Life Happens 03-29

Episode Transcript

Speaker 1 (00:01):
Good morning everyone, Welcome to Life Happens Radio. I'm your
host Lupiro for this morning from Pierre O'Connor and Straussen.
We have a great show for you today and it's
going to focus on something that is important to all
of us at some point in our lives.

Speaker 2 (00:15):
Some of you may be going through this now.

Speaker 1 (00:17):
And I think it was Matilda Cuomo, Mario's wife who
wrote to several books and was quoted as saying, you
either are a caregiver, you will be a caregiver, or
you've been a caregiver, and being a caregiver, a lot
of people don't even realize that they are. You're taking
care of needs of another human being. In many cases,

(00:37):
you start that journey as a parent and you're the
caregiver for your children, but then the roles reverse and
now as your parents' age, your children grow, you are
aging through your thirties, forties, fifties, sixties, and now you
become the caregiver for your parents, and that role reversal

(00:59):
is shock to some. And last week we had a
caller and I haven't done this before, but we had
a caller whose call was so pertinent and so on point.
For today's show that I'm going to repeat it, and James,
if you're out there, thank you for the call last week,
and I'm going to play it right now. And good morning, James,

(01:20):
Welcome to Life Happens.

Speaker 3 (01:23):
Hey, good morning. I would recommend you guys are a
law firm that specializes in some of this preparation for
getting older and maybe guiding some of these I just
listened to the caller you were talking to, guiding them
through some of the challenges they're about to face with

(01:44):
their mother that's now had a broken hip. There's an
entire opportunity out there in this world for a company
to embrace the challenges of this part of life. Literally,
we just went this over five years in my family
with my mom and she recently passed, you know, lover

(02:05):
to pieces and we dealt with it right straight through COVID.
She broke her hip, just like this lady that you
just were talking about. She went into a rehab facility
that was during COVID. She was in rehab for sixteen months.
I couldn't see her. I couldn't none of our siblings

(02:26):
could go see her or visit her. We ended up
pulling her out, bringing her home. She's got a seventeen
room Victorian house, and not one part of that house
was prepared to have her living there as a person
with severe disability. So we had to go through the
construction phases of remodeling the home, and then we had

(02:47):
to get caregivers. I don't care how much money you have.
You can have all the money in the world, but
to get real, good quality caregivers that can help you
twenty four to seven, it's almost impossible. So the challenges
involved in this are absolutely off the charts. There are
programs out there that the state and federal will help

(03:09):
you with, but the hoops that you got to go
through in the waiting periods you got to go through,
you're at the mercy of the system. I'm telling you,
it is the most unreal thing you'll ever go through.
You could be a young couple gonna have a baby, okay,
and you've been sent you You've had no children for
the first three years of your marriage, and now you've

(03:30):
got a serious, a serious, a serious change of time
in your lives as having your first child when your
parents get old and they are no longer able to
be on their own. It's just like having kids coming
into the family even worse though, because the challenges that
are involved in that, all of the healthcare visits and

(03:51):
everything that they can be having. And then they go
through phases. Because they've been very independent all their lives,
they go through phases of depression and all kinds as
issues of their own that are overwhelming. They I'm not
saying they're looking to commit suicide, but they can be
very difficult to deal with. They don't want to eat,
they don't want to eat certain foods, they don't want

(04:12):
to go to the bathroom when they need to. I
could go on and on and on of five years
of living with this, and I'm telling you, somebody needs
to start a company that can understand every aspect of this.
I'm talking about lining up contractors to be able to
do work. I'm talking about every phase of taking care

(04:34):
of elderly at home because ultimately that's where it needs
to be is in your house. That's where they're the
most happy, is when they're in their own space.

Speaker 1 (04:43):
And that is our lead in for today's show. And James,
thank you for that call. It was not a show
about a company to solve those problems, but we just
happened to have had the guests that I have in
studio today lined up already when James called, so I
had to play that just to lead into today's conversation

(05:03):
about care, health care, long term care. How do you
navigate a healthcare system that is so badly fractured and
broken that no one, doctors, hospitals can't make sense of it,
let alone the patience being pushed through this system and
breaking a hip and going to the emergency room should

(05:24):
not be a death sentence, but in today's healthcare system
it can be unless you have the right help. So
I am very thrilled today to have live with me
in studio the representatives of ever Home Care Advisors and
Diane mikkelg Gottabiowski, who is the vice president of client Services,
and Diane has been on the show before. We have

(05:44):
with us also Nina Cressanda and Sherry Catapano, who are
people at ever Home that work day to day with
families in helping to solve these problems. And I'm going
to go left to right. So Nina, I want to
start with you because the healthcare system is something that
I see and I have been witnessing for my whole
career and that's forty years of practicing law and elder

(06:05):
law and special needs and it is just disintegrating before
our eyes. You worked in the healthcare system. How has
that background, what was that background? How has that helped
you today working with our families.

Speaker 4 (06:17):
Yeah?

Speaker 5 (06:17):
Absolutely so. I've been an occupational therapist.

Speaker 6 (06:19):
I've been treating since twenty seventeen. I first started working
at the Center for Disability Services with individuals and adults
with disabilities. From there, I transitioned to traveling therapy so
I could become more independent. I managed two skilled nursing
facilities in different areas in South Carolina. I moved to
Syracuse after that, and I worked at Upstate in their

(06:41):
acute care. I did criminal functional assessments as well as
spinal assessments home assessments to get them back to their
highest level of independence. From there, I worked at an
assisted living and independent living facility. I was the sole
OT for three hundred residents. I would go to their homes,
complete home evaluation and make sure that their goals were

(07:02):
the goals that we were working on together. I've also
worked through some hospital systems, admitting clients to different rehab
facilities and determining if they are effective, or if the
facility is the appropriate match for the client. So my
core focus as an OT has always been and continues

(07:23):
to be meeting clients where they are, prioritizing their needs,
their goals to preserve their independence and enhance their overall
quality of life.

Speaker 2 (07:32):
You're no longer inside the healthcare system.

Speaker 1 (07:34):
You're not working for hospital systems or doctors or healthcare systems.

Speaker 4 (07:37):
Not at all.

Speaker 1 (07:38):
Now you're outside the healthcare system, And just describe that transition,
what you do today and how that background helps you.

Speaker 6 (07:47):
So a lot of times when I was an OT,
I would run into barriers, like I couldn't get doctors
on the phone, I couldn't do lots of things because
I just didn't have the time. My sole focus now
is working on those goals, is getting everything, spending my
time making sure that I'm solving my client's problems. And

(08:08):
I can do that now outside of the system by
being able to have access to tons of resources, networking
and other opportunities that we can bring to our clients
to enhance their lives.

Speaker 1 (08:21):
And I think knowing what's going on inside the system
absolutely helps the people and the patients and their families
that are coming into the system cold that don't have
that knowledge. So I know that we were sharing stories
and you have a recent success story. Just tell our
listeners about that and how you can make a difference.

Speaker 5 (08:41):
Sure, this doesn't often happen.

Speaker 6 (08:43):
I would like to preface that, but I was hired
on Monday this week.

Speaker 2 (08:49):
That's recent.

Speaker 5 (08:50):
That's pretty recent.

Speaker 6 (08:52):
The client needs twenty four to seven care and in
order to get home, he was going to be discharged wednesday.
So we need to define that super super fast. And
I called every agency in their county. Wasn't getting a
lot of luck. Then I got some luck, and on
Tuesday I got the call and we set up twenty

(09:12):
four to seven care for that gentleman to start Wednesday night.

Speaker 2 (09:15):
And that is, as you said, unusual.

Speaker 5 (09:18):
It doesn't normally happen to be able.

Speaker 1 (09:20):
To find that unicorns. Home Health Aids have become unicorns
trying to find the right care, the right home healthcare
and put a program together. And I'll talk about my
experiences because I've been doing it as a caregiver with
my mom, with my uncle, with my dad. And we're
gonna go over to Sherry Cherry Catapano, who comes at
it from a little different angle, but with a background

(09:41):
similar in healthcare and now, Hi.

Speaker 4 (09:44):
Good morning.

Speaker 7 (09:45):
I'm Cherry Catapano. As Lou said, I'm a licensed Master
social worker and a certified case manager, and I worked
over thirty years in the healthcare system at a not
for profit local healthcare organisation and have seen for years
how our system tried to be innovative, to try to

(10:07):
help a lot of the fragmentation and to try to
help a lot of our members. However, since retiring from
that system and being on the outside, I have seen
how the system has gotten even more fragmented, more confused
to navigate through and the follow through for patients at

(10:29):
a time when they really need the care and their
caregivers are really beside themselves because there's no manual that
comes with any of this. There's nothing that a caregiver
can say, oh, let me do ABC that will work.
It'll solve my mom's problems. That's not how it works
for the caregiver and the family. You have to figure

(10:50):
out what do they want, what do they need, and
what can they do and then the next step is
to know the network, to know the agencies, to know
the infrastructure, to know how to access these programs, and
that was something that I had learned and had quite
a good database of those resources to kind of put

(11:13):
the two together. However, in saying that that doesn't mean
that agency worked last week will work this week. It
still really takes somebody coordinating that care that's on the
outside can listen to everyone. And I'm so thrilled to
be working for a company that allows me to do that,

(11:34):
to really help people one person at a time literally,
and it's great and I really look forward to a
lot of success stories that I can share, like Nina
just day.

Speaker 1 (11:45):
So you're newer to ever Home Care Advisors, but the
team is growing, and I want to turn over now
to Diane Mikkel Gottabiowski, who has been working with Everholme
for a time now, who was also an active caregiver
and has been for her parents and as part of
a team that I'm kind of part of as well,
developing new resources. The whole system, the healthcare system has

(12:08):
to be innovated in ways that are hard because so
many stakeholders have financial interests and what you're trying to
do is reduce cost, which in some cases reduces profit.
So how do we get to patient back in the
middle of all this and Diane talk about your experiences
with Everhome as a caregiver and the exciting things that

(12:29):
Everhome is working on.

Speaker 8 (12:31):
Sure, thanks and good morning everyone. I'm happy to be here,
and my experience is as a physical therapist for many
years in the healthcare system, working in it in various
levels and layers. But when I came to Everhome, I
was working prior to that in the home care arena,
but my mom was ill and I was her primary caregiver.

(12:56):
My parents were living in their own home. My dad
is still very vibrant and kicking butt at ninety one,
but my mom unfortunately passed. But whatever Home and its
sister company, Viva Links allowed me to do was be
part of the development of something very exciting to help

(13:17):
caregivers connect with keep connection with their loved ones in
their home. At the same time, I was able to
take advantage of those opportunities in my own situation, so
I could help evaluate the system and see how it
could develop going forward. So I was able to keep

(13:38):
contact with my mom by sensors in the home, by
video chats, by the technology that Viva Links was able
to provide, and working with ever Home hand in hand
to advance goals, to see what we needed as a family,
to see what my mom needed as an individual, to
see what my dad needed as a caregiver in the home,

(13:59):
and then to see what resources are available out there,
and using the strength of ever Home to access those resources,
using the strength of Evil Lenks to tie it all together,
to put that as we like to say, the human
touch meets technology or tech enabled care coordination. So it's
been very exciting to be part of this. And I

(14:20):
think it's the future. It's the present, but it's the future.

Speaker 1 (14:23):
So you had a dad in the home who was
a caregiver for a mom in the home with Alzheimer's,
and you were the daughter who was trying to coordinate
it all while working an hour away and not having
to run down there every five minutes when there was
a situation. Just talk a little bit about how it
helped your dad as the caregiver.

Speaker 4 (14:43):
Sure, So.

Speaker 8 (14:47):
Alzheimer's is a path that it's horrible, a horrible path.
We all know that, and it's different for every single person.
And my mom was physically able to be up and
about but needed thoseitive assists. And my dad would really
need to be there all the time, just anticipating what
her needs were. With the cameras and the sensors we

(15:10):
put in the home, my dad was able to start
his day if my mom was not ready to start
her day, which was typically what happened, and he would
be able to start his day and then get a
text message that would say my mom was out of bed,
or he'd get some kind of alert that my mom
was up and about. He could stop what he was

(15:33):
doing prior to that. He would just wait, and it
gave him some freedom there. It also allowed him to
know if my mom was out of bed in the
middle of the night. We know when certain doors open,
if my mom let someone in the front door and
he was out in the garden and the front door opened.
So there's a huge sense of safety, but there's also

(15:55):
very practical information and that's what as I now work
for this company, I say it helps us make decisions
based on information in real time in the home, whether
you're in the home or not.

Speaker 2 (16:08):
So as a lawyer, we are problem solvers.

Speaker 1 (16:12):
Clients come to us because something's wrong or they want
to plan to prevent things from happening and going wrong,
and as problem solvers. We can only do so much.
We can do legal planning, we can do financial planning,
but we can't do the care planning that's necessary for
our clients.

Speaker 2 (16:29):
So we have to take a short break.

Speaker 1 (16:31):
When we come back, we're going to talk about ever
home care advisors, Viva Links, going to open up the
phone lines. I want to thank James again for teeing
this up, because this is a problem that is not
going to go away. It is not getting better or easier.
And the solutions that we're bringing you today, folks are
innovative and I would say unique, not just in the

(16:52):
Capital region but in the country.

Speaker 2 (16:54):
Stay with us. We'll be right back in studio with three.

Speaker 1 (16:57):
Non attorneys, three people that were professionals in the health
care system that are now working outside the healthcare system
for clients who are in it, who need assistants, who
need guidance, who need to be taken through the maze
of healthcare choices, long term care choices. And we're going
to go back and kind of go through all of this.
But I do want to open up our phone lines.

(17:18):
If you have a call, if you're a caregiver, you
have a caregiving question, or you want to talk to
any of our caregivers here. Give us a call at
eight hundred eight two five five nine four nine. It's
eight hundred talk WGY again eight hundred eight two five
fifty nine forty nine. And Nina, I'm going to come.

Speaker 2 (17:38):
Back to you.

Speaker 1 (17:39):
You've had you shared one of your success stories, and
I know that that is an unusual two day turnaround
to get a twenty four to seven care plan.

Speaker 2 (17:48):
And I'll share my story and.

Speaker 1 (17:50):
What led me into this whole area from a caregiving perspective.
I was a caregiver for my mother twenty five years
ago and she had Alzheimer's and I hired hired a
gentleman by the name of Joe Jackson, who at the
time was one of the only geriatric care managers that's
what they were called then in the Capitol region. And
he wasn't even in the Capital region. He was in Lenox, Massachusetts,

(18:13):
and all but in New York. There were zero twenty
five years ago, nobody doing the job that you ladies
are doing today. So Joe Jackson put a care plan
together for my mom. He found caregivers, he interviewed them,
screened them, did background checks on them, and whittled it
down to four. My sister and I interviewed the four.
We hired two and they became my mother's caregivers for
about three years, four years where we kept her at

(18:35):
home and it was a relationship where they would take
her out to lunch. You get to bond when you
have a consistent care team. You get to bond with
people and the system today, if you're going to a
home health agency, Nina isn't exactly that.

Speaker 5 (18:51):
No, it isn't. It's not so.

Speaker 6 (18:55):
I mean, when we are considering home health agencies and
finding people, a lot of the concerns that we have
with the financial concern of the hourly rates, you know,
finding the right match for people because the human connection
is so important. Social isolation has been a pandemic, just
like COVID has. The effects of individuals with depression is

(19:18):
only skyrocketed, especially in the older adult population. So getting
caregivers that are the appropriate match with the appropriate level
of skill does take some finding, some research, some real
investigation and thought and collaboration with the family and the
client and Cherry.

Speaker 1 (19:38):
You came from the health insurance world partly and the
health insurance plans, and we've had people here from CDPHP,
We've had people here from other insurance companies. Medicare advantage
plans have tried to innovate and bring new services to
the table. Telemedicine has been brought into a lot of
the health insurance plans, and you have just a complex

(20:02):
array of different medic gap plans, Medicare advantage plans. People
need help just sorting out the insurance options, and that's
something that the state actually has an agency and a
part of the state government, the Office for Aging, that
helps people through that. But nobody knows those resources are there.

(20:23):
So how do we get people to utilize the resources
that are available to them.

Speaker 4 (20:28):
Lou You're so correct.

Speaker 7 (20:31):
I would have many conversations and no one would really
know who just called them and where they were from.
Because after a hospitalization, you can be bombarded from your
doctor's office, calling from the home care agency, calling from
the hospital, calling from the health insurance calling, and you
just have a conversation with him, and you really don't

(20:51):
know their purpose and their goal. And that's what's for
me about EVER home Care Advisors is great because I
I'm calling from ever Homecare Advisors, you will know who
I am and kind of be able to trust me
because the relationship is key, and then to build on

(21:12):
that relationship. So you are exactly correct in the fact
that and it's a time also too when people don't
feel good, so you really have to take that into consideration.
You know, they're not feeling great, and they're getting calls
from four or five different places asking the exact same questions,

(21:33):
and they don't know where to turn. And that's why,
ever Homecare Advisors is just such a wonderful resource to
fill so many gaps.

Speaker 1 (21:44):
My experience I went through nine years ago. I just
had my nine year anniversary open heart surgery. I've talked
about it on the show, quintuple bypass surgery and a
valve replacement, a very major surgery. And when I got home,
you know, I was a lawyer at age fifty seven,
and I'm ready to get back to work, and the
phone just kept bringing and it was post hospitalization follow

(22:07):
up calls.

Speaker 2 (22:08):
And they were calling me. Why because they got paid
to call me.

Speaker 1 (22:11):
Because there's reimbursement when somebody leaves the hospital and goes home.
There's reimbursement for hospital follow up, and there's this magic
thirty day window if they can keep you out of
the hospital for thirty days, they get a bonus check,
but if you go on day thirty one, they get
paid again for your readmission, so that thirty days is

(22:31):
a cliff and the phone stops ringing after thirty days.

Speaker 2 (22:36):
I did have one my.

Speaker 1 (22:37):
Primary and it was CDPHP that kept calling me after
that and did more follow up and actually came to
the house and did a follow up check. But hospitalizations
today can be lethal and they can be so confusing because,
as you said, trying to find home care while you're
in the hospital, Nino, what's your experience with that, and

(23:01):
how do people deal with all of this incoming information
and then all of a sudden you get dropped.

Speaker 6 (23:06):
We'll even tell you I've had an experience where a
client that was not cognitively intact was approached with paperwork
and they asked him to sign it, even though it
was well documented that he was not able to do so.
So when we're in the hospital, we need as a patient,

(23:27):
you need an advocate, You need someone to speak up
for you. You need someone that can dedicate their time, attention,
and resources, because phone calls add up. When you're calling
agency after agency, it is frustrating. It takes time. You
have to ask a lot of the same questions and
sometimes they want information you may not know as a

(23:48):
patient or a caregiver.

Speaker 2 (23:50):
We're going to take a short break for the news.

Speaker 1 (23:52):
When we come back, we're going to dig back into
this and I'll open up the phone lines again. Zach's
waiting for your calls. Eight hundred talk WGY. That's eight
hundred eight two five, five nine four nine. Folks, if
you haven't faced this situation, prepare yourself and I'm going
to talk about that on the flip side, because James
was exactly right. You need to be prepared and hopefully

(24:15):
if you listen to this show, you will be will
be real to me, is a show that you shouldn't
miss because there are so many times in your life
that you're going to have responsibilities, caregiving responsibilities, and we've
started with that. When you have children, it's your first
job is to be a caregiver for those children. Make
sure you have a plan, and as time goes on,

(24:38):
you'll be a caregiver for your parents if they age
and have needs, and at some point you'll be a
caregiver for your spouse, and then you'll be a caregiver
for yourself if you want to be independent, you want
to live independently. And we have some great stories of
people who have fought their way through this system, and
we can talk about Stanley and a part of our conversation.

Speaker 2 (25:00):
But how do you access this quality of care?

Speaker 1 (25:03):
And again, if you want to ask questions eight hundred
eight two five five, nine four nine, we're going to
come back to you. Diane, Dianne Mikkel Gottabiowski, the vice
president of Clients Services at ever Home Care Advisors. How
does ever Home start this process? And what can people
and families do to get information?

Speaker 4 (25:23):
Sure?

Speaker 8 (25:24):
What you do to start the processes call us, but
you might be referred to us, you could. We receive
referrals from multiple different sources, whether it be from elder
law attorneys, hospital discharge planners, friends in the community. And
once you call us, the very first thing, and I
want to reiterate something that Nina said before, is that

(25:47):
we find out what your needs are and what you want.
It may not be the same thing, but what you
want is very important and that's what we're going to
work on to advance what your goals are going to
do that and let you know what's reasonable to what
are reasonable expectations, because we all want pie in the.

Speaker 2 (26:07):
Sky just out of curiosity.

Speaker 1 (26:08):
How many times is it the actual patient calling and
how many times is it the child caregiver calling.

Speaker 8 (26:15):
I'm going to just pull a number out of the
air here, but I would say seventy five percent of
the time it's the child or the caregiver calling. And
but we do have patients that do call, but it's
certainly not the majority. It's usually the caregiver and it's
based on need. And we also we have a client
that very astuteley says, if you wait until you are

(26:35):
in a crisis, you've waited too later if you wait
if it's imminent. So if you're in if your loved
one is in the nursing home and they've been talking
about discharge and now that is tomorrow, that is certainly
not the time to get things lined up. So discharge
begins the day you enter any facility, that discussion and.

Speaker 1 (26:55):
If you don't know that, you need to because the
minute they they put your name on piece of paper,
they're looking at the discharge plan and.

Speaker 8 (27:03):
They're projecting the discharge plan, and what you really want
to make sure that happens is that they're projecting the
discharge plan based on what you want, but what you're
able to do as well, because everyone doesn't have the
same opportunities. So we look at all that from the
call perspective, and then we will see what services we

(27:24):
provide fit with what you need. It's not a one
size fits all. It's how much time we have to
do something, what your resources are, and what your payment
structure is as well. Sometimes it is how much you
can afford to do, and we'll try to fit that
all in.

Speaker 1 (27:43):
We're going to take a call. We have Beth in Troy.
Good morning, Beth, Welcome to life happening.

Speaker 9 (27:50):
I found it being the secutor and caregiver from my grandmother.
She since passed, But one of the things we were
running up against is obviously finding people who could be
in the home and care for her, but we were
also being told that we would have to basically be

(28:10):
their employer, pay for taxes, social Security, disability, all the
usual items that you would have if you employed someone.
I didn't know if that was actually true or if
they were just trying to course us into going with

(28:31):
an actual agency that already existed.

Speaker 2 (28:34):
I'll take the legal size.

Speaker 9 (28:35):
I'm wondering, like hiring somebody off off of care dot
com for.

Speaker 1 (28:38):
Example, And Beth, there's so much involved in what you're
talking about. And the truth is, if you hire someone
and they become an employee and their labor law issues
here if they're working forty hours for your mom or
your grandmother, and that's an employee by definition, so you
have to do things like workers compensation, tax withholdings, unemployment insurance,

(29:04):
they are an employee. There are services we work with
services that will provide all that for you, kind of turnkey.
There's one right here in the Capital region that is
something we'll talk about a little bit, but it's a
service that does they even do the criminal background checks
on people that you want to hear. But when you
go through another portal, if you will. There's a state

(29:25):
program called the Consumer Directed Personal Assistance Program. But in
order to get on that program, you have to be
medici qualified, and that's what we do as attorneys. We
get people mediciate qualified and for home care, that's a
very short process. We can get people medicated qualified for
home care right away about the next month, and then
you start the process of trying to find people. And

(29:47):
we'll talk about that with our care coordinators, because that's
their job. We do the legal, the financial, We can
tee it up. We can tell you how to comply
with the law. But I will tell you this. I
do consults, probably ten twelve a week with people who
are in this situation, and more than half say oh,
And I say, do you have any home help?

Speaker 2 (30:06):
Do you have any home healthcare? Oh?

Speaker 1 (30:07):
No, no, no, But we pay the next door neighbor
twenty dollars under the table to come over.

Speaker 2 (30:12):
How often is she coming over? All?

Speaker 1 (30:13):
Six hours a day, five days a week. And that's
just reality. When you need care, you'll do anything. And
we have so many clients that pay under the.

Speaker 2 (30:24):
Table, pay in cash.

Speaker 1 (30:26):
And yes, there are rules, and they're absolutely correct that
there are rules, but I can tell you those rules
are honored in the breach more than they're complied with.
But you want to get a plan and work with
somebody who's a professional that can maximize the value of
your grandmother's resources. What is her income, what are her assets?
How long can she private pay? Is medicate an option?

(30:48):
Is that something that she should be thinking, should have
been thinking about and I'm going to go to who
wants this one? Nina?

Speaker 5 (30:57):
I was chosen. Good morning, Beth, how are you?

Speaker 9 (31:00):
Good morning?

Speaker 8 (31:01):
So?

Speaker 6 (31:01):
Yes, So we're talking about the CDPAP process through Medicaid.

Speaker 2 (31:05):
So if you become Consumer directed Personal Assistance program.

Speaker 6 (31:08):
I'm so used to using acronyms, I'm sorry. So that program,
it is wonderful because the caregiver, the family gets to
decide who they would like to hire, and then another
company comes in and they take over that process, the documentation,
those kinds of things. You still have to provide it

(31:29):
to them. You have to kind of do the legwork
to get it to that agency. And certainly right now
things are changing. So this process is there's.

Speaker 1 (31:38):
A major upheaval. Yes, in New York State in this program.
Just an aside, but there were six hundred companies running
the Consumer Directed Personal Assistance program. They were local, they
were right in your backyard. The governor decided that was
a bad idea. She thought it was wasteful. So they
are getting rid of those six hundred and going to
one single provider called Peace and they're in the process

(32:01):
of transitioning all of that. It was supposed to happen.
Deadline was April first. They just pushed it back a
month and so now it's April thirtieth. But that's a
state program where you can hire people. Now, I'm going
to throw this out there. The dilemma is this. The
reimbursement rate by New York State is about eighteen dollars

(32:22):
an hour.

Speaker 2 (32:23):
How are you going to compete.

Speaker 1 (32:25):
For care with caregivers that are making twenty five and
thirty dollars an hour private pay and Beth, that is
I don't know if you face that, but that's also.

Speaker 3 (32:34):
One of the issues.

Speaker 10 (32:36):
Yep.

Speaker 1 (32:38):
So how do you compete with that? I'll give you
the law firm answer. We create a second payroll, so
the people go on payroll for consumer directed our families
hire them to do other things. So you are using
a little bit of your own money to get that
person to come in and pay them a fair wage.
But it's possible, and we do it all the time.

(32:58):
And it's knowing how to have gate the system. And
this is why Nina. A family that doesn't know how
to bend these rules and make them work for them
is just at risk.

Speaker 5 (33:09):
Absolutely.

Speaker 6 (33:10):
I mean, we've had a situation where we had a
plan for a family to go to skilled nursing and
they were directed to they went a different direction and
they have filed for community Medicaid by accident, and they
are surprised and upset that they cannot admit their family
member to a skilled nursing because the ninety day pri

(33:32):
hasn't been completed. There's lots of those kinds of steps
for placement, so you can be misled by people that
don't fully understand the system. And that's where we want
to talk about supplementing. You know, the money that you
would be paid for the hours by CDPAP, by consumer
directed So in order to do that, you have to

(33:52):
be careful. I would recommend financial advisement or legal advice.

Speaker 2 (33:56):
Just legal advisement. Yes, it's because we actually do the payroll.
We do it.

Speaker 6 (34:01):
Legally and you can't get in trouble. You don't have
to have that worry in the back of your mind.

Speaker 8 (34:07):
Diane, you wanted to add, well, I was just going
to say that sometimes people might also think they're being misled,
but there's so much information and that's the benefit of
having experts who know the system and a team that
knows how to navigate the system. Because you might think

(34:28):
this just doesn't make sense to me, and nobody's going
to spend the time to explain it. If they're the
ones that are trying to get you to go with
that program, they're going to explain their program. But we
explain all options and all programs. We look at it
from a very broad perspective. The only goal that we
have is you meeting your needs, meeting your loved ones needs.

(34:52):
That's what we work for. So it is a very
confusing system. It is time consuming, confusing, and we're the
experts who know how this system works.

Speaker 1 (35:05):
So all of us here, Beth. I hope that started
to address your question. Do you have a follow up?

Speaker 8 (35:12):
Uh?

Speaker 9 (35:13):
No, No, that's that's good. It sort of gives me
some avenues to follow.

Speaker 2 (35:18):
Yeah, it's not easy.

Speaker 1 (35:19):
It's not it's complex, and we're going to go back
to Diane to talk about however home gets started and
how these problems can be addressed. There are solutions, they're
not always easy. But Beth, thank you for the call,
and we appreciate you calling in this morning. If anybody
else has a call, it's one eight hundred eight two five, five,
nine four nine. And Dane, you were starting to talk

(35:41):
about however home starts the process and you can jump
in with both feed er. You can kind of wade
into the water.

Speaker 4 (35:47):
Okay.

Speaker 8 (35:49):
We start the process by letting you know what our
services are because unfortunately there are decisions to be made
on our end too. We are we are a business
and we want to know what you can expect from
us and what you need. So we offer a couple
of different levels of how you can get involved with
ever Home Care Advisors. The first level is you can

(36:13):
just call in and talk to us and get this
information and find out what we can do for you,
and that doesn't cost you anything, and then will advise
you and you make a decision.

Speaker 4 (36:22):
It's always your decision.

Speaker 8 (36:24):
Then we offer a one hour consultation that's two hundred
and fifty dollars for one hour with one of us,
and we will sit down. We will take basic information,
find out what your situation is, whether it's you or
your loved one, what your goals are, what your resources are,

(36:45):
what the path looks like, and then we will give
you some options. We will say here are the resources
that you can access. Here's a couple of different ways
that you can go as far as you could pursue
this avenue of care. You could pursue this referral, et cetera,

(37:06):
and at the end of that hour, we give you
information that you may say, Okay, great, I understand now,
thank you very much. I think I can take it
from here. I have brothers and sisters that can help me,
and we're good, and then we're done until you might
need us again. Or you can say, wow, I can't
handle this, what can you do for me? And then

(37:28):
you can engage us as care coordinators that would be
on an.

Speaker 4 (37:33):
Hourly basis, or we could do a full.

Speaker 8 (37:36):
Assessment coming to your home and really looking at the safety,
the environment of the home of the individual that needs
the care.

Speaker 1 (37:45):
And I'm going to jump in here because I used
to do that as a lawyer, as a young lawyer,
because I had time and my buildable rate was much lower.
So I used to go to people's homes and sit
around the kitchen table and they would pull out all
the insurance policies and I'd review their Medicare insurance. They
have long term care insurance? You know, God help them
if they did, because now you've got something, a resource

(38:05):
that you can utilize.

Speaker 2 (38:06):
Not enough people have it.

Speaker 1 (38:08):
But I would do all of that, look at their assets,
look at their documents, wills, powers of attorney, healthcare proxies,
and do my own assessment. And I had about a
six or seven page letter that I would craft and
I would send to them. And then I realized, Okay,
I I know the law, I know the financial side
of this, I know how Medicaid works, but I'm not
an expert in healthcare. I'm not an expert in the

(38:29):
treatments that they have available and then the medical resources
and the healthcare resources that they have available. So then
I had to go to a care coordinator to do that.
So that in home assessment, and I would walk through
the you know, you open the refrigerator door, is it fresh,
is it spoiled? Are they eating properly? You go into
the bathroom and you kind of look around and see

(38:50):
what's going on. You look at the rugs, do you
know are they at risk for falls? I was doing
that as a lawyer. That's not what I do. You
need someone to do that assessment. And James talked about
that in the initial call. Nina, you do those assessments,
you go into the home, just talk a little bit
about what that assessment is and what that family can expect.

Speaker 6 (39:12):
Yes, so the home assessment can take as long as
we would like it to take, so it includes a
complete assessment of the home. It completes. I will do
standardized assessments of cognition, balance, ADLs, activities of daily living,

(39:32):
instrumental activities of daily living, safety concerns, balance, fall risk.
These are all standardized assessments that we can take again
and use them as a baseline, and doctors can use
them and rely on them as guidelines and resources when
we're making referrals.

Speaker 5 (39:50):
So that is part of it.

Speaker 6 (39:52):
We look at the home, we decide what the family wants,
like we really want to keep Dad on the second floor. Okay,
let's figure that one out. Do we need just two
hand railings? Do we need a stairlift? Let's look at.

Speaker 2 (40:07):
This and elevator is about one hundred thousand dollars.

Speaker 6 (40:09):
An elevator is pretty expensive. So after this full assessment,
we take in a lot of information. You know that
we encourage and almost require family to be there because
we want to make sure that everyone is engaged in
coordinating with us. After this assessment is completed, I will

(40:29):
take all of that data, all of your information, your likes,
your dislikes, your music preferences. If mom and Dad haven't
been able to play like puzzles or play games, I'm
going to address that because that's important to them and
their quality of life. So you're going to expect a
comprehensive care plan that is going to lay out, detail

(40:51):
by detail exactly how you reach each of your goals,
every single one of them.

Speaker 1 (40:57):
Oh, Sherry, my clients say, well, don't I get that
through my health insurance plan. Don't I get that through
my Medicare plan? Don't I get that through with the state.
Doesn't the Office for Agent come to my house and
do this assessment? You guys are all from the healthcare system.
What's the reality check there?

Speaker 7 (41:16):
So the reality there is, yes, you do get an assessment.
Is it an in depth assessment as Nina just described?

Speaker 3 (41:24):
No?

Speaker 7 (41:24):
And is it the follow through and the plan of
care and the tools and checking in on you?

Speaker 4 (41:31):
Did that option work?

Speaker 7 (41:33):
So for the volume of individuals, in reality, that doesn't happen.

Speaker 1 (41:40):
Like health care providers. Your primary care provider gets five
minutes to spend with you, and they may have a
network that they can refer to, but they get twenty
minutes to spend with you. That's their budget and that's
what they get paid for. My experience is that you
need someone in your corner that advocate the healthcare shurpa's
to navigate in the home through the facilities, look at

(42:03):
all the options, every option, and it's the old blind
man in the elephant. Depends on what your perspective is.
Are you a hospital, are you a nursing home? Are
you a home health agency? You know, they all have
their own.

Speaker 2 (42:16):
Perspectives, but the patient's perspective is the most important.

Speaker 5 (42:20):
Yes.

Speaker 7 (42:21):
And the other big part is they'll give you a
resource list or a resource directory that's maybe five years old,
maybe one year old, but the number has changed. And
what we're able to do at EPER Home Care Advisors
is we have constant relationships with so many of the

(42:41):
agencies and community supports that really can help.

Speaker 1 (42:46):
So we're going to come back after the last short break.
I'm going to talk about a program coming up on
April seventeenth that Diane and I and my partner Frank
Kemmi are going to do your home or the nursing home,
where we're going to really dig into all of these
issues legal, financial, and care issues and help our clients plan.
So if you want to join us for that seminar,
stay tuned. We'll be back right after this short break

(43:09):
beatles intro and we're coming back talking with Nina Crisanda,
Sherry Catapano, and Diane Mikkel Gottabiowski.

Speaker 2 (43:17):
Took me a while to get that name right, and
they're from ever Home Care.

Speaker 1 (43:20):
Advisors and this is a business, a company that helps
families and clients stay at home, stay independent. And I
can tell you from my own experience as a caregiver
my mom, my uncle who we had on Consumer Directed
and with Joe Jackson's help, we were able to put
a care plan together where we had five people twenty

(43:41):
four to seven care for four or five years, where
my uncle was able to stay independent.

Speaker 2 (43:46):
And he was a brilliant man who's very bright.

Speaker 1 (43:48):
His back was broken, couldn't get in an out of
a chair, needed twenty four to seven care. But these
women became part of the fabric of his life for
those last five years and they did a phenomenal job.
They all came to the funeral. He left money to
each and every one of those five in his will.
That's how much they meant to him, and if it's

(44:09):
done right, that's the experience, and that's the experience that
you're looking for. But it doesn't happen by accident. So
we're gonna talk about how to plan for this, how
to prepare for this, and it's gonna be on April seventeenth.
It's going to be at the Colony Town Library at
one pm and we're going to talk about all of
these topics. Please join us Thursday, April seventeenth, one pm

(44:31):
and you can sign up as always on our website
Puerrolaw dot com, p I E R r O Law
dot com. Go to the events tab and sign up
for April seventeenths Seminar Your Home or the Nursing Home.
We have Bob on the phone. Good morning, Bob, Hi.

Speaker 10 (44:51):
Good morning. Unfortunately missed most of your program, but one
question was that is ever home care advice? Do they
work in other states?

Speaker 1 (45:05):
So we're going to give a two part answer to that.
They have a network, they're part of a network, and
I'll let Diane talk about that network where there are
counterparts in other states. But they also have a technology
system that is available in those other states as well.

Speaker 4 (45:22):
So Diane Hi, Bob, thanks for calling in.

Speaker 8 (45:25):
Hi. The three people that are here on this call
this show today. We work primarily regionally in the Capital District,
but we are part of an organization called ALCA, another
acronym aging Life Care Association, and we have friends, co workers, peers, colleagues,

(45:46):
and we're part of a network that is all over
the nation. So if someone needs a care coordinator in
a certain location, we can match you with someone and
those people are all bound by the same ethical guidelines
as part of this organization and offer services that are
very very similar. But beyond that ever, Home Care Advisors

(46:09):
has a sister company called Viva Links and we work
for that company. I work for that company as well,
and we provide the technology that I referred to before.
You may not have been on the call to hear
about that, but so we have clients, for example, the son, daughter,
family member is the client lives here in the Capital District,

(46:32):
but their loved one might be across the state.

Speaker 4 (46:36):
Line somewhere else in Florida.

Speaker 8 (46:39):
In Florida, we have technology that we can help connect
you to your loved one with in home device for
the person that needs the care and then an app
which is our app called Viva Links, where you're connected
to that in home device and there's a broad spectrum

(46:59):
of service is that are available there and different technologies
depending on how much the person needs it. Does go
back to that assessment, so we talk about the remote caregiver.

Speaker 4 (47:11):
I mean I was.

Speaker 8 (47:12):
Able to help them participate in my mom's care from
forty five miles away, but once you involve technology, that
forty five miles away could have been four hundred and
fifty miles away or one thousand miles away. So I
think we'll start with that initial phone call find out
what the needs are. So if the loved one is

(47:32):
in another state, we can.

Speaker 4 (47:34):
Help get you set up there.

Speaker 8 (47:36):
If you're in another state and your loved one is here,
then this team could be on you know, boots on
the ground for that person.

Speaker 1 (47:43):
So Bob, if you'll ever home, they could help connect
you to wherever your parent is.

Speaker 10 (47:50):
Okay, yes, this is my stepmother and she's out in Illinois.
My brother and sister in law are kind of, you know,
taking care of things. But I thought, well, if as
any way I could help, I certainly would like to
do that.

Speaker 1 (48:05):
Well, this enables that Viva Links is it's a revolutionary
app and a revolutionary program. You could have five siblings
if you want them all participating in the care. They
can all be on the app. They can all video
chat mom and Dad. They can help manage medications, they
can help manage transportation, calendar schedules, all the things the
app does. And then there's additional technology, and Diane was

(48:26):
talking about the sensors, cameras, the other things that can
be layered in so that you can be a remote
caregiver and really control the entire care plan, Nina.

Speaker 6 (48:37):
Within a Hippo compliance system. Yes, that means your information
is protected. No one else can have access to it
unless the people that you designate.

Speaker 2 (48:47):
Very good point, Bob, does that answer your question?

Speaker 10 (48:52):
Contact the Everholme Care Advisors and good time.

Speaker 8 (48:55):
To give that phone number out there here we go
eight four four six three three five two. That's eight
four four six three three three eight five two, or
you can go on www dot everhomecare dot com.

Speaker 10 (49:11):
Very good, Thank you very much.

Speaker 4 (49:12):
Okay, thanks for calling.

Speaker 2 (49:13):
Bob and Dane.

Speaker 1 (49:15):
You have some other resources, thanks Bob for that call.
On that website and it links to the Viva links
website as well. So the two go hand in hand.
As you said, high touch, because you need the caregivers
to that There's not going to be any technology problem
program until the robots are ready for this to take
somebody to the bathroom, give them a shower, do the

(49:37):
things that they need to do now. The Jetsons was
a very, very way ahead of its time cartoon and
Rosie the robot was doing this and Elroy was getting
telemedicine visits. I use slides from that show, believe it
or not, but every home and Viva links are here today.
And Diane, one more time, how do they contact you?

Speaker 8 (49:56):
Call eight four four six three three three eight five
T two eight four four six three three eight three eight.

Speaker 1 (50:02):
Five two, Nini Crisandez, Sherry Catapano, Diane, Mikkelgtabiowski. Thank you
for sharing your expertise. If any of you are just
tuning in late and you want to hear the rest
of the show, we are on Spotify. You can find
us on Spotify. The shows will be posted there. You
can go to WGY dot com. They also have the
shows up on their website. And I want to thank
you for taking the time to listen this morning to

(50:24):
life Happens Radio. Hope you can join us next week
and we will be back on WGY