Long Distance Elder Caregiving

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Office of Work/Life: And particular long distance caregiving. I will just make a note that we're recording this session. We are going to have time for questions at the end. So feel free to either you know, type those into the chat, or you can come off of your microphone and and speak those questions, but for now we'll turn over to sharing. Thank you.

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Sheri Samotin: Great thanks so much, becca. Thanks for having me back, and good afternoon, everyone.

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Sheri Samotin: So my name is Sherry Saniton, and I am a professional fiduciary and life transition coach

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Sheri Samotin: and I have helped many, many families deal with caregiving challenges including long distance caregiving. And so that is the focus of our conversation for today. So

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Sheri Samotin: we're gonna start by talking about some of the scenarios that typically arise.

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Sheri Samotin: And then I'm going to provide you with a framework for how to kind of get your arms around the problem.

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Sheri Samotin: and then we'll conclude by talking about what I call lifesavers, or some of some of the things that you can grab ahold of when you feel overwhelmed as a caregiver and feel like you're drowning.

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Sheri Samotin: Okay? So there are as many scenarios as there are families. Here's just a few that I see over and over again.

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Sheri Samotin: So one situation, the aging parent and all the adult kids live near each other and want to help.

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Sheri Samotin: How many? Well, I can't see your hands. So I was. Gonna say, how many are you in that situation? I'm gonna bet not very many. So that is Nirvana

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Sheri Samotin: when the parent lives near

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Sheri Samotin: one or the only child. and maybe there's others, but they live far away. The parent lives far from everybody.

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Sheri Samotin: There's in-law situations that complicate things.

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Sheri Samotin: and sometimes there's no children at all, or none who are willing or able to help. And so the scenarios go on and on and on, and while I don't know your individual scenario, and whether it fits snugly into one of these categories.

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Sheri Samotin: I'm sure there are pieces of this that will resonate for your situation.

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Sheri Samotin: So the first thing is, you know, we have to recognize that money helps

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Sheri Samotin: finances are important, and the more of them that are available the more options are available. So one of the important things is to plan and help your older adult loved one plan for their future care needs, ideally, by starting early enough to make a difference, either setting money aside.

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Sheri Samotin: purchasing long term care, insurance, or, if those things fail or or not available, doing some elder care planning, so that you have the opportunity to take advantage of public benefits such as Medicaid

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Sheri Samotin: luck is part of it, too. Sometimes people will live well into their 90 s. Or even beyond be pretty healthy and happy and cognitively sound, and then they pass away. Wouldn't we all like it to be that way.

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Sheri Samotin: but some are not so lucky, and situations start, or there's a precipitating event like a fall that becomes the trigger for a downward spiral.

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Sheri Samotin: So how do we deal with all of this?

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Sheri Samotin: What I like to think about is a kind of circle of care. and it's a continuing circle. It's not a straight line with an end. So the fact that I'm presenting this as a circle is important.

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Sheri Samotin: because when you're done you're not done. You have to then do it again. So it's a constantly evolving plan. And really, this is a framework for making decisions. So the very first thing

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Sheri Samotin: that you're going to need to do is assess your parents current needs current needs.

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Sheri Samotin: And I'm going to talk about ways to do that.

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Sheri Samotin: Likewise, you're going to have to assess what resources are available within the family, and that could be money. It could be time. It could be expertise.

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Sheri Samotin: But you're gonna have to sort out. What resources do you have to apply to the situation.

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Sheri Samotin: figure out a way to quickly fill any current needs.

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Sheri Samotin: and then get into the hard part which is forecasting changes. The what ifs, what are we gonna do moms? Okay, what are we gonna do if dad dies first or mom's got dementia, what are we gonna do. If Dad passes, or vice versa.

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Sheri Samotin: From that you can actually plan for the future.

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Sheri Samotin: And then, of course, the future isn't static. So as things change. You need to start the circle again and begin by assessing the then current needs, which may have changed.

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Sheri Samotin: So every time there's a big change in needs. You need to kind of start this thinking process over again.

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Sheri Samotin: So first focusing on assessing needs.

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Sheri Samotin: there are a variety of needs you're going to want to think about

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Sheri Samotin: physical needs. Can Mom or Dad get up and down the stairs if the laundry room's in the basement and it's a steep flight of stairs. Is that safe?

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Sheri Samotin: Those are just a couple of examples.

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Sheri Samotin: Is there a need for things like walkers, canes.

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Sheri Samotin: wheelchairs, grab bars. shower chairs, all those physical types of things. The second big area to assess is emotional needs.

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Sheri Samotin: Sometimes a loved one is physically okay. But they're having a really hard time. They're lonely.

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Sheri Samotin: and the big need is finding ways for them to interact with other humans and perhaps animals, so that they have a richer life experience.

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Sheri Samotin: Cognitive is a big one, because when cognition starts to fail.

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Sheri Samotin: it can be like dominoes where it starts with financial things start to go amiss, and then going from there it goes to all sorts of other layers of cognitive impairment.

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Sheri Samotin: Financial we've touched on already, but this is on the need side. So what does your parent need. How much care, for example, how much does that cost?

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Sheri Samotin: What is the expectation set in your family or in your culture? So in some cultures it's very important and expected that the elder will move in with family.

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Sheri Samotin: In other cultures the, you know, female child is expected to move in with the elder. So it's different in different families, different cultures, but having a good understanding of the expectations, may help avoid some of the

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Sheri Samotin: issues that will arise if those things go unspoken.

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Sheri Samotin: and then, finally, other kinds of cultural issues that may need to be factored in to sorting out how to best care for your loved one, especially at a distance

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Sheri Samotin: in terms of resources. What is available? What financial resources, you know? Do Mom or dad have long term in care insurance? Have they taken out a reverse mortgage? Do they have a pension?

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Sheri Samotin: What are their expenses?

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Sheri Samotin: Does anybody in the family have the ability to contribute. So those are all the financial kinds of things. You're going to want to assess

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Sheri Samotin: time who has time. Maybe one of the siblings works, and one of them doesn't. Maybe the one who doesn't has more time and can can more easily go and visit

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Sheri Samotin: with Mom or Dad once a whatever week, month.

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Sheri Samotin: 6 months, whatever that the timeframe is. Maybe one of the siblings has medical background or financial background and can assist

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Sheri Samotin: with understanding what's going on medically, financially, and so on. Proximity is a big one, you know, who lives closer. Often they are the ones who get those calls in the middle of the night, and that may not be optimal. So you you that's something that you need to assess and think through.

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Sheri Samotin: And then finally, all of the other responsibilities that may arise in your and loved loved ones. Specific situation.

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Sheri Samotin: so, figuring out what you do have within the family is the first step

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Sheri Samotin: comes down to matching needs and resources. So

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Sheri Samotin: let's say, need one is, mom needs someone to take her to the doctor, and keep track of her medication changes, and maybe you have a sister who's a nurse

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Sheri Samotin: and who's good at that.

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Sheri Samotin: Maybe mom needs help with her activities of daily living or incidental activities of daily living like shopping, going to the market, those kind of things, and maybe in your situation, Dad can help mom.

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Sheri Samotin: and so on. So there's needs and resources. And that's how we determine the gaps. So where we have a need, and we don't have an available resource to fill it.

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Sheri Samotin: That's when we have a gap, and we have to figure out how it is. We're gonna fill that gap

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Sheri Samotin: in terms of planning and thinking ahead.

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Sheri Samotin: What I always ask is what might happen. So we know the As is situation. You just assessed that what is the current need? Where are the resources, and what do we have available to fill

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Sheri Samotin: the needs.

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Sheri Samotin: But it's not if it's when something is going to upset the apple card. So a lot of the what ifs might be, what if Mom dies and Dad needs help, and I'm far away.

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Sheri Samotin: or we thought Dad was gonna live forever, like grandpa did. But he has a stroke, and now he needs round the clock care, and he's only 78 years old.

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Sheri Samotin: What if there's a situation where both parents need lots of help?

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Sheri Samotin: So again, there's as many situations as there are families. And it's really important to think through your particular situation. What are the things that could happen, and to develop a plan for what you're going to do when that happens. Because again, it's not if, but when they're not all gonna happen.

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Sheri Samotin: So you're not going to deal with all the scenarios. But if you thought about them and planned for them.

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Sheri Samotin: it's gonna become a lot easier. So here's an example

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Sheri Samotin: I use often. So let's say your loved one falls and breaks their hip and goes to the hospital to have their hip fixed.

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Sheri Samotin: and then the hospital says they can't go home

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Sheri Samotin: without help, because they need to get stronger and have physical therapy and occupational therapy. How about if they go to rehab?

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Sheri Samotin: And the good news is, Medicare does pay for rehab for a period of weeks.

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Sheri Samotin: let's say as they're at Rehab Rehab says, you know, we're really helping as much as we can. But Dad really isn't strong enough to go home without help in the house. You can't take care of his activities of daily living things like toileting things like dressing, bathing. Stay safely

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Sheri Samotin: without having somebody there. So who's gonna be there? Well, in some cases it may be his spouse.

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Sheri Samotin: In other cases it may be an adult child. In other cases it may be a paid caregiver.

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Sheri Samotin: but this is a situation where it's not uncommon for, there to be some kind of a crisis.

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Sheri Samotin: so it may or may not be a broken hip. But but you get the idea. There's some kind of an event that causes a ho, typically a hospitalization, and then rehab. And then all of a sudden, you're dealt this card where, -oh! Your loved one can't go home. They won't release your loved one to home, because you don't have

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Sheri Samotin: an adequate situation for them.

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Sheri Samotin: So then what do you do? Well, maybe it's assisted living. Maybe it's hiring a caregiver. But again, if you've thought this through, what are we going to do?

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Sheri Samotin: So what are we going to do if our loved one injures themselves. There's a crisis, and they can't go home without help. How are we going to deal with that?

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Sheri Samotin: Another huge one is the whole issue of cognition and cognitive impairment dementia. You know. What are we going to do? If our loved one gets to the point

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Sheri Samotin: where it's clear they have dementia, and they are no longer safe to stay at home by themselves. What is the plan?

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Sheri Samotin: And sometimes it's what's the plan? And then what's the plan after that, because often the plan is well, if Dad's kind of cognizantly impaired, mom will be there.

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Sheri Samotin: Okay, well, mom's the caregiver. She gets burned out. She has a heart attack. She dies. What's the backup plan for Dad? So it's not just the plan. Sometimes it's the plan, and then the backup to the plan. So

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Sheri Samotin: my soapbox is planning

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Sheri Samotin: for me. Planning is what it's all about, figuring out the scenarios, figuring out what we can do, what what we can afford what services are available locally where Mom or Dad live.

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Sheri Samotin: These are all really important things to think through. So one of the questions I often get is well, how do I know what services are available where Mom or dad live? I don't live there.

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Sheri Samotin: and one of your best

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Sheri Samotin: groups to go to. Every county has something called the Area Agency on aging.

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Sheri Samotin: and the Aaa, as they call themselves. have lists of local providers for all kinds of things, and so you can save yourself a lot of time

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Sheri Samotin: by

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Sheri Samotin: contacting the area agency on aging in the county where your loved one lives. That at least gives you a good starting place.

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Sheri Samotin: Another place will be your parents, physician. They often have

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Sheri Samotin: ideas because they've dealt with this with other clients. Other patients.

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Sheri Samotin: Alright.

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Sheri Samotin: So you think about all this. You say help! I'm drowning. I don't even know where to begin. I'm overwhelmed. That word overwhelmed is what I hear the most often when I get a call from a prospective client. I say, how can I help?

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Sheri Samotin: And they say I'm overwhelmed, and then we have to unpack that.

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Sheri Samotin: But what's really important is, if you are drowning.

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Sheri Samotin: you need to yell for help. That's really important. Don't try to do this on your own

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Sheri Samotin: who can help you? Well, of course, your family they're part of. They're part of the puzzle here. Sometimes you have friends who are willing and able to help, or who've been through this with their own family, and can offer you advice, suggestions, and support.

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Sheri Samotin: Perhaps there's a clergy or faith community in your parents area that they've been part of. Very often. Faith communities will have caring committees where they will visit

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Sheri Samotin: people who are home bound, or perhaps bring them a meal facilitating other, you know visitors to keep them company, so faith communities can be very helpful, particularly if your parent has been part of one.

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Sheri Samotin: There are all kinds of support groups. They're virtual. They're in person depending on your need. There's Parkinson's groups, Alzheimer's groups stroke groups, all kinds of groups and the support groups can be invaluable because it's people who are going through the same situation, you are.

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Sheri Samotin: and you know, providing you with their tips and tricks. What they figured out the hard way they could share with you.

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Sheri Samotin: Getting a therapist for you is not a bad idea. Caregiving is a really hard, hard journey, and when you're doing it long distance, it's even harder, because you're not there, and you have to figure everything out without being right there and having somebody to talk to about that and kind of keep you on the right track

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Sheri Samotin: can be very helpful, so that caregiving doesn't completely consume you.

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Sheri Samotin: There are live transition coaches as well, who do this for a living and can guide you. There are geriatric care managers who can guide you, who will live off in. You know the local community where your loved one is, and they can be another excellent source

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Sheri Samotin: for resources. You also, have an employee, assistance plan and eap available to you. And your work life team can give you more information about that. But they can be a huge resource for you as well.

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Sheri Samotin: So in addition to the types of helpers we just talked about there can also be tools that can help you.

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Sheri Samotin: So the first is to have this plan. The plan we were talking about earlier, which is the Life Transition Plan. Make a plan. Do the scenario planning, figure out the resources before you need them. That's an important part of your bag of tricks.

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Sheri Samotin: going to all the different online resources, including keeping the whole family in the loop. That is one of the hardest jobs

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Sheri Samotin: is if there's family that are scattered all over the place, and everybody wants to know what's going on. It can become exhausting, repeating over and over the same information. So there are tools like care pages that you can establish, that you can give login credentials to whoever you want.

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Sheri Samotin: so that you can put updates in one place.

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Sheri Samotin: And then your family members can look at their leisure. And they're not emailing you and calling you and texting you, and asking you the same questions as the other sister did a half an hour ago.

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Sheri Samotin: So here pages and other sites like them.

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Sheri Samotin: Can be very helpful. I mean, you could do that with a group text or a group email as well. There, there are variety of ways to do this. But the point is, communication can become exhausting.

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Sheri Samotin: and there are tools to help make it less. So

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Sheri Samotin: all kinds of monitoring technology exists to keep track of your loved one in their home.

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Sheri Samotin: So there's the simple one. Most of you probably know about the pendant A. I've fallen and I can't get up we've all seen them commercial where you push the button, and they say, Yes, you know, Sherry, how can I help you, and you say I fall in, and I can't get up, and then they will send Ems to come out.

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Sheri Samotin: So that's the simplest form. There are also forms of monitors like that that actually have fall monitors built in, so they can actually tell

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Sheri Samotin: when somebody who's wearing the Monitor has fallen. And if they don't respond when they say sherry is everything. Okay? If sherry doesn't respond, they will then send. Yeah. Ms

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Sheri Samotin: there are other kinds of monitoring technologies. There's these fancy pill containers now that have sensors in them that can tell whether your loved one took the correct pill at the correct time of day.

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Sheri Samotin: So they track when the pills are removed from the Monday afternoon slide.

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Sheri Samotin: And if it's Wednesday morning, then you know, you've got a problem because your loved one is no longer capable of taking their medication at the correct time. By the way, that is a huge reason for visits to the emergency department

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Sheri Samotin: for older adults is, what I call medication mishaps. So taking things twice, not taking them at all, taking them on the wrong day at the wrong time. You know 2 things together that shouldn't be taken together. All those kinds of things which happen despite the fact that you may have medication trays all prepared. And it's important to know when that's happening, because that means they can no longer manage their own meds.

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Sheri Samotin: There's even other kinds of monitoring technologies. Now that you could put in the home that can tell. For example, if the threshold to the bathroom hasn't been crossed by a certain time in the morning

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Sheri Samotin: it will alert you, and you can call your loved one, and if they don't answer, you know, there's probably something wrong, because they didn't get up to go to the restroom at the time they usually do.

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Sheri Samotin: So it it's pretty amazing with technology. Now, how much we can do for an elder who is living by themselves.

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Sheri Samotin: But you. You still have the issue that if something happens and nobody knows that loved one could be there on the floor for hours, days even. And that's very, very dangerous. So those are the kinds of things where there are tools available that will help you.

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Sheri Samotin: Yeah, I know we don't have yellow pages anymore. But a lot of our elders homes. Guess what they do. Have them. And sometimes, if you're there visiting and you go flip through the yellow pages. You may find resources and be able to make note of those. Take pictures of those pages so that you have them handy if you need them.

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Sheri Samotin: In addition to the tools, there are all kinds of professionals who can help.

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Sheri Samotin: Most of these require money, because the professionals charge for their services. But there are organizations, not for profits that will provide some of these services. Many of these services on a sliding scale, or for no cost. It all depends on the community where your loved one lives.

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Sheri Samotin: But there are people called daily money managers, and they will handle day-to-day finances like making sure the bills are paid.

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Sheri Samotin: making sure the mail is sorted all of those kinds of tedious things that can be a big burden on a long distance. Caregiver. You're not there to retrieve the mail.

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Sheri Samotin: so a daily money manager could be helpful.

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Sheri Samotin: If Mom or Dad is going to move to your home to assisted living to anywhere. A senior move manager can be incredibly helpful. They're great at working with your older adult to help them realize what how much stuff they can take with them.

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Sheri Samotin: and to help them narrow things down, they will also do the packing, the unpacking, the staging, all of it. There's an organization, I should have said, for daily money managers, the American Association of Daily Money Managers, Adam.

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Sheri Samotin: and you can go to their website

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Sheri Samotin: and go find a daily money manager, simpler. Similarly, NASA, the National Association of Senior Move Managers, has a find, a move manager function.

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Sheri Samotin: geriatric care managers who are also known as aging life care professionals. Their organization is called Alca, the Aging Life Care Association.

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Sheri Samotin: They, too, have a find, a feature on their website.

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Sheri Samotin: There are placement specialists who are experts in the senior living communities, board and care homes and such in your parents area placement specialists are free to you.

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Sheri Samotin: So they're a deal they get paid by the community. If your loved one moves in so placement, specialists can save an enormous amount of time.

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Sheri Samotin: If that discharge planner at the hospital or rehab says Mom can't go home. Mom needs to go to somewhere where there's care. Don't panic

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Sheri Samotin: find a placement specialist ask the hospital discharge Planner. They'll have a list even. But ask the pace. Get get a placement specialist to help you figure out narrow down, so you only have to look at 2 or 3 places, and you're not overwhelmed by begin being given a list of 25 places like they often will do the discharge. Planner will handle list and say you figure it out.

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Sheri Samotin: So a placement specialist can be extremely helpful in that. And again, you don't pay them. They're paid by the community when your loved one moves in.

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Sheri Samotin: There are all stripes of home care companies. There are many, many, many agencies. My only speech here is to please. Please please try to use a licensed agency I could give a whole talk about why but it is extremely risky not to use license professionals and license agencies. There are ways in our attorneys out there who

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Sheri Samotin: find caregivers who think they haven't been paid by the book in accordance with the law, and they will sue families, and they do. They sue families and say this person didn't have their breaks. They weren't being paid minimum wage. Whatever the issues are, it can be very expensive very quickly. So please use license people for that.

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Sheri Samotin: If your loved one needs it, there are fiduciaries. The role that we play is to act as trustee power of attorney for healthcare and or finances or executors of the State.

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Sheri Samotin: Chances are if your here today. Your loved one doesn't need a fiduciary. But just in case

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Sheri Samotin: so, my point being, there are all kinds of professionals who have expertise in various aspects of this whole world of aging and caregiving.

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Sheri Samotin: Who can really help you as a long distance caregiver. cut through the crap

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Sheri Samotin: and get down to, you know. Narrow the choices substantially. If there are choices you have to make, and you're miles and miles away.

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Sheri Samotin: Finally, think of yourself as the lifeguard. That's your job. So your job isn't to do everything. Your job is to be the lifeguard. What do I mean?

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Sheri Samotin: I mean, your job is first to keep them safe. That's the most important gift you can give. Your older loved one is to make sure they are in a safe place, even if it is not what they want.

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Sheri Samotin: Sometimes you have to override what they want

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Sheri Samotin: for their own safety, so keeping them safe is your job. We're making sure they're in a place where they are safe is your job

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Sheri Samotin: helping them to be as independent as they can be also.

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Sheri Samotin: So what I like to say is, don't swoop in and just take over.

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Sheri Samotin: Take charge without taking over, and it's harder than it sounds. But taking charge is helping to find the solutions and helping to implement the solutions taking over is doing it without involving your loved one in any way. I don't recommend that

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Sheri Samotin: very often.

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Sheri Samotin: you know, a parent says, I don't want to go to assisted living.

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Sheri Samotin: So okay, then, here are the choices.

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Sheri Samotin: You can either move in with Sarah.

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Sheri Samotin: or

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Sheri Samotin: you can stay at home with care until your money runs out, and then you'll have to go to a Medicaid facility.

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Sheri Samotin: And Mom is, gonna say, I don't like those choices.

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Sheri Samotin: Say, Okay, well, let's talk about assistive living again. So sometimes, by helping them understand the reality, the choice isn't to stay home in your own home by yourself anymore. It's not safe.

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Sheri Samotin: So sometimes it takes a minute to work through that, and sometimes you have to just do it.

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Sheri Samotin: I had to just do it for my mom. My mom has dementia. After my dad died for a year we had caregivers in the house.

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Sheri Samotin: She absolutely did not want to leave. But we it was beyond our ability to care for her at home. It got to that point she needed just too much.

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Sheri Samotin: and so my sister and I did it. We found the place. We set it up.

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Sheri Samotin: We put her in the car. We didn't tell her where we were going. We took her there, and we had to leave her.

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Sheri Samotin: and that is one of the hardest things I have ever had to do. But I sleep much better at night, knowing that she is safe.

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Sheri Samotin: And the good thing about dementia is within a few days. She wasn't mad at me anymore because she didn't remember any of it.

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Sheri Samotin: So there was a little bit of a silver lining. But sometimes it's hard. It's really hard to, you know, do what needs to be done. But the goal again. You're the lifeguard. Keep them safe, number one, independent as much as as possible.

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Sheri Samotin: But again, that's always going to be within their physical, cognitive, and financial reality. So your dad may say I'm staying home. I'm not going anywhere. Get bring in care, and the finances may be such that that is not possible.

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Sheri Samotin: So sometimes you just can't do what they want. and when you can't do what they want, or it's not in their best interest, it's not safe anymore. You've got to be the lifeguard and do what you gotta do.

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Sheri Samotin: And again, it's hard. I've done it.

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Sheri Samotin: Okay. So I think we're at the point where we can take questions if there are any.

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Sheri Samotin: Becca

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Sheri Samotin: anybody.

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Office of Work/Life: Hey? Yeah. There were a couple of

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Office of Work/Life: questions that came through the chat. But perhaps those want to share themselves or have any

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Office of Work/Life: anything else I wanna comment on feel free. Otherwise we can go.

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Nina Ham: I have a question that I that I can ask or like to ask. There are a number of

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Nina Ham: lawyers who are available for elder care, financial planning, and sort of

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Nina Ham: Medicaid. You know how to get

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Nina Ham: family members on Medicaid. I have a little, you know.

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Nina Ham: II realize that's probably there is probably benefit to the concern about some.

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Nina Ham: maybe predatory practices. Can you speak to

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Sheri Samotin: legitimacy of some of these phones? So what I would say is the only elder law attorney I would use is somebody who's a member of Malaw, the National

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Sheri Samotin: Elder Law Academy. Something like that. It's Nayla is the

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Sheri Samotin: It's the acronym, and it's a national organization of elder law attorneys who have been vetted.

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Sheri Samotin: And so I think if somebody is a member of Naila, they are legit.

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Sheri Samotin: A lot of the elder law people are trying to get you to just dump money into an annuity for which they get paid a very large commission

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Sheri Samotin: like 30% commission right up front and

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Sheri Samotin: that's what they do. So they're not really attorneys who are really thinking about what's best for this particular family. They're pushing you to get a get a annuity that won't count for Medica Medicaid.

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Sheri Samotin: So does that address your question?

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Nina Ham: Yes, that's that's helpful. Thank you.

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Sheri Samotin: Others.

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Sheri Samotin: Is there anything in the chat.

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Office of Work/Life: Yeah, I'll say, someone did voice a concern. I think it just went to me just around the use of state and local agencies, and how sometimes that can be challenging to navigate and

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Office of Work/Life: not

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Office of Work/Life: always the most helpful. So I wonder if you have any sort of comments on that and on the additional resources or anything, or if anyone else wants to share experiences or ways they've been able to use or not use some of these state and local agencies.

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Sheri Samotin: So what I would say is that highly variable? There are some counties that you know, put a lot of resources into elder care, and others that really don't. So it's a very, very place specific issue.

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Sheri Samotin: But again, if you can find a care manager.

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Sheri Samotin: who's in that area.

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Sheri Samotin: They even if you just hire them for one session, like a consulting session to help you identify which local agencies are worthwhile

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Sheri Samotin: and will be helpful. That can be a well spent, you know, hour simply because it'll you'll avoid wasting time with the ones that are frustrating and not helpful

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Sheri Samotin: states tend to be more frustrating, I will tell you, than local just because they tend to be more bureaucratic.

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Sheri Samotin: Local is so often it's like you're dealing with actual humans who are in the community.

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Office of Work/Life: Thank you.

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Office of Work/Life: Oh, we do have one other question in the chat. Regarding

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Office of Work/Life: parents and children living in different states. So this person wrote, and what if a parent and a child live in different states? And the decision is to bring the parent to the state the child lives in. How do the services work? Do they carry across State lines?

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Sheri Samotin: So so services that are federal like Medicare? It works everywhere. It works in all the States

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Sheri Samotin: services that are State specific, like Medicaid Medicaid is a State. It's a Federal State program in that the Feds fund it

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Sheri Samotin: along with the States, but the States administer it. Those don't carry.

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Sheri Samotin: the rules are different. They they may not be dramatically different, but they can be different from State to state.

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Sheri Samotin: So if your loved one is a Medicaid participant, that's something you will need to learn about in your community and figure out.

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Sheri Samotin: you know, if they're gonna have all the same services. For example, in California, under medical, which is our version of Medicaid we have something that people can qualify for called in home supportive services.

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Sheri Samotin: That's providing caregivers for a certain number of hours per week at home. It's not full time, but it it can help a lot, and that's paid for by Medicaid or medical. If your loved one is a beneficiary, is already receiving public benefit. Not all states have I Hss.

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Sheri Samotin: Many do, but not all. Do

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Mirela: you know, if Columbia has a visiting doctors service, do you know this is more to office of work and life rather than to sherry.

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Amy Rabinowitz: That's not something that I'm aware of, you mean? Yeah. Can you? You mean like

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Mirela: geriatricians who would go to the home. Is that what you mean? So so the P. This particular parent hasn't seen a doctor in 40 years. 4 0. She is 89,

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Mirela: and terribly afraid of doctors and so doesn't see a doctor. But there is a need to

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Mirela: have someone come but and but we can potentially convince her that it is okay, cause she has dementia hallucinations. We're not sure if they are uti related for older people. Sometimes there's hallucination with uti. If there's a vitamin deficiency whether this is full blown, Louis, you know, dementia. We don't. She does not have Parkinson's.

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Mirela: There is a Parkinson's related dementia. Also, I mean sorry hallucination. Sorry!

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Sheri Samotin: Where do you live?

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Mirela: So? I live in New Jersey. She lives in New York. She's actually my husband's mother, and she lives with one of her. The the eldest daughter. My husband is the eldest, but she lives with the eldest daughter, but the eldest daughter has her own mental health issues. So

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Mirela: you know, they sort of take care of each other. But you know we we take care of paying the bills with another sister. We've done a lot of this stuff you indicated, which is very helpful. So we've we've done all of that, so she doesn't find herself out on the street. She happens to live in Columbia housing that she's lived in since the sixties. So

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Mirela: you know. So we're taking care of that, but we would really like for her to be evaluated.

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Sheri Samotin: So in my area in Los Angeles there are a few very few

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Sheri Samotin: doctors who are strictly mobile doctors.

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Sheri Samotin: typically either concierge doctors for people who think they're too busy to go to the doctor's office or geriatricians. For situations like you're describing, but they are few and far between. The one who sees my mom, for example.

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Sheri Samotin: accepts medicare, but we pay a charge because we take we pay like a travel fee every time their practice comes to see her.

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Sheri Samotin: and Medicare pays for the

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Sheri Samotin: visit and the labs, and whatever else so is very possible there is something like that, but I don't know. It's certainly off the top of my head, but you may be able to find somebody, especially in a place like New York.

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Amy Rabinowitz: Yeah, I've I've never. I have not heard of Co, like Columbia docs having a program like that. But you could call the central number for Columbia docs, which are all the Columbia affiliated

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Amy Rabinowitz: doctors, and ask if there's a geriatrician or some some kind of service like that.

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Amy Rabinowitz: It's a great question.

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Amy Rabinowitz: going outside of Columbia, the Mount Sinai, Martha Stewart, Geriatric center?

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Amy Rabinowitz: Is it a pretty incredible center? You could try calling them and see if they have any kind of visiting geriatricians. You could also call the eap and see if they have a list of

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Amy Rabinowitz: of doctors who might come to the home.

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Amy Rabinowitz: This would be off the top of my head. The suggestions on how to even research that I mean the eip would have a generic list.

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Amy Rabinowitz: The Martha Stewart Center at Mount Sinai is great.

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Amy Rabinowitz: but I can't recall if they have anybody who comes to the home. Okay, that's that's helpful.

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Mirela: And also, I think, the last time when we had the last week, was it? There was? I think it's the saop, or something like that. We we are. So you're you. You indicated there was this other potential

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Mirela: service for services for elderly people. And we are looking into that as well.

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Mirela: Yeah, let us know if you find out if that there's a kind of service locally, because it's certainly something that other people would be interested in, and then we have it in our, you know, in our understood. Yes, thank you.

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Office of Work/Life: Thanks for that.

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Office of Work/Life: There's another

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Office of Work/Life: question sharing in the chat, and then a comment,

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Office of Work/Life: question about so saying, is there a resource list with links to the devices for pill checking bathroom threshold check devices, other devices. or home spaces that help people age in place. So it's a sort of like a place, for you might find resources around.

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Sheri Samotin: So there is a group. What the heck are they called? They're aging in place specialists there to

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Sheri Samotin: few Google aging in place specialists. I'm not remembering their name. But there is a national group. They are typically like builders or contractors who've gotten certified in aging in place and are certified to do an assessment and recommend

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Sheri Samotin: all the various things, and many of them will install the kinds of things I was telling you about. So that's probably what I would do. If I were looking for a client I would find an aging in place specialists.

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Sheri Samotin: and then, if they don't know, or if they don't do it, they may be able to then refer you on directly to a manufacturer or something like that. I know that General Electric was spending a lot of money working on sensors for this purpose, and I'm not sure whether they sell anything direct to the consumer or not.

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Office of Work/Life: Thank you. Yeah. So someone did find a link to

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Office of Work/Life: where is it? And now and sure, you know if this is the the National Association of Home Builders.

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Sheri Samotin: yeah. NAHB. But they, I think they have a a section that's

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Office of Work/Life: oh, go ahead! No, I was, gonna say, I think they may have a section or a certification for aging in place.

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Office of Work/Life: Yeah, yeah, that's what's here. It looks like. So that's great.

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Office of Work/Life: thank you.

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Sheri Samotin: And again, this is the kind of thing care managers care. Managers are like gold

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Sheri Samotin: because you ask a care manager who's the person in the area who's the most confident and reasonable to to get aging and place things into this into this person's home. And a care manager is gonna know.

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Sheri Samotin: Because they do this over and over again. They're recommending, typically when they do an assessment, they're saying, we need bars. We need this, we need that. And then the next question always is, Well, where do I get them who puts them in, and they usually have resources and can arrange it so again. Care managers are incredibly helpful, especially if you don't live in the community because they do.

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Sheri Samotin: and they're totally plugged in.

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Office of Work/Life: Thank you. We also have a comment here. So I'll just read this out. It went to everyone, but just in case folks missed it.

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Office of Work/Life: Comment from one of our attendees, saying, Please be careful when taking charge of the elders. Finances, if you have to cancel joint credit cards and a Medicare supplement plan. Premium auto pay is miss. They will cancel level plan by the time this is known, as your elders lost their coverage as long or eligible, due to pre-existing conditions. So

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Office of Work/Life: word of caution. But I don't know if you have any comments regarding that sherry.

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Sheri Samotin: I agree.

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Allison Heaps: Yeah, whenever you, whenever you turn anything, whenever you try to change anything, you have to be super careful what you're doing.

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Sheri Samotin: 100%.

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Allison Heaps: I have a question about that, a follow up question. So does that mean

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Allison Heaps: I'm an only child, and my mother is alone by herself, out of state

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Allison Heaps: does that have to be stipulated

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Allison Heaps: in, and not in a will, but like in some sort of document, where, if she had a stroke

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Allison Heaps: or a heart attack, and I had a

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Allison Heaps: keep paying her bills like her, like her health insurance like, how does that work do? Do I have to have a document in place that would allow me to go in and make the payment, or could I just make the payment like I don't even know

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Mirela: you need a power of attorney. Sorry? Well.

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Sheri Samotin: not not necessarily. You can make the payment with your money.

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Sheri Samotin: If you could go onto a website and pay using your money. Nothing prevents you from doing that.

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Sheri Samotin: If you want to use Mom's money

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Sheri Samotin: or advise a

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Sheri Samotin: a vendor to change something or add something, then you need a durable power of attorney for finance that names you as the attorney, in fact.

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Allison Heaps: Okay, durable power. Yeah. I had spoken to

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Allison Heaps: an attorney friend of mine in Maryland, and of course you know it cost that cost money, too. You know I have to redo it, and that's you know, a couple of grand

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Allison Heaps: but now Columbia just offered a benefit. I'm sh! You guys might have seen it for our for our benefit election that this year where you, we have access to free legal.

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Allison Heaps: It's not free. It's like nominal amount of money where I can

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Allison Heaps: draft that document at a fraction of the cost so to to do the the durable power. And

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Allison Heaps: yeah, I was just curious about that, because II just changed over her life insurance policy. So I can draw off of it

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Allison Heaps: because she has no money. And so the I, it's the bank of me like I'm gonna be paying for everything so I couldn't get into her into that, because it it was she would have to call herself.

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Allison Heaps: And so I she had to call and do it. So that's this whole thing was very helpful. Thank you for

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Allison Heaps: for advising

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Mirela: we we used my husband had the same thing with legal through his job. He, you know, pay mid life, and that's what we use to do. The power of attorney. You will need witnesses, and they cannot be related to the 2 of you. They have to be

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Mirela: independent of of you, and

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Mirela: like a cousin or something. Really, it should be someone.

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Mirela: you know. II guess a friend is okay, but it shouldn't be someone who can benefit from the arrangement

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Sheri Samotin: right? And then in some states you can have a notary, and you don't need witnesses, so you don't need witnesses. You do need a notary. It depends on the State law. What you know. What makes a valid

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Sheri Samotin: dpoa in that state.

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Amy Rabinowitz: Put some things on auto pay. That's when I lived through this also. We had the durable power of attorney, but also we put as many bills as possible on auto pay out of my mother's account, so we didn't even have to touch it. It's safeguarded so that nobody forgot to pay something, and nothing could lapse

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Amy Rabinowitz: and that was really really helpful. And then, you know clearly any of you all are gonna be the ones handling that

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Amy Rabinowitz: because the parent probably is not able to do that. But at least you don't have to worry about any kind of laps.

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Jennifer Colozzi: We actually were the ones that I actually went through this with this, and my mother did lose her benefits without any reprieve whatsoever. But the

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Jennifer Colozzi: the bigger thing is that these companies will not talk to you without the poa, and even when you have the poa complete and ready to turn in, it can take weeks to months for them to even recognize it. And so all of the things that we went through, and Fi, as far as you know, placing both my parents and different institutions, and to clean out the house and and do everything in a very short period of time. The worst by far.

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Jennifer Colozzi: was dealing with the finances, the the Medicare supplement the the inhumanity of the companies. It was it was absolutely traumatizing is the word.

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Sheri Samotin: So my my advice there is, if you have a durable power of attorney

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Sheri Samotin: to put that on file as soon as it's

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Sheri Samotin: written.

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Sheri Samotin: You know, as soon as your mom has signed it. Put that on file with these financial institutions. Just

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Sheri Samotin: so they have it so that if it's needed. so that that at least short circuits, the many weeks waiting for them to approve it.

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Allison Heaps: So are you. Are you saying that? Or your mom, or who whomever was ill? And then you weren't able to get into pay, and they cancelled it, and then they had no insurance. That's absolutely terrifying.

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Jennifer Colozzi: So so real. Briefly, my mother fell. She was primary camera caregiver for my father. With Alzheimer's we had to separately attended both of them. My father needed to go on Medicaid, so we had to separate their finances. They had joint finances, and we had to cancel a joint card. And that's how that

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Jennifer Colozzi: that we had no idea that that payment was being made.

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Allison Heaps: Yeah.

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Sheri Samotin: right? I mean, that's another thing. When we start a case, we immediately start looking at bank statements and credit card statements looking for auto pay

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Sheri Samotin: because you've gotta be really careful. As you said. If there's an auto pay, you want to fix the auto pay before you cancel the card.

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Sheri Samotin: So that's, you know. The more again I'm I'm into planning. So the more you can start early on this

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Sheri Samotin: and have the time at leisure. Not in the middle of a crisis to understand the bills. Who's what's getting paid from? Where? How's it getting paid, and make whatever adjustments should be made?

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Sheri Samotin: Then, if you have to cancel a card or something like that. There shouldn't be a crisis, because you know exactly what is being charged to that card, and what needs to be changed before you cancel the card.

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Office of Work/Life: Anyone else have any other questions or comments in our last few minutes?

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Take a minute.

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Office of Work/Life: the chat one more time.

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Office of Work/Life: Hmm.

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something.

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Office of Work/Life: Someone found another link

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Office of Work/Life: for that

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Office of Work/Life: housing in place. And yeah, okay.

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Office of Work/Life: thank you. Everyone.

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Mirela: Thank you. Thank you. Thank you.

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Sheri Samotin: Thank you. All

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Sheri Samotin: that was quite a bunch.

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Office of Work/Life: right? Yeah.

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Amy Rabinowitz: no, they did ask questions, though.

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Amy Rabinowitz: doesn't happen so.

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Amy Rabinowitz: But alright, that would seem like it was a reasonable turnout. I couldn't really. Yeah. 20 people. I keep.

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Amy Rabinowitz: I keep almost everybody

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Office of Work/Life: alright. I mean, once you St. Once the question started rolling, people did talk a bit.

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Office of Work/Life: So

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Sheri Samotin: yeah, no, I mean, it's you just you never know.