Transcript
1
00:00:00,460 --> 00:00:02,940
Welcome to Something More with Chris Boyd.
2
00:00:03,300 --> 00:00:06,100
Chris Boyd is a certified financial planner, practitioner,
3
00:00:06,360 --> 00:00:08,860
and senior vice president and financial advisor at
4
00:00:08,860 --> 00:00:11,140
Wealth Enhancement Group, one of the nation's largest
5
00:00:11,140 --> 00:00:12,760
registered investment advisors.
6
00:00:13,300 --> 00:00:15,200
We call it Something More because we'd like
7
00:00:15,200 --> 00:00:17,320
to talk not only about those important dollar
8
00:00:17,320 --> 00:00:19,500
and cents issues, but also the quality of
9
00:00:19,500 --> 00:00:21,940
life issues that make the money matters matter.
10
00:00:22,460 --> 00:00:25,700
Here he is, your fulfillment facilitator, your partner
11
00:00:25,700 --> 00:00:28,860
in prosperity, advising clients on Cape Cod and
12
00:00:28,860 --> 00:00:29,900
across the country.
13
00:00:30,280 --> 00:00:32,700
Here's your host, Jay Christopher Boyd.
14
00:00:32,800 --> 00:00:33,500
Hey, welcome.
15
00:00:33,760 --> 00:00:35,580
Thanks for being with us for another episode
16
00:00:35,580 --> 00:00:36,940
of Something More with Chris Boyd.
17
00:00:36,980 --> 00:00:38,740
I'm here with my co-host, Jeff Perry.
18
00:00:38,920 --> 00:00:40,980
We are both of the AMR team with
19
00:00:40,980 --> 00:00:45,300
Wealth Enhancement Group, and we have some great
20
00:00:45,300 --> 00:00:45,920
guests today.
21
00:00:46,100 --> 00:00:48,940
We're talking about really important issues for people
22
00:00:48,940 --> 00:00:50,420
in the aging process.
23
00:00:50,940 --> 00:00:54,200
Joining us today is Kristin Hyde and Deborah
24
00:00:54,200 --> 00:00:54,780
O'Kelly.
25
00:00:55,140 --> 00:00:58,760
They are the founders of Back Nine Nurses.
26
00:00:59,120 --> 00:00:59,940
Thanks for being here.
27
00:01:00,560 --> 00:01:01,020
Thank you.
28
00:01:01,160 --> 00:01:02,480
Thanks so much for having us.
29
00:01:02,760 --> 00:01:03,739
So who's the golfer?
30
00:01:04,660 --> 00:01:05,520
I am.
31
00:01:05,820 --> 00:01:05,980
Okay.
32
00:01:07,600 --> 00:01:08,720
That's the name, huh?
33
00:01:08,800 --> 00:01:10,180
Yeah, I love the double meaning of the
34
00:01:10,180 --> 00:01:10,320
name.
35
00:01:10,760 --> 00:01:13,560
It's been so much fun to combine a
36
00:01:13,560 --> 00:01:16,840
couple of passions in life together, and we
37
00:01:16,840 --> 00:01:18,700
found that it kind of creates some fun
38
00:01:18,700 --> 00:01:21,280
curiosity when we wear our name tags that
39
00:01:21,280 --> 00:01:22,380
say Back Nine Nurses.
40
00:01:22,640 --> 00:01:25,260
It just creates some good conversation and some
41
00:01:25,260 --> 00:01:29,340
opening areas to talk about the business.
42
00:01:30,000 --> 00:01:31,460
Yeah, definitely double meaning there.
43
00:01:31,900 --> 00:01:34,460
Tell us a little bit about, to start
44
00:01:34,460 --> 00:01:38,720
off with, your backgrounds and how that led
45
00:01:38,720 --> 00:01:40,200
to the creation of your business.
46
00:01:40,820 --> 00:01:41,740
Okay, sure.
47
00:01:42,020 --> 00:01:42,720
Yeah.
48
00:01:42,980 --> 00:01:46,220
So Kristin and I are both registered nurses.
49
00:01:47,020 --> 00:01:52,260
We are certified geriatric care managers, certified dementia
50
00:01:52,260 --> 00:01:57,080
practitioners, and we work together.
51
00:01:57,200 --> 00:01:59,320
We met together working at an assisted living
52
00:01:59,320 --> 00:02:02,420
and memory care community, although we've worked in
53
00:02:02,420 --> 00:02:05,960
many different areas of healthcare, including medical, surgical,
54
00:02:06,760 --> 00:02:10,260
short-term care, long-term care, assisted living,
55
00:02:10,360 --> 00:02:14,600
memory care, primary care, so many different areas.
56
00:02:14,760 --> 00:02:16,640
But all along the way, and the reason
57
00:02:16,640 --> 00:02:18,740
that kind of prompted us to launch Back
58
00:02:18,740 --> 00:02:21,580
Nine Nurses was we heard so many times
59
00:02:21,580 --> 00:02:23,840
over and over again from families, we wish
60
00:02:23,840 --> 00:02:25,780
we had known this, we wish we had
61
00:02:25,780 --> 00:02:26,360
known that.
62
00:02:26,860 --> 00:02:29,300
And trying to navigate this world of healthcare
63
00:02:29,300 --> 00:02:35,800
that is so busy, confusing oftentimes, and trying
64
00:02:35,800 --> 00:02:38,060
to help, you know, we saw those families
65
00:02:38,060 --> 00:02:41,980
struggling to navigate all the decisions that need
66
00:02:41,980 --> 00:02:42,500
to be made.
67
00:02:42,600 --> 00:02:46,480
And sometimes within record speed, they're confronted with
68
00:02:46,480 --> 00:02:49,140
really life-changing decisions and needing to make
69
00:02:49,140 --> 00:02:50,460
decisions quickly.
70
00:02:52,300 --> 00:02:55,620
That's a great point about, seems as though
71
00:02:55,620 --> 00:03:00,200
too often families find themselves in crisis when
72
00:03:00,200 --> 00:03:04,860
trying to deal with aging in place or,
73
00:03:04,980 --> 00:03:05,980
you know, aging issues.
74
00:03:07,000 --> 00:03:10,020
Tell us about what leads to the kind
75
00:03:10,020 --> 00:03:12,040
of instances that you work with people.
76
00:03:13,460 --> 00:03:17,620
Is it that kind of scenario where someone's
77
00:03:17,620 --> 00:03:20,660
visiting mom and dad and then says, gosh,
78
00:03:20,900 --> 00:03:23,380
things have changed, we need help, and there's
79
00:03:23,380 --> 00:03:25,340
a sense of urgency about it?
80
00:03:26,080 --> 00:03:29,960
Yeah, so often, like, especially around the holidays,
81
00:03:30,280 --> 00:03:33,620
like, especially being on the Cape, the parents
82
00:03:33,620 --> 00:03:35,560
are retired here, kids come to visit from
83
00:03:35,560 --> 00:03:36,160
out of state.
84
00:03:37,400 --> 00:03:39,460
And, you know, they notice, oh, you know,
85
00:03:39,540 --> 00:03:41,100
mom left the stove on last night.
86
00:03:41,740 --> 00:03:44,120
And they kind of, when they're gone, they
87
00:03:44,120 --> 00:03:45,480
don't really, they kind of put it on
88
00:03:45,480 --> 00:03:46,960
the back burner, per se.
89
00:03:47,040 --> 00:03:49,200
And then these things they start noticing.
90
00:03:49,680 --> 00:03:52,180
And then, you know, it's great when people
91
00:03:52,180 --> 00:03:53,580
are like, you know what, this is kind
92
00:03:53,580 --> 00:03:55,480
of happening, we're seeing changes in mom.
93
00:03:56,520 --> 00:03:58,120
Can you help us now?
94
00:03:58,180 --> 00:04:00,260
That gives us a chance to actually, like,
95
00:04:00,380 --> 00:04:02,160
start the proper planning.
96
00:04:02,580 --> 00:04:04,140
What are some of the examples of the
97
00:04:04,140 --> 00:04:07,640
kind of changes in mom or dad that
98
00:04:07,640 --> 00:04:13,900
the family might be looking for as indications
99
00:04:13,900 --> 00:04:19,140
of aging, creating some challenges?
100
00:04:20,240 --> 00:04:23,720
Yeah, we see, you know, they notice cognition
101
00:04:23,720 --> 00:04:27,380
changes, the way that- What does that
102
00:04:27,380 --> 00:04:27,660
mean?
103
00:04:28,000 --> 00:04:31,800
Not just the names, but- Expired food
104
00:04:31,800 --> 00:04:33,740
in the fridge is like- A big
105
00:04:33,740 --> 00:04:33,920
one.
106
00:04:34,040 --> 00:04:37,120
Not keeping their food, like, they're letting it
107
00:04:37,120 --> 00:04:38,380
sit there and they're not doing anything about
108
00:04:38,380 --> 00:04:38,740
it.
109
00:04:39,280 --> 00:04:42,640
Yeah, they're finding, you know, pill bottles that
110
00:04:42,640 --> 00:04:43,660
may have expired.
111
00:04:43,660 --> 00:04:45,300
Could be on the floor.
112
00:04:46,360 --> 00:04:46,980
Yeah, yeah.
113
00:04:47,340 --> 00:04:51,180
So there's so many signs where, you know,
114
00:04:51,220 --> 00:04:54,680
even just during a conversation, when they're working
115
00:04:54,680 --> 00:04:56,900
to have a conversation and they start kind
116
00:04:56,900 --> 00:05:00,000
of struggling to retrieve what word they're searching
117
00:05:00,000 --> 00:05:04,140
for in a conversation, maybe having some trouble
118
00:05:04,140 --> 00:05:09,700
remembering names, especially immediate recall.
119
00:05:09,880 --> 00:05:11,160
Those are definitely signs.
120
00:05:12,000 --> 00:05:14,380
You know, people tend to remember their oldest
121
00:05:14,380 --> 00:05:17,460
memories the best when they have trouble with
122
00:05:17,460 --> 00:05:18,800
that immediate recall.
123
00:05:19,020 --> 00:05:20,880
So those are kind of signals to kind
124
00:05:20,880 --> 00:05:23,560
of say, hmm, what's going on here?
125
00:05:23,680 --> 00:05:26,140
Is it common that you find issues of
126
00:05:26,140 --> 00:05:28,340
hoarding and things like that come up as
127
00:05:28,340 --> 00:05:28,660
well?
128
00:05:28,760 --> 00:05:30,380
Or is that not so much a norm?
129
00:05:30,760 --> 00:05:33,200
Yeah, no, that's a sign too.
130
00:05:33,440 --> 00:05:36,100
And just the house being in general disarray,
131
00:05:37,040 --> 00:05:40,540
you know, not the best food in the
132
00:05:40,540 --> 00:05:43,160
fridge or- A weight loss, perhaps.
133
00:05:44,160 --> 00:05:46,180
Expired milk, things like that.
134
00:05:46,260 --> 00:05:48,760
So kind of, you know, somebody coming in
135
00:05:48,760 --> 00:05:50,540
and taking a look around the house and
136
00:05:50,540 --> 00:05:52,680
kind of identifying those factors that- The
137
00:05:52,680 --> 00:05:56,960
clothing, maybe certain signs as to how they're
138
00:05:56,960 --> 00:05:58,260
dressing or not, you know.
139
00:05:58,260 --> 00:06:01,100
Dressed in animals, like some of our clients
140
00:06:01,100 --> 00:06:03,840
have had animals and maybe they're defecating in
141
00:06:03,840 --> 00:06:05,320
the house and they're not picking it up,
142
00:06:05,640 --> 00:06:07,960
which is normal behavior for this person, typically.
143
00:06:08,660 --> 00:06:08,760
Yeah.
144
00:06:09,040 --> 00:06:09,240
All right.
145
00:06:09,260 --> 00:06:11,300
So these are all examples of things to
146
00:06:11,300 --> 00:06:13,020
be on the lookout for, huh?
147
00:06:13,400 --> 00:06:13,840
Yeah.
148
00:06:14,020 --> 00:06:17,580
Just like you said, yeah, not dressing appropriately
149
00:06:17,580 --> 00:06:19,980
for the weather at hand, you know, it
150
00:06:19,980 --> 00:06:21,240
can overheat them.
151
00:06:21,720 --> 00:06:21,920
Yeah.
152
00:06:22,120 --> 00:06:23,240
All those things.
153
00:06:23,460 --> 00:06:25,860
I was going to say, it's so common
154
00:06:25,860 --> 00:06:27,500
that I've seen in not only my own
155
00:06:27,500 --> 00:06:29,780
family, but hear from friends and such is,
156
00:06:30,560 --> 00:06:31,900
mom's fine, mom's fine.
157
00:06:32,760 --> 00:06:35,400
And they're interacting maybe for 10 minutes here,
158
00:06:35,560 --> 00:06:37,600
or a phone call, or even maybe a
159
00:06:37,600 --> 00:06:38,160
half hour.
160
00:06:38,340 --> 00:06:41,660
The elderly person really does a good job
161
00:06:41,660 --> 00:06:42,640
at- Mascotting.
162
00:06:42,900 --> 00:06:43,340
Yeah.
163
00:06:43,620 --> 00:06:45,920
Just their routines and how are you, I'm
164
00:06:45,920 --> 00:06:46,240
fine.
165
00:06:46,440 --> 00:06:48,720
There's no difficult conversations when you call mom,
166
00:06:48,880 --> 00:06:50,180
you know, it's like, what are you doing?
167
00:06:50,640 --> 00:06:52,680
But when you're there, you know, your example
168
00:06:52,680 --> 00:06:54,780
of visiting for the holidays or something, and
169
00:06:54,780 --> 00:06:57,880
you're there for a substantial period of time,
170
00:06:58,000 --> 00:07:00,500
hours or days, you can really start to
171
00:07:00,500 --> 00:07:01,340
see the signs.
172
00:07:01,660 --> 00:07:04,380
And what should you do?
173
00:07:04,540 --> 00:07:06,320
What's the first thing a family member should
174
00:07:06,320 --> 00:07:10,220
do when they have that- Aha moment.
175
00:07:10,520 --> 00:07:12,320
Like, oh, something's not right here.
176
00:07:12,500 --> 00:07:13,420
What should I do?
177
00:07:13,680 --> 00:07:16,120
Because sometimes it's too, you know, I've seen
178
00:07:16,120 --> 00:07:18,020
it, not in my family, but I saw
179
00:07:18,020 --> 00:07:21,000
it with a neighbor in that it was
180
00:07:21,000 --> 00:07:23,660
almost like an anger from the children towards
181
00:07:23,660 --> 00:07:24,160
the parents.
182
00:07:24,300 --> 00:07:25,620
Like, you got to shape up here.
183
00:07:25,720 --> 00:07:26,940
You got to do something here.
184
00:07:27,160 --> 00:07:28,540
You know, you're not taking care of the
185
00:07:28,540 --> 00:07:30,720
house rather than maybe something a bit more
186
00:07:30,720 --> 00:07:32,220
compassionate or constructive.
187
00:07:33,380 --> 00:07:33,820
Right.
188
00:07:34,020 --> 00:07:34,880
Yeah, exactly.
189
00:07:35,200 --> 00:07:37,400
Do you see that in your experience where
190
00:07:37,400 --> 00:07:39,740
family members act in a- Scold them,
191
00:07:39,980 --> 00:07:41,500
you know, say, hey- Yeah, exactly.
192
00:07:41,680 --> 00:07:43,200
That's the word I was looking for.
193
00:07:43,300 --> 00:07:43,460
Yeah.
194
00:07:43,580 --> 00:07:43,980
Yeah.
195
00:07:44,020 --> 00:07:47,440
There's so many different emotions involved because, you
196
00:07:47,440 --> 00:07:51,380
know, their memories themselves of their parents are,
197
00:07:51,480 --> 00:07:54,260
oh, my dad was always an athlete and
198
00:07:54,260 --> 00:07:56,100
he's strong and he knows, you know, he
199
00:07:56,100 --> 00:07:58,240
does business finances and he's smart.
200
00:07:58,460 --> 00:08:01,160
And then, you know, they get frustrated about
201
00:08:01,160 --> 00:08:03,740
what's going on and they don't really understand
202
00:08:03,740 --> 00:08:07,700
it themselves quite as well as they may
203
00:08:07,700 --> 00:08:08,240
want to.
204
00:08:08,520 --> 00:08:13,240
And so we strongly recommend reaching out to
205
00:08:13,240 --> 00:08:16,020
anyone in the healthcare world that can kind
206
00:08:16,020 --> 00:08:17,500
of advise them and give them a little
207
00:08:17,500 --> 00:08:21,080
guidance, whether it's a care manager like us.
208
00:08:21,460 --> 00:08:27,000
We belong to an association called the Aging
209
00:08:27,000 --> 00:08:30,640
Life Care Association, which is a wonderful network
210
00:08:30,640 --> 00:08:35,980
of well-certified people who are qualified to
211
00:08:35,980 --> 00:08:37,960
kind of guide people in that area.
212
00:08:38,700 --> 00:08:41,200
And there's also, you know, primary care, reaching
213
00:08:41,200 --> 00:08:43,280
out to their primary care doctor and just
214
00:08:43,280 --> 00:08:45,280
trying to start to get some guidance on
215
00:08:45,280 --> 00:08:46,580
what's going on.
216
00:08:47,540 --> 00:08:49,400
So what would you folks do if a
217
00:08:49,400 --> 00:08:51,480
family member called in the kind of scenario
218
00:08:51,480 --> 00:08:52,560
that we're painting here?
219
00:08:52,920 --> 00:08:54,980
What would be some first steps that you
220
00:08:54,980 --> 00:08:55,520
might take?
221
00:08:56,020 --> 00:08:59,720
So we normally start with when the family
222
00:08:59,720 --> 00:09:01,480
member calls, we like to do a meet
223
00:09:01,480 --> 00:09:02,820
and greet and free consultation.
224
00:09:03,800 --> 00:09:07,080
And doing that starts because this whole relationship
225
00:09:07,080 --> 00:09:08,100
is based on trust.
226
00:09:08,220 --> 00:09:11,160
I mean, we're reading their medical records, we're
227
00:09:11,160 --> 00:09:13,900
finding out the whole family history, you know,
228
00:09:14,320 --> 00:09:16,200
this one, getting the family dynamics.
229
00:09:17,420 --> 00:09:18,680
So we'll go in person.
230
00:09:19,100 --> 00:09:20,880
And clear, not every instance someone is in
231
00:09:20,880 --> 00:09:21,220
crisis.
232
00:09:21,980 --> 00:09:24,520
Not every instance, but even we'll still go
233
00:09:24,520 --> 00:09:26,620
for a meet and greet, see if we're
234
00:09:26,620 --> 00:09:27,600
a good fit for them.
235
00:09:28,760 --> 00:09:31,760
And it almost takes a sense of relief
236
00:09:31,760 --> 00:09:33,360
when we're like, you know what, we'll meet
237
00:09:33,360 --> 00:09:40,100
you at the then how we can help
238
00:09:40,100 --> 00:09:40,320
them.
239
00:09:40,940 --> 00:09:43,460
And then if they do decide to sign
240
00:09:43,460 --> 00:09:45,760
on with services with us, we start with
241
00:09:45,760 --> 00:09:49,080
an initial nursing assessment, which is a comprehensive
242
00:09:49,780 --> 00:09:52,860
whole assessment that looks at like home safety,
243
00:09:53,460 --> 00:09:56,180
the health, like all the whole, your whole
244
00:09:56,180 --> 00:09:57,140
life, basically.
245
00:09:57,920 --> 00:10:01,340
And then we make recommendations and give them
246
00:10:01,340 --> 00:10:04,700
options and implement a plan of care.
247
00:10:08,650 --> 00:10:12,730
I don't think a meeting goes by when
248
00:10:12,730 --> 00:10:15,930
we talk to clientele and because we work
249
00:10:15,930 --> 00:10:17,390
with retired people as well.
250
00:10:17,490 --> 00:10:20,810
And their plan is to age in place.
251
00:10:23,150 --> 00:10:25,410
And, you know, Firmly, that's their plan.
252
00:10:25,610 --> 00:10:27,210
The discussion of anything else.
253
00:10:27,330 --> 00:10:28,270
We're not going to do that.
254
00:10:28,550 --> 00:10:29,350
Absolutely not.
255
00:10:29,430 --> 00:10:29,910
You know what I mean?
256
00:10:29,930 --> 00:10:30,530
Kind of mindset.
257
00:10:30,530 --> 00:10:36,450
Um, with all the extreme, uh, alternative as
258
00:10:36,450 --> 00:10:37,310
a way to deal with it.
259
00:10:37,370 --> 00:10:39,750
Oh, just, you know, smother we're with the
260
00:10:39,750 --> 00:10:42,010
pillow or, you know, the sort of silly
261
00:10:42,010 --> 00:10:42,690
stuff, you know?
262
00:10:43,010 --> 00:10:44,170
Well, that's the deflection though.
263
00:10:44,330 --> 00:10:44,710
Yeah.
264
00:10:44,990 --> 00:10:46,110
They don't want, they don't want to talk
265
00:10:46,110 --> 00:10:46,430
about it.
266
00:10:46,490 --> 00:10:46,630
Right.
267
00:10:47,530 --> 00:10:50,370
But there as a practical reality, that's not
268
00:10:50,370 --> 00:10:51,410
really what happens.
269
00:10:51,650 --> 00:10:55,430
And there's not always the option to age
270
00:10:55,430 --> 00:10:55,810
in place.
271
00:10:55,910 --> 00:10:57,410
Now, sometimes there are.
272
00:10:57,570 --> 00:11:01,690
So when you come in and do this
273
00:11:01,690 --> 00:11:06,790
comprehensive assessment, um, what are some of the
274
00:11:06,790 --> 00:11:09,010
instances that, you know, things can be done
275
00:11:09,010 --> 00:11:11,310
to help someone to be able to age
276
00:11:11,310 --> 00:11:15,170
in place, uh, certain renovations, maybe it's certain,
277
00:11:15,170 --> 00:11:17,590
uh, assistance that can be brought in with
278
00:11:17,590 --> 00:11:18,450
some regularity.
279
00:11:18,790 --> 00:11:20,950
How do you help people identify what those
280
00:11:20,950 --> 00:11:21,570
things are?
281
00:11:21,710 --> 00:11:23,130
And maybe you can elaborate on what are
282
00:11:23,130 --> 00:11:26,710
some examples of, uh, you know, should someone
283
00:11:26,710 --> 00:11:28,110
who's starting to have a little bit of
284
00:11:28,110 --> 00:11:30,870
forgetfulness be managing their own medication as an
285
00:11:30,870 --> 00:11:32,390
example, or whatever it might be.
286
00:11:33,110 --> 00:11:34,650
Um, maybe you can elaborate on some of
287
00:11:34,650 --> 00:11:36,550
those kind of, let's start with that trying
288
00:11:36,550 --> 00:11:38,150
to age in place kind of scenario.
289
00:11:39,490 --> 00:11:39,590
Sure.
290
00:11:39,590 --> 00:11:40,450
And we agree.
291
00:11:40,590 --> 00:11:43,250
I mean, that that's pretty much the, the
292
00:11:43,250 --> 00:11:45,510
goal of most people is, is to age
293
00:11:45,510 --> 00:11:46,970
in place and stay at the home that
294
00:11:46,970 --> 00:11:48,370
they're used to and that they love and
295
00:11:48,370 --> 00:11:49,630
that they feel comfortable in.
296
00:11:49,850 --> 00:11:50,010
So.
297
00:11:50,550 --> 00:11:51,350
Wouldn't prefer that.
298
00:11:51,350 --> 00:11:51,610
Right.
299
00:11:51,950 --> 00:11:52,130
Yeah.
300
00:11:52,330 --> 00:11:52,730
Yeah.
301
00:11:52,870 --> 00:11:53,610
I mean, right.
302
00:11:53,790 --> 00:11:54,190
Exactly.
303
00:11:54,330 --> 00:11:55,570
It makes complete sense.
304
00:11:55,830 --> 00:11:58,970
Um, so, I mean, we really, that, that
305
00:11:58,970 --> 00:12:01,110
the assessment that we do, it talks about
306
00:12:01,110 --> 00:12:03,350
those goals and the, you know, we always
307
00:12:03,350 --> 00:12:05,750
want to align as best as we always
308
00:12:05,750 --> 00:12:06,030
can.
309
00:12:06,250 --> 00:12:07,370
What are the goals and what are the
310
00:12:07,370 --> 00:12:10,190
preferences of that person and the family?
311
00:12:10,890 --> 00:12:13,030
Um, so we look at all those areas
312
00:12:13,030 --> 00:12:16,670
and then just for instance, if somebody has
313
00:12:16,670 --> 00:12:20,070
Parkinson's disease, um, and they've experienced a few
314
00:12:20,070 --> 00:12:22,870
falls at home, um, we can reach out
315
00:12:22,870 --> 00:12:26,350
to their primary care provider, um, set up
316
00:12:26,350 --> 00:12:26,910
a visit.
317
00:12:26,930 --> 00:12:29,210
Uh, there's a certain timeframe that you need
318
00:12:29,210 --> 00:12:31,370
a visit within to get a referral to
319
00:12:31,370 --> 00:12:34,010
say a home care agency to do an
320
00:12:34,010 --> 00:12:37,430
in-home PT OT referral so that they
321
00:12:37,430 --> 00:12:39,750
can come in and look, um, through the
322
00:12:39,750 --> 00:12:41,570
lens of a physical therapist.
323
00:12:41,850 --> 00:12:43,710
Um, what could be done as far as,
324
00:12:43,790 --> 00:12:45,510
you know, could we raise the height of
325
00:12:45,510 --> 00:12:48,310
the, the toilet seating to make it easier
326
00:12:48,310 --> 00:12:50,090
for this person when they're in the bathroom,
327
00:12:50,190 --> 00:12:53,330
the bathroom is one of the top areas
328
00:12:53,330 --> 00:12:56,090
in someone's house that falls occur.
329
00:12:57,210 --> 00:13:00,050
Um, so we, we look at, you know,
330
00:13:00,210 --> 00:13:02,090
what does the environment look like?
331
00:13:02,290 --> 00:13:04,570
Um, how are the medications being taken?
332
00:13:04,870 --> 00:13:06,730
Are they taking them out of pill cases?
333
00:13:07,050 --> 00:13:08,470
Are they trying to take them out of
334
00:13:08,470 --> 00:13:09,170
their bottles?
335
00:13:10,030 --> 00:13:12,930
Um, how are they ambulating?
336
00:13:13,170 --> 00:13:17,330
Look at every kind of safety area, um,
337
00:13:17,330 --> 00:13:20,190
and, uh, take into account what the diagnoses
338
00:13:20,190 --> 00:13:22,250
are, you know, what their med list is.
339
00:13:22,710 --> 00:13:24,130
One of the huge things that we do
340
00:13:24,130 --> 00:13:25,830
is reconcile med lists.
341
00:13:27,210 --> 00:13:30,210
Um, you know, some people have so many
342
00:13:30,210 --> 00:13:32,510
different providers that they're going to.
343
00:13:32,910 --> 00:13:35,390
And so that's one of the top things
344
00:13:35,390 --> 00:13:39,090
we look at immediately is when people, um,
345
00:13:39,290 --> 00:13:42,650
engage in our services, we have a HIPAA,
346
00:13:42,850 --> 00:13:45,010
um, release and consent form that they fill
347
00:13:45,010 --> 00:13:47,890
out so that we then immediately send that
348
00:13:47,890 --> 00:13:49,750
out to all of their providers so that
349
00:13:49,750 --> 00:13:52,090
we can gather their information, look at their
350
00:13:52,090 --> 00:13:55,950
med list, look at their, um, visit notes
351
00:13:55,950 --> 00:13:58,030
and see, you know, what kind of supports
352
00:13:58,030 --> 00:14:00,450
can we put in place to keep this
353
00:14:00,450 --> 00:14:02,170
person at home and keep them at home
354
00:14:02,170 --> 00:14:06,030
safely to, to help them achieve that goal
355
00:14:06,030 --> 00:14:06,930
of staying at home.
356
00:14:07,370 --> 00:14:07,950
You know, it's funny.
357
00:14:08,090 --> 00:14:10,170
I, I had a meeting, uh, in the
358
00:14:10,170 --> 00:14:12,210
last week or two with an octogenarian who,
359
00:14:12,690 --> 00:14:18,110
um, cognitively seems pretty sharp, um, but identified
360
00:14:18,110 --> 00:14:22,130
that she's been having falls and, uh, is,
361
00:14:22,270 --> 00:14:25,790
um, insistent.
362
00:14:25,890 --> 00:14:28,150
She wants to stay where she is and
363
00:14:28,150 --> 00:14:32,170
she's presently living on two levels, uh, probably
364
00:14:32,170 --> 00:14:33,990
could if she wanted to live on one
365
00:14:33,990 --> 00:14:34,330
level.
366
00:14:34,970 --> 00:14:39,550
Um, but, you know, just, uh, the thing
367
00:14:39,550 --> 00:14:41,510
that I was trying to impress upon her
368
00:14:41,510 --> 00:14:45,370
is that things don't stay stagnant.
369
00:14:45,450 --> 00:14:48,450
You know, it tends to be that things
370
00:14:48,450 --> 00:14:51,710
evolve and generally as we age, they progress
371
00:14:51,710 --> 00:14:54,090
for the worse, not for the better.
372
00:14:54,850 --> 00:14:57,390
So how do you help someone find that
373
00:14:57,390 --> 00:15:00,250
path to maybe now while you have your
374
00:15:00,250 --> 00:15:07,270
cognitive and largely good health, uh, maybe, uh,
375
00:15:07,370 --> 00:15:09,990
that independent care living community would be a
376
00:15:09,990 --> 00:15:12,230
good choice for you sooner rather than later,
377
00:15:12,230 --> 00:15:14,110
or I don't know what, you know what
378
00:15:14,110 --> 00:15:14,250
I mean?
379
00:15:14,250 --> 00:15:16,230
How do you help someone figure out what's
380
00:15:16,230 --> 00:15:19,530
their next step, uh, to help them?
381
00:15:19,590 --> 00:15:22,230
And if it's at home, how do, how
382
00:15:22,230 --> 00:15:25,110
do they avoid problems where they're living alone,
383
00:15:25,430 --> 00:15:28,710
but having falls, you know, is there a
384
00:15:28,710 --> 00:15:29,270
lot of resist?
385
00:15:29,370 --> 00:15:31,450
And to add to Chris's question, is it,
386
00:15:31,490 --> 00:15:34,450
is the typical response resistance to these changes
387
00:15:34,450 --> 00:15:36,210
or is it acceptance?
388
00:15:36,850 --> 00:15:39,930
I think we would both say there's resistance.
389
00:15:41,550 --> 00:15:44,190
I thought so, but that's what I was
390
00:15:44,190 --> 00:15:44,850
reading as well.
391
00:15:44,910 --> 00:15:47,850
We haven't encountered anybody that just says, oh
392
00:15:47,850 --> 00:15:48,410
my gosh.
393
00:15:48,650 --> 00:15:49,070
Yes.
394
00:15:50,010 --> 00:15:52,270
Let's go move to someplace else.
395
00:15:54,530 --> 00:15:57,790
Let's go exercise, right?
396
00:15:57,870 --> 00:16:00,110
The idea of a move, a lot of
397
00:16:00,110 --> 00:16:01,130
logistics in that.
398
00:16:01,530 --> 00:16:02,090
Yeah.
399
00:16:02,250 --> 00:16:05,330
I mean, really it's, you know, sometimes there
400
00:16:05,330 --> 00:16:08,170
is a crisis mode where maybe, maybe a
401
00:16:08,170 --> 00:16:11,130
move does need to happen fairly quickly, but
402
00:16:11,130 --> 00:16:14,290
you know, ideally it's something that they kind
403
00:16:14,290 --> 00:16:15,050
of ease into.
404
00:16:15,550 --> 00:16:17,790
And just as we were saying, you know,
405
00:16:17,810 --> 00:16:19,710
we get to know these families so well,
406
00:16:19,710 --> 00:16:22,690
we almost become surrogate family members with them,
407
00:16:22,850 --> 00:16:25,690
which leads, leads to trust in a lot
408
00:16:25,690 --> 00:16:29,390
of open conversations about, you know, the advantages
409
00:16:29,390 --> 00:16:31,630
that they might not even be aware of.
410
00:16:31,710 --> 00:16:33,530
A lot of people go to assisted living
411
00:16:33,530 --> 00:16:35,810
who didn't want to go there.
412
00:16:35,990 --> 00:16:38,130
And then after they get there, we talked
413
00:16:38,130 --> 00:16:38,330
to them.
414
00:16:39,550 --> 00:16:41,190
Why didn't we do this sooner?
415
00:16:41,330 --> 00:16:42,810
This is so wonderful.
416
00:16:43,290 --> 00:16:43,970
That was my mom.
417
00:16:44,090 --> 00:16:45,190
Yeah, exactly.
418
00:16:45,190 --> 00:16:45,630
Yeah.
419
00:16:46,290 --> 00:16:49,450
I mean, there's, there's, you know, there's so
420
00:16:49,450 --> 00:16:53,710
many opportunities with socialization where at home, you
421
00:16:53,710 --> 00:16:56,350
know, they didn't even realize how isolated they
422
00:16:56,350 --> 00:16:56,730
were.
423
00:16:57,150 --> 00:16:57,470
They were.
424
00:16:57,710 --> 00:17:01,450
Not all the time, but yeah, that's about
425
00:17:01,450 --> 00:17:01,830
it.
426
00:17:01,930 --> 00:17:02,050
Right.
427
00:17:02,210 --> 00:17:04,950
And it was really affecting, honestly, you know,
428
00:17:04,990 --> 00:17:08,010
the isolation can lead to a little depression,
429
00:17:08,270 --> 00:17:11,569
which can lead to not showering as much,
430
00:17:11,890 --> 00:17:13,410
not, you know, which could lead to a
431
00:17:13,410 --> 00:17:14,810
urinary tract infection.
432
00:17:14,950 --> 00:17:16,750
It can just really snowball.
433
00:17:17,310 --> 00:17:17,869
Yeah.
434
00:17:19,109 --> 00:17:19,290
Yeah.
435
00:17:19,690 --> 00:17:20,650
Good points.
436
00:17:23,270 --> 00:17:25,589
You know, I think one of the things
437
00:17:25,589 --> 00:17:27,490
I wanted to talk about with you as
438
00:17:27,490 --> 00:17:31,870
well is you mentioned becoming surrogate family members.
439
00:17:33,910 --> 00:17:36,350
I imagine a lot of times you're dealing
440
00:17:36,350 --> 00:17:38,610
with people where, you know, the, the, the
441
00:17:38,610 --> 00:17:43,670
actual family is not geographically local and you
442
00:17:43,670 --> 00:17:46,330
know, when it comes to like, are you
443
00:17:46,330 --> 00:17:50,810
helping people navigate going to doctor's appointments and
444
00:17:50,810 --> 00:17:52,570
who's going to take them?
445
00:17:52,650 --> 00:17:54,290
It's not, that's not something you guys do
446
00:17:54,290 --> 00:17:55,450
yourselves, is it?
447
00:17:55,710 --> 00:17:57,150
You do that.
448
00:17:57,290 --> 00:17:58,170
You actually do that.
449
00:17:58,870 --> 00:17:59,170
Yeah.
450
00:17:59,570 --> 00:18:02,050
So there's the logistics of that.
451
00:18:02,130 --> 00:18:04,750
Then there's the aftermath of that, right?
452
00:18:04,890 --> 00:18:07,450
You know, what are the outcomes that a
453
00:18:07,450 --> 00:18:12,630
particular occasion might require doctor's appointments, logistics in
454
00:18:12,630 --> 00:18:15,670
and of itself could be an enormous task.
455
00:18:15,750 --> 00:18:16,510
I don't know how you guys would have
456
00:18:16,510 --> 00:18:18,150
time to do that for a lot of
457
00:18:18,150 --> 00:18:21,750
people and continue doing all the assessments and
458
00:18:21,750 --> 00:18:22,230
so forth.
459
00:18:22,970 --> 00:18:25,770
I mean, it is an important piece and
460
00:18:25,770 --> 00:18:28,430
not everybody needs that, but we find that
461
00:18:28,430 --> 00:18:31,010
the people who are requesting that are people
462
00:18:31,010 --> 00:18:33,770
who are, you know, their family doesn't live
463
00:18:33,770 --> 00:18:37,110
close by and they love their family member,
464
00:18:37,250 --> 00:18:41,190
but they're not able to manage their care
465
00:18:41,190 --> 00:18:42,170
from far away.
466
00:18:42,510 --> 00:18:46,330
Even when somebody's already in assisted living, there's
467
00:18:46,330 --> 00:18:49,070
still a lot to manage because essentially assisted
468
00:18:49,070 --> 00:18:51,850
living is it's like living in a home,
469
00:18:51,850 --> 00:18:54,870
but with the extra supports of, you know,
470
00:18:54,930 --> 00:18:58,090
activities of daily living, bathing, dressing.
471
00:18:59,150 --> 00:19:01,730
But when that person goes off to the
472
00:19:01,730 --> 00:19:04,410
doctor, they're going by themselves.
473
00:19:04,850 --> 00:19:06,990
And you know, who's looking at the paperwork
474
00:19:06,990 --> 00:19:08,730
afterwards when they do that?
475
00:19:09,030 --> 00:19:10,610
Cognitive decline too, right?
476
00:19:10,730 --> 00:19:11,990
You know, are they going to remember everything
477
00:19:11,990 --> 00:19:13,250
that comes out of that appointment?
478
00:19:13,410 --> 00:19:13,930
Exactly.
479
00:19:14,370 --> 00:19:14,890
Exactly.
480
00:19:15,210 --> 00:19:17,810
So, you know, those, those appointments are really
481
00:19:17,810 --> 00:19:22,390
big, especially in addition, if there's unfortunately an
482
00:19:22,390 --> 00:19:25,810
ER visit followed by, you know, a discharge
483
00:19:25,810 --> 00:19:28,550
where there's all sorts of recommendations on that
484
00:19:28,550 --> 00:19:31,130
discharge list saying, you know, follow up with
485
00:19:31,130 --> 00:19:36,070
cardiology in the next week, visit primary care
486
00:19:36,070 --> 00:19:38,530
within, you know, and then they come back
487
00:19:38,530 --> 00:19:41,930
to assisted living and, you know, there's a
488
00:19:41,930 --> 00:19:43,630
lot of communication that needs to go on
489
00:19:43,630 --> 00:19:47,810
between the family, getting those appointments followed up.
490
00:19:48,030 --> 00:19:50,730
So yeah, attending those appointments are big.
491
00:19:50,870 --> 00:19:54,810
And again, you know, medication reconciliation during those
492
00:19:54,810 --> 00:19:58,190
appointments, making sure the primary care physician is
493
00:19:58,190 --> 00:20:00,170
updated because sometimes it's not.
494
00:20:01,130 --> 00:20:03,030
So yeah, this is hugely valuable.
495
00:20:03,190 --> 00:20:04,370
You can just hearing you talk about it,
496
00:20:04,370 --> 00:20:05,770
you can get a sense of the importance
497
00:20:05,770 --> 00:20:07,890
of how this can really add value.
498
00:20:09,450 --> 00:20:14,110
Obviously it's not free and it's, you know,
499
00:20:14,110 --> 00:20:17,530
it presumes people need some resources to be
500
00:20:17,530 --> 00:20:19,410
able to get this kind of help.
501
00:20:20,570 --> 00:20:25,270
We are, point to ourselves as a fiduciary
502
00:20:25,270 --> 00:20:26,690
in the way we work with people.
503
00:20:27,150 --> 00:20:30,530
There are business models in your field where
504
00:20:30,530 --> 00:20:33,630
people are compensated through some kind of commission
505
00:20:33,630 --> 00:20:37,630
for connecting people with an assisted living or
506
00:20:37,630 --> 00:20:38,770
that kind of thing.
507
00:20:38,850 --> 00:20:41,110
Would you talk about your business model a
508
00:20:41,110 --> 00:20:43,670
little bit that I think positions you maybe
509
00:20:43,670 --> 00:20:48,110
as the client's advocate, as opposed to trying
510
00:20:48,110 --> 00:20:51,790
to find where you get compensated directly, that
511
00:20:51,790 --> 00:20:52,470
kind of thing?
512
00:20:53,390 --> 00:20:54,110
Yeah, absolutely.
513
00:20:54,510 --> 00:20:56,310
And I'm glad you brought that up because
514
00:20:56,310 --> 00:21:00,230
we, as again, we mentioned we're members of
515
00:21:00,230 --> 00:21:02,970
the Aging Life Care Association that has a
516
00:21:02,970 --> 00:21:08,430
huge ethical standard that we always follow as
517
00:21:08,430 --> 00:21:09,870
well as our nursing ethics.
518
00:21:09,950 --> 00:21:14,550
So no, we don't take any commissions, there's
519
00:21:14,550 --> 00:21:18,490
no money, favors, anything being exchanged ever for
520
00:21:18,490 --> 00:21:21,410
the recommendations we make, whether it be for
521
00:21:21,410 --> 00:21:25,150
in-home care, a home healthcare agency, an
522
00:21:25,150 --> 00:21:27,630
assisted living community, a long-term care facility,
523
00:21:27,630 --> 00:21:30,570
there's nothing that we're getting back from them.
524
00:21:30,950 --> 00:21:33,390
We simply are trying to find the absolute
525
00:21:33,390 --> 00:21:37,570
best situation for each individual person in their
526
00:21:37,570 --> 00:21:39,970
own individual unique circumstances.
527
00:21:40,850 --> 00:21:42,190
So tell us how it works after the
528
00:21:42,190 --> 00:21:44,710
initial consultation, which you said you kind of
529
00:21:44,710 --> 00:21:46,670
come in and do an initial consultation.
530
00:21:47,270 --> 00:21:49,570
Do people hire you on a contract?
531
00:21:50,070 --> 00:21:51,870
Is it hourly?
532
00:21:52,310 --> 00:21:53,650
Just how does it work?
533
00:21:54,270 --> 00:21:57,050
So it's a service agreement that we have
534
00:21:57,050 --> 00:22:00,110
that we can send them electronically for them
535
00:22:00,110 --> 00:22:00,650
to read over.
536
00:22:00,770 --> 00:22:02,330
We try to keep it as simple as
537
00:22:02,330 --> 00:22:02,830
possible.
538
00:22:03,530 --> 00:22:05,290
One of the things that we've been happy
539
00:22:05,290 --> 00:22:08,170
that we've done over the last year that
540
00:22:08,170 --> 00:22:10,570
kind of we feel sets us apart from
541
00:22:10,570 --> 00:22:12,950
maybe some other care managers out there is,
542
00:22:13,550 --> 00:22:15,310
you know, we're coming into families at a
543
00:22:15,310 --> 00:22:19,730
time when they are already stressed, making difficult
544
00:22:19,730 --> 00:22:20,310
decisions.
545
00:22:21,030 --> 00:22:23,270
So within our service contract, you know, we
546
00:22:23,270 --> 00:22:25,790
do have an hourly rate, we are private
547
00:22:25,790 --> 00:22:30,430
pay, but we realize that, you know, that
548
00:22:30,430 --> 00:22:31,470
can be a scary thing.
549
00:22:31,650 --> 00:22:33,910
So if there's a really difficult month, families
550
00:22:33,910 --> 00:22:36,630
can be wondering, oh my gosh, what could
551
00:22:36,630 --> 00:22:37,710
this add up to?
552
00:22:37,750 --> 00:22:39,610
If mom's going to the hospital, she needs
553
00:22:39,610 --> 00:22:40,590
doctor's appointments.
554
00:22:41,210 --> 00:22:43,090
So we do have an hourly rate option
555
00:22:43,090 --> 00:22:47,830
on our service agreement, but we also do
556
00:22:47,830 --> 00:22:49,810
want to kind of taking the stress level
557
00:22:49,810 --> 00:22:51,970
down for people, we also have an option
558
00:22:51,970 --> 00:22:54,510
for them where they can set their own
559
00:22:54,510 --> 00:22:58,850
monthly budget cap rate where we will not
560
00:22:58,850 --> 00:23:00,530
go over that.
561
00:23:00,730 --> 00:23:03,350
So if they choose that option, once the
562
00:23:03,350 --> 00:23:05,710
assessment's done as nurses, one of the biggest
563
00:23:05,710 --> 00:23:07,350
things we do is prioritize.
564
00:23:08,070 --> 00:23:09,550
So we can then take a look at
565
00:23:09,550 --> 00:23:12,150
the assessment, see what everything looks like.
566
00:23:12,690 --> 00:23:14,830
And if they choose that monthly budget cap,
567
00:23:14,910 --> 00:23:17,730
we can then say, here's what we feel
568
00:23:17,730 --> 00:23:18,990
are your biggest priorities.
569
00:23:18,990 --> 00:23:19,970
Do you agree?
570
00:23:20,430 --> 00:23:22,190
Do these line up with your goals and
571
00:23:22,190 --> 00:23:22,830
your preferences?
572
00:23:22,990 --> 00:23:25,070
And this is what we can do within
573
00:23:25,070 --> 00:23:27,050
your means to help you the best that
574
00:23:27,050 --> 00:23:27,570
we can.
575
00:23:28,190 --> 00:23:28,290
Yeah.
576
00:23:29,030 --> 00:23:33,730
Are you finding there's an abundance of need?
577
00:23:35,090 --> 00:23:35,550
Yes.
578
00:23:36,530 --> 00:23:37,490
That's my impression.
579
00:23:37,830 --> 00:23:38,910
How are you going to be able to
580
00:23:38,910 --> 00:23:40,410
keep up with that need?
581
00:23:41,090 --> 00:23:42,230
Are you guys growing?
582
00:23:42,470 --> 00:23:43,370
Are you expecting something?
583
00:23:43,370 --> 00:23:45,970
Yeah, we are actually just talking to some
584
00:23:45,970 --> 00:23:50,230
other nurses now because, and we want those
585
00:23:50,230 --> 00:23:52,490
nurses to be in line with us because
586
00:23:52,490 --> 00:23:56,070
everything is a representation of what we want
587
00:23:56,070 --> 00:23:58,770
to present and how we want families to
588
00:23:58,770 --> 00:24:00,070
feel when they work with us.
589
00:24:00,310 --> 00:24:02,590
So we are in talks with other nurses
590
00:24:02,590 --> 00:24:05,850
now because it is such a huge need
591
00:24:05,850 --> 00:24:06,430
out there.
592
00:24:06,650 --> 00:24:06,950
Yeah.
593
00:24:06,970 --> 00:24:08,550
It sounds like you've got a good model
594
00:24:08,550 --> 00:24:11,410
and it just seems like there's a lot
595
00:24:11,410 --> 00:24:13,590
of need for help in this regard.
596
00:24:13,930 --> 00:24:14,730
Yes, there is.
597
00:24:15,490 --> 00:24:19,010
So this is an ongoing endeavor for most
598
00:24:19,010 --> 00:24:19,870
people, right?
599
00:24:19,930 --> 00:24:21,990
Because things change and evolve.
600
00:24:22,450 --> 00:24:25,550
Do you find that people hire you once
601
00:24:25,550 --> 00:24:27,090
initially and then come back?
602
00:24:27,110 --> 00:24:28,750
Or is it just something that is an
603
00:24:28,750 --> 00:24:32,530
ongoing thing and then periodically reassessed for what
604
00:24:32,530 --> 00:24:34,130
should our role be now kind of a
605
00:24:34,130 --> 00:24:34,330
thing?
606
00:24:34,330 --> 00:24:38,310
Yeah, that's a good question because what we
607
00:24:38,310 --> 00:24:42,430
found is people tend to keep us on,
608
00:24:42,710 --> 00:24:44,890
but it can taper down.
609
00:24:45,390 --> 00:24:48,270
So say we, for instance, we've helped somebody
610
00:24:48,270 --> 00:24:50,610
when they were in the home and then
611
00:24:50,610 --> 00:24:53,330
we helped them transition to assisted living and
612
00:24:53,330 --> 00:24:55,850
then they flourished once they were in assisted
613
00:24:55,850 --> 00:24:56,210
living.
614
00:24:56,950 --> 00:25:00,890
And we still see that person, the one
615
00:25:00,890 --> 00:25:03,030
we're talking about, but cut it down to
616
00:25:03,030 --> 00:25:06,230
we see them quarterly now just to kind
617
00:25:06,230 --> 00:25:10,070
of keep that relationship in touch so that
618
00:25:10,070 --> 00:25:13,450
if she did have an emergency, she knows
619
00:25:13,450 --> 00:25:15,150
who we are and we can jump in
620
00:25:15,150 --> 00:25:18,010
if there was an emergency room visit or
621
00:25:18,010 --> 00:25:19,450
something happened.
622
00:25:19,970 --> 00:25:23,310
And then additionally, we have families that we
623
00:25:23,310 --> 00:25:27,370
may start working with a sibling and then
624
00:25:27,370 --> 00:25:29,750
all of a sudden something happens to the
625
00:25:29,750 --> 00:25:30,190
spouse.
626
00:25:31,450 --> 00:25:35,090
So with multiple people within a family.
627
00:25:35,670 --> 00:25:37,110
Yeah, I can see how that could happen.
628
00:25:39,250 --> 00:25:42,850
Without violating any kind of privacy, could you
629
00:25:42,850 --> 00:25:44,910
share just a few examples of the kind
630
00:25:44,910 --> 00:25:47,750
of things you've been running into recently?
631
00:25:48,230 --> 00:25:50,230
What are some examples of the kind of
632
00:25:50,230 --> 00:25:51,710
stuff that comes about?
633
00:25:55,410 --> 00:25:57,330
Advocacy is a huge piece of what we
634
00:25:57,330 --> 00:25:57,610
do.
635
00:25:58,830 --> 00:26:04,570
So sometimes, just to give an example where
636
00:26:04,570 --> 00:26:08,610
advocacy can come in, we've had a situation
637
00:26:08,610 --> 00:26:12,330
where somebody was in the hospital, they were
638
00:26:12,330 --> 00:26:14,010
clearly declining.
639
00:26:15,590 --> 00:26:22,250
Their ultimate wish was to spend their last
640
00:26:22,250 --> 00:26:23,170
days at home.
641
00:26:24,110 --> 00:26:26,250
This wasn't really an expected thing.
642
00:26:26,410 --> 00:26:28,490
This was kind of sped up.
643
00:26:29,950 --> 00:26:31,390
And when they were just playing in the
644
00:26:31,390 --> 00:26:35,750
hospital, the term hospice was not brought up.
645
00:26:36,870 --> 00:26:39,290
But Kristen and I have seen so many
646
00:26:39,290 --> 00:26:43,370
situations where sometimes you can recognize visibly when
647
00:26:43,370 --> 00:26:45,830
somebody- And you knew their preferences.
648
00:26:46,470 --> 00:26:46,570
...
649
00:26:46,570 --> 00:26:47,230
would be appropriate for hospice.
650
00:26:47,510 --> 00:26:50,410
So even though they hadn't brought that up
651
00:26:50,410 --> 00:26:55,070
at the hospital, we did contact one of
652
00:26:55,070 --> 00:26:58,910
the specialists there to prompt the conversation and
653
00:26:58,910 --> 00:27:01,590
say, look, do you think a hospice evaluation
654
00:27:01,590 --> 00:27:03,310
would be appropriate here?
655
00:27:03,410 --> 00:27:05,510
And the answer was absolutely yes.
656
00:27:05,510 --> 00:27:08,210
They had a diagnosis that would qualify them
657
00:27:08,210 --> 00:27:09,070
for hospice.
658
00:27:11,270 --> 00:27:16,090
And they got to get discharged with that,
659
00:27:16,450 --> 00:27:18,530
bringing those services on board, they got to
660
00:27:18,530 --> 00:27:22,450
be discharged, go home, have hospice in place,
661
00:27:22,530 --> 00:27:24,970
and have all of those supports that come
662
00:27:24,970 --> 00:27:27,050
with hospice to- But the comforts of
663
00:27:27,050 --> 00:27:27,270
home.
664
00:27:27,450 --> 00:27:27,550
...
665
00:27:27,550 --> 00:27:30,050
have comfort, to have the emotional support for
666
00:27:30,050 --> 00:27:32,070
the family, and to be in the place
667
00:27:32,070 --> 00:27:34,550
that they wanted to be during that time.
668
00:27:35,110 --> 00:27:38,710
Advocacy is so important in healthcare, especially for
669
00:27:38,710 --> 00:27:39,170
all of us.
670
00:27:39,230 --> 00:27:40,830
I mean, we find ourselves at any age
671
00:27:40,830 --> 00:27:43,150
having to be our advocate sometimes and pushing
672
00:27:43,150 --> 00:27:43,690
back.
673
00:27:44,010 --> 00:27:47,170
But especially with someone who's older and maybe
674
00:27:47,170 --> 00:27:50,870
diminished physically or cognitively, they're not really in
675
00:27:50,870 --> 00:27:53,190
a position to challenge the medical community.
676
00:27:53,510 --> 00:27:54,690
Oh, it's time for me to go home?
677
00:27:54,850 --> 00:27:55,190
Okay.
678
00:27:55,770 --> 00:27:57,370
Right, right, exactly.
679
00:27:57,630 --> 00:27:59,330
And we see that coming up in primary
680
00:27:59,330 --> 00:28:03,090
care too, where, I mean, no disservice to
681
00:28:03,090 --> 00:28:04,890
primary care, it's just very busy.
682
00:28:04,890 --> 00:28:10,410
And sometimes, especially older adults don't realize how
683
00:28:10,410 --> 00:28:12,990
much you need to push for something sometimes
684
00:28:12,990 --> 00:28:17,750
where we've been with someone who had had
685
00:28:17,750 --> 00:28:22,590
a few falls over the prior year, had
686
00:28:22,590 --> 00:28:27,650
been experiencing some balance issues, noticing on his
687
00:28:27,650 --> 00:28:30,870
own that there were some lapses in memory,
688
00:28:31,090 --> 00:28:32,070
cognitive changes.
689
00:28:32,430 --> 00:28:35,170
So the primary care at that visit had
690
00:28:35,170 --> 00:28:39,410
put in an order for an MRI, and
691
00:28:39,410 --> 00:28:41,650
that person was good with that.
692
00:28:41,770 --> 00:28:45,590
But I actually asked for an additional referral
693
00:28:45,590 --> 00:28:48,250
to a neurologist to kind of take a
694
00:28:48,250 --> 00:28:50,390
deeper look at what could be going on.
695
00:28:51,150 --> 00:28:54,810
And lo and behold, they had a very
696
00:28:54,810 --> 00:28:59,010
thorough evaluation from the neurologist, and there was
697
00:28:59,010 --> 00:29:01,390
a diagnosis that came from that visit.
698
00:29:03,230 --> 00:29:06,230
So we can't say enough about advocacy.
699
00:29:07,450 --> 00:29:08,090
Good.
700
00:29:09,190 --> 00:29:11,690
Well, I mean, this just scratches the surface.
701
00:29:11,870 --> 00:29:17,030
I'm sure that you guys have numerous anecdotes
702
00:29:17,030 --> 00:29:19,330
of the kind of ways you've been able
703
00:29:19,330 --> 00:29:21,630
to help families in one form or another.
704
00:29:21,630 --> 00:29:24,430
I think one of the things we've had
705
00:29:24,430 --> 00:29:27,690
similar conversations with people is the idea of
706
00:29:28,650 --> 00:29:30,850
sooner is better than later.
707
00:29:31,210 --> 00:29:34,970
When it comes to talking with professionals like
708
00:29:34,970 --> 00:29:40,070
your firm, don't wait till there's a crisis.
709
00:29:40,810 --> 00:29:43,730
Get some manner of a plan in place
710
00:29:43,730 --> 00:29:45,890
as to, this is what your needs are
711
00:29:45,890 --> 00:29:47,850
now, this is what it looks like we
712
00:29:47,850 --> 00:29:49,390
might need to be looking toward.
713
00:29:49,390 --> 00:29:52,250
Do you help people sort of navigate a
714
00:29:52,250 --> 00:29:55,490
plan of sorts of where we're at, where
715
00:29:55,490 --> 00:29:57,830
we might be headed, and what are the
716
00:29:57,830 --> 00:30:00,350
things to look out for as to when
717
00:30:00,350 --> 00:30:03,110
the timing might be coming, that kind of
718
00:30:03,110 --> 00:30:04,730
a process?
719
00:30:05,450 --> 00:30:05,730
Yes.
720
00:30:06,710 --> 00:30:06,990
Yes.
721
00:30:07,230 --> 00:30:11,530
So even though one of our clients has
722
00:30:11,530 --> 00:30:16,770
Alzheimer's and the mind is still working fine
723
00:30:16,770 --> 00:30:19,530
right now, but we're already talking about, what
724
00:30:19,530 --> 00:30:21,130
are your goals for the future?
725
00:30:23,810 --> 00:30:28,250
You're going to need more care in the
726
00:30:28,250 --> 00:30:28,930
next few years.
727
00:30:29,250 --> 00:30:32,090
So do you have our funds allocated for
728
00:30:32,090 --> 00:30:32,390
this?
729
00:30:32,610 --> 00:30:34,490
Do you want to do an assisted living?
730
00:30:34,630 --> 00:30:35,550
Do you want to stay home?
731
00:30:35,850 --> 00:30:37,530
So we'd like to talk about all of
732
00:30:37,530 --> 00:30:38,810
that early.
733
00:30:38,890 --> 00:30:41,610
A game plan and then- And come
734
00:30:41,610 --> 00:30:45,490
up with the resources that they'll need.
735
00:30:45,710 --> 00:30:47,790
Some people haven't updated their will.
736
00:30:48,290 --> 00:30:49,930
They may not have a durable power of
737
00:30:49,930 --> 00:30:54,910
attorney in place, health proxies, things to set
738
00:30:54,910 --> 00:30:56,730
up preserving their assets.
739
00:30:57,610 --> 00:31:01,030
So we look at every, we love it
740
00:31:01,030 --> 00:31:04,510
when people are planning, when they're planning because
741
00:31:04,510 --> 00:31:07,310
- It avoids strife as well.
742
00:31:07,610 --> 00:31:10,770
If the parent has, I'm thinking of the
743
00:31:10,770 --> 00:31:14,090
traditional setting, but if the parent has their
744
00:31:14,090 --> 00:31:17,610
wishes known, it will decrease the likelihood of
745
00:31:17,610 --> 00:31:20,390
siblings arguing about what's the best plan for
746
00:31:20,390 --> 00:31:22,870
mom when she maybe can't make those decisions.
747
00:31:23,150 --> 00:31:23,250
Oh my gosh.
748
00:31:23,530 --> 00:31:25,430
It's so important.
749
00:31:25,730 --> 00:31:27,350
It's a gift, actually, to your family.
750
00:31:27,970 --> 00:31:28,150
Yeah.
751
00:31:28,290 --> 00:31:29,950
One will be like, mom would want to
752
00:31:29,950 --> 00:31:30,710
be on life support.
753
00:31:30,850 --> 00:31:32,630
And the other one's like, no, she wouldn't.
754
00:31:32,770 --> 00:31:37,470
If the wishes were already spoken by the
755
00:31:37,470 --> 00:31:40,370
parent, then that takes the burden off the
756
00:31:40,370 --> 00:31:40,710
kids.
757
00:31:41,430 --> 00:31:42,710
And we talk to them too and give
758
00:31:42,710 --> 00:31:46,650
them guidance on sometimes people, seniors have a
759
00:31:46,650 --> 00:31:50,710
tough time picking their healthcare proxy and they're
760
00:31:50,710 --> 00:31:53,790
like, they don't want to show one over
761
00:31:53,790 --> 00:31:55,610
the other.
762
00:31:55,710 --> 00:31:58,510
But one of the things we've gathered along
763
00:31:58,510 --> 00:32:01,070
the way as far as helping them guide
764
00:32:01,070 --> 00:32:04,070
that, it's almost like, hopefully they understand football
765
00:32:04,070 --> 00:32:05,410
because I think it's a great analogy.
766
00:32:05,630 --> 00:32:06,830
But if you think of it this way,
767
00:32:07,410 --> 00:32:09,230
who would you want to be your quarterback
768
00:32:09,230 --> 00:32:14,830
where there's a stressful situation and who is
769
00:32:14,830 --> 00:32:17,450
going to make the decisions that you would
770
00:32:17,450 --> 00:32:21,190
want made for yourself in a time of
771
00:32:21,190 --> 00:32:22,090
stress?
772
00:32:22,110 --> 00:32:24,790
Who can stay level-headed and make the
773
00:32:24,790 --> 00:32:26,790
decision the way you would want it made
774
00:32:26,790 --> 00:32:27,630
for yourself?
775
00:32:28,390 --> 00:32:31,110
And try to go- Not impose their
776
00:32:31,110 --> 00:32:32,170
own priorities.
777
00:32:32,510 --> 00:32:32,910
Yeah.
778
00:32:33,650 --> 00:32:33,750
Yeah.
779
00:32:35,030 --> 00:32:36,390
Challenging stuff, right?
780
00:32:37,950 --> 00:32:40,390
Well, you guys come back again.
781
00:32:40,870 --> 00:32:42,010
This was really good.
782
00:32:42,210 --> 00:32:46,230
We could probably dig into some particular circumstances
783
00:32:46,230 --> 00:32:49,950
and elaborate on the kind of planning that
784
00:32:49,950 --> 00:32:51,190
could be benefited from.
785
00:32:51,730 --> 00:32:53,130
Found this really worthwhile.
786
00:32:53,450 --> 00:32:55,330
And let's tell everyone a little bit more
787
00:32:55,330 --> 00:32:56,830
about how to reach you if they have
788
00:32:56,830 --> 00:32:59,290
interest or need to do some planning of
789
00:32:59,290 --> 00:33:01,350
this sort, or to get an assessment for
790
00:33:01,350 --> 00:33:04,050
a family member or their own kind of
791
00:33:04,050 --> 00:33:05,670
assistance with their care planning.
792
00:33:06,770 --> 00:33:08,370
Share a little bit about how you can
793
00:33:08,370 --> 00:33:08,810
be reached.
794
00:33:09,610 --> 00:33:09,950
Sure.
795
00:33:10,170 --> 00:33:14,070
You can always call us at 508-737
796
00:33:14,070 --> 00:33:18,670
-4277, or you can go to our website
797
00:33:18,670 --> 00:33:24,290
at www.back9nurses.com.
798
00:33:24,330 --> 00:33:26,550
It's all spelled out B-A-C-K
799
00:33:26,550 --> 00:33:29,510
-N-I-N-E, nurses.com.
800
00:33:29,850 --> 00:33:30,410
Excellent.
801
00:33:30,670 --> 00:33:32,690
I'll put that website in the show notes.
802
00:33:32,990 --> 00:33:34,750
So if people are listening, they can just
803
00:33:34,750 --> 00:33:36,350
directly click the notes in the show.
804
00:33:36,710 --> 00:33:37,110
Wonderful.
805
00:33:37,410 --> 00:33:37,910
Thank you.
806
00:33:37,910 --> 00:33:38,450
All right.
807
00:33:38,530 --> 00:33:40,770
Thanks for being with us and hope everyone
808
00:33:40,770 --> 00:33:41,750
got something out of this.
809
00:33:41,930 --> 00:33:43,810
The bottom line is you've got to be
810
00:33:43,810 --> 00:33:45,550
planning for these kinds of challenges.
811
00:33:46,410 --> 00:33:48,410
Plan or not, they may occur.
812
00:33:48,650 --> 00:33:51,410
And if you're not prepared, better to have
813
00:33:51,410 --> 00:33:53,450
some planning in place than to be in
814
00:33:53,450 --> 00:33:56,730
a moment of crisis that inevitably may arise
815
00:33:56,730 --> 00:33:58,110
for many people.
816
00:33:58,470 --> 00:34:00,210
So start early.
817
00:34:00,550 --> 00:34:00,930
All right.
818
00:34:01,570 --> 00:34:02,850
Thank you both for being here.
819
00:34:03,210 --> 00:34:05,010
Thank you so much for having us.
820
00:34:05,010 --> 00:34:05,570
Okay.
821
00:34:05,770 --> 00:34:07,949
Until next time, everybody keeps striving for something
822
00:34:07,949 --> 00:34:08,250
more.
823
00:34:54,150 --> 00:35:05,310
Transcribed by https://otter.ai Any
824
00:35:05,310 --> 00:35:06,150
financial decisions.
