Life Happens 07-12

Episode Transcript

Speaker 1 (00:05):
Welcome to Life Happens Radio, featuring the attorneys from Purou,
Counter and Strauss. Tune in every Saturday morning at nine
am for the most in depth discussions that help you
navigate the legal, financial, and health related challenges we all face.
Life Happens. Are you preparing?

Speaker 2 (00:35):
Dew are we on? We're on you give me in
the back.

Speaker 3 (00:39):
I'm Luke Piro, your host for this morning, and welcome
to Life Happens Radio, your weekly radio broadcast that brings
you ideas for living, aging, being successful throughout the process,
having your first children, getting them educated, working through your
working years, making sure you have a plan that keeps
pace with a busy life and a very very crazy society.

(01:02):
And then as you look at retirement, beginning to prepare.
You just heard Dave Kopek and his group talking about
retirement planning, making sure that you have prepared financially and
that you have income to keep yourself going through retirement
and achieving the goals that you have set for yourself.
And then as you retire and as you age after retirement,

(01:23):
looking at staying healthy, maintaining your independence, and making sure
that if the situation arises where you need help and
you need care, that you have a plan, And today's
show is going to focus on the people that need care,

(01:44):
but more importantly, today we're going to focus on the
people that provide it, who are the caregivers. And if
you're a caregiver, raise your hand, and Matil, everybody in
the studio here is raising their hand.

Speaker 2 (01:56):
Mattil de Cuomo wrote a book and she talked.

Speaker 3 (01:58):
About caregiving and being a caregive and she said that
you are either a caregiver now, you've been a caregiver
in the past, or you will be a caregiver. And
many people don't self identify as a caregiver.

Speaker 2 (02:11):
They just do it.

Speaker 3 (02:12):
They're just taking care of an aging parent and they're
doing the things that the parent needs them to do.
Recent article in the Harvard Business Review has statistics to
show that more people who are in working years, who
are at work are right now caring for aging parents
than are caring for young children. And that is the

(02:33):
first time that demographic shift has occurred. So caregiving is
an enormous responsibility, and one of our sayings is it's
the hardest job you are never trained for because there
is no preparation to be a caregiver today We're very,
very fortunate to have with us in studio a whole
cast and crew of people who not only have been

(02:57):
in our caregivers, but counsel and guide caregivers. How do
you prepare? How do you build a plan? How do
you make sure that when the need arises, you have
a legal plan, you have a financial plan, and you
have a care plan. And that's what our group today
is going to focus on. And I'm going to start
on my right. We have three very special guests. We're

(03:19):
going to be with us live on the radio today
with Diane Mikkel Gottabiowski.

Speaker 2 (03:23):
Good morning, Diane, Good morning, Lou.

Speaker 4 (03:25):
Nice to be here.

Speaker 3 (03:26):
Diane has been here with us before on the show.
You may have heard her on some past appearances. Diane,
talk a little bit about what you were doing today
and your history as a caregiver and in the long
term care field.

Speaker 4 (03:39):
Sure Today, I'm working as vice president of client services
for ever Home Care Advisors and Viva Links. Ever Home
Care Advisors is a care coordination company and you'll hear
more about that as the morning goes on. And what
we do is exactly what Lou said, We help caregivers
and care recipients at what they need and what they get.

(04:03):
My history is, I'm a physical therapist. I've been involved
in healthcare in many different settings for many many years.
Before I came to everhome, I was in home care,
so we really want to focus on providing that care
in the home. Additionally, I'm a daughter, I'm a wife.
I was a caregiver for my mother in law, my

(04:25):
father in law, my mother, And I'm not going to
say I'm a caregiver for my father because he might
be listening and he's ninety one and he's pretty darn independent,
but I'm there firm if he needs me. So being
in that position helping navigate in Alzheimer's diagnosis, helping navigate
how a one hundred and two year old woman is
going to continue to live in her own home. We

(04:48):
take our personal experience and our professional experience and we
meld them together to try to help and enable and
advocate for people who need to do the same.

Speaker 3 (04:58):
So background in physical therapy, I had your own practice
as a physical therapist, went into the home healthcare world,
work for one of our large providers locally, and now
we're counseling individuals and families on how to navigate what
has become a ridiculously complex and fragmented system. And I'm
going to go right to left and move over to
Sherry Catapano, who comes from a different background but with

(05:21):
similar goals.

Speaker 5 (05:22):
Good morning, Lou, pleasure to be here. As Lu said,
my name is Sherry Katapano. I'm a licensed Master Social
worker and a certified case manager, and I've had over
thirty years experience in the healthcare arena. I worked at
one of our local not for profits for over twenty

(05:43):
seven years as a medical social work case manager, helping
to navigate.

Speaker 2 (05:48):
Care in a little more that was an insurance.

Speaker 5 (05:51):
That was an insurance provider. You are correct, I retired
and I've known about Eber Home Care Advisors for for
many years and I'm very honored to be the newest
addition to this wonderful team because the work that is
done here is amazing. And on a personal note, I

(06:13):
was the primary caregiver for my mom who was on
hospice and that, as Diane said, our personal experiences, in
addition to our professional clinical experiences, helped to make us
who we are today.

Speaker 3 (06:29):
Thank you all right, keeping right to left theme, We're
going to go over to Nina Cresanda, and Nina comes
to us with a very different background.

Speaker 6 (06:38):
Yes, absolutely, so I'm Nina, nice to speak with everyone
this morning. I'm an occupational therapist by training and licensure.
I have my master's degree of bachelor's and both. I've
been working as an OT for over seven years. But
in those seven years, I've crammed every single type of
OT you can have. I've done it all. I've done

(06:59):
a cute care, long time care. I've worked with individuals
with disabilities. I've worked with children, I've worked with you
name it. I've worked in the criminal system. I've worked everywhere.
And so we talk about elder law planning. I'm a daughter,
I'm a granddaughter, I'm a sister, and I'm a friend,
and as a friend, speaking to people my own age

(07:21):
talking about this planning, talking about this stuff now is
so important and they're really a lot more.

Speaker 7 (07:27):
Receptive to it closer to the age gap.

Speaker 6 (07:30):
So I usually relay messages to my parents, who then
install the ramp to my grandparents' home.

Speaker 3 (07:38):
And it's an intergenerational plan. You have parents, grandparents, great grandparents.
My family is preparing a celebration of a one hundred
and third birthday for my aunt, who I've talked about
on the radio, who's been a client of ever Home
Care Advisors and stayed at home with a wrap around
service of technology and cameras and sensors and all the

(07:59):
things we're going to talk about today. And my aunt
Nettie is going to be one hundred and three on
August fourteenth, and we're going to have a big party.
It's worth of celebration every time you have a birthday
at that age.

Speaker 2 (08:09):
So people are living.

Speaker 3 (08:11):
More and more frequently into their nineties hundreds, and so
here I am sitting as an attorney with a cast
of people who are from the healthcare side of things,
and it's acute care, which we talk about as hospitals
and doctors. But as we're going to talk about, the
acute care system ain't what it used to be, and

(08:32):
we have some budget cuts that we're going to maybe
mention and talk about things that are coming in the
future and what we can anticipate in the social service networks.
So we're going to look at this from the perspective
of how do we prepare ourselves for what are lapses
and gaps in the healthcare system? And how do we

(08:53):
fill those gaps. So I'm an attorney, I'm an elder
law attorney. I'm also a four time caregiver. And that's
two parents, an aunt, and an uncle. And so I've
been through this throw from a whole series of perspectives.
And I go back twenty five years with my mom

(09:15):
having Alzheimer's, and as an attorney, I had a whole
host of resources, I mean a little attorney. I was
the chair of the New York State Bar Elder Law Section.
I knew everybody in long term care, every social service agency,
state agency. And I started making phone calls to try
to get help for my mom. And I was given
a phone number, and the phone number that I was
given I called and I had a nice conversation. They

(09:36):
were very pleasant, and they said, oh, we feel so
bad about your situation. We empathize with you, but here's
another number. Tried this number. They might be able to
provide you with a service. And I called the second number.
I had a nice, pleasant conversation, and by the time
I called the third number, I wasn't so pleasant because
I kept getting the same answer. We empathize with you,

(09:57):
but we can't help you. We don't have any service
that we can provide to your mom. She has Alzheimer's,
she's living at home alone. We can't really help you.
And so I went through that and I got to
the sixth phone number that I was given, and what
it was was the first phone number that I had.
So I went through a whole circle and got nothing,
no services. So I reached out to a gentleman who
I'm still very good friends with. And I've talked about

(10:18):
Joe on the show before, a gentleman by the name
of Joe Jackson. And twenty five years ago, the care
coordination care management field with Nation it was just starting
and Joe was kind of a rogue pioneer. I had
to go to Lenox, Massachusetts to find him, and he
came over and took care of my mom here in
New York and we did an assessment, and we did
a care plan, and we kept my mom at home
with caregivers only because Joe Jackson was able to bring

(10:41):
his expertise.

Speaker 2 (10:42):
And knowledge to me and my family.

Speaker 3 (10:45):
And so, Diane, when you get calls, these are the
kinds of calls that you get because people are facing
the same types of issues.

Speaker 4 (10:54):
Absolutely, this is what I've been told this is what
I'm dealing with, but nobody has a solution for me.
What I don't know, what I have access to, I
don't know what to do. How can you help me?
And that's what we do. We listen, we find out
what the situation is, we find out what led to

(11:14):
that situation, and we found We asked what the goals are.
And I've said this on the show many times. What
people want helps drive our plan, your plan, their plan,
and that's why it's so important to be talking now
before you need something about what you're going to want
when you need it.

Speaker 3 (11:33):
So we're going to talk about whatever Home Care Advisors does,
some of the cases you are working on, some of
the things that you've done to help families. But we're
also going to open up the phone lines and if
you have a situation that you're dealing with, if you're
a caregiver, give us a call eight hundred talk WGY.
That's eight hundred eight two five five nine four nine.
We have a physical therapist, an occupational therapist, and licensed

(11:55):
masters and social work and certified care manager our care.
What's the what's the destination, Cherry, It's a.

Speaker 4 (12:02):
Care manager, care manager manager.

Speaker 3 (12:05):
So we have talent in the studio eight hundred eight
two five, five, nine, four nine.

Speaker 2 (12:11):
Give us a call. We're gonna take a short break.

Speaker 3 (12:12):
When we come back, we're going to tackle the issues
of aging and how to prepare yourself and your loved
ones to age successfully. We'll be right back after this,
and we are back. I'm Lupierr, your host for this morning.
We have a studio full of care coordinators and we're

(12:33):
very happy to be here today talking about a topic
that is vital as we age, as we have loved
ones aging. Where do we get the help that we need?
And we have some workshops coming up that I'm going
to talk about. One is coming right up and it's
this Thursday, the seventeenth of July.

Speaker 2 (12:49):
We're gonna do a series of these. This is in.

Speaker 3 (12:51):
Southern Saratoga at the YMCA. Everybody start singing, there we go.

Speaker 2 (12:57):
We got a lot.

Speaker 3 (12:57):
YMCA is going on the studio here. It's at the
YMCA in Southern Saratoga and that is July seventeenth at
twelve noon registration twelve thirty to one thirty is the program.
And this is your home or the nursing home. How
do you prepare yourself to stay out of the nursing home,
to stay independent, to keep your dignity, to have resources,
and we're going to cover it from the financial perspective,

(13:20):
the legal perspective, and the care perspective. So we're putting
a very unique program on to cover all the spectrum
of caring for aging loved ones, legal, financial care planning.
And you can join us this Thursday the seventeenth at
twelve thirty twelve twelve o'clock registration at the YMCA in
the Southern Saratoga that's one Wall Street. We have other

(13:43):
sessions coming up August sixth Wednesday at twelve noon and
on the August thirteenth at twelve thirty. The first is
at the East Greenbush Community Library and the thirteenth is
that the YMCA in Guilderland. So those programs are going
to talk about what we're going to talk about now
and again, if you have a question, an issue, a

(14:03):
case of something that you're dealing with, give us a
call one eight hundred talk WG why that's eight hundred
eight two five five nine four nine. And we talked
about cases and we talked about things. We have some
some live cases here questions that you've gotten, the situations
that you've had to deal with.

Speaker 2 (14:22):
And here's one.

Speaker 3 (14:23):
My ninety four year old mother lives alone in our
family home, keeps falling. She calls the EMT to help
her up, then refuses to go to the hospital. I'm
an only child, I live out of state, and I
have a very demanding job. How can I get her help?
Who wants to tackle that one?

Speaker 7 (14:42):
Jerry, I would love to start.

Speaker 5 (14:44):
First of all, I didn't share that I'm a proud
carrying Medicare Red, White and Blue card holder myself as
so I think that gives me that perspective that if
somebody said to me, you need to leave your home
today because it's not safe, I would stop my feet
and not go. So I think in that instance of
that case, it is really and truly to engage the daughter,

(15:09):
let her know what we do and how we do it,
and then to go out and actually meet her mom
and assess the situation. Because maybe it's as simple as
a scatter rug in front of where she falls.

Speaker 7 (15:23):
All the time. Maybe it's not.

Speaker 4 (15:25):
Maybe it's more complex.

Speaker 5 (15:27):
But until we're able to really do a thorough client
based assessment, we don't know, so.

Speaker 2 (15:34):
That's the beginning of the process. Correct.

Speaker 3 (15:37):
And there are a lot of things. You know, falls
are caused by a lot of different issues, rugs not
having safety. My aunt who we talked about was falling
at night getting up to go to the bathroom. So
we got automatic lighting installed so that their motion lights,
so that the lights pop on every time she got
out of bed, so that she had to come out

(15:58):
if she really had an emergency, it was right now
next to the bed and problem went away. Because these
are simple things, but you don't know until you know.
And Diane, this is something not only with appliances like
a commode next to the bathroom, but there are other
technologies that EVERHME uses that are very unique in the marketplace.

Speaker 4 (16:18):
Absolutely, we work with Viva Inks, which is our sister company,
to provide. When we say technology people, some people they
dig their feet in as well and say, oh I
don't like technology. Do you use a remote control? Do
you have a cell phone? Do you use it? A
smart television or a dumb television? You use technology? We

(16:41):
have we consider two things. We have what we call
the care recipient, So that's the person we're talking about
who might need some help in the home, and we
have the caregiver, which we've already talked about a lot here,
and we want to connect them so that they're that
care In this case, here's this daughter. She lives out
of state. We can have a device in her mom's home.

(17:05):
She can have an app, the Viva Links app on
her phone, and then she can have that contact at
a moment's notice with her mom. And there are further
levels of technology which could be monitors and sensors, so
we know when a door is open, we know when

(17:26):
there's motion in an area that there shouldn't be, or
there's a motion where there should be. Not everything is
a negative. We want to help people be as safe
as they can, preserve their dignity and as much autonomy
as possible. And that technology, which is the monitors, the sensors,
the devices being able to handle the schedule, the medication,

(17:46):
all that can bridge some of those gaps and increase
safety to allow people to stay in their homes with
this support.

Speaker 3 (17:54):
And I know some of the ever Home clients because
they are also our clients, and we've done legal planning
and financial planning and the care planning. There's one client
who has been on the show and has been a
good spokesperson for ever Home. And it happens to be
an RN who works at a local hospital at a
very demanding job and is in the healthcare system and
knows how broken the healthcare system is.

Speaker 2 (18:14):
And she had two.

Speaker 3 (18:16):
Aging parents, one with Alzheimer's in one with Parkinson's that
she was caring for while working full shifts as an
RN at the hospital, and that is only possible with
the right systems.

Speaker 4 (18:29):
How well I know that I started my career with
Everholme caring full time for my mom, and with my
dad's help, of course, I got to keep plugging my
dad and I was able to be in touch at
a moment's notice, know what was going on, and yet
be productive at work. And that sense of security and

(18:53):
peace of mind was incredibly empowering for my father as well,
who knew that there was some out there.

Speaker 7 (19:00):
And I'd like to interject the moment's notice.

Speaker 6 (19:02):
The touch could be from the client, it could be
from the caregiver, and what that could be is a call,
an audio call from the app to the tablet that's
installed in the client's home, or.

Speaker 7 (19:17):
It could be a video call.

Speaker 6 (19:18):
It could be a simple touch the picture, call my daughter,
Oh I see your face.

Speaker 7 (19:22):
I feel so much better.

Speaker 3 (19:24):
Let's break that down a little bit because the appliance
that goes into the home is a very unique appliance.
It isn't just ANAD and it isn't something that is
off the internet. It's a closed circuit Internet signal that
goes right to this tablet that's installed in the home,
and it's programmable for each individual user. And Dane, you

(19:45):
had experience with it that the RN that I was
talking about her dad who had Alzheimer's advanced Alzheimer's, and
we'll talk about his story a little bit because he
really sparked to this and other users. But the tablet,
you can call in yourself with a video chat and
the end, the person in the home doesn't have to
even do anything to touch your picture.

Speaker 7 (20:05):
It's correct.

Speaker 6 (20:05):
Or if they are for some reason unable to touch
the picture and they're comfortable with it, the family can
auto answer so they can actually check and see, Oh
Mom's just sitting at the kitchen table. She couldn't reach
at this moment, No big deal, everything's fine. You can
you can track biometrics and everything is happening.

Speaker 7 (20:25):
Contemporaneously. It's sinked time to time.

Speaker 6 (20:28):
So if you have an internet connection, you can mom
can simply check in. You know that she's up for
the day, and that can give you enough peace of mind.
It depends on the situation.

Speaker 3 (20:37):
Yeah, And you know, as we talk to people in
the healthcare system, and we do a conference every year
and we examine every aspect of this, from individual home
health agencies to pace programs all across the board, insurers, providers.
The level of sophistication of technology in the home is dismal.

(20:58):
There just is no out a lot out there there.
You know, something as simple, Diane is proof of life,
which a lot of people don't have, just knowing that
someone's okay and is up and about.

Speaker 4 (21:09):
I use this story all the time. And we have
a check in system. So with this device, there's a
button that says check in, and we ask and sort
of people get used to knowing that that's the first
thing they do they check in, So that then puts

(21:30):
a prompt on the app. So I'm getting ready for
work in the morning, I open my app, I look,
I see that my dad has checked in, and that
gives me information that tells me that dad's up, he's about,
he's got his wits about him, he checked in, he
knows what he has to do. I can then take

(21:50):
a breath, continue to get ready for work. In another
case scenario, it is exactly what you're saying, proof of life.
It's proof of being able to follow through and knowing
that maybe you don't have to act right now. I
talk very often about these systems help us determine action

(22:10):
based on information. We are making decisions based on information
that we're getting, not just wondering what's happening. And it's
really great.

Speaker 3 (22:20):
And I just want to harken back to something you said,
something as simple as using a television remote. But there
are people that can't and have it and have never
used the remote. They're still getting up out of their
chair to turn the television on and off. But the
tablet worked for those people. And there's one case in
particular that I'm thinking of who was a client of
ours and a client of yours. She has since passed,

(22:43):
but for several years this technology made a difference for her.
Just in the minute we have for this first half,
if you.

Speaker 4 (22:49):
Could hurt this client, her daughter said, my mother's never
touched technology, but yet she became almost dependent upon the
table She loved it. She looked at the news, she
played games on it, she did video calls with her daughter.
It's a very intuitive It's designed to be simple, and

(23:10):
I think that's the key to it. It's if you
can read or recognize what red and green means, stop
or go, you can intuitively do what you need to do.
My mom was able to use this to a pretty
advanced point in her Alzheimer's disease. She was still engaging
with this tablet.

Speaker 3 (23:28):
And the beauty is you can program it so you
can send videos and if your if your child is
doing a recital or playing in a game, you can
post the video on the tablet. The next morning, the
grandparent wakes up and that's the first thing they see
is their grandchild in a dance recital, and man, isn't
that the way to start your day and to get motivated?

(23:50):
And then it pulls them into Okay, did I take
my medications?

Speaker 2 (23:52):
Do I have a.

Speaker 3 (23:53):
Doctor's appoint So let's come back after the break. We
have to break for the news and really pull this apart.
And I know that you have a lot of experience
with hands on counseling in the home, and we want
to talk about what it takes the human touch aided
by technology and how that can make a difference for you.

Speaker 2 (24:10):
We'll be back right after the news. All right, we're back.

Speaker 3 (24:22):
I'm Lupiro, your host for this morning from Pierre O'Connor
and Strauss. We are a law firm here in Albany,
New York, but we have offices all around New York State,
and we practice in the areas of trust in the
state's business, business succession, and elder law, and special needs planning.
Today we're really focusing on the elder law topic. We
can maybe fold into special needs a little bit, but

(24:43):
elder law has become a practice that we have rethought
throughout my career. And in the beginning of my career,
I saw it as Okay, we do wills, we do trusts,
we do Medicaid planning. And then I started getting calls
from people asking me the questions, well, you know, how
do we find a home health and what does this
insurance policy really provide? They have health insurance, they have Medicicare,

(25:06):
What benefits can we get from these insurance policies? Oh,
my goodness, my parent has long term care insurance. We
found it in the drawer. We had no idea it
was there. What can we get from that long term
care insurance policy? And if mom and Dad don't have
enough money to pay for the care that they need,
how do we access Medicaid? All of those questions. I'm

(25:29):
sitting at the kitchen table triaging all of these papers
as an attorney, and man, they don't want to pay
an attorney's rate to be doing that triage. Nor am
I trained in most of the questions that they're asking me.

Speaker 2 (25:41):
I'm not a trained.

Speaker 3 (25:42):
Social worker or physical therapist or occupational therapist. So we
had started to bring care management into our law practice.
Ever home is kind of an evolution. It's a separate company,
it has its own identity, it has Viva links. But
this marriage of elder law and elder care is absolutely necessary. Folks,

(26:07):
what's coming down the pike. If you haven't been watching,
if you've been under that rock and not watching the news,
that there's a bill that passed in Washington that is
going to cut roughly one trillion dollars out of the
Medicaid system. And I had Greg Olsen, who's the director
of the New York State Office for aging on this
show a few months ago talking about what these cuts
might mean. Well, now we know exactly what they mean.

(26:29):
And Medicaid program, social services, a lot of things that
people rely on are going to be cut.

Speaker 2 (26:36):
How do we prepare?

Speaker 3 (26:38):
And it's going to come down to a lot more
And I'm just going to say this personal responsibility. You
are going to be more personally responsible for yourself your
family than ever before because the government resources that have
been built up that social safety net is going to
be taken down. So what we're talking about today is
vital not just for today, but for next year, the

(26:59):
year after the year after that, because we're going to
face significant challenges in healthcare and long term care. So
on a day to day, minute to minute basis, here's
a case that I'm going to put it out there.
My eighty year old father has stopped going out of
his home. When asked why, he says he just doesn't
want to go out. He's happy being in his home.

(27:21):
His neighbor and longtime friend called me to say he's
worried about him. Male's piling up, law's not being mowed,
he's refusing my help. What should I do? Nina, I'm
going to turn to you for this one, and this
is something.

Speaker 2 (27:33):
That we deal with.

Speaker 3 (27:34):
People are reluctant, as you said, sherrit to accept help.
How do we put a network together that can overcome
these barriers.

Speaker 6 (27:43):
So I think the first thing is getting the conversation
to be between the client and us, because at the
end of the day, it's about the client, the person
that is receiving the care, that has the needs. And
what we do and what we can all specialize in
is meeting the client where they're at. They're like, man,

(28:05):
this really stinks. I don't want someone in the house.
And I can say I hear you, I hear what
you're saying, and I understand, and I can sit with
you through that, and I can also gently explain why
that might be helpful, what the process would look like,
step by step, so they're comfortable with it, and if

(28:26):
they have questions, they know they can ask me, and
I'm going to be honest with them, whether it's hey,
how long are my VA benefits going to work?

Speaker 7 (28:32):
Or should I apply for medicaid first?

Speaker 6 (28:34):
The answer is right now, medicaid first before your VA benefits.
And you know, it's questions like that they have, you know,
lots of different things. I need a cat groom or
delivered to my house. I've done that, I've gotten that done.
But I mean it was for a medical reason. This
person could not leave their home. It would be endangering them,
putting them at risk. And also the cat having lung

(28:57):
claus could cause significant steps us for this individual, which
could cause their death. So it actually can be quite
serious to you know, even these small things.

Speaker 3 (29:10):
When we look at people living in their homes and
not wanting to get help, how often do you turn
to Okay, well here are your alternatives, and the alternatives
ain't good.

Speaker 7 (29:22):
Yeah, I mean that's what I mean.

Speaker 6 (29:24):
I'm going I'm never going to be rude, but I
will be upfront and I will be honest with all parties.
This is the reality of the situation. If you hire
under the table, you're breaking four laws.

Speaker 2 (29:37):
Many people do you.

Speaker 6 (29:38):
Are responsible for that. You hope that doesn't happen. But
if you aren't covering your bottom through either some kind
of insurance policy, whether it's consumer directed choices, and you're
hiring people.

Speaker 7 (29:52):
That you trust, and you know that's a medicaid p.

Speaker 6 (29:55):
That is a medicaid program or if you were to
choose licensed home care, that's great because they do all
the vetting.

Speaker 7 (30:03):
You can even find out what that vetting is by
asking them.

Speaker 2 (30:06):
You'd bring up.

Speaker 3 (30:07):
A great point and let's open that up for discussion,
because this is the elephant in the room, and that
is as care coordinators. And I've watched this happen with
my clients. They live in Scoharey County. How many home
health agencies are licensed and operative in Scoharey County two
And when you call those two home health agencies and

(30:28):
say I need a home health aid for mom, what
do they say?

Speaker 7 (30:30):
We don't have anyone, we.

Speaker 2 (30:32):
Don't have the staff.

Speaker 3 (30:33):
And one of our largest home health agencies and day
End you actually worked in this organization and we've had
them on the show as well, the Eddie VNA. They
had a licensed home health care agency and the director
got up at our conference, our Elder Law form and said,
we had four hundred home health aids that we deployed
throughout seven counties and now we have forty. That's all

(30:54):
we could find, from four hundred to forty. And that
just shows the start nature of the lack of caregivers
out there and Nina, you bring up a great point.
In the old days, you pick up the phone, you
call an agency, you get an aid and they come
to the home and they do workers' compensation, they pay
payroll taxes, they do unemployment insurance, all the things as

(31:16):
a home health employer you're charged with doing. So there
are companies that will do that, and you work.

Speaker 2 (31:23):
With some of those.

Speaker 6 (31:24):
Yes, absolutely, so there are companies that will manage payroll,
that will do those kinds of things, and we connect
through them.

Speaker 7 (31:32):
So I had a conversation.

Speaker 6 (31:34):
I had just a one hour consult with a woman
and we were just discussing her options for that very topic,
and we discussed the companies locally that she was comfortable with,
and she, through our.

Speaker 7 (31:45):
Discussion, made decisions based on that.

Speaker 6 (31:47):
So she decided to go with a company versus a
different one because it matched what she wanted, That information
was more organized, more.

Speaker 7 (31:58):
Able to be understood by her in layman's terms. And yeah,
so it's.

Speaker 3 (32:02):
Hard for people to wrap their head around that I
actually have to pay for something that I'm told is
available to me, because every agency has oh we have caregiving,
we have this, we have that. And my experience is
you call the numbers and there's nobody home that they
just can't provide the service. So how do you overcome
that lack of understanding with people that these are the

(32:27):
realities of the system and here are the things that
you really need to be thinking about. How do people
start the process with you at ever home care advisor.

Speaker 6 (32:35):
So normally we have an intake call. You might speak
with me, you might speak with some of our other
staff Davin or Karen will take down some information and
then one of the life care coordinators will call you
back and we'll talk about what might be a good
match for our services with you, what's the situation a
little bit more and just match say hey, this is

(32:56):
what we could offer, this is what would be beneficial.

Speaker 7 (32:58):
Here, here's a few options.

Speaker 6 (33:00):
It's a comprehensive home assessment at this point, that's what
you need. So that would be top to bottom, roof
to floor, person, head to toe, everyone in the home,
looking at everything.

Speaker 3 (33:12):
Yeah, and talking to the caregiver in California, absolutely, the
caregiver in Hong Kong.

Speaker 7 (33:16):
You gotta loop everybody in.

Speaker 6 (33:18):
It's got to be a collaborative effort with everyone buying in.

Speaker 3 (33:22):
And so that's what a professional brings to the table.
So in terms of and I'm going to put this
out there because people are going to ask me and
ask you, how do you get involved, how do you
start the process, and what's going to cost me to
have a conversation with you and get a detailed analysis
and then maybe lead up to a home visit and

(33:42):
then what comes next.

Speaker 6 (33:44):
Sure, so the first little call that's free, it's probably short, ten, ten,
fifteen minutes, but we're going to get to the.

Speaker 2 (33:52):
Right idea and find out what the real issues are.

Speaker 6 (33:54):
Exactly, and then follow up with email or whatever is
the best preferred method for communication. But a good one
hour with me is two hundred and fifty dollars, yes,
and that comes with some research time. We're going to
work hard to make sure that we've addressed every single
one of your issues and that we've given you a
resource to address that issue, whether that's referring to the

(34:17):
certain counties office for the aging or if it's just
something they don't quite know about yet, we can just
walk them through.

Speaker 7 (34:23):
Actually, here's a link.

Speaker 6 (34:25):
Archives dot gov you can get pull your full You
know that the person you're looking for, you can pull
the record they need, so you can apply for VA
benefits for a widowed person or something like that.

Speaker 3 (34:36):
And the oldest question most people have face is how
do I find caregivers? And you have access to a
number of resources, as I understand that everyhome does not
provide home healthcare, but you help access it and have
resources to find care.

Speaker 7 (34:49):
That's correct.

Speaker 6 (34:50):
So we personally have stepped out of direct care for
various reasons, so we no longer physically provide care.

Speaker 7 (34:58):
However, we are the bridge.

Speaker 6 (35:01):
We have the first name basis of the person at
this agency who knows a person at that agency who
actually knows that this woman is in Scoharry County and
she can work four hours a week, two times a week,
and it matches, and that's happened. We get lucky, but
we're also persistent. It's a matter of perseverance, luck and

(35:24):
also just our overall knowledge and connections that we make
through our previous professional experiences and our current ones.

Speaker 4 (35:32):
Now, can I talk about that persistence for a minute?

Speaker 2 (35:34):
You absolutely can die.

Speaker 4 (35:36):
I was speaking to someone who was inquiring about our services.
It's a full time job. It can be a full
time job to find care.

Speaker 2 (35:46):
O ye.

Speaker 4 (35:47):
To be a loved one caregiver trying to find that
extra care. It's what we do. We can put our
headset on call the agency, be on hold for twenty
five minutes, we're still if you're at work, you can't
do that. If you're trying to do that as a
daughter or a son or a loved one. And we

(36:07):
have those made those connections. We're going to call based
on our experience, based on what you've told us you need.
The other thing I say when people call us, there
are different There are some people that know exactly what
they want. There are some people that know exactly what
they want we can connect them quickly. Or there some

(36:28):
people that know they need something but they don't know.
So again, it's very personalized, very customized. It's knowing how
to ask the right questions. And I think that's what
we're all very good at.

Speaker 3 (36:40):
And the experience that you derive from doing this day
to day and knowing the people picking up the phone
and knowing the director of the Office for Aging and
Scohera County and saying, hey, we have this case, what
do you have available? What kind of resources can you do?
And building those bridges, as you said, Nina, is so
important as lawyers. We just don't have the time to

(37:01):
do that, nor do you want to pay us our
hourly rate to do that, because we're a lot more expensive.
So having a care coordinator work with your family, and
I've done it again several times. I've used everhome before
everyhome existed. I used Joe Jackson, and it made a
world of difference to our family bringing all the pieces together.
And my sister and I were battling, and I don't

(37:21):
know if you've ever had experience with this where the
family disagrees on the care plan. This happens a lot
in my experience, and my sister and I were just
at loggerheads constantly. And when we had Joe Jackson come
in and do the assessment of my mom, who didn't
want anybody in her house, but we were able to
get Joe in as my buddy, and he just came
in and did an assessment. Once we had that in writing,

(37:43):
and you do a written report, I think is part
of the in home assessment.

Speaker 7 (37:47):
That's correct.

Speaker 6 (37:47):
There's also a little summary provided for the consult but yes,
the in home assessment is a full, comprehensive written plan
of care.

Speaker 3 (37:56):
And so when we got that, my sister and I
sat down. We both read it. We looked at each
other and said, well, this is simple.

Speaker 2 (38:02):
You know.

Speaker 3 (38:02):
Here, here are the choices, here's the reality of the situation.
Here's what we need to do. And we both agreed
immediately on what the course was once we saw a
professional opinion with all of the factors. Your mom has this, this, this,
and this these here's their medical records which you look at.
She says these conditions, she needs this kind of help.
Here's what I recommend. Here's how many hours a day

(38:23):
she needs. Here's how we're going to find it. Here's
how you're going to pay for it. Put the plan together,
I said, go, let's go.

Speaker 2 (38:30):
It was that simple.

Speaker 3 (38:32):
And so you know, ever Home and Viva Links are
companies that provide that care to our clients. And we're
very relieved that I don't have to do that because
I don't have the time or the.

Speaker 2 (38:42):
Expertise to do it. We're very relieved that our clients
have the ability to.

Speaker 3 (38:46):
Use the professional services at ever Home and Viva Links.
And when we come back, we'll talk a little bit
more about our seminars that are upcoming where you can
learn more about this and talk about some of the
things that ever home provides that are so vital if
you are a caregiver. We'll be back right after this
short break. Welcome back Life Happens Radio. Glad you could

(39:14):
join us today. It's a little bit of a gloomy Saturday,
but I understand the sun is somewhere up there and
it may come out later today, if not today, tomorrow,
so we may see the sun. And we hope that
you're enjoying your weekend. It's summertime. I hope you're enjoying
all the things that you're doing. And if you're a caregiver,
we hope that you're able to manage the stress and

(39:35):
all of the issues that are presented to you on
a day to day basis as a caregiver, because it
takes your life in a direction that you never expected
and you become a slave to the caregiving that you're doing.
And I've had people tell me that their relationship with
their parents was not a child parent relationship, it was
a caregiver care recipient relationship. We're gonna talk a little

(40:01):
bit about that and how do you get that relationship back,
and how to find the help that you need to
get that relationship back. We have some seminars coming up
and I want to put those out there one more
time this week July seventeenth in Saratoga at the YMCA
and Southern Saratoga that's one Wall Street. You can join
us on the seventeenth at twelve noon to register. Lunch

(40:23):
is provided, and twelve thirty to one thirty is the program.
It's legal, financial, and care issues rolled up so that
you can get a handle on all the things that
you have to do as a caregiver to fulfill those responsibilities.
We're gonna repeat this program in East Greenbush at the
East Greenbush Community Library on Wednesday, August sixth at twelve noon,

(40:47):
and again in Guilderland at the Guilderland YMCA Wednesday August
thirteenth at twelve thirty. You can always find these on
our website because we're part of this Piro lot, and
if you go to pier Law dot com events, you'll
see each one of these and you can register on there.
You can email us at info at pyrolaw dot com

(41:07):
to register for these seminars, or you can register by
calling our office anytime at five one eight four five
nine twenty one hundred This is such an important issue.
It's going to become more important as budgets begin to
get cut and services begin to get cut. So I
want to cover one more issue. And then we're going
to go back to the caregiver relationships, and this is

(41:31):
they want my husband home. I want my husband home
from rehab, but he still needs help, and they're telling
me that I don't have a care plan in place
for a safe discharge. How do I know that I
can handle his care at home? And how do we
make this transition. He went to the hospital, he's now

(41:53):
in rehab. How do I get my husband back home safely?

Speaker 2 (41:57):
Nina?

Speaker 7 (41:58):
Sure?

Speaker 6 (41:59):
So first things first is we would want, ideally for
this client probably to offer a decent number of hours
to do some work because it sounds like we would
want a full medical review.

Speaker 7 (42:13):
We would want to.

Speaker 6 (42:14):
Look at those rehab notes, the hospital notes we would
want to attend or.

Speaker 3 (42:19):
I'm just going to say that as a as a layperson,
reading hospital notes is like reading Greek.

Speaker 7 (42:24):
Yeah, it's super quick for us.

Speaker 3 (42:25):
We just kind of just don't know what's in there.
Or talking to a medical provider, they talk to you like.

Speaker 7 (42:31):
Your you're specialist.

Speaker 3 (42:33):
Or that you're two years old and they won't tell
you anything. But if you're a professional peer.

Speaker 7 (42:38):
To peer, it's different.

Speaker 2 (42:39):
You could read there and have a conversation. It makes
a world a difference.

Speaker 7 (42:42):
It does.

Speaker 6 (42:43):
So when they say mild cognitive impairment or early moderate
severe stage dementia, Alzheimer's, Louis body frontal dementia, you know, Parkinson's,
any of these kinds of things, we know exactly how
to respond to that. And so so part of that
getting someone home from rehab, knowing their existing conditions, what's happened,

(43:05):
and then finding out what their current level of function is.
So for us, we would want to attend a care
plan meeting, a discharge plan meeting is what they would
call it. At the soil at the facility, we would
work with a social worker there and we would coordinate
care and we would establish a care plan. So that
might include then a comprehensive assessment, so we could look
at the client head to tell go to the home,

(43:27):
check it out, see what's needed. Because maybe it's that
lighting system that you talked about, but maybe it's Viva links,
or it could be we need a fall detection necklace,
not a fall pendant with a push button, because what
if Dad's unconscious?

Speaker 3 (43:41):
Yeah, Diane, as a physical therapist, this is something that
you were involved with and discharge planning, and you worked
actually with technology at the VNA as well.

Speaker 4 (43:51):
Yes, so I have experience in that realm and knowing
that getting the right resources in place is very important.
I just want to step back for us a second
and add on to what Nina was saying. The other
word that I don't think we've used that much today
is another service that we provide at over home, and
that's advocacy, and we would be an advocate in this

(44:11):
situation as well. We would go sit at a care
conference because sometimes the goals are not the same, not,
you know, for any reason other than that the goal
of the facility is to help you get out of
the facility, and sometimes they don't know what your situation
is at home, or they don't know what the resources are,

(44:34):
and a lot of assumptions are made, and we can
help with that advocacy and then doing a physical assessment.
When Nina was saying, you know, talking about different levels
of cognitive impairment, I was also thinking another language that
I speak very fluently is maximum assist stand by contact guard,

(44:54):
assist of two sliding boards, all of those things. You
can see that written, but do you really know what
that means? And as a therapist and someone who's been
in healthcare can help weed through those kind of issues
as well.

Speaker 3 (45:08):
And if you call a home health agency and say, hey,
we want to bring my dad home or my husband
home and I want the home health agency to come
in and help me transition him, what do you get?

Speaker 4 (45:19):
So we were talking before about licensed home care agencies,
but it's important and we could be on this show
for four hours. Well I know we can't. But licensed
home care agencies and certified home health agencies are two
different animals so to speak. Some companies have both. The
licensed agency that we talked about before, so essentially a

(45:41):
private pay agency that's where you can get long term services.
You pay for it. There are some payers, but that
is not Medicare covered. So if you're coming home from
rehab and you need home care, that is most likely
Medicare covered. It's short term, it's intermittent, and there have
to be goals to transition to either taking care of

(46:03):
things yourself.

Speaker 3 (46:04):
Here's the big question for me, how many hours a
week from that Medicare skilled care coverage are you getting
because people say, oh, we have home health care through Medicare.

Speaker 2 (46:11):
What does it give you.

Speaker 4 (46:13):
It may give you a nurse that visits once or
twice a week. It might give you a therapist that
visits once or twice an hour for an hour. You
may get a home health aid for two hours a week.
It is not long term care. It's short term intermittent care,
which means that you have to be able to provide
the care in between or find somebody else to do that.

Speaker 3 (46:36):
Yeah, and following up on that, Hospice, to me is
a wonderful program, provides wonderful services, but it's very misunderstood
by a lot of people.

Speaker 2 (46:43):
And this is one of the issues with hospice as well.

Speaker 4 (46:45):
Yes, and I will tell you that I have experienced
there too. My mom was on hospice and I advocated
for her to be on hospice. People don't necessarily understand
that hospice isn't a death sentence, an imminent death sentence.
There used to be a billboard that hospice had out there,

(47:07):
that community hospice had out there that said live longer,
live better, involve hospice sooner so that could be a
whole other show. But hospice is great, but again, they
aren't going to provide an aid and I think that's
what we're really talking about, a to do personal care
for more than one or two hours a week unless

(47:29):
it's a special situation.

Speaker 3 (47:31):
So as lawyers, what we very often have to do
is educate our clients. Every home becomes very valuable in
that continuum. That's why we're doing seminars together. Educate our
clients and the realities of what they're going to get
from hospice or from Medicare skilled rehabilitation care, and then
look at what the alternatives are to provide. How do
you get mom showered, how do you get her up

(47:51):
and dressed in the morning, activities of daily living, and
that's medicaid, And so we will look at Medicaid and
getting Medicaid in on top of that so that you
have a coverage for the long term care, the things
that you're going to need to stay at home long term.
And Medicaid is not an easy program to navigate, as
we know, Nina.

Speaker 7 (48:10):
Yes, and it just recently changed.

Speaker 3 (48:12):
It's changing, Yes, So happy we're going to talk a
little bit about that at seminar because there are things
called activities of daily living, and that's how they measure
your needs. And the old rules said that you need
to need it to have two out of six activities
of daily living that you required substantial assistance with.

Speaker 2 (48:29):
They're elevating that to three.

Speaker 7 (48:31):
That's right.

Speaker 6 (48:32):
And there is a grandfather clause if you have your
evaluation done before September first, or it's scheduled before oh
September second.

Speaker 7 (48:40):
Excuse me, oh September one.

Speaker 2 (48:42):
Oh yeah, no, no, I'm I'm anyway signaling the engineer.

Speaker 6 (48:45):
Yes, there's sound engineering going on. It's very complex. Yes,
So the medicare home care stuff that we're used to.
Our bread and butter just got the rug pulled out
from under us. Everything is going to change and we're
changing with it. So we're growing and learning getting medicaid
in the home. If it's home care, we might be

(49:06):
talking about there's more language there, there's more lingo. You
might hear of the Nursing Home Diversion and Transition waiver,
you might hear about the TBI waiver.

Speaker 3 (49:17):
And I will say, if you're in this game and
you're looking at what the options are for medicaid homecare,
come to one of the seminars your home or the
nursing home. Go to our website at purolow dot com
and you can get the full range of all the
educational programming we have. We have Medicaid Monday coming up
this Monday, which we're going to talk about some of
these rules on Frank Heming and I are going to
be doing that, so stay educated. Purolo dot com is

(49:39):
a resource. Everhome dot com is also a resource, Diane.
How do they find you.

Speaker 4 (49:46):
Ever homecare dot com? Just search ever Home. We have
a fantastic new person helping us with our online presence,
so I think you can find us a lot easier now.
Or there is the thing called the telephone five one
eight four zero seven one six two five five one
eight four zero seven one six two five. You don't

(50:08):
you get to speak to a person, but you get
access to a team, and you're listening to that team
here this morning.

Speaker 3 (50:14):
Nini Risandez, Cherry Ketapano, Diane Mikol Gottabiewski, thank you for
joining me today. It's been a very educational show. I
hope everyone that's listening enjoyed it. And if you're a
little bit afraid. Maybe you should be, but you won't
be afraid once you have a plan in place. Take
the angst and anxiety away, get peace of mind, get

(50:35):
your legal, financial and care needs in order, and we
hope to see you again next.

Speaker 2 (50:39):
Week, right back here on Life Happens.

Speaker 1 (50:42):
You've been listening to Life Happens Radio, brought to you
by the law firm of Piero Connor and stress.

Speaker 3 (50:48):
For more information or it's a contact and attorney at
the firm, visit Piro Law dot com or call five
one eight four five nine twenty one hundred.

Speaker 1 (50:57):
Please join us again next Saturday at nine am for
Life Happens Radio on News Radio E ten and one
oh three point one WGY, and you will be prepared