Latest / The Retirement Navigator / Episode 4: Home Care, Assisted Living or Memory Care - How to Know Which One

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Episode 4: Home Care, Assisted Living or Memory Care - How to Know Which One · The Retirement Navigator

• 0:00
  SPEAKER_00: Welcome to Retirement Navigator, the podcast for adults 55 and above who are ready to make their next chapter their best one.
• 0:10
  SPEAKER_00: I am your host, Kwame Kwade, co-founder of Benefits Insider and adjunct professor of finance at Johns Hopkins University Kerry Business School.
• 0:19
  SPEAKER_00: Joining me today is Nikki Giwatz.
• 0:21
  SPEAKER_00: Nikki has spent more than 30 years in senior care, primarily serving as an executive director in assisted living and memory care communities.
• 0:31
  SPEAKER_00: She has spent her career supporting older adults and guiding families through important care decisions.
• 0:38
  SPEAKER_00: For the past eight years, Nikki has been with a place for mom where she first worked directly with families and now serves as the training manager for the sales performance and training team, helping advisors better support seniors nationwide.
• 0:55
  SPEAKER_00: She also contributes to a Place for Mom's YouTube channel, sharing practical insights on memory care and other key topics to help families make informed, confident choices.
• 1:07
  SPEAKER_00: And I'm really excited to have her here with us today.
• 1:10
  SPEAKER_00: Thank you for being here, Nikki.
• 1:13
  SPEAKER_00: Nikki, thank you for joining us.
• 1:16
  SPEAKER_00: I am so glad.
• 1:17
  SPEAKER_00: I am looking forward to this conversation with you about senior living.
• 1:21
  SPEAKER_00: And uh, we have a lot of questions that I want to cover with you.
• 1:24
  SPEAKER_00: And for our audience, you know, this conversation is probably been about 30 minutes, and uh hopefully we can cover a lot of ground here.
• 1:31
  SPEAKER_00: Welcome.
• 1:32
  SPEAKER_01: Thank you.
• 1:33
  SPEAKER_01: Thank you for having me.
• 1:34
  SPEAKER_00: Okay, so let's start with your background.
• 1:37
  SPEAKER_00: And I want to, you know, I'm I I watched your videos online, you're very passionate about this topic.
• 1:42
  SPEAKER_00: I wanted to understand you've spent two decades um in this industry.
• 1:47
  SPEAKER_00: What drew you to this work?
• 1:50
  SPEAKER_01: Uh yeah, my my whole adult career has been working in senior care.
• 1:55
  SPEAKER_01: I started as an activity director in a skilled nursing memory care in the mid-90s.
• 2:00
  SPEAKER_01: Uh, went on to uh being an executive director mostly for assisted living and memory care communities for almost 20 years.
• 2:07
  SPEAKER_01: And uh just a little over eight years, I've been working uh at a place for mom.
• 2:11
  SPEAKER_01: I started as a senior living advisor working directly with families, and uh for the last several years I've uh become a manager on our learning and development team.
• 2:20
  SPEAKER_01: So I train, uh I manage our trainers who work directly with our senior living advisors, helping them to understand how to best serve our families.
• 2:30
  SPEAKER_00: Right.
• 2:30
  SPEAKER_00: No, that's great.
• 2:31
  SPEAKER_00: So let's shift to families.
• 2:34
  SPEAKER_00: I mean, those are the people that you deal with, and this is one of those sensitive topics for a lot of families.
• 2:40
  SPEAKER_00: Um, it sometimes comes by surprise, sometimes it's a long road to get in here.
• 2:48
  SPEAKER_00: But the first thing I wanted to dive into is when families begin to take this step, they often feel overwhelmed, they often feel uninformed because it's a whole new world for them to navigate.
• 3:04
  SPEAKER_00: So, what are some of the first things that you think families should be looking for, you know, in preparation for the eventual decision of deciding uh about senior living?
• 3:17
  SPEAKER_01: You know, there's a lot of different things we we look at, whether it's assisted living or memory care, uh, certainly the seniors' ability to live safely, right?
• 3:26
  SPEAKER_01: And how much support do they need?
• 3:28
  SPEAKER_01: And is that uh sustainable for the family?
• 3:31
  SPEAKER_01: So a lot of times when when families reach out, it's become unsustainable for them.
• 3:36
  SPEAKER_01: Uh, when we hear families having to uh reduce their hours at work or completely quit their jobs, um that's you know telling.
• 3:44
  SPEAKER_01: If they're having to miss out on family obligations because of the need to take care of their senior loved one, that becomes you know telling for us.
• 3:53
  SPEAKER_01: So uh, you know, what's the impact?
• 3:55
  SPEAKER_01: And and so many times we think of how is this disease or aging process affecting the senior, you know, with with help with their care needs or their cognition uh deficits, but really we also look at how is this affecting the family when it comes to their uh, you know, the need for them to be present, whether it's you know taking time off of work or missing family obligations and the toll it takes on their health as well.
• 4:23
  SPEAKER_01: We see that so many times that caregiver burnout.
• 4:25
  SPEAKER_01: I experienced this with my family.
• 4:27
  SPEAKER_01: My grandfather had vascular dementia, and my grandmother, I'm the expert, and I couldn't convince her, like, you really need to get him some help because it's affecting you.
• 4:36
  SPEAKER_01: And it got to the point where she ended up in the hospital with shingles because of the stress that it took on her body trying to be the sole caregiver for my grandfather, and and finally it was at that point that she, you know, we were able to convince her, like, look, this is this is not sustainable for you.
• 4:52
  SPEAKER_00: So, and and so, you know, one of the going through the my own research uh for today's podcast, one of the things I realized is the many types of you know, facilities that are considered as senior living.
• 5:09
  SPEAKER_00: And I think that a lot of people have one thing in mind when they think of senior living, and so that also becomes a barrier.
• 5:17
  SPEAKER_00: So just as a baseline, can you go through the various forms of senior living options and what each does?
• 5:24
  SPEAKER_01: Absolutely.
• 5:24
  SPEAKER_01: And I think I know what you're talking about, skilled nursing facilities, right?
• 5:27
  SPEAKER_01: That's I mean, that how long have we had skilled nursing facilities, right?
• 5:31
  SPEAKER_01: A long time.
• 5:32
  SPEAKER_01: I think the the uh the concept of assisted living and standalone memory care communities is still relatively new.
• 5:39
  SPEAKER_01: And if you've never had to look for it, you don't know, right?
• 5:42
  SPEAKER_01: So in in the early 90s, if grandma had Alzheimer's, she went to skilled nursing.
• 5:46
  SPEAKER_01: That's all we had.
• 5:47
  SPEAKER_01: And now, fast forward 30 years or so, if mom has Alzheimer's, maybe I think skilled nursing is the only answer because I don't know what's out there, right?
• 5:55
  SPEAKER_01: So there's a lot of different options.
• 5:57
  SPEAKER_01: There's, you know, starting with independent living retirement communities.
• 6:00
  SPEAKER_01: So a great resident there would be somebody who might uh not want to deal with the house maintenance anymore, right?
• 6:08
  SPEAKER_01: Maybe shoveling the snow or taking care of the yard is too much.
• 6:11
  SPEAKER_01: Um, maybe they just lost a spouse and they're isolated and they really want to be in a community setting where there's a lot of activities and people their own age, maintenance-free.
• 6:21
  SPEAKER_01: Um, you know, they can still drive, but maybe they don't like to drive in the snow.
• 6:24
  SPEAKER_01: So there'll be transportation there for them, housekeeping services.
• 6:28
  SPEAKER_01: So it's kind of that cruise ship on land, right?
• 6:30
  SPEAKER_01: Where you don't go anywhere unless you want to go on the bus, but otherwise, you know, you can come and go as you like.
• 6:36
  SPEAKER_01: Then we go into assisted living, and this is where I think there's a misperception of, oh, that must be like a skilled nursing.
• 6:43
  SPEAKER_01: Far from.
• 6:44
  SPEAKER_01: We have a lot of really great assisted living options out there for people with a variety of uh cares that can be provided, uh, as well as amenities and services.
• 6:54
  SPEAKER_01: So uh think of you know the person who might need a little extra assistance taking a shower or getting dressed or with medication management.
• 7:02
  SPEAKER_01: Maybe they've got some mobility challenges and they need some assistance getting out of a wheelchair into bed or making sure that they're using their walker safely.
• 7:11
  SPEAKER_01: Uh you know, lots of activities.
• 7:12
  SPEAKER_01: All of their meals are provided.
• 7:14
  SPEAKER_01: So for that person who's just not eating very well, maybe they're relying on frozen meals instead of good, nutritious, you know, healthy meals.
• 7:21
  SPEAKER_01: That's something that could be beneficial for them as well.
• 7:24
  SPEAKER_01: A lot of those communities have visiting medical professionals.
• 7:27
  SPEAKER_01: So you could have a visiting doctor, a podiatrist, dentist, uh, you name it.
• 7:31
  SPEAKER_01: They do it, right?
• 7:32
  SPEAKER_01: So uh a lot of great options there, and they can adjust the care that's being given along the way.
• 7:38
  SPEAKER_01: So you can move into an assisted living not really needing a lot of assistance, but knowing that maybe down the line you will, they can just add that on when you need it.
• 7:45
  SPEAKER_01: So assisted living is probably the biggest level of care that we uh uh advise families for at a place for mom just because there's so many options and it really is a versatile option for a lot of families.
• 7:57
  SPEAKER_01: Moving on from there, you've got your memory care.
• 8:00
  SPEAKER_01: Some of our uh communities that you'll see out there have a combination of assisted living with a wing that might provide memory care, or you might find a standalone memory care community.
• 8:09
  SPEAKER_01: Uh I've actually run both as an executive director, and there's a lot of differences that you see in those, but memory care is really about that specialized training that the staff has to help people as they you know are transitioning or progressing through that dementia disease process.
• 8:27
  SPEAKER_01: So you'll have people maybe with early stages of dementia, maybe they need a little extra guidance or redirection through the day all the way through end of life, uh, even working alongside hospice services inside the community.
• 8:41
  SPEAKER_01: So we look at a lot of nonverbal cues as people become unable to verbalize what they need.
• 8:48
  SPEAKER_01: Uh we look at, you know, how can we uh adjust their surroundings to where if we know that maybe too much noise or stimulation might get somebody a little ramped up, we can modify that for them and really look at those cues as to how can we make sure that we are looking at those nonverbal cues and those those, you know, um, you know, people just asking for help without asking for it.
• 9:10
  SPEAKER_01: How can we uh you know really um anticipate those needs and then make that work for them?
• 9:15
  SPEAKER_01: And then we also you know have home care.
• 9:17
  SPEAKER_01: So for people who aren't quite ready to move mom into a community, but they know she needs a little extra help or maybe just to give the family a break, that's a great option maybe to start the uh conversation of let's get a little extra help before we we look into you know a community.
• 9:32
  SPEAKER_01: So there's a lot of options for people depending on what those needs are.
• 9:36
  SPEAKER_00: Right.
• 9:36
  SPEAKER_00: No, I'm I'm that that's a good lay of the land, and there's many places I want to dive in.
• 9:41
  SPEAKER_00: But the first is you know ADL.
• 9:45
  SPEAKER_00: You know, I think that um families sometimes don't know what triggers a conversation, you know, and so you know, I I want you to talk about you know the what ADL means, what people families can begin to look for, and you know, there are certain things that you may not be able to do, but it doesn't necessarily mean that you have to move out of your home, you know, and then we're talking about independence, you know, a lot of you know to preface this, one of the reasons why we launched this podcast, and actually our branding is around the fact that retirement is not what it used to be, you know.
• 10:24
  SPEAKER_00: Conceivably you could have 25 to 40 year retirement period, and so we're looking at it as your next chapter, and so when you are navigating this next chapter, a lot of people are gonna be at home for a long time before they have to go to you know a facility if that becomes you know necessary.
• 10:42
  SPEAKER_00: But at home, you know, being home safely means that there are certain things that you should be able to do that is considered, you know, under the safety, you know.
• 10:53
  SPEAKER_00: So talk about ADL, what that means, and so that families can also understand when they are seeing some of these signs missing, that may be an opening for a conversation.
• 11:04
  SPEAKER_01: Yes.
• 11:04
  SPEAKER_01: So when I think of ADLs, I think of what can be scheduled versus what doesn't need to be scheduled.
• 11:11
  SPEAKER_01: All right.
• 11:11
  SPEAKER_01: So if if my mom is in a wheelchair and she needs help transferring from the chair to the couch, or she needs help getting from the living room to the kitchen, or needs help, you know, she needs to go to the bathroom, that can't be scheduled, right?
• 11:26
  SPEAKER_00: I can you can you define ADL for the audience?
• 11:28
  SPEAKER_01: Oh yeah, so ADLs, activities of daily living.
• 11:31
  SPEAKER_01: So those are your things like um bathing, dressing, help in the bathroom if there's incontinence concerns, or just you know, help with any sort of hygiene related to that.
• 11:41
  SPEAKER_01: Um, and your basic hygiene for, you know, maybe shaving, um, brushing your teeth, um, and then transfer assistance, um uh meals, you know, those kind of things, medications, so anything that requires some sort of physical assistance if they're not able to do that on their own.
• 12:00
  SPEAKER_01: So a shower, I could schedule that for my mom.
• 12:02
  SPEAKER_01: If she's tentative about getting in the shower, maybe she's got some some balance issues or she's afraid of slipping and falling.
• 12:09
  SPEAKER_01: I can schedule a caregiver to come in and help her on the days that she wants her shower.
• 12:14
  SPEAKER_01: That's great.
• 12:15
  SPEAKER_01: If, you know, I need to schedule somebody to come in and prepare breakfast for her in the morning, I can do that.
• 12:21
  SPEAKER_01: But I can't schedule somebody to say, okay, well, at two o'clock, that's when she's going to need to go to the bathroom, right?
• 12:27
  SPEAKER_01: I don't know when she's going to need to go to the bathroom.
• 12:29
  SPEAKER_01: So, so when I talk to families about, well, you know, what can be scheduled versus what does she need help with that can't be scheduled?
• 12:37
  SPEAKER_01: That's where we talk about, well, in-home care might be a good solution for this, but really we need to look at community living where they have 24-7 caregivers to be able to help whenever that that need is.
• 12:49
  SPEAKER_00: Right.
• 12:50
  SPEAKER_00: That's that's so then so the people that you found to, you know, quote unquote age in place, live at home, you know, obviously some of them need care.
• 13:02
  SPEAKER_00: What does that care look like?
• 13:04
  SPEAKER_00: And how do families prepare for that?
• 13:07
  SPEAKER_00: You know, in the in in the whole planning of okay, this is a stage and a season, what does that care look like?
• 13:14
  SPEAKER_00: How, you know, how is it funded?
• 13:17
  SPEAKER_00: Who pays for it, and and how can families prepare themselves?
• 13:21
  SPEAKER_00: Because that probably may be the first step for a lot of people.
• 13:24
  SPEAKER_00: Sure.
• 13:24
  SPEAKER_01: Yeah.
• 13:25
  SPEAKER_01: Well, um, it's understanding what what that looks like.
• 13:28
  SPEAKER_01: So when it when you look at cost, for instance, if you're looking at a community, there's typically a monthly fee for that, right?
• 13:35
  SPEAKER_01: For home care, it's really going to be dependent on how much care you need, how many hours per day, how many days per week.
• 13:42
  SPEAKER_01: So if I just need somebody to come in and help my mom a couple hours a day, a few times a week, I can I can you know plan for that.
• 13:49
  SPEAKER_01: And on average, we're looking at that being anywhere from$20 to$30 an hour.
• 13:55
  SPEAKER_01: It really just depends on the agency and where you're located, but say it's$30 an hour.
• 14:00
  SPEAKER_01: So that can add up very quickly.
• 14:02
  SPEAKER_01: If I need somebody with my mom eight hours a day or 10 hours a day, or 24-7, that can be very expensive and actually costs a lot more than being in a community in some cases.
• 14:12
  SPEAKER_01: We've talked to families who are paying$50,000 a month for home care, whereas assisted living or even memory care, memory care national average is about$6,600 a month.
• 14:23
  SPEAKER_01: There's a big difference.
• 14:24
  SPEAKER_01: Um, but it's, you know, okay, let's start with what does that look like bringing in home care and just, you know, getting used to the idea of somebody helping me.
• 14:32
  SPEAKER_01: That's a lot easier for some people than others to admit they need help or accept that help.
• 14:36
  SPEAKER_01: For me personally, I don't like to accept help.
• 14:38
  SPEAKER_01: I like to think I can do everything on my own, but there may be a point where that's not possible.
• 14:43
  SPEAKER_01: So again, it's really what can be scheduled, what can't be.
• 14:46
  SPEAKER_01: What does the family intend to continue to do where versus maybe they don't feel comfortable helping mom with a shower, right?
• 14:54
  SPEAKER_01: Or maybe they, you know, they're dealing with somebody who needs assistance transferring and it's you know a very large person that it might not be easy for them to do that.
• 15:04
  SPEAKER_01: So we also look at, you know, when when you put in dementia on top of that, how safe is this person really at home?
• 15:11
  SPEAKER_01: You know, if if if I've got somebody who's a fall risk and they're forgetting to use their walker, I can't schedule, oh, well, they're gonna fall at 10 o'clock.
• 15:19
  SPEAKER_01: I need somebody there with them.
• 15:20
  SPEAKER_01: Somebody can fall anytime.
• 15:23
  SPEAKER_01: So that's again where we might think, you know, if having 24-7 care at home is not going to be financially feasible, um, maybe we need to look at a community setting.
• 15:32
  SPEAKER_01: And I've seen many instances where people start with home care for their loved one who has a you know maybe mid-stages of of dementia, and um the person with dementia is locking them out of the house or they're saying, get out, I don't know who you are, right?
• 15:47
  SPEAKER_01: And then, you know, they're kind of stuck at square one again.
• 15:50
  SPEAKER_01: So if somebody's, you know, wandering out and getting lost, you know, having a couple hours of home care is not going to be the solution.
• 15:58
  SPEAKER_00: Right, right, right.
• 15:59
  SPEAKER_00: And uh I was watching one of your videos on your YouTube channel, and the conversation was around preparing for the conversation and the fact that the earlier it happens when, you know, the earlier it happens, the better, because then, you know, number one, you know, the person is in their right mind, and also because there's less defensiveness.
• 16:25
  SPEAKER_00: Um, and so I want you to talk about you know obstacles to this whole process and and how it's important for families to start the conversation and when when is it a good time to start having that conversation?
• 16:40
  SPEAKER_01: Yes.
• 16:40
  SPEAKER_01: Um, start before the crisis.
• 16:43
  SPEAKER_01: A lot of families wait for a crisis to occur and then they start to search, and that's where they get stuck making the wrong decision or you know, just having to scramble at the last minute, you know, to find just what might be available.
• 16:57
  SPEAKER_01: So starting early, I like to say be proactive, not reactive.
• 17:01
  SPEAKER_01: So it could be as simple as just having a very relaxed conversation of, you know, um, my friend told me that she moved her mom into an assisted living community and it's going all right, but you know, I've never really thought of that.
• 17:14
  SPEAKER_01: What would be important to you if we needed to find a community?
• 17:17
  SPEAKER_01: Are there any amenities or or specifics about the community that you'd want me to, you know, to be aware of?
• 17:23
  SPEAKER_01: Um for my mom, it would be she wants to have her dog, no ifs, ands, or buts, right?
• 17:28
  SPEAKER_01: They have to have transportation because we don't like to drive in the snow.
• 17:32
  SPEAKER_01: And you know, just different things that would be the must-haves versus the would-be nices.
• 17:37
  SPEAKER_01: But you can really start that conversation at any time, but definitely before you think, okay, we're getting to the point where we we really need to do something.
• 17:45
  SPEAKER_01: That way they can be part of that conversation and feel that they have an active part of that decision.
• 17:51
  SPEAKER_00: Right.
• 17:51
  SPEAKER_01: And a lot of families haven't had that discussion.
• 17:54
  SPEAKER_01: We hear from many families at a place for mom where they've never discussed what mom's financial resources are, or dad's financial resources.
• 18:01
  SPEAKER_01: They have no idea what their social security is or how much they have in savings, or if they would intend to sell their home, or if there's a long-term care insurance policy.
• 18:08
  SPEAKER_01: So having those conversations brings you to the conversation um with a lot more knowledge, right?
• 18:14
  SPEAKER_01: And a lot of times you talk about barriers where maybe there's this thought that, well, you know, mom and dad aren't going to want to talk to me about this.
• 18:21
  SPEAKER_01: They're they're digging their heels.
• 18:22
  SPEAKER_01: Every time I bring it up, they shut me down.
• 18:25
  SPEAKER_01: Well, there's nothing keeping you from going out and doing tours on your own and checking out what's out there.
• 18:31
  SPEAKER_01: Because uh, and we hear this from families a lot saying, you know what?
• 18:35
  SPEAKER_01: I know we say don't wait for the crisis, but in this case I'm going to have to because mom won't hear me talk about this.
• 18:42
  SPEAKER_01: Like it's gonna be her in the hospital and then me making this decision.
• 18:46
  SPEAKER_01: Okay, that happens.
• 18:47
  SPEAKER_01: I mean, that's reality.
• 18:48
  SPEAKER_01: So be proactive, be your own family expert and get out there and visit communities, talk to the agencies, get the information so that when the time comes, you're not, you know, behind.
• 19:01
  SPEAKER_01: You're ahead of the eight ball, and you're like, okay, I've I've seen some places.
• 19:05
  SPEAKER_01: And frankly, we all know our loved ones better than anybody.
• 19:07
  SPEAKER_01: I could walk into any community and know right off the bat if my mom would like it or not, because I know my mom.
• 19:13
  SPEAKER_01: And, you know, so go in with the eyes of your parent or your loved one, whoever that is, and think, okay, would they would they, you know, get this?
• 19:21
  SPEAKER_01: Would they feel comfortable here?
• 19:22
  SPEAKER_01: Are the people living here, you know, the same uh, you know, as them as far as maybe their physical limitations or abilities, right?
• 19:31
  SPEAKER_01: So that way, when the time comes, you're you're that much closer to being able to make an informed decision.
• 19:37
  SPEAKER_00: Right.
• 19:37
  SPEAKER_00: No, that is that is that is an advice that uh, you know, I want to internalize because oftentimes we think that we need their permission to begin the search.
• 19:49
  SPEAKER_00: And so by the time you actually get that, you probably never get that permission, and then there's an emergency, which I want to talk about next.
• 19:56
  SPEAKER_00: But knowing that if you feel resistance or you feel like they would not want to talk to you about this, you the fact that you say you can go and do the search, you know, so that you're you you are informed, you know the lay of the land, and then you know, when the conversation can happen, you actually have more information.
• 20:12
  SPEAKER_00: I think that's great advice.
• 20:13
  SPEAKER_00: So that segues into people who all of a sudden are confronted with this, there's an emergency, yeah, and then we have to look.
• 20:23
  SPEAKER_00: How do you walk them through that process and what are where should they start looking?
• 20:27
  SPEAKER_00: I and I want to talk about your platform um and the services that you guys offer and everything, but if somebody gets into an emergency situation where all of a sudden there is you know Alzheimer's or dementia or something else, and now they need care immediately, how should they navigate that?
• 20:45
  SPEAKER_01: Right.
• 20:46
  SPEAKER_01: Well, it's much easier to get somebody to help you, like place for mom, but you know, really, you know, doing it on your own is going to be hard.
• 20:54
  SPEAKER_01: If you're just relying on the internet of, okay, I'll just pull up a list of places and start making phone calls, it's a waste of time, right?
• 21:00
  SPEAKER_01: You don't know if that community will be able to provide insulin that your mom might need, or if they do a two-person assist to transfer that your dad might need, right?
• 21:07
  SPEAKER_01: So using you know an expert resource can certainly help you save time.
• 21:12
  SPEAKER_01: Um, but knowing financial uh resources is definitely going to help.
• 21:17
  SPEAKER_01: I could have three different assisted living communities that range anywhere from 4,000 a month to 10,000 a month, right?
• 21:24
  SPEAKER_01: So knowing what would be affordable is definitely gonna help, right?
• 21:28
  SPEAKER_01: There's lots of different resources out there that families have no idea about.
• 21:32
  SPEAKER_01: Uh veterans' aid and attendance benefits.
• 21:34
  SPEAKER_01: We talk a lot about that to families who had no idea that that's available for our wartime vets.
• 21:39
  SPEAKER_01: Um, long term care insurance policies, right?
• 21:41
  SPEAKER_01: Does mom have a 401k or any other kind of assets to draw from?
• 21:46
  SPEAKER_01: Um is there a house?
• 21:47
  SPEAKER_01: And would there be a plan to sell the house or use that house as in as rental income?
• 21:52
  SPEAKER_01: Really?
• 21:52
  SPEAKER_01: So having those conversations, a lot of times there's multiple people in the family who might be power of attorney, like one over five.
• 22:00
  SPEAKER_01: Finances, one over medical.
• 22:02
  SPEAKER_01: So have those meetings.
• 22:03
  SPEAKER_01: Talk about, you know, what are we looking at?
• 22:05
  SPEAKER_01: Get a financial planner involved if you need to to really understand.
• 22:09
  SPEAKER_01: Like, you know, we talk about in our family, because I've been doing this for so long, like, how many months or years of assisted living do we have saved for our retirement?
• 22:16
  SPEAKER_01: Because a lot of times it's not a matter of if, it's it's when you're gonna need to get some sort of help.
• 22:22
  SPEAKER_01: So really understanding that I think is is invaluable.
• 22:26
  SPEAKER_01: That's gonna save a lot of time.
• 22:28
  SPEAKER_01: And then, like I said, just understanding what would be important to your loved one in regard to not only having their care needs met, but this is their new home, right?
• 22:36
  SPEAKER_01: So, does having a library because they love to read, does having um religious services because they like to do Bible studies or or go to church, or just having that available?
• 22:46
  SPEAKER_01: Um, you know, maybe having uh a certain diet, right?
• 22:50
  SPEAKER_01: Do they need a gluten-free diet?
• 22:52
  SPEAKER_01: Are they a kosher diet?
• 22:53
  SPEAKER_01: Is it a vegetarian diet, whatever that looks like?
• 22:56
  SPEAKER_01: Understanding what would be important so that you can share that information with the communities when you're touring, and then they can help you understand the value that they will bring to that loved one situation.
• 23:07
  SPEAKER_01: When it comes to dementia, it's important to know too that the communities are supporting not only the resident, the senior, but the family as well.
• 23:14
  SPEAKER_01: So many of them have support groups or educational programs for families so that they can continue to be an active part of their loved one's life.
• 23:22
  SPEAKER_01: Um, so many times in those later stages of dementia, um, they lose the ability to communicate verbally, but there's other ways that they can still have a meaningful uh relationship.
• 23:32
  SPEAKER_01: And the communities do a great job of helping to foster that so that families can still feel an active part of their loved ones' life and not feel awkward about visiting and not talking, right?
• 23:42
  SPEAKER_01: There's other things they can do to connect.
• 23:44
  SPEAKER_01: So um, so those are the kind of things that you know, as people are are starting to look, they need to be asking those kind of questions.
• 23:50
  SPEAKER_01: What will you do to support my family?
• 23:52
  SPEAKER_01: What happens if like what would happen if my mom would not be able to stay here?
• 23:58
  SPEAKER_01: What kind of uh care needs would she need to have that go beyond the scope of what would be allowable that they would need to go to a skilled nursing facility or bring in hospice services or home health services?
• 24:10
  SPEAKER_01: Like, what can the community do to really help them understand can they stay there through end of life, or are there prohibitive conditions that they need to keep in mind as well?
• 24:19
  SPEAKER_01: So those are the kind of questions they should be asking initially just to make sure they're making the right decision and not having them yet move their loved one again, which is disruptive to everybody.
• 24:28
  SPEAKER_00: So yeah.
• 24:30
  SPEAKER_00: So let's get to money.
• 24:32
  SPEAKER_00: You've talked a little bit about that.
• 24:34
  SPEAKER_00: Yeah, um, you know, being somebody that creates content about Medicare, Medicaid, and understanding how those programs work.
• 24:42
  SPEAKER_00: A lot of people are surprised, especially I don't I think you know, once the adults get into Medicaid and Medicare, they know that it has what it covers and doesn't cover.
• 24:53
  SPEAKER_00: Yeah, I think the children are the ones that are surprised that Medicare, Medicaid does not, you know, and the limitations of what it covers based on your income, especially Medicaid.
• 25:02
  SPEAKER_00: Yeah.
• 25:03
  SPEAKER_00: So can you talk about you know how people typically finance assisted living, um, and what people can do proactively to prepare for that.
• 25:17
  SPEAKER_00: And you can also look in there, you know, long-term care insurance and how that also supports that.
• 25:23
  SPEAKER_01: Yeah.
• 25:24
  SPEAKER_01: Yeah, it's it's not cheap by any means.
• 25:27
  SPEAKER_01: Uh the national average for assisted living is around$5,400 a month.
• 25:30
  SPEAKER_01: Um, memory care I mentioned is about$6,600.
• 25:32
  SPEAKER_01: So it depends certainly geographically where you're located and any additional care needs that you may have that you know might constitute a higher cost, like insulin injections or you know, things like that.
• 25:45
  SPEAKER_01: Um so yeah, we we we look at you know what is monthly income, you know, Social Security, pension, anything like that, any sort of uh investments or savings.
• 25:57
  SPEAKER_01: Um do they own a house, you know, some property that can be sold?
• 26:01
  SPEAKER_01: Um yeah, we talk about long-term care insurance policies.
• 26:04
  SPEAKER_01: We see those more often than we used to, but they're very expensive.
• 26:08
  SPEAKER_01: So if somebody is very concerned about money, um then there's probably not a likelihood that that that's something that they have.
• 26:15
  SPEAKER_01: But we ask.
• 26:17
  SPEAKER_01: Um I mentioned veterans' aid in attendance benefits for for our wartime vets.
• 26:21
  SPEAKER_01: Um, that's a great benefit.
• 26:23
  SPEAKER_01: And I've personally known people where that has made or break, you know, it can make or break their ability to uh to you know afford care.
• 26:31
  SPEAKER_01: Um and it can be that's a benefit that can also help to offset the cost of home care as well.
• 26:36
  SPEAKER_01: And there are some really good long-term care insurance policies.
• 26:39
  SPEAKER_01: They used to just cover skilled nursing and that's it, right, back in the day.
• 26:42
  SPEAKER_01: But now they do cover things like assisted living, memory care, even some home care, depending on the policy.
• 26:47
  SPEAKER_01: So it's always worth looking into and asking about.
• 26:50
  SPEAKER_01: Um, life insurance policies, people can look into, you know, if they want to sell their life insurance policy.
• 26:57
  SPEAKER_01: Uh, there's bridge loans they can get for their house if they don't want to sell their house or use their house as rental income.
• 27:04
  SPEAKER_01: Uh, and then family support.
• 27:05
  SPEAKER_01: Um, I worked with a family once when I was an advisor.
• 27:08
  SPEAKER_01: Um, they were looking for options in California.
• 27:11
  SPEAKER_01: Mom was already on Medi-Cal, which is their version of Medicaid, but there were five kids, and they were able to pitch in and we were able to get her referred to a community that did not need Medicaid because the the kids were able to support her.
• 27:25
  SPEAKER_01: That's not always the case, obviously, but you know, we we want to, you know, uncover every possible, you know, source because, yeah, you're right.
• 27:33
  SPEAKER_01: I mean, I I think a lot of people think, especially if they've never researched this before, they they call in and they're like, oh well, uh, my mom needs memory care, so I'm thinking, you know, 2,000 a month.
• 27:43
  SPEAKER_01: And we're like, mm, that's not gonna come close.
• 27:47
  SPEAKER_01: So we really have to dive in and and determine, you know, what might be available.
• 27:50
  SPEAKER_01: And sometimes it it you know means a family pitching in if it means keeping mom safe.
• 27:55
  SPEAKER_00: Right, right, right.
• 27:56
  SPEAKER_00: So now let's talk about a place for mom.
• 27:59
  SPEAKER_00: Um, who do you serve and what services do you provide to them?
• 28:04
  SPEAKER_01: Okay.
• 28:04
  SPEAKER_01: Uh so we serve families and their seniors.
• 28:08
  SPEAKER_01: Sometimes it's the senior calling in for themselves.
• 28:10
  SPEAKER_01: I remember a lady calling in once, she uh it was during COVID, and she was living with her family and they were driving her nuts.
• 28:16
  SPEAKER_01: She's like, I love my family, I love my grandkids, but I need my own space.
• 28:21
  SPEAKER_01: Um, but yeah, the families uh who typically, I mean, there's a need, right?
• 28:25
  SPEAKER_01: There's hundreds of other things they could be looking into other than senior care.
• 28:29
  SPEAKER_01: So typically something has occurred.
• 28:31
  SPEAKER_01: Maybe mom's in the hospital, maybe they were visiting mom over the weekend and they saw a bunch of medication spilled on the floor that she wasn't aware of, or I mean, something occurred.
• 28:39
  SPEAKER_01: There's a catalyst to that.
• 28:40
  SPEAKER_01: Um, so we're a free service to the families who reach out to us.
• 28:44
  SPEAKER_01: Uh, we're paid by our community uh partners uh and home care agencies that we work with that we get paired with them.
• 28:50
  SPEAKER_01: So you could look at it as almost like a matchmaking service.
• 28:53
  SPEAKER_01: We ask families, you know, what's the concern?
• 28:55
  SPEAKER_01: What are the care needs that are occurring?
• 28:57
  SPEAKER_01: How is this affecting you?
• 28:58
  SPEAKER_01: You know, the pain points for the family.
• 29:00
  SPEAKER_01: Uh we find out about lifestyle preferences because, again, it's not just about care needs, what's going to make mom happy in her new home?
• 29:07
  SPEAKER_01: And then we have a database of over 18,000 different community customers that we work with across the country.
• 29:15
  SPEAKER_01: And we can narrow down those options for the families based on all that information they've shared with us.
• 29:20
  SPEAKER_01: So we're not just throwing 20 options and saying, all right, good luck, you're on your way.
• 29:24
  SPEAKER_01: Like we really tailor it to what they need, and then we continue to follow up with them and help them.
• 29:29
  SPEAKER_01: We schedule tours so that they can actually get out there and visit those communities and uh and continue to help them as you know, maybe things change.
• 29:36
  SPEAKER_01: Maybe initially they were looking at independent living, but now they realize mom might actually need assisted living, or maybe they thought assisted living, but mom has a new dementia diagnosis and we need to pivot to memory care.
• 29:47
  SPEAKER_01: So we help them along the way until they can make you know a good solid choice for themselves.
• 29:51
  SPEAKER_00: So no, that's that's great.
• 29:53
  SPEAKER_00: And so what does a you know what does a typical relationship look like?
• 29:59
  SPEAKER_00: So somebody goes to your what would be a good place to search?
• 30:02
  SPEAKER_00: They go to your website first and narrow it down, and then they get a link to an advisor.
• 30:07
  SPEAKER_00: How does that relationship work and how long does the advisor work with them?
• 30:13
  SPEAKER_00: And once the handoff it's it's happens with the facility, are you guys still involved?
• 30:18
  SPEAKER_00: I wanted to share with our audience, you know, the full gamut of your services so that they get a good understanding of how you can help them.
• 30:24
  SPEAKER_01: Absolutely.
• 30:25
  SPEAKER_01: So uh the majority of folks find us through our website, a placeformom.com.
• 30:30
  SPEAKER_01: Uh, we have some affiliate websites.
• 30:31
  SPEAKER_01: You might see television commercials, newspaper ads, social media ads.
• 30:36
  SPEAKER_01: We're we're out there everywhere.
• 30:38
  SPEAKER_01: Um, but typically you can go to our website, aplaceformom.com, uh, you enter your contact information in, and within a few seconds, somebody from our contact center will be reaching out to find out where you're looking, and they'll get you connected with an advisor who serves that specific area.
• 30:52
  SPEAKER_01: So they're very well educated on the different options within that search area that the family's looking at.
• 30:58
  SPEAKER_01: Um but they can look all over.
• 30:59
  SPEAKER_01: So say, you know, I'm in Colorado, say I reach out to a place for mom and I'm looking here, but I also want to consider um Oregon because that's where my brother lives, and maybe mom wants to live there too.
• 31:10
  SPEAKER_01: So we can look anywhere, but you know, typically it's within a certain area.
• 31:15
  SPEAKER_01: And then um they will ask all the questions we talked about, get them some options, get them some tours scheduled, and then they um will pass them on to an advisor who will continue to work with them throughout the course of whether it's an immediate move, you know, this month, or maybe three years down the line, five years down the line.
• 31:31
  SPEAKER_01: Some people call in just really wanting to do some initial research.
• 31:35
  SPEAKER_01: I had a lady call in once when I was an advisor, and she was getting ready to meet with her financial advisor, and she just wanted to make sure she had enough money for when the time came.
• 31:43
  SPEAKER_01: She's thinking five, ten years down the line, but she wanted to make sure she was financially set up.
• 31:48
  SPEAKER_01: I still set up tours for her, explaining that you you can see three assisted living communities and they all look different.
• 31:53
  SPEAKER_01: What's important to you is what you want to keep in mind because one might be more expensive.
• 31:57
  SPEAKER_01: That's what you want to make sure that you have enough to cover when the time comes.
• 32:02
  SPEAKER_01: So uh whether it's an immediate need or something far down the line, we continue to work with them.
• 32:06
  SPEAKER_01: So, yes, we're we're getting them connected with communities, getting them touring, but we're also continuing to follow up because their needs can change pretty significantly.
• 32:15
  SPEAKER_01: Mom's doing great today, but what if she falls and breaks a hip tomorrow?
• 32:18
  SPEAKER_01: Now, instead of independent living, we're looking at assisted living, right?
• 32:21
  SPEAKER_01: So we want to shift gears with that family and make sure that at any given time that they have viable options that they can consider for their loved one.
• 32:29
  SPEAKER_00: So a quick follow-up to that.
• 32:32
  SPEAKER_00: If they have worked with you to solve, you know, one situation, let's say that we ended up in a home situation where we have skilled um professionals coming in and helping mom, and then now there is a new development.
• 32:48
  SPEAKER_00: Can the relationship continue?
• 32:50
  SPEAKER_00: Can they reach back out and say, okay, we're at a new stage?
• 32:53
  SPEAKER_00: Can you help us?
• 32:54
  SPEAKER_01: 100%.
• 32:54
  SPEAKER_01: Yeah, they can reach out again via our website or our 1-800 number, or they can reach out directly to that advisor who helped them before, uh, because all the advisors have their own uh unique contact information.
• 33:07
  SPEAKER_01: So they can just reach right back out to that person to continue on for additional options, and that happens quite often, actually.
• 33:13
  SPEAKER_00: Okay, I have three more questions and then we'll wrap up.
• 33:16
  SPEAKER_00: So, first one is um, you know, estate planning and power of attorney and all these things when memory issues are developing.
• 33:28
  SPEAKER_00: How have you seen, or what would you say is the best practices for people to navigate this to be able to get the legal authority to be able to make some of these decisions?
• 33:39
  SPEAKER_01: Yeah.
• 33:39
  SPEAKER_01: Yeah, it becomes an issue when somebody has been diagnosed with dementia and no POA has been put in place.
• 33:45
  SPEAKER_01: Now you have to go through a lot of legal hoops like guardianship, conservatorship, because that person with dementia doesn't have the legal capacity now to sign over that POA.
• 33:55
  SPEAKER_01: So, yeah, if there's any sort of any hint, I mean, I think it's just best practice to have somebody in charge, right?
• 34:02
  SPEAKER_01: My mom is completely alert, completely great, but she has, you know, put that in place in case something happens, right?
• 34:10
  SPEAKER_01: And I think it's important for families just to know like if something happens, if especially if there's multiple kids, who do you want to be making those decisions for you?
• 34:19
  SPEAKER_01: Do you want it to be all of us?
• 34:20
  SPEAKER_01: Do you want it to just be one of us?
• 34:22
  SPEAKER_01: Let's make sure that we've got that documentation in place because God forbid you end up in a coma in the hospital.
• 34:28
  SPEAKER_01: Who's the one who's going to be able to make those decisions for you?
• 34:31
  SPEAKER_01: So I think that's just best practice no matter what.
• 34:33
  SPEAKER_01: I mean, my husband and I have it, and we're certainly not anywhere close to retiring, but you know, we've got a son and we want to make sure that you know things are in place if something happens to us that you know somebody can make decisions for us.
• 34:45
  SPEAKER_00: So at minimum, you recommend that families be at least have that in place now, you know.
• 34:51
  SPEAKER_01: Oh, yeah.
• 34:51
  SPEAKER_01: Well, and and every assisted living and memory care community is going to require that to be in place because if there's a medical emergency there, the community they need to know who to call to uh to alert to what's happening.
• 35:04
  SPEAKER_00: Okay.
• 35:04
  SPEAKER_00: Yeah.
• 35:05
  SPEAKER_00: So uh second question is um, what are some of the myths or misconceptions that come to the top of mind about you know senior living that you want to dispel?
• 35:16
  SPEAKER_01: Um we we touched on it earlier.
• 35:19
  SPEAKER_01: Uh, that everything is like a skilled nursing facility.
• 35:21
  SPEAKER_01: Everything's gonna be clinical and depressing.
• 35:25
  SPEAKER_01: And you know what you remember grandma being in back in the 80s, completely false, right?
• 35:30
  SPEAKER_01: Uh we've got some beautiful, beautiful communities out there uh that really do an amazing job, not only with the aesthetics, but their their focus on hospitality and customer service and just making sure that people feel that they still matter, right?
• 35:45
  SPEAKER_01: It's not just about giving your care or having your care needs met, but it's honoring who you are as a person.
• 35:51
  SPEAKER_01: And I think a lot of our communities are really doing a great job of making it feel like home and not like you're just at this care facility.
• 36:00
  SPEAKER_00: Right, right.
• 36:02
  SPEAKER_00: And last question.
• 36:03
  SPEAKER_00: Um, anything I haven't asked that any point you wanted to make that I haven't asked yet, or anything you want the, you know, our listeners to know um about senior living?
• 36:15
  SPEAKER_01: Uh I think the biggest piece of advice I can give is just get out there and look at some because there's only so much information you can get from a brochure or a website.
• 36:25
  SPEAKER_01: Uh, I just had a conversation with some new advisors today.
• 36:28
  SPEAKER_01: They went out and visited some communities for the first time yesterday, and they came back saying, Wow, we didn't know that they could be so pretty.
• 36:35
  SPEAKER_01: They had this preconceived notion they were going to be depressing and people there weren't going to be happy.
• 36:41
  SPEAKER_01: And uh, as they were touring, they got involved in activities, they had lunch.
• 36:45
  SPEAKER_01: Um, you know, one girl she said, Yeah, I came in and they had a sign there welcoming me, you know, and I'm just this, you know, advisor.
• 36:53
  SPEAKER_01: Who am I?
• 36:54
  SPEAKER_01: But um really like, and but she said, you know, this one place it seemed very bright, it smelled good, the foods like you're not going to experience that just from a brochure.
• 37:03
  SPEAKER_01: You really need to get into those communities and and and really experience it with all your senses.
• 37:08
  SPEAKER_01: Really see how the care staff interacts with the with the residents there.
• 37:12
  SPEAKER_01: It's not the pretty curtains or the carpet taking care of the people, it's it's the people taking care of the people.
• 37:17
  SPEAKER_01: So get in there and ask questions.
• 37:20
  SPEAKER_01: Um, here at A Place for Mom, we have a touring checklist that we give to families before they tour, and that way they know what questions to ask because so many families don't know what they don't know.
• 37:28
  SPEAKER_01: And that way they can compare each community and say, oh, well, this one, you know, offered this, but this one didn't.
• 37:34
  SPEAKER_01: Or this one had a great answer to this, but this one, you know, they they were kind of vague about it.
• 37:38
  SPEAKER_01: It really helps them as they're narrowing down those options as well.
• 37:41
  SPEAKER_01: Um, a lot of our communities also have some really great resources to give families when it comes to cost comparison.
• 37:47
  SPEAKER_01: I think another misperception is, well, it's cheaper to keep mom at home.
• 37:51
  SPEAKER_01: Well, actually, to get, if you're comparing apples to apples to the kind of care she would get 24-7 in a community setting, plus meals, plus all the utilities, plus the activities and socialization, all those things compared to staying at home and paying for a 24-7 caregiver, which we know could cost a lot more, plus you're still paying for food, plus utilities, all the things.
• 38:14
  SPEAKER_01: You know, so they have those cost comparisons of what you know you get at a community versus what you're you know, what staying at home would look like.
• 38:21
  SPEAKER_00: So no, that's great.
• 38:23
  SPEAKER_00: Uh Nikki, you've been you've you've given us so much.
• 38:25
  SPEAKER_00: I mean, I have learned a lot today.
• 38:26
  SPEAKER_00: The things that jump at me, the fact that it's important to look.
• 38:32
  SPEAKER_00: Uh if you don't even feel like you have permission from your loved one to go do this, you know, you can go look independently.
• 38:39
  SPEAKER_00: So I like that.
• 38:40
  SPEAKER_00: I want our listeners to really consider that the fact that planning financially is important, power of attorney, understanding that these communities are not what your perception is, and that you know they could be a great option, and that you need to go out there and and look at them.
• 38:55
  SPEAKER_00: And also the the questions you need to ask your loved one before you know something happens and then you you don't understand what their wishes are.
• 39:03
  SPEAKER_00: So all those are great advice.
• 39:05
  SPEAKER_00: So if somebody wants to work with you guys, how can they reach out to you?
• 39:08
  SPEAKER_00: Or if they want to, you know, just keep you guys, you know, in at the back of their mind as they make this decision, how can they reach out to you?
• 39:16
  SPEAKER_01: Absolutely.
• 39:17
  SPEAKER_01: So again, we're a free service.
• 39:18
  SPEAKER_01: Uh, all they need to do is go to our website, a placeformom.com.
• 39:24
  SPEAKER_01: And from there they can put their their information in and we'll get them connected with an advisor in their area.
• 39:30
  SPEAKER_00: Awesome, awesome.
• 39:32
  SPEAKER_00: Thank you so much, Nikki.
• 39:33
  SPEAKER_00: This was great, and uh I you've given us a lot to chew on and I appreciate you.
• 39:37
  SPEAKER_01: My pleasure, thank you so much.
• 39:39
  SPEAKER_00: Thank you.
• 39:43
  SPEAKER_00: And to our listeners, thank you for spending part of your day with us.
• 39:47
  SPEAKER_00: If today's conversation was helpful, be sure to subscribe to the retirement navigator so you don't miss future episodes.
• 39:56
  SPEAKER_00: You can also find more retirement guidance and resources through Benefits Insider.
• 40:01
  SPEAKER_00: And if you are looking for connection and support, we invite you to join our next chapter community on the school platform.
• 40:12
  SPEAKER_00: Until next time, take care, and remember retirement is not the end of the road, it is a new season to navigate with clarity and confidence.