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What do you need to know about getting home health care for your loved ones?
Aging Issues Radio is the station that will help you age into and through retirement. We bring advice and education on all of the issues that we face as we get older, offering financial and life strategies. Hope you enjoy the subject matter and our down-to-earth and simple solutions to the problems we all eventually face. While the issues are not unique, the solutions are for you.
Joe Soricelli 00:02
You are listening to Aging Issues Radio and Joe Soricelli. This is the station that will help you age into and through retirement. We bring advice and education on all of the issues that we face as we get older, offering financial and life strategies. Hope you enjoy the subject matter and our down-to-earth and simple solutions to the problems we all eventually face. While the issues are not unique, the solutions are for you.
Joe Soricelli 00:37
Hi, it's Joe Soricelli again, coming to with the third edition of Aging in Place and the decisions that you have to make around that. So today, I'm sitting here with Lou Giampa. We're sitting in the training facility of Right at Home In-Home Care & Assistance; it's a home healthcare agency. But his organization is a little different. And why we're sitting in this training room, he helps train the people that he hires, so you always want to know quality, the quality of care and so forth. But I ask other questions. So, Lou, we talked before this a little bit: how did you get into this business? It's not like you were...how can I say? You were not destined to be here from college.
Lou Giampa 01:39
Right.
Joe Soricelli 01:39
But you are here now.
Lou Giampa 01:41
Right.
Joe Soricelli 01:41
So again, how did you get into the business?
Lou Giampa 01:43
Well, if you were to ask me in college, I would have known nothing about the homecare industry and how it all works. But you know, life works in mysterious ways. I spent the first 15 years of my of my career in Wall Street and the finance world. The last year of my career, my grandmother had gotten sick; she had dementia, so I actually left my job to become a Certified Nurse's Aide to help care for her. After working with my grandmother, I developed a passion for working for seniors; I actually worked in a local nursing home in the dementia unit. It became something I just love to do; I love working with that particular group of clientele. And I decided to start a homecare agency. The good thing about us is: I actually know this job from the ground up, I've actually been the one in the fields, doing the care myself. So I know what made a great caregiver, I know what made a great agency, I knew how to really take care of people firsthand. And that translated into running an exceptional homecare business.
Joe Soricelli 02:39
I have introduced Lou to many a client. And part of the reason I am comfortable in doing the introduction is it is an exceptional program. Because, you see, homecare agencies are all over the board.
Lou Giampa 02:55
They are.
Joe Soricelli 02:56
They're all over the board. They're from the referral network to...one of the reasons why I had a referral, I had a person that was working from a referral network that I transferred to Lou. And he was able to take a care provider that the family liked and had been using for about a year and bring that person into the system.
Lou Giampa 03:21
Right.
Joe Soricelli 03:22
So Lou works sometimes outside of the box.
Lou Giampa 03:25
You have to, because every situation is different; every client has different needs. So we have to adapt our care plans, our models, our aides, our training to whatever it is that the client needs.
Joe Soricelli 03:35
Okay, I'm going to back up for a second. And what I mean by backing up, I said this is the third part of a series. The first series is Planning and Decision Making. You just have to recognize that at some point things are going to change, whether they be for yourself, or for your parents, or for someone else you may know, because everybody knows someone that needs care or is having some issues as they age. There are a lot of things that drive that. So, we talked about the decision-making process. Then we talked a little bit about "Oh, I want to stay in my house." First things first, make it a safe environment. We had the interview with One-on-One Mobility. Now we're sitting here as: "Okay, we're at the next level. We can't take care of ourselves." And there are reasons for that, and then there are some solutions. Let's talk about first the reasons that you have.
Lou Giampa 04:31
At the end of the day, we know that people are living longer. The vast majority of people would really prefer to live in their homes as opposed to being in a community or facility. That's usually the number one choice for people. But in order to do that and maintain some level of independence, they might need a little bit of help. Back in the day, it was a lot easier for the adult children to take off and take care of mom and dad. In this day and age we're seeing in the "Sandwich Generation" that both families are usually working to support themselves on two incomes. Also, they're having children later on in life, so they have their own needs and responsibilities. It's getting harder and harder to become that family caregiver. And even when you do become that family caregiver, which I think is a very noble act, you do need some times for respite to take care of your own health and your own responsibilities. So that's where agencies like ours come into play. The idea for what we do is to give somebody a sense of independence, so they can stay inside their home and be a fully functioning person and enjoy their livelihood and also make sure the family dynamic keeps working. And that's what's really important about homecare. Again, we all come into...as adult children, the relationship evolves where you're taking a hard look sometimes at mom and dad or grandma and grandpa, and you're noticing some changes in their condition or some attitudes. It could be subtle; it could be substantial. And that's usually the time where it's important to start asking questions, to start seeing how that person is performing on their own. Are you noticing: Does that person seem to be a little off? Maybe their clothes aren't washed, or there's some expired food in the refrigerator, an extra dent or two in the car? Things that would make you concerned. Or they've missed a dosage of medications...things that raise your own alarm bells: "Wait, maybe it's time to get some professional help." Sometimes starting out with just a professional coming in for a couple hours a few times a week can make all the difference, because we can see changes in mental conditions. We can see changes in attitude and all those kinds of things. We can alert the families to: "Hey, maybe it's time to start getting a little bit more proactive and involved with their care.
Joe Soricelli 06:32
It is not even a question. I've been doing this for 20+ years; I have identified a number of different things in those 20 years. Number one, the original European model for multi-generational households are few and far between.
Lou Giampa 06:51
Yes, very true.
Joe Soricelli 06:54
I grew up with my grandfather living in our house until I was 13 or 14. I have a vivid memory of when my mother had to tell her siblings that he couldn't live there anymore.
Lou Giampa 07:10
Right.
Joe Soricelli 07:12
And not to be a horror story, but my grandfather was getting dementia and was starting to get a little antagonistic, like a lot of old Italians do. And he stabbed me at the kitchen table. So that was the night that I'm sitting in the bedroom upstairs listening to my mother on the phone with her siblings saying, "Okay, we've got to figure out the next step."
Lou Giampa 07:36
Right. You have to make safe plan that is safe for both your grandpa and the family themselves.
Joe Soricelli 07:44
And that's what we're talking about here.
Lou Giampa 07:46
Right.
Joe Soricelli 07:47
And then the other part, which I'm trying to make people realize, which is what you were just attesting to, is this process is not a light switch. It can become a light switch; you have a major event, you have a crisis management, you have a stroke, you have something of the nature where all of a sudden there's an additional need for care. But when you're talking about, you know, dementia, Alzheimer's, just basic aging, it's like the flame starts to go out.
Lou Giampa 08:17
Right.
Joe Soricelli 08:18
It's a process, and you start to look for reasons, symptoms of the flame starting to be smaller. Now, one of the most important things that everybody has to ask about is, and this comes from the financial planning background, how are we going to pay for this?
Lou Giampa 08:38
Right.
Joe Soricelli 08:41
I profess financial and life strategies; you got to have plans.
Lou Giampa 08:45
Right.
Joe Soricelli 08:46
And then you have to make decisions. Your experience when you start to talk about the planning and the cost...how do you broach the subject? And what would you recommend a family do?
Lou Giampa 09:04
It's a great question. A lot of the care, the most important part is how do you finance it? Some of the great things that take advantage of is, for instance, a company like ours does a free assessment, a free consultation with one of my care managers. During that time, you talk about the care needs, what this person needs, what's going to help inside the home. But also we get to: What programs are out there to subsidize the cost of homecare? We do so much education for people and we're finding ways to source homecare services from places they never even thought of. So obviously, the easiest thing always is to private pay for funds, but some families don't have the means to do that. But there are plenty of other things out there. You deal in the long-term care insurance world; I can tell you firsthand that long-term care insurance is the absolute number one thing that every person should have. If you have long-term care insurance, it fully covers licensed agencies like myself. You can get the Cadillac-highest level of service and you never really have to worry about your funding. But when you don't have long-term care insurance--I believe maybe 15% of the population has it these days, and I'm not sure if that exact number is correct...
Joe Soricelli 10:06
Unfortunately, I'm gonna say it is this low. And being in New York, which we are right now, it's not really available for different types. The traditional model...
Lou Giampa 10:14
Right, it is getting harder to get because the people that have it now are outliving and outspending their benefit, which is fantastic for those that have it, but difficult for those that don't have it now. But the good thing is, besides long-term care, there are lots of other things out there. We actually work very closely with the Veterans Association [Administration]. So we have a contract with the VA where we do some veterans' hours for free services for veterans. But there's also something out there called homecare aides and attendance benefits, which I would tell you that 99% of our veterans out there don't know this exists where a veteran can get up to $30,000 a year fully covered by the government for homecare, and their spouse can be entitled to $15,000 a year for homecare. The VA means well; it's a long process to go through it with the VA. We actually work with a consultant who does it for free for my clients where if you are ever interested in veteran services, we get you in touch with her, she goes through the process, she'll tell you within a couple of weeks what you're going to be entitled to, and how you're going to get it from the government. So that's a fantastic resource, because you're talking about anywhere between $15,000 to $30,000, or $45,000 for a couple. So that's a great resource as well. Also, there are grants that we work with, with the Parkinson's Foundation, the MS Foundation...the Alzheimer's Association has a "time-away grant" that we sponsor with them where somebody can get respite services for homecare if someone has dementia. I can tell you, there's a lot of great programs buried in certain people's pensions and certain people's union funds, because my wife is a New York City public school teacher. From being married to a New York City public school teacher, I can tell you that there is a homecare benefit embedded in their union policy that gets 25 hours a week free homecare services. No teacher I've ever spoken to knew this was there until we found it for them. And now I actually have a lot of teachers that we're taking care of for free; not a dollar is coming out of their pocket. So there are lots of things out there. I wouldn't tell people to assume that you can't afford services to get quality homecare; it's best to talk to a professional who's going to go out of their way and jump through a few hurdles and try to show you what kind of programs are available to you. That's what we can do for people. We're not just a homecare agency; we're also client advocates that are trying to find ways for people to make this all work.
Joe Soricelli 12:21
That's what people have to understand. The last word you used--advocate--is what I consider myself, what you have become. But at the same point, individuals don't know what's out there.
Lou Giampa 12:40
Right.
Joe Soricelli 12:41
I'm even gonna go as simple as: I had a conversation with a patient advocate this morning, and we're talking about a simple situation, the changes in Medicare. There's a lot of people that don't understand that when they get the Joe Namath program on TV, it has to have basic Medicare benefits, and they enhance it. But it has different underwriting criteria and claims paying criteria.
Lou Giampa 13:12
Right. It gets very confusing, even for professionals.
Joe Soricelli 13:15
It gets very confusing and you usually need somebody to decipher everything that's going on. Most people become overwhelmed when they have a need, when someone in their family becomes slightly impaired or fully impaired and they need services. You used a phrase of "25 hours' respite." That's all part of the plan. I would like to tell you that everybody has the resources, or we can get 24/7 care. The only way that that sometimes is available is through a Medicaid program, and frequently one of the Medicaid programs like a PACE program. It's a little different, but at the same point, they are few and far between. So what we have to do is we have to create a situation or a plan that's going to work with a professional that, as you said, will do an evaluation...what are the care needs. You don't always have to agree with everything. It may be financial reasons, or whatever. A family member may be able to provide eight hours of supervision. When you start with dementia cases, a lot of it is supervision; it's not physical. So, that person might spend the night and it might rotate through family. We're going to talk about some stories, but I had a DBA that I called Family Financial Harmony. It was from around my own family and I can always talk about my own family. I can talk generically, but it was talked about and we were all on the same page. We had the meeting; we knew from Day One that whatever my parents had was going to take care of my parents. Subsequently, whatever we can supplement we could do, and we all took roles. A harmonious thing, it sounded great.
Lou Giampa 15:12
That is priceless that you had that type of situation. I wish that was the norm, because that is not always the case.
Joe Soricelli 15:20
That's why the DBA isn't here anymore because, unfortunately, what we have is we have somebody singing off-tune, and all they want to do is protect money to inherit it.
Lou Giampa 15:32
Unfortunately, we see that as well.
Joe Soricelli 15:34
The one thing about the aging issues concept is we are the patient's advocate, the impaired individual's advocate. You have many people in the families that have different motivations. But the first thing is safe environment, appropriate care. And if you can't put it together, you may have to go outside. An attorney gets involved in a guardianship when somebody says: "We think there's elder abuse." You don't want to go down those roads. So you need to work with a home healthcare agency when the need arises. Or actually, I'm going to say this, BEFORE the need arises, you have to understand what you may need.
Lou Giampa 16:19
And that's a perfect statement, because a lot of what we do is triage situations. Someone falls or is in a hospital and is discharged, there's a change of condition, a stroke, things happen. And we get forced into a very difficult situation which we can handle. But it's not the easiest thing in the world. What we always recommend for people is to get involved with homecare, you know, whether it's starting out with just a handful of days and hours, you know, once or twice a week, just so you know what it's like, getting that person familiar with having some type of care in the home, someone that can get there before a problem actually starts. Because when you do that it makes for much, much better outcomes. Again, when we get called in a difficult situation, we have to move quickly. And that could be someone who needs a lot of care, a lot of hours. And we can do that. But the situation always goes the most smooth. When you have somebody in there in the beginning a couple of days a week, mom and dad are comfortable having someone in the home, they're open to the idea of homecare, they see how it helps them in their livelihood, how they become more independent. And then when something happens, you already have the team in place, you already have the nursing oversight, the homecare agency that people that can move very quickly to react to situations. So again, it's all about, like in your world of financial planning, it's having a plan. Sometimes that plan is to slowly introduce something like homecare so you're ready when the time really comes where the physical needs get to be great; it's already embedded, it's part of your life. Your agency is working with you during that whole process of aging. It just makes for a much better outcome and a much more seamless transition.
Joe Soricelli 17:54
I'm going to summarize. There's two ways of approaching this: You can plan for it or you can react.
Lou Giampa 18:00
Right.
Joe Soricelli 18:00
Crisis management forces you to make decisions quickly and sometimes not in the right direction.
Lou Giampa 18:08
Very true.
Joe Soricelli 18:09
So, we try to avoid crisis. But we all run into it. Because unfortunately, and I will say this, my experience is I get called in more for crisis than for the planning. I don't know about yourself, but it's usually the case: "There's an accident."
Lou Giampa 18:25
Yeah, it's a mixture of both for us. We get a lot of those calls were someone just fell and there in the hospital with an immediate discharge home. And the other half of the calls are: "We noticed subtle changes in mom and dad and we want a professional in there to keep an eye on things so it doesn't turn into a bigger problem." So, we get almost equal of both sides. But I can definitely tell you: The sooner we are in there, the more positive the outcomes are. Oftentimes we can actually head off that bigger crisis because we noticed that change in condition. We made sure that person's hygiene was kept up, their medications were taken, they have three healthy meals a day. We saw a change in physical or mental condition before it turned into a full or an episode. If we can get in there earlier, it definitely leads to much, much higher outcomes, much better outcomes for the patient, and much more peace of mind for the family member more than anything else. One of the things that I always tell people when we're talking about should you go down the homecare route is: As great as the care is for the person receiving that care, it's equally good, if not better, for that family member that we take the burden off--for that peace of mind that we give them, knowing that someone professional that sees us every day is actually in there monitoring my parents and they're letting me know if they see something that we really need to be concerned about. And I'll tell you that's that's really the game-changer here.
Joe Soricelli 19:50
You just covered my next question or my next example. What people don't realize in many cases is the care provider will actually sometimes predecease (if it's a husband and wife or something of that nature) the impaired individual, because the stress that takes place for a care provider is higher than anything. There's no other way to put it. Now the other part is, depending upon the personalities, there's a thing called guilt.
Lou Giampa 20:27
It's very prevalent.
Joe Soricelli 20:28
Very, very prevalent. It's: "Mom only wants me to take care of her. And if I don't take care of her, she's going to guilt me." She's going to dump a ton of guilt onto you. And this is what I try to teach people, that you have to stay healthy because you're going to have to make more decisions for Mom or Dad down the road.
Lou Giampa 20:53
Right. You have to be there for your own family.
Joe Soricelli 20:56
That is the true Sandwich Generation,
Lou Giampa 20:58
The data that we see, and these are proven facts, is that the health of the person providing the care, the family caregiver, if they're doing too much, is going to go down faster than the people that they're caring for.
Joe Soricelli 21:10
As I just said.
Lou Giampa 21:10
That's exactly 100% factual information. The other part of that, too, is we often see, believe it or not, sometimes a parent, as that parent-child relationship switches, will not take direction from a child, from their son or their daughter, because their whole life they've been telling them what to do...whereas we are able to go in there sometimes as a professional caregiver, between my nurses and my caregivers, and get the outcomes we're looking for, because they're more likely to listen to us than they would their own children. That's not every case, but that certainly happens often enough that it does make a big difference.
Joe Soricelli 21:52
I've been involved in basically care management, from the Senior Law Day Committee for over 20 years to a lot of other areas. What you just described is a major, major issue. I'm the baby; I have four siblings. We were all on the same page, but we all took roles to do different things. My sister was the caregiver; she was hands-on. I was the planner. My brother was what I call "Deep Pockets." If a check had to be written, he was able to write a check. But we did a lot of protecting of assets; we did a lot of things that provided my father, I'll say, 95 great years and three or four not-so-great years, but he lived to 99. So that comes from a plan, and plans change.
Lou Giampa 22:45
Yes they do.
Joe Soricelli 22:48
And with this period of time where we are living longer... Have you ever had the conversation with the person, and I had this at a meeting at a golf outing dinner last night, the person said, "I should be dead." Diabetic, two bouts with cancer and open-heart surgery.
Lou Giampa 23:13
Wow.
Joe Soricelli 23:15
He's not old. He's not old. He looked great, and that's what I was talking about. He's upfront, and he accepts his mortality. Now to get dad who was independent for 90 years to accept somebody, it's sometimes really hard.
Lou Giampa 23:34
Yeah, it's not easy. I mean, it all depends on that person's makeup, sometimes...older individuals come from a different era. They want to do things for themselves and some are not always accepting help, particularly from their children. So, I think that's important when we talk about homecare in general. That's why we don't do contracts, because you literally can start and stop as you see fit. Because what I always tell people is: Just try it out, see how this fits into your lifestyle. This is having someone in your home for a few hours helping with this helping with that. If it's working for you, great, keep it going. If you need more hours down the road, just add them. But if it's not working for you, just stop. And that's why it's important to be very flexible to families. Because if you give a person the option of dictating what they need in their life, and they understand that they're in control, it makes people much more accepting. We actually have a whole guide that we have on our website about how to talk to someone about accepting care, how to get someone in their home; we teach the children how to present this in a meaningful way, where again, you're trying to preserve somebody's independence, but you have to let them also understand that they are the final decision maker here. If we do our job, and our job is making sure that we do a great assessment, we have the right care plan in place, the right match for the right caregiver--if I put that right person in the home who physically can handle everything mom and dad needs, personality-wise they're a great match and they look forward to them, things are going to go well and they're going to enjoy actually look forward to the times that someone's actually in their home helping them. I can tell you numerous times where a son or daughter came to me and said, "There's no way mom and dad is going to be accepting of help, it's just not going to happen. They don't want anyone in their home." I said, "Let's try it. Let's see how it goes. You can cancel after a couple days if it's not working." Almost 95% of the time, that person became so close to the caregiver and actually look forward to the time that they were coming there, that we got the outcomes we wanted, and the children were shocked. But again, we've been doing this for so long, we see it over and over. That's why we have to sometimes explain to people: This is what could happen, this is what we're hoping to happen if we do our job and get the right person in there. And that's what it really boils down to, because a really good agency is going to take the time to develop the care plan, really assess the client, really put the right caregiver in place. You're sitting here in my training room right now; we have a PCA training program where my nurse comes down here and goes through skill labs with all our caregivers. We make sure that we have exceptional people; we're not just putting anyone inside the home. At the end of the day, if you go through all those steps to make sure you have the right people in the home, you're going to get great outcomes.
Joe Soricelli 26:07
I listen, and I will say from many years of experience, a lot of what Lou just talked about are the basics. So let's start to summarize. First, parents, you have to have the conversation; you have to have a plan. You have to know how to present this stage of life. And I'm going to say it's a stage. The stages can go both ways--they can go from one day a week to five days a week to, unfortunately if the care needs create a point where you need it, 24/7 nursing care. That's not usually where people stay in their home, but it can happen.
Lou Giampa 26:53
Yes.
Joe Soricelli 26:55
So that the stages. As I said, it's not a light switch; it's more of a dial. All right, so now we've got that piece. Now, during that evaluation that we're talking about, we start to talk about, like everybody always does, what's it going to cost? How is it gonna be divvied? It's a conversation with everyone. It's a conversation with the family and saying, "These are the assets. This is how long they will last, wherever it may be. These are the available funding mechanisms. Oh, dad's a veteran? God bless." I am very familiar with the program. I might make the program as simple as possible. If your expenses for your care and your living expenses exceed your income, you're eligible for benefits. It's pretty much that simple. You don't have to be impoverished. It's really an income-driven situation.
Lou Giampa 27:51
Right.
Joe Soricelli 27:52
It's not an asset-driven situation. So if your income is if your income is $50,000, and your expenses that are $75,000, you may be eligible to $25,000.
Lou Giampa 28:01
That's right. That's a great way of explaining it.
Joe Soricelli 28:03
It's easy. As I said, I'm certified to do Medicaid planning and I'm certified to do veteran planning, because my side is always identifying resources and identifying the financials. And I have to say, because of my experience, I do a lot of what Lou had talked about, but I defer to a professional. I do a fiduciary training program that talks about when an attorney identifies something, they have to do some due diligence on who they refer. And if you do the due diligence on Right at Home, it reads very well.
Lou Giampa 28:42
Thank you.
Joe Soricelli 28:42
It reads very well. It's not the only agency. But what I'm more concerned with, everybody always talks: "Well, I've got my neighbor down the block that will come in." You know what? Initially, if it's just companionship, if it's basic supervision, it might work out for a period of time. But you have to know the next steps.
Lou Giampa 29:02
Yeah, and there's a lot and--I don't know if this is the time and place for it, but there's a lot of pitfalls that go into the idea of private caregiving, especially in New York State where unknowingly you become the employer. And you have to have payroll taxes and insurance and all those great things. We field a lot of phone calls of people that go down that route and then really, really wish they hadn't because something goes wrong.
Joe Soricelli 29:26
There's no question about that. As I said, I'm an advocate. I am an advocate of using professional services. Yeah, it's a financial decision. It's no question about it.
Lou Giampa 29:42
100%.
Joe Soricelli 29:44
While you say, "Oh, I have So-and-So that will accept X. But if I use a professional service, it's going to cost Y." It could be two times; it could be whatever. But there are other expenses that are not being recognized that you talked about. Unwittingly, you become the employer. And when you talk to an advisor, I'm going to tell you that if you're using somebody your homeowner's policy only covers you to a certain limit of Worker's Compensation. But if you're paying this person on a weekly basis for an extended period of time, they're your employee and then you have to start talking about potential tax consequences, and the liability, and the worker's comp and everything else. So you have that. Then there are these, I'll say, referral networks for home health care.
Lou Giampa 30:37
Yes, there are registries that are basically brokers for private caregivers.
Joe Soricelli 30:41
It's the best way to put it; they don't have any liability.
Lou Giampa 30:45
Right. There's lots of pitfalls for those as well. It's basically the same thing as hiring a private caregiver, but someone's just finding you that person.
Joe Soricelli 30:53
Exactly. And then receiving some sort of compensation, you know, in the law.
Lou Giampa 30:57
But you still need your own insurances, payroll, and all the pitfalls...
Joe Soricelli 31:02
So you have to understand who you're dealing with, and what their insurance is, what their training is, which is a very important part. Because well, we talked about, and I keep on using that dial, that gas, that sometimes you have a roaring flame, sometimes you have a very low flame?When the roaring flame is there then everybody can do everything they need to get out. They can do whatever else...it's easy.
Lou Giampa 31:29
Right.
Joe Soricelli 31:29
But when the flame starts to dim a little bit, the needs get higher. And mistakes happen.
Lou Giampa 31:35
100% There's a lot for the average person out there to evaluate. My recommendation for people when you're vetting this and doing your own homework is the safest thing to do is to always go with a New York State Licensed Home Care [Services] Agency, they call that a LHCSA, what a LHCSA means is that you're regulated by the Department of Health. You can do companionship care, personal care, and even skilled nursing care. For instance, I have a full-time RN on my staff, 24/7, 24/7 available staff to go out there for emergencies. When you're working with a Licensed Home Care Agency, it's kind of the keyword when you're doing your vetting process, then you know you're in good hands, like you know you're with the most professional agency, regulated by the state, does everything by the book, all your bases are covered. And again, these are important questions that most people wouldn't think to ask. But that's probably the safest bet when you're doing your homework. Then again, you should read the reviews, talk to the people, go with who you're most comfortable with, see what type of programs they offer you. At the end of the day, you're building a relationship with someone that's really going to help you take care of your aging parents or grandparents.
Joe Soricelli 32:43
Whoever needs the care, and we've talked about parents and grandparents, but there's also--I use the phrase "impaired individual"--it doesn't always have to be a senior citizen.
Lou Giampa 32:53
No, it doesn't. Unfortunately, in this business, we've seen lots of young people, whether it's accidents, strokes...lots of things happen where we're involved a lot earlier in the process and their aging process than obviously you would like to be, but it does happen. And that's the reality of this. So, our service is not just for the elderly; it's also for the disabled. We can take care of anyone over the age of 18. Things do happen. But it's good for people to know that these kinds of things are out there.
Joe Soricelli 33:28
As I said, due diligence; work with licensed individuals. Relationships are very important. Understanding that you're comfortable working with Lou and his team, right? Or if you're not, I have to say there are options. Everybody talks about estate planning, long-term care planning, "Elder Law" is the generic term. A lot of times you're moving towards asset protection to eventually get onto Medicaid. I don't know what the criteria is, but once you're on Medicaid, especially in New York, you're under a managed care program. You don't make your own decisions. You can participate in the decision-making process. But if you have a plan and you understand everything else that goes into that plan, you maintain your independence, you maintain your decision-making capabilities, or the capabilities of your children to make decisions on your behalf. It's always going to be in the best interest of the impaired individual.
Lou Giampa 34:44
100%.
Joe Soricelli 34:45
So we're going to close up. You've been listening to Joe Soricell, Aging Issues Radio. What we talked about today was, as I said, the third part of a series of Aging in Place, and this third part of the series is: I need some care, I need some assistance. How do I get it? Why do I get it? Where does the conversation start and end? And that conversation is a difficult one, especially if you're dealing with parents that expect their children to take care of them. That is a major issue. And it's a hard thing, because sometimes you have to just tell a person, you can't say no. Last quick thing: As I said, I've been doing this a long time. I was doing a long-term care insurance presentation at the Rye Town Hilton, for those of us in Westchester. I was on a podium; my phone kept on going off. Cell phones were brand new, so they were big, bulky, and all the other stuff. And I said: "Okay, this is my parents' house" and everything else. I walked off the stage, took the phone call, and behind the divider talked and everything else. My father was calling me; my mother had fallen. My father was 120 pounds; my mother was 200 pounds. He couldn't pick her up. It was the beginning of a cycle, which we knew was going to take place...as I said, stages and dials. And I say, "Okay, put her head on a pillow, put a blanket under her or call the cops. I can't get I can't get there for an hour." And the audience was aghast that I was not going to run to my parents to pick up my mom. And I said, "It's not the first time this has happened. I've got to start to get my mother to realize she needs other care than me."
Lou Giampa 36:34
Right?
Joe Soricelli 36:34
Because I didn't have a real job; I was an insurance agent. So I had flexibility.
Lou Giampa 36:39
It's a lot to put on on a family member's shoulders. And again, that's why we're here.
Joe Soricelli 36:44
That's exactly right.
Lou Giampa 36:44
At the end of the day, my advice would be: Know that you're not alone. That's why there are programs out there to help you. No one's expected to do this all on their own. It's too much.
Joe Soricelli 36:56
Lou, thank you.
Lou Giampa 36:57
Thank you, Joe. I appreciate your having me.
Joe Soricelli 36:58
We will talk more. And again, it's Right at Home homecare. Local...White Plains. Easily Googlable, and I say Googleable, because everybody just goes onto Google and looks up things, or let's give contact info.
Lou Giampa 36:59
We're Right at Home Westchester County. The name of our company is Right at Home. We service Westchester County and the Bronx. Our phone number is 914-468-1944; it's a 24/7 on-call number. You can reach us nights, weekends, and in cases of emergency. Our website is www.westchesterseniorcare.com.
Joe Soricelli 37:37
Thanks again.
Lou Giampa 37:37
All right. Thank you, Joe. Thank you for having me. Have a wonderful day everyone. Best of luck.
Joe Soricelli 37:43
You've been listening to Aging Issues Radio, and Joe Soricelli. This podcast has been for informational and educational purposes only. It is not to be construed as financial or legal advice specific to your circumstances. If you need help with any matter, be sure to consult with an advisor regarding your specific needs. Thank you and tune in again.