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In this episode of The Sandwich Generation Survival Guide, host Candace Dellacona welcomes Albert Eshoo and Joyce Barocas, owners of Right at Home Home Care in New York City. They discuss their paths into the home care industry and delve into the new Medicare GUIDE Program, designed to assist families and caregivers of those with Alzheimer's and dementia. The discussion covers the limitations of traditional Medicare coverage, the importance of activities of daily living (ADLs), and the significant benefits of the GUIDE program, including free access to care navigators and respite care. The episode provides listeners with comprehensive insights on how to effectively utilize home care services and the GUIDE program to maintain their loved ones' independence and improve the quality of life for caregivers.
00:00 Introduction and Guest Welcome
01:29 Getting into Home Care: Personal Stories
03:22 Understanding the Home Care Crisis
04:44 Medicare and Home Care: The Basics
08:22 Introducing the GUIDE Program
12:46 Steps to Access the GUIDE Program
15:24 Comprehensive Services of the GUIDE Program
22:06 Training and Safety in Home Care
27:41 When to Call a Professional
36:06 Conclusion and Contact Information
01:29 Getting into Home Care: Personal Stories
03:22 Understanding the Home Care Crisis
04:44 Medicare and Home Care: The Basics
08:22 Introducing the GUIDE Program
12:46 Steps to Access the GUIDE Program
15:24 Comprehensive Services of the GUIDE Program
22:06 Training and Safety in Home Care
27:41 When to Call a Professional
36:06 Conclusion and Contact Information
To learn more about Right at Home, visit their website at https://www.rightathome.net/lower-manhattan
For RightConversation resources, visit https://www.rightathome.net/lower-manhattan/resources/guides/right-conversations
Follow Right at Home on social media:
Twitter: https://x.com/rightathomeNY
Connect with Albert and Joyce on LinkedIn:
Creators and Guests
What is The Sandwich Generation Survival Guide?
Welcome to The Sandwich Generation Survival Guide, where we explore the challenges and strategies of navigating life caught between work demands and supporting our loved ones while maintaining our own well-being. Join us in this dynamic podcast series as we uncover the complexities individuals face balancing multiple roles in the modern world. Our host, Candace Dellacona, shares personal experiences and professional insights to guide listeners through this complex journey.
Candace Dellacona: Welcome everyone to
the Sandwich Generation Survival Guide.
I am your host, Candace Dellacona.
I am so happy today to welcome my
colleagues, my trusted referral sources
in the world of home care, Joyce Barocas
and Albert Eshoo, who are owners of
Right at Home Home Care here in New York
City, where we are broadcasting from.
I am welcoming Joyce and Albert
because they are my go-tos in terms
of long-term care, particularly
when my clients and the people that
I know are looking for home care.
They have so much knowledge and they
are kind enough to join me today
to share that knowledge with us.
So welcome guys.
Albert Eshoo: Thank you very much.
We're really glad to be here.
Candace Dellacona: So happy to have you.
So why don't we start before we get
into home care and how people access
it and really the sort of highlight
of what we're talking about today,
which is this really incredible new
pilot program, beyond the pilot stage.
But this new program that has been
created by Medicare called the
GUIDE Program that's going to help
families and caregivers and those
with Alzheimer's and dementia.
The two of you are my resident experts in
the program, and I cannot wait for you to
share with our listeners what it's about,
how to access it, how it'll help us.
But let's first start with how did both
of you get into the home care space.
Albert Eshoo: Well, why don't I start?
I had a career on Wall Street for about 25
years, and when that was over we needed,
a new sort of second act for ourselves.
And in my case I wound up taking care
of an aunt in my family and got very
deeply involved in the caregiving and
learned that really, you don't have
to be a nurse, you really just need an
extra set of hands, extra set of eyes.
And that's, that was my exposure to it.
Joyce, do you wanna share yours?
Joyce Barocas: Sure.
And I started as a brand manager in the
beauty industry and, my brother was a
captain in the fire department and had
9/11 related cancer, and that's where
I came in as the caregiver for him.
And Albert said it exactly right.
You just wanna go do a run at the
supermarket and not worry about
the person you're caring for.
And I had a whole established
group of people to help me and
I still felt a burden and I felt
I wasn't taking care of myself.
And it's very taxing to take care of
someone when they have, when they're
older and when you have a disease.
So this was the perfect, we
saw the need for this industry.
Albert Eshoo: So when the opportunity
presented itself with Right at Home,
it really made sense because we don't
have to give the hard sell to anybody.
We're not giving someone something
that they don't need or want.
It's, we explain what the service is
and either they need it or they don't.
A lot of people are under the
impression that, they needed to
get a nurse and they didn't even
know a service like this exists.
And we've been doing this for 12
years now, and still every once
in a while, if we come across
someone who had no idea that this
business model is even out there.
Candace Dellacona: Let's talk about that.
So first of all, you know
what I endeavored to do.
When I started this podcast, the
Sandwich Generation Survival Guide,
was to provide resources to people.
And the three of us have known each
other for a while, and a lot of the
things that we think other people know,
we all have found out they don't know.
Right to your point.
And we all, the three of us also have a
common thread, which is being personally
impacted by being a caregiver and really
trying to learn on the job, if you
will, of the best resources, how to get
those resources, access those resources.
And one of the things that I really
enjoy with working with the two of you
is that you have all of these resources
and knowledge and you have a deep
understanding of the home care process.
And just so that our listeners
know, I think that most people don't
realize is that traditional Medicare
does not cover for long term care.
So do you wanna talk a little
bit about maybe what I'm calling
the home care crisis or the
caregiving crisis in America?
Why this guide program is, so
exciting to so many of us who
are in the industry, if you will.
Tell everybody a little bit
about why home care comes into
play and why it's so important.
Because the traditional ways of paying
for the care just don't fit the bill.
Joyce Barocas: So that's exactly it.
So when you turn 65 in America,
you take your healthcare system
is Medicare and what Medicare is.
There are a couple of parts.
Part A is your hospitalization.
Part B is your health, your
doctors, your wellness visits.
And then there's part D, which
is drugs, and Part C, which is
advantage, which is like an HMO.
None of these options except maybe Part C,
which is Advantage help pay for home care.
That's it.
You have your hospitalization
and you have your doctor visits.
So where 90% of your work really is
where you need the help is at home.
You need someone to help you take a bath.
You need someone to remind you to
take your medication, and that's
not covered by any health insurance
except for a long-term care policy,
which many people, it's out of
reach, affordability wise for that.
So that's why the home care industry
where you have a home health aide or
homemaker companion come in for a couple
hours, as many as you need, whether
it's a live-in or just a couple hours
a day, just to do those things that
you want your daughter to do for you
or someone, a friend to do for you.
But you need the reliability
of having a caregiver there.
So that's how we that's where the.
The system is broken, and that's
where home care agencies fulfill it.
Candace Dellacona: Yeah, and we'll
talk about that a little too.
And then Albert I'll let you hop in.
But what you bring up Joyce in terms of
care are the activities of daily living.
And the reason why Medicare doesn't pay
for that is because it's not skilled
and it's not for quote, unquote rehab.
And so it's the tasks that we all
need as we age we need assistance
with in order to remain independent.
And so having an agency like
yours and understanding how to
access that care is so important.
Albert, can you fill us in a little
bit about what people do when they
don't have long-term care insurance?
How do they then access home care?
Albert Eshoo: If they don't have
long-term care insurance, they can one,
reach out to a private duty home care
agency like us, or they can sometimes
get a family member or sometimes, which
Candace Dellacona: provide the care.
Albert Eshoo: very taxing.
And that goes right into, your thing with
the sandwich generation because a lot
of those people who are providing family
members who are providing the home care
are 57, 55-year-old women who have kids.
And grandparents themselves.
So there's that.
Sometimes there's employee
assistance programs that people
can buy, like insurance or Weight
Watchers or smoking cessation.
They can get those programs from
their HR department if they work
for a company that provides that.
There's also some nonprofits
and disease organizations that
will provide home care grants.
Candace Dellacona: And
those are limited though.
And one of the things that we've
talked about too is that the
Medicaid program here in New York
is supposed to pay for home care.
As we know, we are in the trenches
with the program that is really falling
short, particularly in states that
have no home care program to speak of.
And unfortunately we're getting
glimpses of that here in New York.
And so I think a lot of clients
of mine and people that I know
reach out to agencies like yours
to do a combination of things.
Where they have a family member involved
and then they bring in your agency.
That is not private duty nursing,
although you can get private duty nurses.
You are providing those people that check
in and do the activities of daily living.
And, having worked with the two of
you for so many years, you were kind
enough to reach out to me and talk to
me about this new GUIDE Program, which
is really what I wanna talk about today.
Joyce, do you wanna jump in
and give us the broad strokes
of what the GUIDE Program is?
Joyce Barocas: Yes.
So Medicare saw this space that
wasn't being addressed in the need and
GUIDE stands for guiding an improved
dementia experience, and that's
because dementia is on the rise.
As seniors get older, it's a more common.
Disease, even though it's not only related
to old, you don't necessarily get it
as you age, but it just happens that as
you're older, you have more likely, and
dementia courts a lot on the system.
There's more falls, more re
hospital, re readmittance.
So that's just costing
medicare more money.
So this type of program is something
that they felt could fulfill a need
and help maintain a consistent care.
So therefore, there's the client
who has dementia, gets better
services, get better care.
Their caregiver, their non-paid
family member or just the non-paid
caregiver gets better support.
Their burden is taken off of them.
They have a place to go to ask questions.
And then it keeps the dementia client
in their house longer, which is
where most people who wanna age in
their home, and it's safer that way.
So those are the three key things that I
think this program really helps address.
Candace Dellacona: I love the fact
that it was born out of the need.
And I think what's unique about this
program, what you've shared with me,
was that it was really a joint effort.
And I think the origin was
through the national plan to
address Alzheimer's disease.
And, in a time of such political
disconnect, there were bipartisan
efforts to try to get this program.
Off the ground.
Albert, do you know much about the
national plan to address Alzheimer's
disease and why it's different in
the guide program with respect to
caregivers and not just the patient.
Albert Eshoo: I'm aware of this plan,
but I don't know the details of it.
I mean, I know that it's a national plan.
They could create it an advisory
council, and they're trying to
foster inter-agency coordination.
I can see how the GUIDE program
would've grown out of that because
that what it is intended to doing.
Candace Dellacona: I think one of
the things that I understand is
that, there are close to a hundred
million aging people in this country.
There's something called
the gray or the aging wave.
Albert Eshoo: The silver tsunami.
Candace Dellacona: It's the tsunami.
Thank you for that, Albert.
So that's even more foreboding.
It sounds really scary when you put
it in those terms instead of a wave a
tsunami, but I think that that's accurate
because joyce, when you bring up the
fact that this program was created
because there's this awareness that the
falls and all the things that lead up
to it are costing our country money.
The study that was done through the
NAPA was basically to show that,
look, we are in big trouble unless
we address the aging crisis and
the caregiving crisis in America.
'cause there is this ripple effect, right?
You have the sick person and then
you have the family around them and
everyone's throwing in their ropes
to help the person who is sick.
And if you have a memory
impairment, you can't grab the rope.
So you have all of these people around
you really not able to accept the care.
And then you have the
caregivers who in many ways are
sacrificing their own careers.
Their own economic safety.
They're dealing with trying to raise
kids and maybe even throwing the
a hand to raise their grandkids in
some ways or pick them up for school.
And they're also dealing
with aging parents.
So it seems to me that the GUIDE
program it has been born out of
pure necessity, which is, as they
say, it's the mother of invention.
And so what I love about the GUIDE
program though, and maybe Albert,
you can talk to this a bit about.
How the caregiver is
also part of the program.
So do you wanna talk about the first step?
So let's say I have a, a parent who has
dementia and I'm the sole caregiver.
Albert, what are the steps
that I would go through?
I'm gonna call you 'cause you're a
home care agency and say, Hey, I heard
about this program, what do I do?
Albert Eshoo: The first thing we wanna
do is we wanna make sure that people
are qualified to be in the program,
Candace Dellacona: Okay.
Albert Eshoo: right?
So in order to be in the program, you have
to have original Medicare parts A and B.
Candace Dellacona: Okay.
Albert Eshoo: You need to
have a dementia diagnosis.
And if you don't have a dementia
diagnosis you can get one through a plan
participant in our case the participant
is pocket RN and where their partner
so they can actually do a diagnosis
and get the ball rolling with that.
Candace Dellacona: So, just to interrupt
you, Albert, I think it's important to
know, if people are listening and saying
like, how do you not have a diagnosis?
It happens all the time, guys.
What that means is we're helping our
mom or our dad, or our aunt or our uncle
in our case, or your brother Joyce.
And that they have memory impairment,
but there's not yet a formal diagnosis.
So that formal diagnosis,
everyone is really important.
Albert and Joyce can connect
you with a partner that will
provide the diagnosis, but that is
absolutely one of the first steps.
Albert Eshoo: Exactly.
And there's no there's
no cost to any of this.
There's no copays or anything like that.
It's completely free.
There are some disqualifying
factors though.
For instance, if you are on a Medicare
Advantage program, that's disqualifying.
If you're on hospice,
that's disqualifying.
And if you're in a long-term
care facility like a nursing
home who's also disqualifying.
Those will be the first steps.
After they get in touch with our partner,
there's then a welcome call that is
scheduled and they will go through the
details of the GUIDE program with them,
so that way they'll verify their original
Medicare parts A and B, and they'll
explain what all the next steps are.
They will then provide an assessment.
If they don't have an official
diagnosis and they can arrange
that and then care, they would
be assigned a navigator for life
Candace Dellacona: So you go
through the assessment process.
You have your diagnosis, you
have the right type of Medicare.
You're not in a nursing home, you're not
receiving palliative care or hospice.
You make the call, you get enrolled,
which again, Albert said it's free, guys.
This is something that is absolutely free.
You are then assigned a care
navigator, is that right?
Albert Eshoo: That's correct.
Candace Dellacona: So
tell us about the program.
What does the program actually
do for people and families?
Albert Eshoo: So there are a
bunch of wraparound services.
There are like eight domains, and
I'll talk about the first four and
Joyce will talk about the next ones.
So the first the first thing that is
provided is a comprehensive assessment.
They will by the phone and
internet assess the care recipient.
Come up with a plan for them and they will
also assess the family and the caregiver
and see where they can best get help.
So then a care plan will be provided
for them that they can follow up
with on a periodic basis to make
sure the plan is being followed.
Candace Dellacona: So
Albert, what is a care plan?
What does that mean?
Albert Eshoo: Well, it could be anything
from providing a schedule for social
interaction, for getting to doctor's
appointments who is going to provide
home care for them, if they need home
care because all of these services
are in addition to home care, right?
The GUIDE program is coming
into your home virtually.
So you have access to a navigator, access
to a nurse who's been trained in dementia.
There's other parts of it in terms
of, do they have any other situations
or comorbidities or some, other.
Ailment that is also
impacting their dimentia.
And then you have access
to that person 24 7.
So if you need help you've hit a
roadblock, you don't know what to do.
You have someone to call
24 hours a day, which is, not
something that ever happened before.
Even the wealthiest people couldn't
get in touch with somebody, like that.
Then there's ongoing
monitoring and support.
So regularly scheduled calls
with the navigator or regularly
scheduled calls with the nurse.
They can suggest home modifications,
they can suggest, dietary changes.
They can suggest what sort of home
care the person's going to need, what
that person is gonna do with them.
Joyce Barocas: So the navigator
or the care coordinator.
They work with the community as well.
So what community resources are available
to help you, to help the caregiver
and to help the person with dementia?
So maybe it's Meals on Wheels in New York,
or maybe it's a company that could do
a modification in the bathroom to help,
with showering when they're in the shower.
So she can coordinate that as well.
The other thing she
coordinates is healthcare.
So if there needs to be another doctor's
appointment, maybe she'll coordinate
getting the transportation there and back.
A schedule of the doctor's appointments.
And a lot of times, dementia or
Alzheimer's isn't your only sickness
at this age, you might have other
morbidities such as diabetes or other
things like that, and they can oversee
the coordination of that which comes
into your medication management.
And that's another thing
the care coordinator does.
She makes sure your medications, your, you
understand that the caregiver understands,
what needs to be done when, what can't
be, overlapped, what the side effects.
Could be of those medications.
So the caregiver is aware and knows,
oh, he's falling asleep too early.
Well, maybe we could adjust that and she
could work with you to talk to the doctor.
And lastly, there's the caregiver
support, which is education.
They could provide classes that the
caregiver can take just to learn.
Why does my father keep on talking
about something that happened 20 years
ago, like, why does he remember that?
So it's just stuff to help you.
And in addition to that, people with
moderate to severe dementia are able
to get 72 hours of respite care.
So that's where our agency would come in,
in addition to help with the respite care.
Those, the care navigator is just,
it's like having a big brother
there that you could ask questions
to when you just need that help.
And it's really someone who knows
what the symptoms are of dementia
and knows what, when you need to step
out and get another level of support.
Albert Eshoo: It's a free care manager.
Candace Dellacona: Yeah, I was just
gonna say, it's really what it is.
The title of the program is pretty
accurate, that it's your guide.
I think no matter what I'm in
this industry, you are in this
industry, it still feels like
we're operating in the blind.
Every person is unique.
Everybody has a unique set of
circumstances, health and otherwise.
And unique personalities.
We'll mention that too because
that can certainly factor
into who is providing care.
And so having this care manager,
this navigator that really can
serve as, your guide in the darkest
of times is really remarkable.
Going back to what you said, Albert,
and the plan of care, I think
that's one thing that many families.
Skip over.
And what I mean by that is that in
the beginning it seems to be all hands
on deck and there's a lot of chaos.
Albert Eshoo: Flailing.
Candace Dellacona: Flailing.
Exactly.
There's a lot of flailing and oftentimes
it's well intended, and everyone's
trying to do the best that they can,
but when it wears off, you're left
with saying, okay, there's this one
person who's probably doing 80% of it.
So setting up a plan of care for families
is so important, don't you think?
Albert Eshoo: Absolutely.
It's, a good metaphor would be like a
rowboat everyone's playing on the, oar
at the same time, in the same direction,
rather than a scattershot sort of plan.
Candace Dellacona: Yeah.
And having an expert assist you
in setting up that plan to say you
don't need four hours a day of care.
You need eight hours a day of care.
You have an expert saying, no,
this is untenable, because,
it'll feel untenable to us.
But I think a lot of times, and I don't
know if you said this Albert, or you said
a Joyce, but a lot of times the burden
falls on women and Albert, you're a great
nephew for helping your aunt, but a lot
of it falls on us as women, and I think
we have a tendency to try to do it all.
And so it's great to have a care
navigator coming in and saying
to us, Joyce, okay, no, no, no.
You can't do it all, right.
Joyce Barocas: No, you're exactly right.
And especially if you're
working, that's important to you.
You have to have your own health,
Candace Dellacona: yeah.
It's so important.
The one thing too that I wanna mention
in terms of caregiving is that, even if
you do have a willing daughter-in-law
or a very good friend to help you with
those activities of daily living, I think
it's important to point out that although
home care attendants are not nurses.
They do have training.
So can you talk a little bit about the
type of training that home care attendants
have so that when you when, let's say the
Care Navigator says, okay, we are putting
this plan in place and we're gonna connect
you with Right at Home here in New York.
They're going to send trusted people
in to help you take care of your mom.
What sort of instruction and
training do your people and home
care attendants get in general?
To provide the care of
activities of daily living.
Albert Eshoo: One of the things that
we do and have done in the past is
they would get a virtual dementia tour.
So they would have equipment that
they would wear that would simulate
what it's like to have dementia.
But then we would give them tasks to do
and inevitably they would fail or struggle
with those tasks, simple tasks, and so
that gave them a little bit of empathy
for people who suffer from dementia.
In addition to that, things that HHA do
like bathing and dressing and feeding.
You can't perform those ADLs the same
way with a person who has all their
cognitive abilities versus someone
who has diminished cognitive ability
just from the way you approach them.
You wanna approach them straight on.
You don't wanna come up behind them.
You don't wanna surprise them.
Bathing them is gonna be, sometimes
it's a mind sort of experience.
'cause you can't just explain them or give
them instructions, it's not gonna fly.
That would be a huge benefit to
having, caregivers who are trained
in dementia care to do the same
thing that they would do for
somebody who did not have dementia.
Candace Dellacona: Yeah.
Yeah.
And let's talk about that too.
So Joyce, I think what is most common
or what I see is that there is a
realization among family members
when something happens and they
say, oh, we are over our heads.
We need to bring in a professional.
And usually what precipitates is a fall.
So in your experience.
Bringing in a professional, what are the
things, let's say, that family members as
a stop gap can do to prevent things like
a fall and help mobilize and transport,
if you will a person with dementia
and guide them throughout their home.
Joyce Barocas: I think it's important
to you have to work together, first
of all, and everybody should have
a part, and you have to decide, am
I in charge of the living space?
You don't want a messy living space,
hoarding could be something that's
very, it takes up a lot of space.
It's a fall risk.
It's very common in our small apartments.
People shop online now and they
buy a lot of stuff they collect
and amass a lot of stuff.
So that's one thing.
Someone could be in charge of that.
Making sure the living
space is always neat.
There's no throw rugs,
so you're not tripping.
Even if they're using a rollator, that
can get caught and that can do it.
The lighting in the area, so there's
the environment that they live in.
You wanna make sure that that's.
Correct for them, right?
The noise, any distractions could
be super sensitive for them,
so you wanna make sure of that.
The other thing is then you could have
someone who coordinates the schedule
of who's gonna be taking care of them,
who's gonna, making sure the meals
are getting here, whether it's, a
delivery service or whether a caregiver
will be cooking and preparing meals.
Whether someone in the family is gonna be
making the meals and dropping them off.
So you have to have things like that.
The other thing is I think you,
the HHA is that we use, which is
considered a home health aide.
So they're trained, they take a
certificate class by New York State.
And they have to keep their credits,
12 credits a year of updated training.
So they know how to transfer a person
who might be, we might just pull
them out of bed, but they know the
correct body mechanics to do that.
They know what to look for.
The person hasn't eaten or their
medication hasn't been taken.
They could see that the
pills are still in the box.
So those type of things are what
an outside person could help
with a trained home health aid.
Candace Dellacona: I think all of those
are great tips and I think, as being
a family member, being really close to
the situation, it's hard to see those
issues like, clutter, if that is the way
a parent or a loved one has always lived.
And, people become really attached
to their stuff, their quote unquote
stuff, particularly when they
have memory impairment issues.
Finding out a way to kindly figure out a
a methodology to keep their space safe.
But what you just said, Joyce, is so
important which is the transporting
and getting people in and out
of bed, in and out of a chair.
You have to be a trained professional when
somebody has limited mobility to do that.
And I think that's really important
because all what we're talking about and
what we're doing, and this whole movement
of GUIDE is to keep people aging in place.
It's a term that's way overused for sure,
but if you ask anyone, I think most of us
would say that we would definitely prefer
to live out our lives in our own space.
And I think that that's
what this program does.
That's what your agency does, right?
To keep people as independent
as possibly in their home.
And the first step in
getting there is safety.
Can you talk a little bit about, the
best way for a family to know when it's
time to call in the professional, when
do they call the home care agency and
say, you know what, it's before the fall,
Joyce and Albert, what is, what are the
red flags for families that they should
really be thinking about and saying,
you know, this is happening in my house.
I should probably call Albert and Joyce.
Albert Eshoo: There's several signs.
If you visit your parents not that
frequently, and then you go there and
you see that the house isn't as clean as
it used to be, you see that maybe their
personal hygiene isn't what it used to be.
If you see science projects in the
refrigerator if you see mail that
hasn't been open for weeks, maybe the
bills aren't getting paid anymore,
maybe all sorts of laundry's piling up.
Those are all signs that,
something's not right and someone
needs to intervene in some measure.
There's a probably a right way to
do that and a wrong way to do that.
You don't want to beat your parents
over the head but you want to
show that you wanna help them.
Candace Dellacona: Yeah.
Albert Eshoo: Staying at home,
like you said is preferable.
But if you think about it, when we
spoke about that silver tsunami earlier.
If there's no other choice, if there's
nowhere for them to go, there's so
many of them that if you didn't have
a GUIDE program or something similar,
it's gonna be disastrous for society
because there's just, we're not prepared
to take care of all these people.
Candace Dellacona: It's so true
and we talk about this quite a bit.
In fact, PBS has a great documentary
on care giving right now.
We've seen Emma Willis, Bruce
Willis' wife, wrote a book about
the caregiving crisis and what
she's going through as a caregiver.
So when you get to the point where you
think your loved one, you're seeing
these signs, Albert Joyce, what's
the best way to tell your parent or
your loved one, I think it's time
that we bring in someone to help you.
How do you say that in a way?
Or in your experience, are there
tricks that work that don't alienate
our loved ones or make them feel
like they're no longer independent.
Do you have any advice for us?
Joyce Barocas: That's a very hard
challenge, and I think the best way to do
it, you try to explain it, but you have to
remember, they've achieved so much, right?
They're your parents.
They helped you grow up.
They've always been in charge,
they've taken care of you, but
now you are the caregiver, right?
You could try to be rational, but with
a dementia client, that's really hard.
But I think you have to explain to
them that it's a burden on the family.
And I wouldn't use the word
burden, but you could just say,
to improve your quality of life,
to make me sleep better at night.
I know someone seeing you during the day.
'cause I can't come every
day during the week.
I try to appeal to their sense that
you're doing it for me to make us
the family feel that you are safer.
And I think that has a stronger pull.
There's certain things you could say
you could try to point out, but this
is an industry where being rational,
it's a very emotional industry.
Sometimes even a caregiver doesn't
wanna admit that my mother might
need help or something like that.
I can't handle it.
I have to pay someone and
there's nothing wrong with it.
So I think as more people talk about.
It's hard being a caregiver, even if
you're not being paid, it's emotionally
draining, it's physically draining
and it's just a hard situation.
So if I could have a little bit of peace
by knowing and just a little money up
front spending for a caregiver who could
be there a few hours, that puts me at
rest, I could breathe while I know my
parents are being taken care of, and
then I can call them at night and have,
I could be the daughter, instead of being
the caregiver, I could say how my day
went and talk and how their day went,
rather than, did you take your medication?
Did you have a bath today?
That's, you don't wanna do that.
And they don't want you to do that.
Candace Dellacona: And it could be
really hard on the relationship.
And that's one of the great sort of
features of the GUIDE program too, is
that there is a instead of just focusing
on the care being provided to the
patient there's a wide angle view of the
caregiver too, and I love that part with
the respite and the number of hours.
So let's just go into a
little bit about that.
So I think, Albert, you had mentioned that
when you're part of the GUIDE program, if
you are the caregiver, the guide program
can also award a certain number of hours.
Albert Eshoo: That's correct.
Candace Dellacona: Okay.
So can you tell me what, repeat again?
The number of hours you said 70.
Albert Eshoo: 72 hours a year.
So that's based on a calendar year.
And if that is awarded separately from
the GUIDE program, so you could be in
the guide program and not necessarily
get the respite if you don't have a
moderate to severe diagnosis of dimentia.
But if you do, you get 72 hours and then
the following year they would assess
again and probably award another 72 hours.
Which is great, because even if the family
is , providing the caregiving, they could
always have someone there for, holidays
when they wanna travel or someone has
to, whatever they can't get out of, they
can get someone to come in and help for
a few hours and, 72 hours isn't a lot,
but if, in blocks of four or eight.
If you use it judiciously, it
can make a huge difference.
It's, going out for a kid's
birthday or meeting a friend
once a month for, to get a break.
Candace Dellacona: And look, it's
72 free hours, so it's something
that we didn't have before.
Joyce Barocas: And it's a good way to
get them slowly into being used to a
different person, a professional caregiver
coming in and then, they could see
it's, oh, they're not bossing me around.
They're giving me my space
and just get used to it.
Candace Dellacona: Yeah.
I love that.
I think that.
I'm hopeful that this program and all
of its attributes will be more widely
recognized and, we're lucky here in, in
New York where the program exists and you
are one of the partners in the program.
And have you gotten any sense
when the program will be widely
available across the country?
Do you have any inside
information on that?
Albert Eshoo: It's been in place
for a year in test markets.
Texas was one of them, I think.
Massachusetts might have been another.
It's been live in New York since July 1st.
When the other markets are gonna be
added, i'm sorry I don't have inside
information on that, but I know
that it's been widely successful and
people are very, very pleased with it.
I'm sure it'll be coming
sooner rather than later.
People should be aware
though, that it is a process.
It's not like flipping on a switch.
It takes time to gather the information to
see if they qualify, then do the welcome
call, then schedule the navigators.
People wanna get that started as
soon as possible if they think that
it's something that they could use.
Candace Dellacona: Listen, it's
another tool in the toolbox for the
family and nothing is perfect, but I'm
glad to see that there has been some
recognition of the role of the caregiver
and you guys have been out there.
Are in the trenches, certainly helping
a lot of clients that I know make sure
that they can stay at home and they are
not having to go into a nursing home
because as you point out, Albert, there
isn't gonna be enough room for everybody
and nobody wants to be there anyway.
Albert Eshoo: Exactly.
I should also add that all of
these GUIDE services are additive.
So if you're getting veterans
benefits, you can get GUIDE services.
If you're getting union benefits, you
can get GUIDE services if you're on
whatever, and you're getting some sort of
service, the guide is an overlay to that.
So it's not gonna take
anything away from anybody.
It's only additive.
Candace Dellacona: Fantastic.
I'm gonna thank you both again for, first
of all, educating me on the program.
I've done a lot of research since,
I got the call I think shortly
after July 1st from Albert saying,
do you know about this program?
And trying to make sure that
my clients were aware of it.
Thank you for being ambassadors for
long-term care, for always looking
out for people here in New York City.
And really for filling in our
listeners on this amazing program.
I'm gonna have Joyce and Albert's
contact information in our show notes
if anyone wants to reach out to them.
But thank you so much
for being here today.
Albert Eshoo: Oh, thank you for having us.
We really enjoyed it.