Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:02):
Deil are we on. We're on give me in the back.
Speaker 2 (00:06):
I'm Lupiro, 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 crazy society. And then
(00:29):
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, looking
(00:50):
at staying healthy, maintaining your independence, and making sure that
if the situation around is 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,
(01:10):
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. But til de
Cuomo wrote a book and she talked about caregiving and
being a caregiver, and she said that you are either
a caregiver now, you've been a caregiver in the past,
(01:33):
or you will be a caregiver. And many people don't
self identify as a caregiver.
Speaker 1 (01:38):
They just do it.
Speaker 2 (01:39):
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
(02:00):
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 were 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
(02:24):
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
(02:46):
going to be with us live on the radio today
with Diane Mikkel Gottabiowski.
Speaker 1 (02:50):
Good morning, Diane, Good morning.
Speaker 3 (02:52):
Nice to be here.
Speaker 2 (02:52):
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 are doing today
and your history as a caregiver and in the long
term care field.
Speaker 4 (03:05):
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 match what they need and what they get.
(03:30):
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
(03:51):
father in law, my mother. And I'm not going to
say I'm a caregiver for my father because he might
be listening. He's ninety one and he's pretty darn and dependent.
But I'm there firm if he needs me. So being
in that position helping navigate and 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
(04:14):
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 2 (04:24):
So background in physical therapy, and you 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
(04:47):
similar goals.
Speaker 5 (04:49):
Good morning, Lou, pleasure to be here. As Lou 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
(05:09):
seven years as a medical social work case manager, helping
to navigate.
Speaker 1 (05:15):
Care in a little more that was an insurance that
was an insurance provider.
Speaker 3 (05:19):
You are correct.
Speaker 5 (05:21):
I retired and I've known about ever home Care Advisors
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 was the primary caregiver for my mom who was
(05:43):
on hospice and that, as Diane's aid, our personal experiences,
in addition to our professional clinical experiences, helped to make
us who we are today.
Speaker 2 (05:55):
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 (06:04):
Yes, absolutely so. I'm Nina. Nice to speak with everyone
this morning.
Speaker 7 (06:08):
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 a cute care,
long term care. I've worked with individuals with disabilities. I've
(06:30):
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 talking
about this planning, talking about this stuff now is so
(06:51):
important and they're really a lot more receptive to it closer.
Speaker 6 (06:55):
To the age gap.
Speaker 7 (06:56):
So I usually relay messages to my parents, who then
install the ramp to my grandparents' home.
Speaker 2 (07:04):
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 wraparound service
of technology and cameras and sensors and all the things
(07:25):
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
a celebration every time you have a birthday at that age.
So people are living 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
(07:47):
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 we have some budget cuts that
we're gonna maybe mention and talk about things that are
coming in the future and what we can anticipate in
(08:08):
the social service networks. So we're gonna 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 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,
(08:30):
and so I've been through this throw from a whole
series of perspectives, and I go back twenty five years
with my mom having Alzheimer's, and as an attorney, I
had a whole host of resources, I mean an olderle attorney.
I was the chair of the New York State Bar
(08:50):
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 were very pleasant, and they said, oh,
we feel so bad about your situation. We empathize with you,
(09:12):
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, 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
(09:34):
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 Joe on the 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
(09:54):
it was just starting and Joe was kind of a
rogue pioneer. I had to go to Lenox, Massachusett's the
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 his expertise and knowledge to me and
my family. And so, Diane, when you get calls, these
(10:18):
are the kinds of calls that you get because people
are facing the same types of issues.
Speaker 4 (10:23):
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
(10:43):
that situation and we found we asked what the goals are.
And I've said this on this 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 2 (11:02):
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.
Speaker 1 (11:21):
We have a.
Speaker 2 (11:22):
Physical therapist, an occupational therapist, and licensed masters and social
work and certified care manager or care what's the what's
the destination Cherry.
Speaker 3 (11:31):
It's a care manager, care manager, care manager.
Speaker 2 (11:34):
So we have talent in the studio. Eight hundred eight
two five five nine four nine.
Speaker 1 (11:40):
Give us a call. We're going to take a short break.
Speaker 2 (11:41):
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.
Speaker 1 (11:48):
We'll be right back after this, and we are back.
Speaker 2 (11:56):
I'm Lup Pierrer, your host for this morning. We have
a studio full of care coordinators and we're 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. We're going to do a series
(12:19):
of these. This is in Southern Saratoga at the YMCA.
Everybody starts singing, there we go. We got lot 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
(12:39):
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,
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 plans.
(13:00):
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
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
(13:24):
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 case,
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
(13:46):
cases here, questions that you've gotten, the situations that you've
had to deal with.
Speaker 1 (13:51):
And here's one.
Speaker 2 (13:52):
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
am 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 3 (14:11):
I would love to start.
Speaker 5 (14:13):
First of all, I didn't share that I'm a proud
carrying Medicare Red, White, and Blue card holder myself, 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,
(14:34):
it is really and truly to inngage the daughter, 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 3 (14:52):
All the time. Maybe it's not.
Speaker 5 (14:54):
Maybe it's more complex, But until we're able to really
do a thorough client based assessment, we don't know.
Speaker 2 (15:03):
So that's the beginning of the process. Correct, 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
(15:23):
the lights pop on every time she got out of bed,
so that she had a comode. If she really had
an emergency, it was right next to the bed and
problem went away.
Speaker 1 (15:32):
Because these are simple things, but you don't know until
you know.
Speaker 2 (15:36):
And Diane, this is something not only with appliances like
a comode next to the bathroom, but there are other
technologies that EVERHME uses that are very unique in the marketplace.
Speaker 4 (15:47):
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.
Speaker 3 (16:02):
Do you use a remote control? Do you have a
cell phone? Do you use it?
Speaker 4 (16:06):
A smart television or a dumb television? You use technology?
We 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
(16:28):
lives out of state.
Speaker 3 (16:30):
We can have a device in her mom's home.
Speaker 4 (16:34):
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
(16:55):
there's motion in an area that there shouldn't be, or
there's a motion where there should be. Not everything's a
negative if 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,
(17:15):
all that can bridge some of those gaps and increase
safety to allow people to stay in their homes with
this support.
Speaker 2 (17:23):
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. And she had
(17:44):
two aging parents, one with Alzheimer's and one with Parkinson's
that she was caring for while working full shifts as
an RN at the hospital.
Speaker 1 (17:54):
And that is only possible with the right systems.
Speaker 4 (17:58):
How well, I know that I started my career with
ever home, caring full time for my mom, and with
my dad's help.
Speaker 3 (18:06):
Of course, I got to keep plugging my dad.
Speaker 4 (18:08):
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 peace
of mind was incredibly empowering for my father as well,
who knew that there was some help there.
Speaker 6 (18:29):
And I'd like to interject the moment's notice.
Speaker 7 (18:31):
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.
Speaker 6 (18:45):
Or it could be a video call.
Speaker 7 (18:47):
It could be a simple touch the picture call my daughter,
Oh I see your face, I feel so much better.
Speaker 2 (18:52):
Oh, let's break that down a little bit, because the
appliance that goes into the home is a very unique appliance.
It's something that is off the internet. It's a closed
circuit Interranet signal that goes right to this tablet that's
installed in the home, and it's programmable for each individual user.
(19:13):
And Dane, you 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 6 (19:34):
It's correct.
Speaker 7 (19:34):
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 contemporaneously.
Speaker 6 (19:55):
It's sinked time to time.
Speaker 7 (19:57):
So if you have an Internet connection, you can Mom
can simple check in you know that she's up for
the day, and that can give you enough peace of mind.
Speaker 6 (20:05):
It depends on the situation.
Speaker 2 (20:06):
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 insures providers.
The level of sophistication of technology in the home is dismal.
Speaker 1 (20:27):
There just is not a lot out there there.
Speaker 2 (20:30):
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 (20:38):
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
(20:58):
a prompt on the 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
(21:19):
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
(21:39):
based on information. We are making decisions based on information
that we're getting, not just wondering what's happening.
Speaker 3 (21:48):
And it's really great.
Speaker 2 (21:49):
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,
(22:12):
but for several years this technology made a difference for her.
Just in the minute we have for this first half,
if you could hurt.
Speaker 4 (22:19):
This client, her daughter said, my mother's never touched technology,
but yet she became almost dependent upon the tablet.
Speaker 3 (22:29):
She loved it.
Speaker 4 (22:30):
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 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
(22:54):
her Alzheimer's disease. She was still engaging with this tablet.
Speaker 2 (22:57):
And the beauty is you can program it so you
can send videos and 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? And
(23:19):
then it pulls them into Okay, did I take my medications?
Do I have a doctor's appoint So let's come back
after the break. We have to break for the news
and really pull this apart. And Nina, 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 1 (23:39):
We'll be back right after the news. All right, we're back.
Speaker 2 (23:51):
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.
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 elder
(24:12):
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 aid? And what does
this insurance policy really provide? They have health insurance, they
(24:34):
have Medicare, 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
(24:58):
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.
I'm not a trained social worker or physical therapist or
occupational therapist. So we had started to bring care management
(25:20):
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, 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
(25:41):
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. And Medicaid program,
social services, a lot of things that people rely on
(26:03):
are going to be cut.
Speaker 1 (26:05):
How do we prepare?
Speaker 2 (26:07):
And it's gonna 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
(26:27):
not just for today, but for next year, the 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
(26:47):
go out. He's happy being in his home. His neighbor
and longtime friend called me to say he's worried about him.
Mail's piling up, law's not being mowed, He's refusing my help.
What should I do?
Speaker 1 (26:59):
Nina.
Speaker 2 (26:59):
I'm going to turn to you for this one. And
this is something that we deal with. People are reluctant,
as you said, schry to accept help. How do we
put a network together that can overcome these barriers?
Speaker 7 (27:12):
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,
(27:34):
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
(27:55):
they have questions, they know they can ask me, and
I'm going to be honest with them, whether it's hey,
how long long are my VA benefits going to work?
Speaker 6 (28:01):
Or should I apply for Medicaid first?
Speaker 7 (28:03):
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
(28:26):
clause could cause significant sepsis for this individual, which could
cause their death. So it actually can be quite serious
to you know, even these small things.
Speaker 2 (28:39):
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 6 (28:51):
Yeah, I mean, that's what I mean.
Speaker 7 (28:53):
I'm going I'm never going to be rude, but I
will be upfront and I will be honest with all parties.
Speaker 6 (28:59):
This is reality of the situation.
Speaker 7 (29:02):
If you hire under the table, you're breaking four laws.
Speaker 1 (29:06):
Many people do.
Speaker 7 (29:07):
You 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 that.
Speaker 6 (29:21):
You trust and you know that's a medicaid program.
Speaker 7 (29:24):
That is a medicaid program, or if you were to
choose licensed home care, that's great because they do all
the vetting.
Speaker 6 (29:32):
You can even find out what that vetting is by
asking them.
Speaker 2 (29:35):
You bring up 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
(29:56):
agencies and say I need a home health aid for mom,
what do they say?
Speaker 1 (30:00):
Don't have anyone, we don't have the staff.
Speaker 2 (30:02):
And one of our largest home health agencies and Day
and 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
(30:23):
we could find, from four hundred to forty. And that
just shows the stark 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
(30:45):
a home health employer you're charged with doing. So there
are companies that will do that and you work with.
Speaker 1 (30:52):
Some of those.
Speaker 7 (30:53):
Yes, absolutely, So there are companies that will manage payroll,
that will do those kinds of things, and we connect
through them.
Speaker 6 (31:01):
So I had a conversation.
Speaker 7 (31:03):
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 6 (31:14):
Discussion made decisions based on that.
Speaker 7 (31:16):
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 6 (31:27):
Able to be understood by her in layman's terms. And yeah,
so it's.
Speaker 2 (31:31):
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.
Speaker 1 (31:49):
So how do you overcome that.
Speaker 2 (31:52):
Lack of understanding with people that these are the 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 every home care adviceor.
Speaker 7 (32:04):
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 what
(32:25):
we could offer, this is what would be beneficial. Here,
here's a few options. 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 2 (32:41):
Yeah, and talking to the caregiver in California, absolutely, the
caregiver in Hong Kong.
Speaker 6 (32:45):
You got to loop everybody in.
Speaker 7 (32:47):
It's got to be a collaborative effort with everyone buying in.
Speaker 2 (32:51):
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 gonna cost me to have
a conversation with you and get a detailed analysis and
then maybe lead up to a home visit and then
(33:11):
what comes next.
Speaker 7 (33:13):
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 1 (33:21):
Right idea, find out what the real issues are.
Speaker 7 (33:23):
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 gonna 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 certain
(33:47):
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 6 (33:52):
Actually, here's a link Archives.
Speaker 7 (33:54):
Dot gov you can get pull your full you know
that the person you're looking for, you can pull the
records they need so you can apply for VA benefits
for a widowed person or something like that.
Speaker 2 (34:05):
And the hardest question most people face is how do
I find caregivers? And you have access to a number
of resource as I understand that everyhome does not provide
home health care, but you help access it and have
resources to find care.
Speaker 6 (34:18):
That's correct.
Speaker 7 (34:19):
So we personally have stepped out of direct care for
various reasons, so we no longer physically provide care.
Speaker 6 (34:27):
However, we are the bridge.
Speaker 7 (34:30):
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 Skoharry County and
she can work four hours a week, two times a week,
and it matches, and that's happened.
Speaker 6 (34:46):
We get lucky, but we're also persistent.
Speaker 7 (34:49):
It's a matter of perseverance, luck and also just our
overall knowledge and connections that we make through our previous
professional experience and our current ones.
Speaker 4 (35:01):
Now, can I talk about that persistence for a minute,
you absolutely can. I was speaking to someone who's inquiring
about our services. It's a full time job. It can
be a full time job trying to find care. Oh yeah,
to be a loved one, a caregiver, trying to find
that extra care.
Speaker 3 (35:20):
It's what we do.
Speaker 4 (35:22):
We can put our heads set on call, the agency
be on hold for twenty five minutes, we're still working.
If you're at work, you can't do that. If you're
trying to do that as a daughter or a son
or loved one, and we have those made those connections.
We're going to call based on our experience, based on
(35:42):
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 are some 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
(36:05):
right questions, and I think that's what we're all very
good at.
Speaker 2 (36:09):
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
Skoherry 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 do that,
(36:31):
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 every
home 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
know if you've ever had experience with this where the
(36:52):
family disagrees on the care plan. This happens a lot
in my experience, and my sister and I were.
Speaker 1 (36:58):
Just at loggerheads constantly.
Speaker 2 (37:00):
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.
Speaker 1 (37:09):
Did an assessment.
Speaker 2 (37:11):
Once we had that in writing, and you do a
written report, I think is part of the in home assessment.
Speaker 6 (37:16):
That's correct.
Speaker 7 (37:16):
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 2 (37:25):
And so when we got that, my sister and I
sat down, we both read it. We looked at each
other and said, well.
Speaker 1 (37:30):
This is simple.
Speaker 2 (37:31):
You know, here are the choices, here's the reality of
the situation, here's what we.
Speaker 1 (37:35):
Need to do. And we both agreed immediately on what
the course was.
Speaker 2 (37:39):
Once we saw a professional opinion with all of the
factors your mom has this, this, this, and this. Here's
their medical records which you look at. Yes, she says
these conditions, she needs this kind of help. Here's what
I recommend. Here's how many hours a day she needs.
Here's how we're gonna find it. Here's how you're gonna
pay for it. Put the plan together. I said, go,
let's go. It was that simple. And so you know,
(38:02):
ever Home and Diva Links are companies that provide that
care to our clients.
Speaker 1 (38:07):
And we're very.
Speaker 2 (38:08):
Relieved that I don't have to do that because I
don't have the time or the expertise to do it.
We're very relieved that our clients have the ability to
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
(38:31):
you are a caregiver. We'll be back right after this
short break. Welcome back Life Happens Radio. Glad you could
join us today.
Speaker 1 (38:44):
It's a little bit of a gloomy.
Speaker 2 (38:45):
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 all of the issues that are presented to
(39:06):
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
they their relationship with their parents was not a child
parent relationship, it was a caregiver care recipient relationship. And
(39:29):
we're gonna talk a little bit about that and how
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 the YMCA in Southern Saratoga. That's one Wall Street.
You can join us on the seventeenth at twelve noon
(39:51):
to register. Lunch is provided, and twelve thirty to one
thirty is the program. It's legal, financial, and care is
is 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 going to repeat
this program in East Greenbush at the East Greenbush Community
(40:12):
Library on Wednesday, August sixth at twelve noon, and again
in Guilderland at the Guilderland YMCA Wednesday, August thirteenth at
twelve thirty.
Speaker 1 (40:24):
You can always find these on our website.
Speaker 2 (40:27):
Because we're part of this pyrolaw dot com and if
you go to pirolaw 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 to
register for these seminars, or you can register by calling
our office anytime at five Pine 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
(40:50):
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 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
(41:11):
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 in rehab. How
do I get my husband back home safely?
Speaker 1 (41:26):
Nina?
Speaker 6 (41:27):
Sure?
Speaker 7 (41:28):
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. We would want to look
at those rehab notes, the hospital notes we would want
to attend or.
Speaker 2 (41:48):
I'm just going to say that as a as a layperson,
reading hospital notes is like reading Greek.
Speaker 6 (41:53):
Yeah, it's super quick for us.
Speaker 2 (41:54):
We just kind of just don't know what's in there.
Or talking to a medical provider, they talk to you.
Speaker 6 (42:00):
Like you're specialist, or.
Speaker 2 (42:02):
That you're two years old and they won't tell you anything.
But if you're a professional, peer.
Speaker 6 (42:07):
To peer, it's different.
Speaker 1 (42:08):
You could read there and have a conversation. It makes
a world a difference.
Speaker 6 (42:11):
It does.
Speaker 7 (42:11):
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 part of that getting
someone home from rehab, knowing their existing conditions, what's happened,
(42:34):
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.
Speaker 6 (42:41):
Is what they would call it. At the facility.
Speaker 7 (42:44):
We would work with the 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 TOEE, go to
the home, check it out, see what's needed. Because maybe
it's that lightnings system that you talked about, but maybe
it's FEV links, or it could be we need a
(43:05):
fall detection necklace, not a fall pendant with a push button,
because what if Dad's unconscious.
Speaker 2 (43:10):
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 (43:20):
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 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 situation as well.
(43:42):
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 and a
(44:03):
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, assist of
(44:23):
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 2 (44:37):
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.
Speaker 1 (44:46):
What do you get?
Speaker 4 (44:48):
So we were talking before about licensed home care agencies,
but it's important and we could be on this show
for four hours.
Speaker 3 (44:56):
Well I know we can't.
Speaker 4 (44:57):
But licensed home care agencies and certified home health agencies
are two different animals, so to speak.
Speaker 3 (45:04):
Some companies have both.
Speaker 4 (45:06):
The licensed agency that we talked about before is essentially
a 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
(45:27):
there have to be goals to transition to either taking
care of things yourself.
Speaker 2 (45:33):
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 healthcare through Medicare,
what does it give you?
Speaker 4 (45:42):
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.
Speaker 3 (46:04):
To do that.
Speaker 2 (46:05):
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 1 (46:12):
And this is one of the issues with hospice as well.
Speaker 4 (46:14):
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,
(46:36):
that community Hospice had out there that said live longer,
live better, involve hospice sooner.
Speaker 3 (46:44):
So that could be a whole nother show.
Speaker 4 (46:46):
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, ay to do personal care for more than
one or two hours a week unless it's a special situation.
Speaker 2 (47:00):
So as lawyers, what we very often have to do
is educate our clients ever, home becomes very valuable and
that continuum.
Speaker 1 (47:07):
That's why we're doing seminars together.
Speaker 2 (47:08):
Educate our clients on 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 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
(47:29):
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 6 (47:39):
Yes, and't it just recently changed.
Speaker 2 (47:41):
It's changing, Yes, So we're going to talk a little
bit about that at the seminar.
Speaker 1 (47:45):
Because there are.
Speaker 2 (47:46):
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 1 (47:58):
They're elevating that to.
Speaker 7 (48:00):
That's right, and there is a grandfather clause if you
have your evaluation done before September first, or it's scheduled
before Oh September second.
Speaker 6 (48:09):
Excuse me, oh September first.
Speaker 1 (48:11):
Oh yeah, no, no, I'm I'm anyway signaling the engineer.
Speaker 7 (48:14):
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
(48:35):
talking about, there's there's more language there, there's more lingo.
There's you might hear of the Nursing Home Diversion and
Transition Waiver, you might hear about the TBI waiver.
Speaker 2 (48:46):
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 purolaw dot com
and you can get the full range of all the
educational programming we have. We have Dedicaid Monday coming up
this Monday, which we're going to talk about some of
these rules on Frank hemming and I are going to
be doing that, so stay educated. Pure Loo dot com
(49:08):
is a resource. Everhome dot com is also a resource, Diane.
How do they find you.
Speaker 3 (49:15):
Everhome care dot com? Just search ever Home.
Speaker 4 (49:19):
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 you get to speak to a person, but
(49:39):
you get access to a team, and you're listening to
that team here this morning.
Speaker 2 (49:43):
Nini Crisandez, Sherry Ketapano, Diane, Mikl 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 take the
angst and anxiety away, get peace of mind, get your legal,
(50:04):
financial and care needs in order, and we hope to
see you again next
Speaker 1 (50:08):
Week right back here on Life Happens
Deil are we on. We're on give me in the back.
Speaker 2 (00:06):
I'm Lupiro, 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 crazy society. And then
(00:29):
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, looking
(00:50):
at staying healthy, maintaining your independence, and making sure that
if the situation around is 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,
(01:10):
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. But til de
Cuomo wrote a book and she talked about caregiving and
being a caregiver, and she said that you are either
a caregiver now, you've been a caregiver in the past,
(01:33):
or you will be a caregiver. And many people don't
self identify as a caregiver.
Speaker 1 (01:38):
They just do it.
Speaker 2 (01:39):
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
(02:00):
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 were 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
(02:24):
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
(02:46):
going to be with us live on the radio today
with Diane Mikkel Gottabiowski.
Speaker 1 (02:50):
Good morning, Diane, Good morning.
Speaker 3 (02:52):
Nice to be here.
Speaker 2 (02:52):
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 are doing today
and your history as a caregiver and in the long
term care field.
Speaker 4 (03:05):
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 match what they need and what they get.
(03:30):
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
(03:51):
father in law, my mother. And I'm not going to
say I'm a caregiver for my father because he might
be listening. He's ninety one and he's pretty darn and dependent.
But I'm there firm if he needs me. So being
in that position helping navigate and 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
(04:14):
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 2 (04:24):
So background in physical therapy, and you 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
(04:47):
similar goals.
Speaker 5 (04:49):
Good morning, Lou, pleasure to be here. As Lou 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
(05:09):
seven years as a medical social work case manager, helping
to navigate.
Speaker 1 (05:15):
Care in a little more that was an insurance that
was an insurance provider.
Speaker 3 (05:19):
You are correct.
Speaker 5 (05:21):
I retired and I've known about ever home Care Advisors
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 was the primary caregiver for my mom who was
(05:43):
on hospice and that, as Diane's aid, our personal experiences,
in addition to our professional clinical experiences, helped to make
us who we are today.
Speaker 2 (05:55):
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 (06:04):
Yes, absolutely so. I'm Nina. Nice to speak with everyone
this morning.
Speaker 7 (06:08):
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 a cute care,
long term care. I've worked with individuals with disabilities. I've
(06:30):
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 talking
about this planning, talking about this stuff now is so
(06:51):
important and they're really a lot more receptive to it closer.
Speaker 6 (06:55):
To the age gap.
Speaker 7 (06:56):
So I usually relay messages to my parents, who then
install the ramp to my grandparents' home.
Speaker 2 (07:04):
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 wraparound service
of technology and cameras and sensors and all the things
(07:25):
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
a celebration every time you have a birthday at that age.
So people are living 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
(07:47):
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 we have some budget cuts that
we're gonna maybe mention and talk about things that are
coming in the future and what we can anticipate in
(08:08):
the social service networks. So we're gonna 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 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,
(08:30):
and so I've been through this throw from a whole
series of perspectives, and I go back twenty five years
with my mom having Alzheimer's, and as an attorney, I
had a whole host of resources, I mean an olderle attorney.
I was the chair of the New York State Bar
(08:50):
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 were very pleasant, and they said, oh,
we feel so bad about your situation. We empathize with you,
(09:12):
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, 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
(09:34):
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 Joe on the 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
(09:54):
it was just starting and Joe was kind of a
rogue pioneer. I had to go to Lenox, Massachusett's the
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 his expertise and knowledge to me and
my family. And so, Diane, when you get calls, these
(10:18):
are the kinds of calls that you get because people
are facing the same types of issues.
Speaker 4 (10:23):
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
(10:43):
that situation and we found we asked what the goals are.
And I've said this on this 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 2 (11:02):
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.
Speaker 1 (11:21):
We have a.
Speaker 2 (11:22):
Physical therapist, an occupational therapist, and licensed masters and social
work and certified care manager or care what's the what's
the destination Cherry.
Speaker 3 (11:31):
It's a care manager, care manager, care manager.
Speaker 2 (11:34):
So we have talent in the studio. Eight hundred eight
two five five nine four nine.
Speaker 1 (11:40):
Give us a call. We're going to take a short break.
Speaker 2 (11:41):
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.
Speaker 1 (11:48):
We'll be right back after this, and we are back.
Speaker 2 (11:56):
I'm Lup Pierrer, your host for this morning. We have
a studio full of care coordinators and we're 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. We're going to do a series
(12:19):
of these. This is in Southern Saratoga at the YMCA.
Everybody starts singing, there we go. We got lot 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
(12:39):
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,
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 plans.
(13:00):
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
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
(13:24):
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 case,
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
(13:46):
cases here, questions that you've gotten, the situations that you've
had to deal with.
Speaker 1 (13:51):
And here's one.
Speaker 2 (13:52):
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
am 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 3 (14:11):
I would love to start.
Speaker 5 (14:13):
First of all, I didn't share that I'm a proud
carrying Medicare Red, White, and Blue card holder myself, 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,
(14:34):
it is really and truly to inngage the daughter, 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 3 (14:52):
All the time. Maybe it's not.
Speaker 5 (14:54):
Maybe it's more complex, But until we're able to really
do a thorough client based assessment, we don't know.
Speaker 2 (15:03):
So that's the beginning of the process. Correct, 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
(15:23):
the lights pop on every time she got out of bed,
so that she had a comode. If she really had
an emergency, it was right next to the bed and
problem went away.
Speaker 1 (15:32):
Because these are simple things, but you don't know until
you know.
Speaker 2 (15:36):
And Diane, this is something not only with appliances like
a comode next to the bathroom, but there are other
technologies that EVERHME uses that are very unique in the marketplace.
Speaker 4 (15:47):
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.
Speaker 3 (16:02):
Do you use a remote control? Do you have a
cell phone? Do you use it?
Speaker 4 (16:06):
A smart television or a dumb television? You use technology?
We 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
(16:28):
lives out of state.
Speaker 3 (16:30):
We can have a device in her mom's home.
Speaker 4 (16:34):
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
(16:55):
there's motion in an area that there shouldn't be, or
there's a motion where there should be. Not everything's a
negative if 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,
(17:15):
all that can bridge some of those gaps and increase
safety to allow people to stay in their homes with
this support.
Speaker 2 (17:23):
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. And she had
(17:44):
two aging parents, one with Alzheimer's and one with Parkinson's
that she was caring for while working full shifts as
an RN at the hospital.
Speaker 1 (17:54):
And that is only possible with the right systems.
Speaker 4 (17:58):
How well, I know that I started my career with
ever home, caring full time for my mom, and with
my dad's help.
Speaker 3 (18:06):
Of course, I got to keep plugging my dad.
Speaker 4 (18:08):
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 peace
of mind was incredibly empowering for my father as well,
who knew that there was some help there.
Speaker 6 (18:29):
And I'd like to interject the moment's notice.
Speaker 7 (18:31):
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.
Speaker 6 (18:45):
Or it could be a video call.
Speaker 7 (18:47):
It could be a simple touch the picture call my daughter,
Oh I see your face, I feel so much better.
Speaker 2 (18:52):
Oh, let's break that down a little bit, because the
appliance that goes into the home is a very unique appliance.
It's something that is off the internet. It's a closed
circuit Interranet signal that goes right to this tablet that's
installed in the home, and it's programmable for each individual user.
(19:13):
And Dane, you 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 6 (19:34):
It's correct.
Speaker 7 (19:34):
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 contemporaneously.
Speaker 6 (19:55):
It's sinked time to time.
Speaker 7 (19:57):
So if you have an Internet connection, you can Mom
can simple check in you know that she's up for
the day, and that can give you enough peace of mind.
Speaker 6 (20:05):
It depends on the situation.
Speaker 2 (20:06):
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 insures providers.
The level of sophistication of technology in the home is dismal.
Speaker 1 (20:27):
There just is not a lot out there there.
Speaker 2 (20:30):
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 (20:38):
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
(20:58):
a prompt on the 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
(21:19):
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
(21:39):
based on information. We are making decisions based on information
that we're getting, not just wondering what's happening.
Speaker 3 (21:48):
And it's really great.
Speaker 2 (21:49):
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,
(22:12):
but for several years this technology made a difference for her.
Just in the minute we have for this first half,
if you could hurt.
Speaker 4 (22:19):
This client, her daughter said, my mother's never touched technology,
but yet she became almost dependent upon the tablet.
Speaker 3 (22:29):
She loved it.
Speaker 4 (22:30):
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 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
(22:54):
her Alzheimer's disease. She was still engaging with this tablet.
Speaker 2 (22:57):
And the beauty is you can program it so you
can send videos and 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? And
(23:19):
then it pulls them into Okay, did I take my medications?
Do I have a doctor's appoint So let's come back
after the break. We have to break for the news
and really pull this apart. And Nina, 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 1 (23:39):
We'll be back right after the news. All right, we're back.
Speaker 2 (23:51):
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.
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 elder
(24:12):
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 aid? And what does
this insurance policy really provide? They have health insurance, they
(24:34):
have Medicare, 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
(24:58):
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.
I'm not a trained social worker or physical therapist or
occupational therapist. So we had started to bring care management
(25:20):
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, 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
(25:41):
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. And Medicaid program,
social services, a lot of things that people rely on
(26:03):
are going to be cut.
Speaker 1 (26:05):
How do we prepare?
Speaker 2 (26:07):
And it's gonna 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
(26:27):
not just for today, but for next year, the 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
(26:47):
go out. He's happy being in his home. His neighbor
and longtime friend called me to say he's worried about him.
Mail's piling up, law's not being mowed, He's refusing my help.
What should I do?
Speaker 1 (26:59):
Nina.
Speaker 2 (26:59):
I'm going to turn to you for this one. And
this is something that we deal with. People are reluctant,
as you said, schry to accept help. How do we
put a network together that can overcome these barriers?
Speaker 7 (27:12):
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,
(27:34):
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
(27:55):
they have questions, they know they can ask me, and
I'm going to be honest with them, whether it's hey,
how long long are my VA benefits going to work?
Speaker 6 (28:01):
Or should I apply for Medicaid first?
Speaker 7 (28:03):
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
(28:26):
clause could cause significant sepsis for this individual, which could
cause their death. So it actually can be quite serious
to you know, even these small things.
Speaker 2 (28:39):
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 6 (28:51):
Yeah, I mean, that's what I mean.
Speaker 7 (28:53):
I'm going I'm never going to be rude, but I
will be upfront and I will be honest with all parties.
Speaker 6 (28:59):
This is reality of the situation.
Speaker 7 (29:02):
If you hire under the table, you're breaking four laws.
Speaker 1 (29:06):
Many people do.
Speaker 7 (29:07):
You 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 that.
Speaker 6 (29:21):
You trust and you know that's a medicaid program.
Speaker 7 (29:24):
That is a medicaid program, or if you were to
choose licensed home care, that's great because they do all
the vetting.
Speaker 6 (29:32):
You can even find out what that vetting is by
asking them.
Speaker 2 (29:35):
You bring up 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
(29:56):
agencies and say I need a home health aid for mom,
what do they say?
Speaker 1 (30:00):
Don't have anyone, we don't have the staff.
Speaker 2 (30:02):
And one of our largest home health agencies and Day
and 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
(30:23):
we could find, from four hundred to forty. And that
just shows the stark 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
(30:45):
a home health employer you're charged with doing. So there
are companies that will do that and you work with.
Speaker 1 (30:52):
Some of those.
Speaker 7 (30:53):
Yes, absolutely, So there are companies that will manage payroll,
that will do those kinds of things, and we connect
through them.
Speaker 6 (31:01):
So I had a conversation.
Speaker 7 (31:03):
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 6 (31:14):
Discussion made decisions based on that.
Speaker 7 (31:16):
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 6 (31:27):
Able to be understood by her in layman's terms. And yeah,
so it's.
Speaker 2 (31:31):
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.
Speaker 1 (31:49):
So how do you overcome that.
Speaker 2 (31:52):
Lack of understanding with people that these are the 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 every home care adviceor.
Speaker 7 (32:04):
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 what
(32:25):
we could offer, this is what would be beneficial. Here,
here's a few options. 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 2 (32:41):
Yeah, and talking to the caregiver in California, absolutely, the
caregiver in Hong Kong.
Speaker 6 (32:45):
You got to loop everybody in.
Speaker 7 (32:47):
It's got to be a collaborative effort with everyone buying in.
Speaker 2 (32:51):
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 gonna cost me to have
a conversation with you and get a detailed analysis and
then maybe lead up to a home visit and then
(33:11):
what comes next.
Speaker 7 (33:13):
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 1 (33:21):
Right idea, find out what the real issues are.
Speaker 7 (33:23):
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 gonna 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 certain
(33:47):
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 6 (33:52):
Actually, here's a link Archives.
Speaker 7 (33:54):
Dot gov you can get pull your full you know
that the person you're looking for, you can pull the
records they need so you can apply for VA benefits
for a widowed person or something like that.
Speaker 2 (34:05):
And the hardest question most people face is how do
I find caregivers? And you have access to a number
of resource as I understand that everyhome does not provide
home health care, but you help access it and have
resources to find care.
Speaker 6 (34:18):
That's correct.
Speaker 7 (34:19):
So we personally have stepped out of direct care for
various reasons, so we no longer physically provide care.
Speaker 6 (34:27):
However, we are the bridge.
Speaker 7 (34:30):
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 Skoharry County and
she can work four hours a week, two times a week,
and it matches, and that's happened.
Speaker 6 (34:46):
We get lucky, but we're also persistent.
Speaker 7 (34:49):
It's a matter of perseverance, luck and also just our
overall knowledge and connections that we make through our previous
professional experience and our current ones.
Speaker 4 (35:01):
Now, can I talk about that persistence for a minute,
you absolutely can. I was speaking to someone who's inquiring
about our services. It's a full time job. It can
be a full time job trying to find care. Oh yeah,
to be a loved one, a caregiver, trying to find
that extra care.
Speaker 3 (35:20):
It's what we do.
Speaker 4 (35:22):
We can put our heads set on call, the agency
be on hold for twenty five minutes, we're still working.
If you're at work, you can't do that. If you're
trying to do that as a daughter or a son
or loved one, and we have those made those connections.
We're going to call based on our experience, based on
(35:42):
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 are some 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
(36:05):
right questions, and I think that's what we're all very
good at.
Speaker 2 (36:09):
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
Skoherry 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 do that,
(36:31):
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 every
home 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
know if you've ever had experience with this where the
(36:52):
family disagrees on the care plan. This happens a lot
in my experience, and my sister and I were.
Speaker 1 (36:58):
Just at loggerheads constantly.
Speaker 2 (37:00):
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.
Speaker 1 (37:09):
Did an assessment.
Speaker 2 (37:11):
Once we had that in writing, and you do a
written report, I think is part of the in home assessment.
Speaker 6 (37:16):
That's correct.
Speaker 7 (37:16):
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 2 (37:25):
And so when we got that, my sister and I
sat down, we both read it. We looked at each
other and said, well.
Speaker 1 (37:30):
This is simple.
Speaker 2 (37:31):
You know, here are the choices, here's the reality of
the situation, here's what we.
Speaker 1 (37:35):
Need to do. And we both agreed immediately on what
the course was.
Speaker 2 (37:39):
Once we saw a professional opinion with all of the
factors your mom has this, this, this, and this. Here's
their medical records which you look at. Yes, she says
these conditions, she needs this kind of help. Here's what
I recommend. Here's how many hours a day she needs.
Here's how we're gonna find it. Here's how you're gonna
pay for it. Put the plan together. I said, go,
let's go. It was that simple. And so you know,
(38:02):
ever Home and Diva Links are companies that provide that
care to our clients.
Speaker 1 (38:07):
And we're very.
Speaker 2 (38:08):
Relieved that I don't have to do that because I
don't have the time or the expertise to do it.
We're very relieved that our clients have the ability to
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
(38:31):
you are a caregiver. We'll be back right after this
short break. Welcome back Life Happens Radio. Glad you could
join us today.
Speaker 1 (38:44):
It's a little bit of a gloomy.
Speaker 2 (38:45):
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 all of the issues that are presented to
(39:06):
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
they their relationship with their parents was not a child
parent relationship, it was a caregiver care recipient relationship. And
(39:29):
we're gonna talk a little bit about that and how
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 the YMCA in Southern Saratoga. That's one Wall Street.
You can join us on the seventeenth at twelve noon
(39:51):
to register. Lunch is provided, and twelve thirty to one
thirty is the program. It's legal, financial, and care is
is 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 going to repeat
this program in East Greenbush at the East Greenbush Community
(40:12):
Library on Wednesday, August sixth at twelve noon, and again
in Guilderland at the Guilderland YMCA Wednesday, August thirteenth at
twelve thirty.
Speaker 1 (40:24):
You can always find these on our website.
Speaker 2 (40:27):
Because we're part of this pyrolaw dot com and if
you go to pirolaw 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 to
register for these seminars, or you can register by calling
our office anytime at five Pine 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
(40:50):
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 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
(41:11):
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 in rehab. How
do I get my husband back home safely?
Speaker 1 (41:26):
Nina?
Speaker 6 (41:27):
Sure?
Speaker 7 (41:28):
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. We would want to look
at those rehab notes, the hospital notes we would want
to attend or.
Speaker 2 (41:48):
I'm just going to say that as a as a layperson,
reading hospital notes is like reading Greek.
Speaker 6 (41:53):
Yeah, it's super quick for us.
Speaker 2 (41:54):
We just kind of just don't know what's in there.
Or talking to a medical provider, they talk to you.
Speaker 6 (42:00):
Like you're specialist, or.
Speaker 2 (42:02):
That you're two years old and they won't tell you anything.
But if you're a professional, peer.
Speaker 6 (42:07):
To peer, it's different.
Speaker 1 (42:08):
You could read there and have a conversation. It makes
a world a difference.
Speaker 6 (42:11):
It does.
Speaker 7 (42:11):
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 part of that getting
someone home from rehab, knowing their existing conditions, what's happened,
(42:34):
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.
Speaker 6 (42:41):
Is what they would call it. At the facility.
Speaker 7 (42:44):
We would work with the 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 TOEE, go to
the home, check it out, see what's needed. Because maybe
it's that lightnings system that you talked about, but maybe
it's FEV links, or it could be we need a
(43:05):
fall detection necklace, not a fall pendant with a push button,
because what if Dad's unconscious.
Speaker 2 (43:10):
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 (43:20):
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 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 situation as well.
(43:42):
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 and a
(44:03):
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, assist of
(44:23):
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 2 (44:37):
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.
Speaker 1 (44:46):
What do you get?
Speaker 4 (44:48):
So we were talking before about licensed home care agencies,
but it's important and we could be on this show
for four hours.
Speaker 3 (44:56):
Well I know we can't.
Speaker 4 (44:57):
But licensed home care agencies and certified home health agencies
are two different animals, so to speak.
Speaker 3 (45:04):
Some companies have both.
Speaker 4 (45:06):
The licensed agency that we talked about before is essentially
a 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
(45:27):
there have to be goals to transition to either taking
care of things yourself.
Speaker 2 (45:33):
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 healthcare through Medicare,
what does it give you?
Speaker 4 (45:42):
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.
Speaker 3 (46:04):
To do that.
Speaker 2 (46:05):
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 1 (46:12):
And this is one of the issues with hospice as well.
Speaker 4 (46:14):
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,
(46:36):
that community Hospice had out there that said live longer,
live better, involve hospice sooner.
Speaker 3 (46:44):
So that could be a whole nother show.
Speaker 4 (46:46):
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, ay to do personal care for more than
one or two hours a week unless it's a special situation.
Speaker 2 (47:00):
So as lawyers, what we very often have to do
is educate our clients ever, home becomes very valuable and
that continuum.
Speaker 1 (47:07):
That's why we're doing seminars together.
Speaker 2 (47:08):
Educate our clients on 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 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
(47:29):
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 6 (47:39):
Yes, and't it just recently changed.
Speaker 2 (47:41):
It's changing, Yes, So we're going to talk a little
bit about that at the seminar.
Speaker 1 (47:45):
Because there are.
Speaker 2 (47:46):
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 1 (47:58):
They're elevating that to.
Speaker 7 (48:00):
That's right, and there is a grandfather clause if you
have your evaluation done before September first, or it's scheduled
before Oh September second.
Speaker 6 (48:09):
Excuse me, oh September first.
Speaker 1 (48:11):
Oh yeah, no, no, I'm I'm anyway signaling the engineer.
Speaker 7 (48:14):
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
(48:35):
talking about, there's there's more language there, there's more lingo.
There's you might hear of the Nursing Home Diversion and
Transition Waiver, you might hear about the TBI waiver.
Speaker 2 (48:46):
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 purolaw dot com
and you can get the full range of all the
educational programming we have. We have Dedicaid Monday coming up
this Monday, which we're going to talk about some of
these rules on Frank hemming and I are going to
be doing that, so stay educated. Pure Loo dot com
(49:08):
is a resource. Everhome dot com is also a resource, Diane.
How do they find you.
Speaker 3 (49:15):
Everhome care dot com? Just search ever Home.
Speaker 4 (49:19):
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 you get to speak to a person, but
(49:39):
you get access to a team, and you're listening to
that team here this morning.
Speaker 2 (49:43):
Nini Crisandez, Sherry Ketapano, Diane, Mikl 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 take the
angst and anxiety away, get peace of mind, get your legal,
(50:04):
financial and care needs in order, and we hope to
see you again next
Speaker 1 (50:08):
Week right back here on Life Happens
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