There's a.
I think there's also a mythabout what they look like, um,
and it's quite different intoday's.
Speaker 2 (10:08):
Yeah, yeah, many of them, and they look like you
know beautiful college campuses.
Some of them, that's rightthat's right.
Speaker 3 (10:16):
I mean, really what we're looking for is providing
the best level of care for thecare recipient and their family.
We include the family as partof that piece that needs
supporting and we reallysurround them with all of the
services they need, based onreally where they are in their
(10:36):
journey and what kind ofresources they have available to
spend on it.
Speaker 2 (10:41):
So that would be anywhere from home care right to
giving them guidance of whereto move and to say it's a memory
care facility, or I shouldn'tsay facility, community, or
maybe it's an assisted livingcommunity that has memory care.
Speaker 3 (10:58):
Yeah, and we're also very conscious of how people
want to spend their money orshould be spending their money.
And early on in the diseasethere are challenges that the
family faces, really, as thedisease is kind of kicking in,
where you aren't at that placewhere a family member forgets
(11:19):
who their loved ones are, but atthe earlier stages where you
understand there's something notquite right and you're noticing
maybe some forgetfulness orsome anger or some depression,
all of those signs.
(11:40):
We really believe and areproving out that people don't
need what we think oftraditionally as hands-on
dementia care at that point, butwhat they can really benefit
from is some socialisation andsome friendship and we lean very
heavily into providing bespokecompanions.
(12:03):
So people who will come in andif the family is the primary
caregivers they often are,especially in the early stages
maybe a husband and wife who'velived together for 50, 55, 60
years and the the wife isnoticing there is something not
quite the same with her husband,may talk to the family about it
(12:27):
.
The children will probably getinvolved.
Um, and there's a lot offrustration and a lot of
impatience with the patient whomay be displaying what other
people might see as signs ofdementia, but for that spouse
it's incredibly difficult tounderstand that that's happening
(12:49):
to this.
Speaker 2 (12:51):
The denial could be both the family and the actual
person who's starting to decline.
Speaker 3 (12:58):
Very much, very much.
And so we recognize that atthat point it can be extremely
beneficial for the spouse andthe care recipient to not be in
the same place all the time andto give permission really
permission to that spouse to saygo out, go do what you need to
(13:20):
do, have a little bit ofself-care for yourself and we'll
bring somebody in who canengage with your loved one and
really form a relationship.
Speaker 2 (13:29):
Is that the same person who's going to be doing
the in-home nursing, or is thata separate person?
Speaker 3 (13:34):
Occasionally it will be the same person, but quite
often, you know, we start withwhat we call companion care and
then we may transition over timeinto more hands-on care.
Sometimes that person will beable to perform those duties and
sometimes it will be somebodyelse.
It really depends on the case,and it may be that somebody
decides they they have it makessense for their family situation
(13:58):
, for them to be living inanother, in another community,
not living at home.
There is no right and no wrongand it definitely is not one
size fits all.
But, understanding and givingthat support to the family in
the earliest stages of thedisease can really help
everybody come to terms with thesituation and be making
(14:22):
decisions that are notcrisis-driven.
Speaker 2 (14:27):
So basically, the reason they they reach out is
when, at the first moment, theythink that their loved one is
starting to decline mentally andmay fear that they have
dementia.
Now shouldn't they go to thedoctor first to get a diagnosis?
Speaker 3 (14:42):
They should definitely, definitely speak
with their doctor and then theirdoctors may well recommend that
they get in touch with us,because the typical scenario at
the moment so we deal witheverybody at every stage of
dementia Typically somebody willreceive a diagnosis from their
PCP or their neurologist andthen they are said come back in
(15:05):
six months and if we need to putyou on medications, we will, or
we'll see how you are in sixmonths.
Meanwhile, the family goes backhome and things can decline
during those six months andthey're noticing things and
they're not really sure what todo.
Who can help?
How do we move through this?
How do we even tell my husbandthat we think he has dementia?
(15:31):
Because it's still got thatstigma, especially for the
generation that are beginning toreceive the diagnosis.
So, yeah, there's a lot ofparts to it, but we really try
to be there as a support systemfor the families.
So they have a resource, theyhave someone in their corner
(15:51):
that they can talk to and theycan plan and strategize with,
and then, as we create what wecall a care plan, we do that
together with the families andwe have everybody's.
Everybody is a stakeholder inthat.
Speaker 2 (16:07):
And is that, together with their doctors or you,
provide?
Speaker 3 (16:11):
We consult with their doctors, so we have a medical
team as well, and we do all ofthis through a platform, through
an app that's on people'sphones.
Through an app that's onpeople's phones, our caregivers,
our companions, our caregivers,whoever is part of what we call
that care circle will writenotes on the platform.
(16:33):
If there's a family memberwho's living on the other side
of the country or, as in my case, in another country, they can
see what's happening really inreal time and on a daily basis.
Oh, my dad went for a walk withthe caregiver today, but she
noticed that there was someunsteadiness with his walking.
The lizzie care team thenreviews those notes on on a
(16:57):
regular basis, talks to the pcps, we discuss what the best plan
is and we're trying to stay onestep ahead of a crisis by
working together with thefamilies.
And then, as we recognize thatmore care is needed, we do this
through.
You know we have.
We analyze the data, we look atit with our clinical teams.
(17:19):
Then we can step in and provideadditional services with the
agreement of the family.
Speaker 2 (17:28):
Right, okay, and then if they decide to go through a
senior living or memory care, dothey then employ the use of an
assisted living kind of locator,or is that where you would?
Somebody from Lizzie Care wouldtake them around to the
different communities for youknow to decide what the best
option is it's really up to them.
Speaker 3 (17:50):
It is a service we offer as part of our um you do
offer that we do yes, yes okayand we have done that quite
successfully with a with acouple of people recently, but
we're trying to maximizeeverybody has a finite budget at
the end of the day that thatfinite budget may be bigger and
(18:10):
for some people than it is forothers, but we are trying to
manage that money with them andmake sure that they're making
the right decisions for theirsituation so when did uh lizzie
care, like, where did it start?
Speaker 2 (18:23):
Where did the company start, in terms of what part of
the country, and why is itcalled Lizzie Care?
Speaker 3 (18:30):
Yeah, good question.
So we started in New York, justoutside of the city, and we
started two and a half years ago.
My background is really as ageriatric care manager.
As I mentioned, I startedworking with a family and, as a
result of the work I did withthem, I was recommended to
(18:51):
numerous neighbours and startedworking with them as well, and
then I was actually introducedto one of my co-founders, ollie,
through a New York Cityplayground convoluted connection
.
He and I got on a phone calltogether.
He had built a technologyplatform and one of the things
(19:13):
that I had understood when I wasbuilding out these systems in
the early days was how importantcommunication is between family
members, between care teammembers, providing that
consistency so that the the carethat the care recipient was
receiving was always consistentand based on what had happened
(19:34):
the day before.
For example, if she had eatensomething and had an upset tummy
, we would know not to give thatto her again or there would be
a reason why she had an upsettummy quite often carers,
caregivers are not given enoughsupport with the work that
they're doing and we're tryingto avoid always trying to avoid
(19:55):
hospital appointments andhospital admissions.
ollie had my, my co-founder,ollie fielding, had built a
technology platform based onat-home caregivers, trying to
connect them, because not onlydoes the care recipient
sometimes suffer from socialisolation, but their caregivers
can as well.
(20:16):
So, we came together and werealized there was some magic
that could happen together.
Realized there was some magicthat could happen together, and
a few months later we werefortunate enough to bring in our
CEO, who is Dr Mark Rothman,who has been a geriatrician for
the last 20, 30 years and iscompletely passionate about
(20:40):
dementia care and is able toprovide some clinical oversight.
That really differentiates usfrom other people.
Speaker 2 (20:49):
Wow, and then you know who's Lizzie.
Speaker 3 (20:53):
Lizzie.
So Lizzie was the first.
Lizzie is named in honor of DrElizabeth Blackwell.
Dr Elizabeth Blackwell forthose of you who may not have
studied the history at schoolwas the first female MD in the
United States and purelycoincidentally, she also was
(21:16):
born in England.
But I'm not, I'm not pretendingto be Lizzie.
Yes, yes.
She was the first female MD inthe USA.
Wow yeah, so we, we, we therehas been a tradition of women
being the primary caregiver inthis field, so we wanted to
honor that with our name yeah,that's great.
Speaker 2 (21:38):
And so how do people pay, like, how does it work?
Speaker 3 (21:54):
with with Lizzie Care .
Does insurance cover it?
Is it a monthly plan?
How does it work?
Paid?
We do have a monthlysubscription and that will
really depend on the level ofservice, and I'm happy to
discuss that with anybody thatwants to call us.
I'll give you those detailslater.
We are covered as well bylong-term care, so the Lizzie
(22:17):
Care component is often coveredby long-term care insurances,
depending on how the insurancepolicy is written.
And, most excitingly, come Julywe are going to be covered.
Some of our services will becovered by Medicare, so that is
going to be a big game changerfor people who are not able to
(22:44):
use our services as of today.
Speaker 2 (22:46):
Right, that's great.
Yeah, so I have, you know, acouple of other questions, and
you know these are things that Ithink people would you know,
and I guess you guys can answersome of these things right, but
you don't have to answer themnow, but you know it's.
I think the biggest thing thatfaces families is how do I know,
you know, if my mom's justforgetting things or if she's in
(23:09):
cognitive decline?
And then if you've determinedthat, like, how do I know if we
should bring her to a memorycare community or if she could
stay at home with home care,right?
And and I guess, as a family,like, how do you deal with it If
you have multiple siblings andyou have different relationships
and one's maybe caring more fortheir parent because they live
(23:29):
nearby, where the other oneshave moved away?
I'd imagine there's a lot ofthat that goes on, like who's
the main stakeholder whenthere's many kids and some of
them don't live here, and theseare all the types of questions
and, I guess, experiences thatyou can help with.
Is that true?
Speaker 3 (23:47):
That's, that's exactly why Lizzie Care was born
, because of all those variances.
So instead we are we, we care,we start with somebody wherever
they are on their journey and westay with them.
So we don't just come in and doa job and then move out.
(24:07):
We stay where we business modelis a subscription service, so we
help set up a care plan andthen, as I said, through the app
, we monitor that care plan and,as we're noticing changes, we
talk to the family members andwe help to make decisions.
It's also quite beneficial forfamilies, because having a third
(24:32):
party who is not emotionallyattached or involved with it is
really a very useful it.
It can help keep peopleaccountable.
We we employ people that we ascoaches, so they are social
workers and RNs and they do.
That's exactly the type of workthey do for us.
(24:54):
They speak with the families andhelp to make decisions together
.
Speaker 2 (25:01):
I mean, I think it's again I'm, I'm fortunate, my
parents are 90 years old andthey're okay, but my, my son's
godmother is, I mean godfather,his mother is.
He said yeah, she's, she's gone.
You know you go talk to her andshe has no memory recollection
of anything and it's and they'respending, uh I don't know, like
(25:23):
120 000 a year.
Yeah, um, you know they soldtheir house and all that is
going to her.
You know memory care.
So, um, you know it'sdefinitely a daunting, um, you
know experience to go through,but unfortunately it seems to be
more and more prevalent.
But, but fortunately there'speople like you and Lizzie Care
(25:44):
to help guide us.
So you're based or started inNew York City, but we're in
Bergen County in New Jersey.
If someone is in Bergen Countycan they call you for help?
Speaker 3 (25:54):
Absolutely.
Yes, we are fully all over thetri-state and we have a number
of clients that we're servicingat the moment in Bergen.
We have patients we've workedwith in Teaneck, in Tenafly, in
Florham Park, and we also coverMorris and other parts of and
(26:23):
Paramus.
Yes, we've got patients allover Bergen.
Speaker 2 (26:27):
I should have asked how do they get a hold of you?
What's the best way to reachyou?
Speaker 3 (26:30):
Okay, so they can call us on 234-567-9449.
That's 234-567-9449.
234-567-9449.
They can visit our website,which is www.
(26:52):
highlizzy.
com.
That's H-I-L-I-Z-Z-Ycom.
Speaker 2 (27:07):
Or you can email me directly if you would like to.
My email address is Sarah.
That's S-A-R-A-H athighlizziecom.
We're going to have that at thebottom of the podcast too, so
there'll be a summary with allof your contact details.
So, sarah, thank you very muchfor joining us.
This was great.
I think we could continue onwith maybe some specific
subjects and we could talk aboutthat.
Maybe we can have you back on.
Speaker 3 (27:24):
Thank you.
Thank you so much for having me.
I appreciate it.
Speaker 2 (27:27):
Absolutely All right, bear with me for a few seconds.
Chuck's just going to saygoodbye.
Speaker 1 (27:33):
Thank you for listening to the good neighbor
podcast.
To nominate your favorite localbusinesses to be featured on
the show, go to GNP Bergen.
com.
That's GNP Bergen.
com, or call 201-298-8325.
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