Life Happens

April 6th, 2024

Episode Transcript

(00:00):
Good morning everyone, Welcome to LifeHappens Radio. I'm Lupiro, your host
for this morning, and we havea very special show for you today to
Life Happens. As a show webring every weekend morning on Saturday at eleven
am to try to educate you onthings that you need to do to prepare
as we all age as we gothrough our lives. Life happens. That's

(00:20):
part of it. If those forthose of you who felt the tremor on
Friday, there was an earthquake inNew Jersey, if you hadn't heard,
and earthquakes happen. On Monday,we have an eclipse which is going to
tie up traffic are here, butprobably not have a direct impact on your
life. But every day we facerisks and we face things that change the

(00:41):
way our lives and our trajectory inlife is going. So how do we
deal with that? How do weplan for that? How do we prepare?
We do legal documents. Our lawfirm is pier O'Connor and Strauss,
so we do wills, trusts,powers of attorney, healthcare proxies, look
at financial issues, financial planning,retirement. But today we're going to focus
on another topic that is very closeto what we do and something that is

(01:06):
an outgrowth of what we do,and that is planning for long term care.
And when I say long term care, I don't mean a nursing home,
because most long term care is notprovided there. Most people, if
I ask them, say I wantto age in place. I want to
be in my own home. Idon't want to leave the comfort of the
house that we built, or thehome that we're in, or my apartment.

(01:27):
I want to be where my comfychair is, where my things are,
where I can live my life asI have and I don't want to
have to go to a facility.So today we're very fortunate to have with
us in studio two professionals who arewith a company called ever Home Care,

(01:47):
and that's the theme, you wantto be ever Home. Ever Homecare Advisors
and Diane Mikkel Gottabiowski and Nina Cressandaare with us today and we're going to
introduce each of them. Diane,Good morning, morning lou and Diane,
just for our listeners, a littlebit about your background, how you got
into this field of healthcare, longterm care. Sure, I'm a physical

(02:10):
therapist. I've been a physical therapistfor over forty years and working with aging
adults has been my passion. Andthat's because I've been surrounded by older adults
all my life, my family members. I was blessed to have many many

(02:30):
great aunts and uncles. I gotinto physical therapy, as most people do
with health care, to be helpa helper and to assist people, and
decided that helping them stay home that'swhere the problems are, that's where the
challenges are, and helping them stayhome physically and from a safety perspective was

(02:51):
what I wanted to do, andthat led me to at this point in
my career, helping people stay wherethey want to be from a little different
perspective, helping them tie to otherresources, helping them connect with other people
that can help them and services thatcan help them. So here I am,
and I'm aging as well, bythe way, aren't we all?

(03:12):
I mean that's the day you're bornis the day you start aging. So
some of us have advanced further thanothers. Yes, we in that regard.
But this is a family situation,isn't it. When we talk about
long term care? Okay, dadhad a stroke, Mom's got dementia,
Dad's her caregiver. Dad's now inthe hospital. What do we do.
I mean, that moment, thatcrystallization of our life just changed, and

(03:37):
we are not prepared for it.That hits us like a ton of bricks.
It sure does. And you knowfrom my personal experience that I was
blessed to have my mom until lastyear we were very close dementia and lung
cancer, but she obviously needed moreand more care as time went on.

(03:59):
I'm equally blessed to have my dad, who is still healthy at ninety years
old and was able to care formy mom. But their starts to show
gaps in the care their start.The evolution is that you need a little
more help here and there. Unfortunately, there is a fact to aging that
we get weaker, we need morehelp as we go on, depending on

(04:23):
what our situation is. So beingable to be involved in this organization,
being able to help my mom,support my mom, while still helping and
supporting others has been a blessing forme as well. And I know I've
said a lot of blessings there well, that deaths. We're past Easter,
but we can We'll take all theblessings we can get. And Nina,
you are new to ever home careadvisors and you are in the healthcare profession

(04:46):
as well. Tell us a littlebit about that. That's correct, and
good morning Loo. I'm an occupationaltherapist. I started about seven years ago
working with adults with disabilities. Ireally have always loved the older adult population.
Not that working with kids isn't great, but I have just had this
passion for older adults. I've beenfortunate to be a traveling therapist, so

(05:09):
I've been able to go to differentstates and work in them and see how
healthcare is provided there, again witholder adults and skilled nursing, acute care
as well as a few different settings. But my last position, I was
able to work in an older adultcare environment where I got to see everyone

(05:29):
wanting to age in place, butmissing that care coordination piece, and it
was over and over again. Theyneeded just a little bit more help,
but they couldn't find it, andit became very frustrating for me. And
that's what led me to this position. And this job is I get to
now be the person that connects othersto resources and things that can allow them
to stay home and allow them tobe comfortable and be dignified and be respected

(05:55):
and not have their choices just takenaway from them. I've been a care
give her now four times over mydad thirty years ago, my mom who
had Alzheimer's and who we struggled mightilyto try to get a care plan for
her. And in that struggle,and I'm an attorney, I'm an elder
law attorney. I was the chair, big deal, the chair of the

(06:16):
Elder Law Section of the New YorkState Bar Association. I knew every commissioner
on the State Department of Health Officefor aging. And my mom lived in
a town called Hudson, New York, and I could not get services for
her. I called every number thatI could think of. I was given
all of these references and referrals.Information and referral folks. It's an empty
promise. And when you get informationin referral, you call the number and

(06:40):
say, oh, my mom needshome health care. Can you help me?
Oh well, here's another number.Call these folks and maybe they have
somebody that can help your mom inher home. And at the end of
the loop of phone calls, Icalled the same number I called first,
and finish the eternal loop of nohelp. So I was lucky enough to
reach out to a gentleman I wasintroduced to by the name of Joe Jackson,

(07:03):
who at the time was called ageriatric care manager. And that profession,
Diane, is something that is nowcalled the Aging Life Care Association.
They've morphed their name a little bit, but it's the same profession. And
why are geriatric care managers so valuable? Geriatric care managers know the system,

(07:25):
they know the resources, they knowthe challenges that people face in their goal
to stay as independent as possible andto stay in their home. And they
also know the rules and the regulations. So it's a very complex system.
We know it can be very confusing, and the geriatric care manager can help
connect those dots, put those peoplein touch with each other. And when

(07:48):
someone gives an answer that's not correct, the geriatric care manager knows enough to
say, no, that's really nothow it works and can help them navigate
the system the way it was meantto be navigated and to get to where
the goal is. And it's theclient's goal. It's the person who's at
home, it's their goal. Andthe geriatric care manager works with the family

(08:13):
who may be providing care remotely orlocally, and the providers that are rendering
care, and the individual themselves.And I didn't put them last intentionally,
the individual themselves. That's why planningis so important, so people know what
you want before it's a crisis.Yeah, and every care need is different.

(08:35):
We have a lot of clients whoare self directing. They're physically disabled,
but they're fully able to manage theirown care. They just need help.
We have other clients that cognitively needmore assistance, and it could be
that's the children or a professional carecoordinator who is working with them. Nina,
in your experience in the healthcare systemas an occupational therapist, you were

(08:58):
helping people try to get back toa certain level of functioning. What did
you see and where did you seethe gaps in your job as an occupational
therapist. So I would be ableto work with people, you know,
for a set limit of time dependingon insurance. So, oh, insurance
plays into Oh, of course,insurance makes all the rules here. So

(09:22):
as much as I would want tocontinue to see someone to get them to
that back to their baseline as wecall it, we would work on strength,
We would work on getting dressed andbathed and all of those functional tasks
that you need to do to beable to stay home independently and to get
back to that and be safe indoing that. And the gaps were I

(09:43):
wasn't able to be there all thetime, and there weren't staff that were
able to be there to help withthe follow through. So there was that
big gap that occurred that people weregetting services, learning new skills, and
then where's the follow through after?Right? And Dan, I know that
Viva Links is part of the everHome portfolio and it's a fortunate combination.

(10:07):
You have a care coordinator that isnow having the most well developed technology in
the home. Scary word technology,but it's tools for people who want to
age in place and for caregivers.We're going to get in through this a
little bit more, but just tellme what that means to a care coordinator
to be able to monitor things remotelyand to have the care giver and that

(10:30):
was you have that tool that allowsthem to communicate and manage a care Absolutely,
it's critical and it's very reassuring toknow that you're not there, but
you're there virtually. And twenty fourto seven care people are told they need
twenty four to seven care, butthat's not always twenty four to seven physical

(10:52):
care. That means somebody needs toknow what's going on twenty four hours of
the day. And this technology,Viva Links specifically, can have sensors in
the home. It has means tocommunicate with the individual in the home.
At the touch of a screen,you can find out what's going on.

(11:13):
You can monitor medications, you canmonitor appointment and in my personal case,
it allowed me to come to work. It allowed me to check in as
needed. I knew when appointments wereand I could get information if something was
out of the ordinary, I couldsee that in advance, and often you

(11:33):
can get ahead of a problem.So it's just critical. It's the communication,
it's the connection. So we're fortunatethat people are looking at this and
willing to participate. And we hada group in Columbia County, New York
called the Home for the Aged,and the Home for the Aged had no
home because they sold it. Theycouldn't manage it. It was over one

(11:56):
hundred years and this wonderful nonprofit organizationtook care of people in this assisted living
facility for many many years, butthen couldn't run any longer. Sold it.
Now had a little bit of moneythat they wanted to put back into
Columbia County and they have funded apilot program that's been going on now for

(12:16):
over a year, almost a yearand a half, so people are utilizing
care coordination with this in home technology. And now the in home technology is
really starting to sizzle with AI andwe'll get into that in the second half,
but we're going to have on whenwe come back from the break.
One of those caregivers who is aprofessional it happens to be a healthcare professional.

(12:41):
Her name is Susan Cappelletti, andSusan's going to join us when we
come back to talk about her experienceand the pilot program will talk about that
down in Columbia County. Ever HomeColumbia it's called And when we come back,
we're going to unpack this because folks, if you're a caregiver today or
you need care, it's not today, it's going to be tomorrow. So
stay tuned. You're listening to LifeHappens Radio on Talk Radio WGY. We're

(13:05):
going to be right back after thisshort break. Welcome back, and yeah,

(13:31):
we all need somebody to lean on. Thanks Zach for that intro.
I'm Lupierr, your host for thismorning. We are live in studio with
Nina Crisanda, occupational therapist and lifecare coordinator with Ever Home Care Advisors.
Diane Mikkel Gottabiowski, an occupational therapistand life care coordinator and manager a shoot
physical therapist, shaking her head atme, I should know that with Ever

(13:54):
Home Care Advisors. And we haveon the line with us Susan Capelletti.
Good morning, Susan, Good morning, Lou, thank you for joining Good
Hi, Susan, thank you forjoining us this morning and for bringing to
our listeners your real life experience asto what it's like. And Diane lived

(14:15):
this, but we're gonna a lotof people live this. You had two
parents that needed assistance, and youwere an RN working at a local hospital,
not next door to your parents,but working about forty miles away.
And how to manage that situation whereyou're the primary caregiver and you know that

(14:37):
you need to manage care and beresponsive to those care needs. Tell us
before you got into this pilot program, what were the struggles as a caregiver
trying to work and to take careof two parents that had very different conditions.
Thank you, Thank you for invitingme, so I can say I

(14:58):
could see struggles from two different perspectives. I was a case manager and him
a case manager in a hospital.So I'm looking and talking to families who
are being discharged, who are sayingI can't care for myself. Families are
saying I work, there's nobody hometo health care for mom or dad or
grandma, etc. And trying tosee whatever I could offer from a hospital

(15:22):
setting to that transition, which wasquite limited. You know, maybe if
they were eligible for home care,I could ask a social worker to go
in, but there wasn't a lotthat I could do in terms of that
transition, though I knew that therewas that need. Yeah, and just
to stop out there. This iskind of the endemic problem in the healthcare
system. Nina brought it up.She's an occupational therapist. She gets an

(15:43):
hour or two with the client anddoes as much as she can do.
You're an URN. You get anhour or two with the patient and do
what you can do, But thenthey get passed on and there is no
handle exactly. There's a real hugegap. And even if they were handed
off, what's available is so muddy. It's really hard even for me as

(16:07):
a healthcare professional to find out whereto go, who to ask. I
didn't know the resources available. Sothere were two things that happened. When
my parents had moved in with meyears ago, they started to decline.
I was noticing the writing on thewall with Dad's dementia was worsening. So
at that point, all of hisadvanced directives were still listed. Moms were
putting him as his power of attorney, and he was the healthcare proxy.

(16:32):
So we had decided we needed tomeet with an elder attorney, and knowing
the community that Lou was from andour families worked together, we met with
you, Lou, and there weretwo very influential things that happened at that
meeting. One the first one wasafter reviewing everything you did say that they
my parents would be eligible for Medicaidin the community. And that was huge

(16:55):
because there's no way to pay forcare unless it's out of your pocket.
So if you want AIDS and helpin the home, knowing that you were
able to look at that and say, even though there's a spend down,
there's a way to manage that witha pool of trust. So that was
huge on one level because I couldget more resources for them in the home.
The second thing is that you talkedabout the pilot program with ever Home.

(17:19):
So that was so helpful because whatthat was able to do was to
bring a care manager into the home, someone who knows the community and the
resources, and to really kind ofmeet my mom and dad and myself to
talk about what our needs were,what could be helpful, and what resources
where to access that. Again,otherwise you're on your own. You have

(17:41):
a phone book maybe or word ofmouth where to go to. So Shoe
came to the home. Was reallyhelpful developing a plan of care for us,
and then at the same time wetalked about other needs. I work
full time. I work full timein Albany, so between the commute and
the work hours, I'm gone tenhours the day at least Monday through Friday.

(18:03):
That became too long to keep momand dad here without any oversight.
So aside from the Medicaid helping toget a caregiver for a few hours a
day in the home, I wasable to have some technology that I can
at a glance at any time knowwhat's happening in the house. Anything from
an alert let's say Mom's she hasthe pendant that will go off even if

(18:26):
she doesn't press it if there's afault. That was really helpful. We've
had to utilize that a few timeswhere it would go off. Sometimes thankfully
it was a false alarm. Butwhen that alarm goes off, I'm able
to access her from the house througha couple devices that I have that were
provided through this pilot, either througha camera that we can talk back and

(18:48):
forth Mom or you okay, yes, it was just an accident. You
know, I'll explain to her againhow to turn the alarm off. There
were other devices of you know,how often she's getting in and out of
bed. There was the ability forher to use her iPad because when my
dad's dementia was worsening, she wouldneed she's elderly, would need to take

(19:10):
her you know, time her restperiods, and having him in another room
was worrisome to her. So shecould on her iPad literally go into the
camera in the living room and seethat he's sitting there contently watching TV.
Or there could be an alert fromthe pad or the back door or the
any of the sensors that he's movingand that would alert her to say,

(19:32):
oh, I got to go checkon him. So the ability to have
the care manager combine that technology washuge. I had been away, there
were times that I'm you know,had traveled to see my family, my
children that are out of state,and I'd be able to check in on
them. I could look on theapp. I could look at activity in
the house. I could see ifthere were any alarms that went off,

(19:57):
any alerts there. I could writefor the app just to a video call
or a phone call with like onebutton the other piece. That was really
helpful in terms of managing one toour home. There's different doctors, there's
different appointments, there's different agencies.To be able to have everything on that
app. I have all of hermedications, I have her advanced directive documentations

(20:18):
on there. I can have let'ssay, if I'm not there and the
caregiver takes her to a doctor's appointment. My mother used to always say,
oh, I don't know if I'mfree that day, meaning I might have
another doctor's appointment. Right the caregiverslook right on the app, look on
the calendar and say, yes,Tuesday at ten is perfect. So it
has been a relief for me asa caregiver to be able to kind of

(20:41):
glieve and know that I can't controleverything that happens in the home, but
at least I can be aware ofit, and that's been super helpful.
Susan, that's that's an amazing story. Thank thank you for sharing that with
us and with our listeners. AndDiane. Ever Home has Everhome Columbia,
which is the pilot, but Everhomeis doing this not just in Colombe County,

(21:06):
but talk a little bit about whateverhome does in the broader reach of
Everhome Sure. Ever Home Care Advisorsis a care coordination company and actually ever
Home Care Advisors provides a certain amountof care to the pilot participants where we're
providing those services, and that iswe call them a life care coordinator in

(21:32):
our organization, as Lou alluded topreviously called geriatric care manager. Life care
coordinators can work on different issues thatpeople come to us with. So the
kind of calls we get are I'moverwhelmed, I can't do this anymore,
or my mom's in the hospital andthey say she has to come home tomorrow,

(21:55):
and what can I do? Ihave to work, or I don't
think I can afford what they're recommending. I don't know what I'm eligible for.
I have a long term care insurancepolicy, does it pay for anything?
So we sit down with clients,we do an assessment. We can
do an assessment in the office togo over their needs and what their resources

(22:18):
are and what their concerns are.We can also do a home assessment,
which is a safety assessment, lookingat perhaps barriers. There might be space
issues, there might be navigation issueswithin the home, there might be repair
issues, and the person might nothave the resources to get those things taken

(22:40):
care of, and we can helpconnect them to agencies to start to fix
those small problems that become large problems. Before we were talking about aging in
place, what we do to keeppeople in the home. And one of
the things about home is it's afamiliar place and familiar enhances safety. Going

(23:03):
to a new place often is disorienting. So we help people find those resources
based on assessment, and then wetravel with them through this process and we're
always there to go back what didwe do before? What are your needs
now? Referring them to agencies,to elder law attorneys, to occupational and

(23:26):
physical therapists, to health systems toget them the care they need and get
it paid for through benefits they mayhave but don't know how to access.
And as an elder law attorney happenedto be one, I don't know how
we function without care coordination because asan attorney, I have a limitation.

(23:47):
I'm in my office and I'm goingto do a trust or will get as
with Susan's family, get people onMedicaid because it is possible. We talk
about it all the time, Weeducate on it all the time. Frank
Hemming, associate does medicate applications everyday, and it is something that when
you look at the whole range ofservices and you've got attorneys and care coordinators

(24:08):
working together, we think that isthe most potent combination for our clients.
And that's why we love working withover homecare advisors because it solves a piece
of the puzzle that is a lawyerI couldn't solve for my mom and I
just needed that help with Joe Jacksonand now with over homecare Advisor, Susan
stay with us. I want totalk about your mom and dad's response to

(24:30):
the technology because a lot of peoplewhen we bring this up, they say
Oh, my mother will never gofor that, So stay with us,
stay tuned. I'm Lupiro, yourhost for today, and you're listening to
Life Happens Radio. Caregiving is whatit's all about today and if you're not
one now, you're likely to beone in the future. So stay with
us. We'll be right back andwe're back. Thanks for listen the Life

(25:00):
Happens Radio. I'm Lupiro, yourhost with this morning. We're talking about
care, how to get care,how to find it, how to pay
for it, how to be inyour own environment. And that is so
important to ninety nine point nine percentof our clients. They want to be
where they're comfortable where they are.And my mom, God bless her soul.
She passed away a number of yearsago, but her statement to me
and my sister was the only wayI'm leaving this house is feet first,

(25:25):
and she was going to hunk herdown. And it took us going and
finding a care coordinator. My goodfriend Joe Jackson, who for the last
twenty five years has been a friend. From that experience, we actually have
worked together over the years and Joefound caregivers for my mom. He had
put ads in the paper, Heinterviewed them, he did background checks on
them, he hired them, hemanaged them. He did all of those

(25:48):
things for our family because I wasworking, you know, an hour away,
my sister was working two and ahalf hours away, and we were
it. So Joe provided a vitalfunction for us and helped our moms stay
at home where she wanted to be. Nina, you've approached this from a
variety of perspectives as an occupational therapistand now as a care coordinator. Susan's

(26:12):
story is one that resonates, Iknow with me and with Diane. How
do you approach this from your newperspective as a life care coordinator. Well,
it sounds incredibly challenging. And thefirst thing that I approach my clients
or my client's family with is empathy, hearing them out and really putting myself

(26:33):
in their shoes as best as Ican. And when they tell me what
is going on, I'm thinking solutionsfirst. This is what we can do.
Okay, this is what's most appropriate. Number one, safety, number
two, whatever, the next goalis. We want to work together collaboratively
while the person evolves in their care, so we are able to be on

(26:55):
top of things, prevent things.And so when I think about Susan Cappilletti's
parents and their safety, integrating thetechnology seems to have been so paramount in
her ability to stay at home andtheir ability to stay at home and her
ability to stay at work. Sothe way that I view it is just
empathy first and you know, reallyfollowing what the goals are of the person.

(27:18):
But safety comes down to a lotof things, absolutely, And Susan
as an r end in the inthe hospital, you're working with patients,
you see them come through, yousee them come in, go out.
The healthcare system is just not builtfor the patient. So the healthcare system
is so not built for the patient. And they call it a healthcare system,

(27:41):
but it's truly a sick system becausepatients will come in with medicare,
the elderly population, they'll have theirMedicare or their managed Medicare, and they'll
say, well, doesn't my insurancepay for AIDS or doesn't my insurance pay
for you know, whatever it isthey're looking for, And in reality,
insurance will pay for home care fora very short skills period of time.

(28:03):
That's what your Medicare pays for.But after that you know, they don't
pay for what's called chronic care,which is your day to day needs,
whether it be the caregiver, thehome health aid, a shopper, all
of those things is not paid forby the healthcare system. And so many
patients come in and I'll say thingsto them about, well, have they

(28:25):
ever thought about if you can't stayhome alone anymore? What your plans are?
And patients they people don't, Theydon't want to think about that.
It's they just well that they takeday by day. Each day is okay,
they're home for that day. Butmy worry is, and my experience
was watching this, which is whyI really reached out to you, was

(28:45):
if you're waiting until you need it, it's too late. So it takes
a long time to get some ofthese services in place, particularly the medicaid
and then the aids, you know, the aids that you hire yourself,
the consumer directed ones that take awhile. So I just encourage patients and
families everywhere. You cannot rely oninsurance, and unless you have oodles of

(29:07):
money, you really can't afford topay for care at home because it's extremely
expensive. So to start the processof just you know, inquiring about where
do I start, What are someof the options I have going down the
road and getting those ideas early ratherthan when you need it. Then you're
trying to make decisions from a hospitalbed, and that's not the best place

(29:30):
to make decisions. I couldn't agreemore and oodles of money, just for
those who don't know what this kindof care costs. Nursing homes in the
Capital region right now are averaging aroundtwo hundred thousand dollars a year. So
put that into your budget and smokeit. See what you can afford along
with a check every month for sixteenthousand dollars? Can you budget that into

(29:53):
your budget? A lot of peoplehave purchased long term care insurance, unfortunately
not enough. But if you dohappen to have a policy of long term
care insurance, that is your firstfirst line of defense. I can tell
you when people come to see me, they've never looked at that policy.
They don't know what's in it.And one of the things that's in it
in most of the contracts is acare coordination benefit, which day they don't

(30:15):
know is there. Where there's nowaiting period, they can get your services
paid for by their long term carecontract right, and so that's a question
we ask right up front, doyou have long term care insurance? And
we all know it's complicated. It'scomplicated to travel through this life, it's
complicated to age through this life,and so many people. Let's use the

(30:41):
example of a woman who is lefthome alone her husband passes away and he
took care of everything. She mightnot even know she has a long term
care insurance policy. So there's alot of detective work that goes on.
There's a lot of exploration that goeson. Yeah, and Susan, you're
right on target. Once you needthe care you've you're out. You're now

(31:06):
scrambling. It's no longer planning,it's reacting and there are still many many
things that we can do. Thegood news for Medicaid home care and if
you want to learn more about Medicaid, which is the only program that covers
these services, on our website,we have a series of videos we call
them Medicaid Mondays. We do themlive every second Monday of the month.
But we have all of our prerecords on there, including Medicaid home care,

(31:30):
how to qualify, what the limitsare, how to use the pool
trust, how to get care,and we're going to talk a little bit
about the assessment process, which nowis just so daunting. That's on our
website purolaw dot com. You canview it. You can do it at
your leisure. But Susan, whenit came time to look at this,
did you have any idea that yourparents could get medicaid? I had no

(31:52):
idea. Working in the hospital,you would always hear, you know,
is someone Medicaid eligible? And thefirst thing that would always come back after
read you know they're over income,know they're over income, and that just
shut it down right there. Idon't know if it's a different type of
Medicaid they were looking for, butregardless, no, there's only one I
knowed. So most people are justmisinformed on it exactly. So then you

(32:14):
would hear, oh, there's aspend down and then you have to send
bills in every single month to makesure to keep it current, and that
was just a daunting thought, especiallyfor two parents to try to manage that.
But that's when, with further discussionwith you, came up the pool
trust that really does manage that spenddown piece of it behind the scenes without

(32:36):
having to save all your receipts eachand every month and send it into the
social services. So one of theexpenses that we do pay for out of
the pool trust is the care coordinationand technology, which Medicaid doesn't provide.
I mean, the government doesn't provideany of these things. Folks just don't
even think about it. You're incharge, you're on the hook. So
when it comes time to find someonewho knows how to navigate the system and

(33:01):
work the system, you want yourlawyer, you want your care coordinator,
and you want them working together becauseit is a one two punch that really
gets the benefits you need and helpsyou manage and coordinate them. But one
of the things that really is novelin this system now, through the pilot
and you know, branching out,we're watching vv links grow and it's growing

(33:22):
across the country in different markets.But is the technology that you mentioned earlier.
And one of the things one ofthe scary things when we talk to
clients about this and we say,oh, there's technology, Oh, my
parents will never go for that.They can't even turn on the television.
How hard was it to get yourdad and your mom to adopt the technology?

(33:45):
I think because the technology was prettyseamless. It was pretty easy.
All of the other like the devicesin the whole are pretty discreete so it's
not anything they have to do forthe devices. When it came to what
my mother calls her brain was thetablet that was provided. It's a larger

(34:05):
looks like a computer screen, kindof a larger one, and it's all
touch screen, so it's not thatshe needed to have a keyboard or have
to manage anything other than pointing andswiping. That she was able to kind
of engage in that. She reallyloved the calendar piece because then she could

(34:25):
look at either daily or weekly what'scoming up. That kind of helped to
keep her focus. The piece thatmy dad, because his dementia was progressing,
he wasn't as engaged with that untilmy mother. We had it on
a rolling cart the screen so wecould plug it in different areas, so
when they were on the couch,she would start to either play games,

(34:46):
the word search, solitaire, thingslike that that he was still able to
engage and to work with. Healso started his ability to read. He
didn't lose, so he was startingto You would read the news or read
the stories, or there were kindof quotes for the day, you know,

(35:07):
Catholic quotes for the day, etcetera. So for him, the
dementia piece that helped to engage hima little bit more. There were also
pictures that we put on and anyof my family members are able to just
send the pictures right to the tabletof what's going on in their lives with
their kids. So there's a scrollingslide show that was really the main screen
that we'd have up and he wouldjust see all these familiar faces and smiles

(35:31):
and you know, some pictures fromway back, some pictures current. That
was enjoyable to both of them.Definitely enjoyable to both of them. And
then the other piece that was superhelpful was my mother had the ability to
download YouTube videos for senior exercise classes, so things like balancing or yoga or

(35:54):
Thaie Cheek silver slippers, all ofthose we would be able to Taylor which
ones were appropriate her. We didhave the help of Blessed Devin Farr at
Everhome, who was your IT guruthere. We would call him and have
him help us find you know,if I couldn't do it myself, he
would help to load up those videosfor her. So that was really helpful.

(36:16):
Also tell the tablet itself because itwas easy to access. It wasn't
difficult at all. It wasn't anythingthat technology that scared them, Dane.
Viva Links is at its heart anapp which integrates all of these various devices
and foster's communication. And I knowthere's some developments ongoing with Viva Links,

(36:38):
but you were also a caregiver andthis tablet was part of your parents' life
as well. And we have anotherclient who was part of the pilot program
who had never even turned on atelevision, never touch technology, but could
use the tablet because it literally isone touch and your use and how that

(37:01):
adoption occurs with drawing people in fromthings that they're familiar with, especially with
dementia patients, which many people thinkvought this would never work, but drawing
them in with those family photos andvideos and things. It was to me
critical for my mom toward the endof her time with us that my father

(37:25):
used to say that she watches thattablet more than she watches the television,
he said, But she would belooking at it and a picture of her
brother in high school would show up, and she would get this huge smile
on her face or a picture ofher granddaughter. It didn't really matter what
generation we were in. She recognizedthose pictures. She probably couldn't tell us

(37:50):
who it was, but it wasa recognition and it made her happy.
And if you read about dementia,and there are a couple of books about
from dementia patients writing these books,while they still can remind us of our
past, show us pictures, itconnects us to our identity. So I
felt it connected my mom to heridentity. And Susan, your mom said

(38:14):
something that I thought was very helpfuland telling with regard to the tablet and
the sensors and the cameras and thehome. She said at one of our
meetings, I like the idea thatsomebody's looking out for me. I like
the idea that while they're not here, I don't feel alone and you're there,

(38:36):
Susan for her. So while somepeople think it's intrusive, there's a
lot of safety and a lot ofsecurity and peace of mind that comes with
us, and I think that outweighsit. Yeah, we have to take
one more short break, Diana,do want to give out the contact information
Forever Home, so in case anyone'slistening that wants to access this both the
phone number and maybe the website aswell. Sure so you can well Ever

(39:00):
Homecare Advisors at five one eight forzero seven one six two five. It's
ever Homecareadvisors dot com is our website. There is also if you like words
eight four four need TLC, youcan call that number as well. Five
one eight four zero seven one sixtwo five. All right, we're gonna
take a short break. We're gonnacome back talk more with Diane, with

(39:22):
Nina, with Susan and talk abouthow this new system maybe can revolutionize the
way that care is being provided andhelp people navigate this aging conundrum. So
stay with us. I'm Lupiro,your host for this morning. You're listening
to Life Happens Radio. We'll beright back after this short break. I'm

(39:52):
just gonna listen to this song,my brother. You're listening the Life Happens
Radio. Welcome back were we're talkingabout care, getting care, being at
home, being in your familiar surroundings, having your family, your caregivers part
of that care team, and thengetting professional help. Having an attorney like

(40:13):
someone from Pierre Connorance Strauss commercial commercialwho is an elder law attorney and then
having someone like Diane and Nina fromever Home Care Advisors and Nina, you've
been working with clients now and introducingthem to care coordination and what the services
are and the technology. How hasthat gone? And this is something that

(40:34):
I know that you are relatively newto, and that's kind of a good
thing because you're you're seeing it forthe first time in some of these situations.
What has struck you about this process? I found it actually quite simple.
My clients, they're very interested incare coordination. You know, a
lot of times they are, unfortunatelyin crisis, and we're going along the
care coordination path. We're working ondifferent goals of safety, getting care the

(41:00):
home, working on their power ofattorney and those kinds of things. And
at the same time, the family'slike, well, I would like more,
I would like more connection with them, So we talk through the technology
and then now we're doing technology.And it's even happened the other way around.
Where we do the technology. Maybewe do a basic package so they

(41:22):
don't get to speak with me ona regular basis as part of that package,
but of course they could always call, and then they end up needing
more care, so we end upbeing care coordinated partners as well. So
it ends up being just a reallyfantastic collaboration between care coordination and the technology
where the family gets to be reallyin charge and help the client, and

(41:46):
the client gets to be in chargeand stay at home, and I get
to help with all of the thingsin the middle that I used to not
be able to just as my priorprofession. So it's so wonderful and beautiful
in my opinion that we get toand I get to do this position because
it's been life changing so far,and as sousan as you know, being

(42:09):
in a hospital and being in ourend, this process leaves so many gaps
that need to be filled. Whatare you seeing from the hospital perspective?
Part of we see from the hospital'sperspective is delays and discharge and because it
takes time to get things in placein the home, and that's a huge

(42:32):
concern on so many levels because thatmeans somebody's in a hospital in a hospital
bed that doesn't require that level ofcare, and then you have people in
the emergency room who truly do thatcan't get to that bed yet. So
that's one of the biggest things interms of if families don't have the supports
in place already or planning in place, then there's that delay to get people

(42:54):
home, either getting them home orgetting people do a nursing home. If
they truly are saying I can't gohome, there's nobody and there's not any
time to put this in place.So that's one of the biggest barriers that
I see in terms of what happensto people in the hospital trying to leave.
So again when I said, ifyou wait till you need it,

(43:17):
it's too late. You know.That's why this would have been helpful to
have a lot of people have thatdiscussion of what happens if I can't stay
at home any longer, or whathappened, what happens if I need more
help to stay at home. Idon't think that's things that people explore,
and I think again the cost thatthey initially hear is what scares them away

(43:39):
of even pursuing it. So wecan talk a little bit about that,
But I want to talk about thetwo doors to the hospital, and you're
talking about the exit door, whichis looking at discharge planning and getting people
who have a length of stay thatis now way beyond what they truly needed.
But the entrance door, which istypically for most seniors, the emergency

(44:00):
room, and Diane, that's that'sno picnic either. Absolutely not the last
place any of us want to goas an emergency room. Nothing against the
emergency room, but if you've beenthere, you know. And one of
the features that we offer with VivaLinks and are the pilot program and Viva

(44:21):
Links, by the way, isavailable outside of the pilot program, just
not subsidized by the Columbia County Grant. The Home for the Age, the
Home for the Absolutely they deserve it. They're phenomenal, they're they're wonderful.
But one of the features of ourservice is something called we call Er at

(44:42):
Home. We have a telemedicine providerthat is part of the subscription and that's
twenty four to seven access to amedical provider, typically an emergency room level
provider, and you can call youcan do a tele medicine visit. There's
two ways to access or it couldbe a telephonic visit twenty four to seven,

(45:05):
so if it's in the middle ofthe night, or if you're having
transportation issues sometimes like Susan in yourcase, if you had two parents at
home and one needed to go tothe emergency room. And I know in
my case, I had to takemy dad to the emergency room once,
I had to bring my mom alongalong with me. And honestly, it's
something that could have been done througha telemedicine visit. So it solves for

(45:27):
so many problems, but mostly itkeeps someone out of that emergency room where
they might be for I've heard upto thirty six to forty eight hours just
waiting either for a bed or fordiagnostic tests. Yeah, and taking one
step further, the ambulance that's bringingthem in most cases is waiting in the
parking lot just to get them inthe door to the emergency room three four

(45:47):
or five hours. And that's aproblem we've that's been well documented in the
local media. Susan, what's yourexperience been with ers? Have you used
the telemedicine side of this. Ihaven't had to access the telemedicine, and
I have philosophy and I've had thisdiscussion with my parents of if you don't

(46:07):
need to go to the emergency room, do not go to the emergency room.
My mother did have a fall whileshe was at an exercise class,
and the first place that I evenconsidered was the urgent care because again,
it's you don't have that burden ofwait time of everything else that happens in

(46:30):
an emergency room. The second timeshe had the fall, the rescue squad
did come and they did ask,do you want me to take her to
the emergency room, and it wasno. You know, and people do
have that choice to say no,thank you. I want to do everything
I can in my power, andso does she to stay at home,
and even if that means if shedoes get hurt, then we end up

(46:52):
having whatever care we can or evaluation. We started having physical therapy in the
home now to help get her strongerso these falls don't happen. But I'm
telling medicine I haven't had the needto use yet. I know that it's
there, and I'm grateful that it'sthere. But whatever people can do to
stay away from emergency rooms, Iwould definitely recommend it because they are just

(47:15):
overwhelmed at this point, and overwhelmed. Somebody will come to an emergency room
because they say, I can't takecare of mom at home anymore. Mom's
not sick, she doesn't have anyreason to be in a hospital, but
families are bringing their elderly parents orgrandparents there because they can't provide that care
anymore. And then now it's reallymessy because insurance won't pay for the hospital

(47:37):
to stay. So there's so manyreasons to plan ahead, to think ahead,
and to get help ahead of time. And Nina using the tools that
are available as a care coordinator isso important to families. How do you
build a plan and how do youintegrate the technology and does it static?
I mean, aging isn't a date, it's a process. It's an experience

(47:59):
and aging continue use. How doyou deal with that in terms of monitoring
and then adding new pieces to thepuzzle in terms of home care. Absolutely,
aging is a fluctuating and ever changingprocess. So it's something that the
way that we address it is firstwe create a client centered plan of care

(48:19):
that is focused on what they preferand what they their goals are, and
then we check in. We dothese bi weekly calls that we check in
on all of our clients, soit's being proactive. We are being proactive.
We want to be preventative. Soand then for our pilot clients,
they get an hour every month sowe can be proactive. We can help

(48:42):
them with transportation services, we canhelp them with whatever they're looking for in
that time. And can you videochat with the patient in the home as
well? Absolutely, from my phoneor from my tablet that's in my office.
And Dane, that's something you've utilizedas well. Absolutely. I used
to worry about my mom and mydad. I'd have a meeting coming up

(49:04):
in ten minutes. I would peekin on the camera and then peek in.
They knew they were very comfortable withit, and I'd see my dad
wasn't in the immediate area, butmy mom would look, you know,
maybe sad or for Lauren sitting inher chair, and it made me sad.
I would just hit the button onmy phone and my picture would pop

(49:27):
up on her tablet and I wouldsee a change immediately. She was able
to reach out and touch the tablet, but if she couldn't, I could
answer it for her and I itwould improve my day and it would improve
her day, and it was peaceof mind, and then I could focus
and go to my meeting. Solet's ask the question, what does it
cost for a basic package for Vivalinks, and then what how do you

(49:51):
build forever home. I'll start withthe last question, Ever Home. It's
by the hour. There are differentpackages you can buy of time together,
but it's it is by the hourand or there are certain tasks or goals
we would work toward. You couldget a package if it was a Medicaid
application assist Viva links. Depends onwhat you get without the censors. It's

(50:17):
private pay. It's one hundred andninety nine dollars a month, and that
may sound like it's a lot ofmoney to some people, but if it
keeps you from having to hire extrahelp. And then if you're in Columbia
County, that's a whole different situation. So you should contact us. So
home Care if you want twenty fourto seven care and you're going through an
agency, Folks is about six orseven hundred dollars a day and you're talking

(50:40):
about one hundred and ninety nine dollarsa month. So that's the difference.
We're running out of time, Diane, one more time. That phone number,
Forever Home, How can they reachyou? Five one eight four zero
seven one six two five Susan,thank you so much. It's been enlightening
for me and for our listeners.And thank you for sharing your experiences with
us today, Nina, thanks forjoining us live in studio Diane as well.

(51:02):
Thank you all for listening every Saturdaymorning at eleven a m. Till
Life Happens Radio. We'll be backnext week. Hope you have a great
week. Don't look at the eclipsewithout your glasses.