WEBVTT NOTE This file was generated by Descript 00:00:07.049 --> 00:00:09.889 Candace Dellacona: Welcome to the Sandwich Generation Survival Guide. 00:00:09.899 --> 00:00:15.709 I am your host, Candice Dellacona, and I am thrilled to have join us 00:00:15.709 --> 00:00:21.549 this morning, Beth Weeks a nurse and one of the co founders of Senior 00:00:21.549 --> 00:00:23.349 Living Consultants of New York. 00:00:23.539 --> 00:00:24.139 Welcome, Beth. 00:00:24.544 --> 00:00:25.954 Beth Weeks: Thanks so much for having me, Candace. 00:00:26.744 --> 00:00:27.814 Candace Dellacona: I'm so happy to have you. 00:00:27.864 --> 00:00:34.004 I hear from so many clients and families about the quagmire that senior housing 00:00:34.004 --> 00:00:39.534 really is not understanding all of the options and the opportunities 00:00:39.564 --> 00:00:42.024 available to seniors as they age. 00:00:42.024 --> 00:00:43.274 So I'm thrilled that you're here. 00:00:43.274 --> 00:00:44.694 You are the expert. 00:00:44.914 --> 00:00:51.154 You are my go to for senior housing options and guiding families through 00:00:51.164 --> 00:00:57.124 what is, to the rest of us lay people, a really complicated landscape. 00:00:57.124 --> 00:00:58.734 So we're thrilled to have you. 00:00:59.394 --> 00:00:59.944 Beth Weeks: Thanks again. 00:00:59.944 --> 00:01:01.294 I really appreciate being asked. 00:01:01.664 --> 00:01:02.354 Candace Dellacona: Absolutely. 00:01:02.354 --> 00:01:05.954 For our listeners and, Beth, I'm sure you know a lot of these statistics, 00:01:05.954 --> 00:01:10.187 but I read a really interesting statistic that the number of people 00:01:10.187 --> 00:01:15.237 over 65 years old will increase by 42%. 00:01:15.752 --> 00:01:20.962 And the number of people over 85 will increase by 111 00:01:20.962 --> 00:01:22.442 percent in the next 20 years. 00:01:22.532 --> 00:01:25.122 That is baffling when you really think about it, right? 00:01:25.422 --> 00:01:25.962 Beth Weeks: Absolutely. 00:01:25.962 --> 00:01:29.922 It's a staggering statistic that not only do we have this larger population 00:01:29.952 --> 00:01:35.222 of seniors, but people are living longer and longer and having to make plans for 00:01:35.222 --> 00:01:39.682 a lifespan that their parents never had to or their grandparents never had to. 00:01:39.682 --> 00:01:42.962 So it's a whole new unknown world for a lot of people. 00:01:43.287 --> 00:01:43.987 Candace Dellacona: Absolutely. 00:01:43.987 --> 00:01:48.887 So why don't you tell us a little bit about who you are and what your background 00:01:48.887 --> 00:01:54.357 is and really what prompted you and your wonderful partner, Paul, to find 00:01:54.387 --> 00:01:56.137 Senior Housing Consultants of New York. 00:01:56.147 --> 00:01:56.967 What led you to that? 00:01:56.967 --> 00:02:01.207 And then we'll get into the nuts and bolts of the different senior housing options. 00:02:01.317 --> 00:02:01.737 Beth Weeks: Sure. 00:02:01.767 --> 00:02:06.907 My background is that my very first real job was as a secretary in a 00:02:06.907 --> 00:02:10.607 medical equipment company that owned senior living communities as well. 00:02:10.927 --> 00:02:12.147 I had a great mentor. 00:02:12.167 --> 00:02:16.427 It was a really great small family owned company and I really loved the 00:02:16.427 --> 00:02:20.887 population that we were serving and they liked me too, so they kept, moving 00:02:20.887 --> 00:02:24.047 me to different divisions and I got to try out all sorts of different jobs 00:02:24.427 --> 00:02:28.267 within the senior living company and eventually found my way to a community. 00:02:28.642 --> 00:02:31.702 And was in the process of becoming a licensed administrator when my 00:02:31.702 --> 00:02:35.132 mentor had a rule that we had to do every job in the building if we 00:02:35.132 --> 00:02:36.552 were going to be effective leaders. 00:02:37.052 --> 00:02:42.152 So I went to CNA school, which was terrifying but it was an interesting 00:02:42.152 --> 00:02:46.162 experience and one that I didn't know that I would enjoy or be good at. 00:02:46.652 --> 00:02:51.702 And the first time I did hands on care with a senior, I fell in love and I 00:02:51.722 --> 00:02:54.852 decided in that moment I wanted to be a registered nurse and I wanted to be 00:02:54.852 --> 00:03:00.307 a nurse administrator to be able to better lead and instruct the staff in 00:03:00.307 --> 00:03:04.817 communities and to have more empathy when it came to working with this population. 00:03:05.227 --> 00:03:10.397 So after almost 20 years of working directly in communities or in offices 00:03:10.397 --> 00:03:14.127 related to communities my business partner, Paul and I met while working 00:03:14.127 --> 00:03:19.097 at a senior living community and decided that there's a lot of noise out 00:03:19.097 --> 00:03:21.827 there when it comes to this process. 00:03:21.847 --> 00:03:25.037 There's a lot of misinformation on the internet. 00:03:25.057 --> 00:03:29.977 There is a lot of confusion and I don't want to be so dramatic to say 00:03:29.977 --> 00:03:32.087 subterfuge, but it's not clear. 00:03:32.137 --> 00:03:37.247 There's not a lot of transparency in the process and as a result, people can waste 00:03:37.257 --> 00:03:42.147 a lot of time and sometimes precious time looking at places that aren't appropriate 00:03:42.147 --> 00:03:46.067 for them or their loved one or their, whoever they're taking care of or that 00:03:46.097 --> 00:03:49.697 they can't afford, but they're not told that up front before they go to visit. 00:03:50.137 --> 00:03:53.687 So the impetus for this was Paul and I were working together one day 00:03:53.687 --> 00:03:57.977 and someone referred a client to the community where he and I worked and it 00:03:57.987 --> 00:04:00.437 was a totally inappropriate referral. 00:04:00.767 --> 00:04:04.577 In that there was no way the type of community we worked for could support 00:04:04.577 --> 00:04:06.387 the care needs of this individual. 00:04:06.927 --> 00:04:12.897 And it was so sad because that family had been led to believe that we could. 00:04:13.217 --> 00:04:16.017 And until I actually had that conversation, they weren't aware of it. 00:04:16.047 --> 00:04:20.767 So in that moment, Paul and I decided we would create this company, Senior Living 00:04:20.767 --> 00:04:26.827 Consultants of New York with the mission to guide people through this process. 00:04:26.927 --> 00:04:32.357 By advocacy, education and transparency and make sure that we are advocating 00:04:32.357 --> 00:04:36.787 directly for that person and not just their physical needs, but their desires, 00:04:36.797 --> 00:04:40.577 their wants, all the things that make up a human and eliminate that noise. 00:04:41.107 --> 00:04:41.427 Candace Dellacona: Right. 00:04:41.477 --> 00:04:44.617 I think the way that you put it is just perfect with the noise. 00:04:45.117 --> 00:04:48.387 I think one of the things that surprised many families that I deal with when 00:04:48.387 --> 00:04:52.367 they're looking for the next place to go is the fact that they're being sold. 00:04:52.667 --> 00:04:56.677 And that's really what I understand you and Paul are trying to avoid to 00:04:56.677 --> 00:05:01.297 ensure that the person is looked at as a whole person and to make sure 00:05:01.297 --> 00:05:05.292 that the place that they endeavor to live, maybe for the rest of their 00:05:05.292 --> 00:05:06.972 lives is the right place to live. 00:05:06.972 --> 00:05:10.192 So let's talk about the different housing options. 00:05:10.512 --> 00:05:14.342 I know that you and Paul are specifically keyed into assisted living and 00:05:14.352 --> 00:05:18.652 independent living facilities, but just for our listeners in general, 00:05:18.862 --> 00:05:23.322 there are options that don't involve assisted living facilities, but I want 00:05:23.322 --> 00:05:26.642 to go over them for people who are thinking about what the options are. 00:05:26.652 --> 00:05:29.302 So obviously the first one is aging in place, right? 00:05:29.302 --> 00:05:30.652 And staying in one's home. 00:05:31.667 --> 00:05:36.717 And, I have many clients who say that they want to stay at home, that that is where 00:05:36.717 --> 00:05:39.457 they are most comfortable, they feel safe. 00:05:39.877 --> 00:05:43.847 It's been a place that perhaps they've called home for, a good number of decades. 00:05:43.857 --> 00:05:46.497 So it's no wonder why it makes sense. 00:05:46.897 --> 00:05:50.267 I think many of the clients that I see and that you see, Beth, 00:05:50.687 --> 00:05:55.147 are the people that can no longer stay at home for various reasons. 00:05:55.197 --> 00:05:57.837 I think one of the major issues is safety. 00:05:59.007 --> 00:06:03.407 And I'm sure you as a nurse when you are, helping your clients and 00:06:03.407 --> 00:06:06.407 the families, safety is a big issue. 00:06:06.447 --> 00:06:10.127 Do you want to talk about the safety issues that arise that people 00:06:10.137 --> 00:06:13.617 should be on the lookout for when a loved one is staying home and 00:06:13.617 --> 00:06:15.317 maybe shouldn't be staying home? 00:06:15.907 --> 00:06:16.647 Beth Weeks: Absolutely. 00:06:16.647 --> 00:06:17.767 And you're exactly right. 00:06:17.767 --> 00:06:19.637 It always comes down to safety. 00:06:19.977 --> 00:06:23.687 And Paul and I, even though we do this for a living, we believe that 00:06:23.687 --> 00:06:27.897 home is the best place for someone because that's where people want to be. 00:06:27.897 --> 00:06:29.617 That's where I want to be when I'm older. 00:06:30.057 --> 00:06:34.947 But it's only the best place until it's not and what makes it not the right place. 00:06:34.977 --> 00:06:36.437 And the first thing is safety. 00:06:36.437 --> 00:06:41.477 So certain barriers that are obvious and here in New York City, does the person 00:06:41.477 --> 00:06:45.607 live in a walk up apartment and they're no longer able to safely navigate stairs? 00:06:46.157 --> 00:06:48.717 Are they reliant on medical equipment that makes it not 00:06:48.717 --> 00:06:50.487 possible for them to use stairs? 00:06:51.022 --> 00:06:56.002 Do they require 24 hour home care or live in home care, but 00:06:56.002 --> 00:06:57.432 they live in a studio apartment. 00:06:57.432 --> 00:07:02.352 So there's not space for a caregiver to live and have quality of life while 00:07:02.352 --> 00:07:03.972 they're caring for this individual. 00:07:04.382 --> 00:07:05.712 Is there a hoarding issue? 00:07:05.712 --> 00:07:07.062 Is there a clutter issue? 00:07:07.542 --> 00:07:09.192 Is there a navigation issue? 00:07:09.192 --> 00:07:13.022 Do they need specialized equipment that can't physically fit in this apartment? 00:07:13.412 --> 00:07:18.202 And then the biggest fear for us with our clients, the bathroom situation. 00:07:18.482 --> 00:07:23.022 Is there a bathtub in this, and it's not safe for this person to step 00:07:23.052 --> 00:07:26.662 over the bathtub to get into the shower, so they're not, maybe they're 00:07:26.662 --> 00:07:30.617 not taking care of their personal hygiene, which can lead to infections. 00:07:30.677 --> 00:07:32.187 There are a lot of different factors. 00:07:32.237 --> 00:07:35.617 And it's very, very individualized and it's very personal. 00:07:36.047 --> 00:07:41.277 And some people don't have the resources to either have home care at home or to 00:07:41.287 --> 00:07:43.867 modify their home to make it safe to live. 00:07:44.537 --> 00:07:46.727 Candace Dellacona: I think that those are all really good points and 00:07:46.787 --> 00:07:51.517 points that families should take in and think about when these things are 00:07:51.517 --> 00:07:56.897 happening to their loved ones, these should be triggers to you that maybe 00:07:56.937 --> 00:08:01.057 you should endeavor to start having a conversation about this particular home 00:08:01.057 --> 00:08:03.567 not being the right home at this point. 00:08:03.887 --> 00:08:09.097 I was just, walking here in the city to work and I'll tell you, people 00:08:09.097 --> 00:08:11.107 walk really quickly on the sidewalks. 00:08:11.407 --> 00:08:13.927 There's not an awareness of personal space. 00:08:13.957 --> 00:08:17.417 And there was an elderly gentleman walking in front of me who clearly 00:08:17.417 --> 00:08:19.237 was just out for his morning walk. 00:08:19.727 --> 00:08:21.977 And I was sort of bracing for him. 00:08:22.327 --> 00:08:26.377 So you add all of those factors together, even leaving one's apartment 00:08:26.387 --> 00:08:30.137 to run out to the store and grab a cup of coffee, you might be taking your 00:08:30.137 --> 00:08:32.107 life into your own hands as a senior. 00:08:32.107 --> 00:08:35.647 So safety, I think, is something that's always top of mind. 00:08:36.067 --> 00:08:39.870 When the families get to the point where home maybe isn't the right place, can 00:08:39.970 --> 00:08:45.575 you get into sort of the facts about Independent living and assisted living 00:08:45.605 --> 00:08:50.145 and what those two settings are and the type of care that one would receive so 00:08:50.145 --> 00:08:54.125 that we can maybe educate our listeners on the difference between the two. 00:08:54.555 --> 00:08:55.285 Beth Weeks: Absolutely. 00:08:55.285 --> 00:08:59.285 And just to back up a tiny bit people aren't always sure what they need. 00:08:59.305 --> 00:09:01.765 And most people don't know they need me until they need me. 00:09:02.240 --> 00:09:04.420 When somebody like you refers me to come in. 00:09:04.670 --> 00:09:09.110 What Paul or I will do is we'll go to someone's home if they allow us to, and we 00:09:09.110 --> 00:09:14.490 can help them identify if they have all of the resources or the possibility to make 00:09:14.490 --> 00:09:15.880 their home safe for them to stay there. 00:09:15.880 --> 00:09:19.110 And then we connect them with the appropriate resources 00:09:19.110 --> 00:09:20.190 to make that possible. 00:09:20.400 --> 00:09:23.480 But if even after that, it's not possible or after a couple 00:09:23.480 --> 00:09:24.860 of years, they call me again. 00:09:25.459 --> 00:09:26.779 So independent living. 00:09:27.229 --> 00:09:31.879 It used to be a misnomer, but these days it truly does mean independent living. 00:09:31.919 --> 00:09:36.479 Basically what that is, is an unlicensed senior living residence. 00:09:36.749 --> 00:09:40.709 So it's an apartment building kind of on steroids geared towards seniors. 00:09:41.199 --> 00:09:44.799 So you have a private apartment, whether it's studio, one bedroom, two bedroom. 00:09:45.279 --> 00:09:49.709 All of the amenities that one would enjoy in a traditional assisted living 00:09:49.709 --> 00:09:55.119 setting like meals in a common dining room restaurant setting programs, 00:09:55.119 --> 00:09:59.989 activities, engagement from a variety of sources, whether it's lecturers 00:09:59.989 --> 00:10:04.459 or entertainers coming in, outings to different cultural events in the city 00:10:04.809 --> 00:10:08.434 and communal living socialization, which is really key, and another 00:10:08.434 --> 00:10:12.574 safety factor for considering being at home as one might become isolated. 00:10:13.164 --> 00:10:16.924 What's not offered in independent living sometimes meals are not included. 00:10:16.924 --> 00:10:19.754 Sometimes just like a meal plan that you pay for, personal 00:10:19.754 --> 00:10:21.174 laundry is typically not included. 00:10:21.174 --> 00:10:23.554 You might have to pay someone to do your laundry or do it yourself. 00:10:23.564 --> 00:10:26.534 There are laundry machines either in the apartment or in a common space. 00:10:26.884 --> 00:10:29.554 But the biggest factor for someone would be to consider their care needs. 00:10:30.539 --> 00:10:35.579 If someone needs a lot of supervision or hands on care assistance or medication 00:10:35.579 --> 00:10:40.649 management, the independent living community typically has relationships with 00:10:40.649 --> 00:10:45.459 home care providers who might be on site or that you can bring in to provide that 00:10:45.459 --> 00:10:50.049 type of care on an hourly basis, but it's not the staff of the actual community. 00:10:50.409 --> 00:10:50.859 Candace Dellacona: Got it. 00:10:51.519 --> 00:10:55.539 Beth Weeks: In assisted living, it is licensed by, let's just speak about 00:10:55.579 --> 00:10:58.659 New York, it's licensed by the state of New York, Department of Health. 00:10:59.189 --> 00:11:03.299 And so it's overseen, there are regulations in place for the types of 00:11:03.299 --> 00:11:07.519 people that the community can employ, the types of people that they can 00:11:07.519 --> 00:11:09.359 care for depending on their license. 00:11:09.889 --> 00:11:12.299 And assisted living in New York is a varied model. 00:11:12.309 --> 00:11:13.749 There are lots of different options. 00:11:13.759 --> 00:11:17.749 It's not as black and white as, oh, you have to be able to walk 150 00:11:17.919 --> 00:11:19.259 feet to live in assisted living. 00:11:19.259 --> 00:11:21.049 That's just patently not true. 00:11:21.499 --> 00:11:25.779 There are a lot of different layers to different types of licenses and some 00:11:25.779 --> 00:11:31.406 communities can offer care almost up to, I'm not going to say skilled nursing, but 00:11:31.736 --> 00:11:37.526 they can come pretty darn close to really high levels of care where one can truly 00:11:37.526 --> 00:11:42.686 age in place in that setting, barring some unprecedented medical event that's 00:11:42.686 --> 00:11:44.716 not a normal part of aging like a stroke. 00:11:45.106 --> 00:11:45.436 Candace Dellacona: Right. 00:11:45.526 --> 00:11:48.366 Beth Weeks: And so the biggest difference is, The care is delivered 00:11:48.556 --> 00:11:52.176 by the community, it's overseen by the community, they're held to a 00:11:52.176 --> 00:11:53.516 standard by the state of New York. 00:11:53.981 --> 00:11:56.381 And there's emergency response systems in place. 00:11:56.391 --> 00:11:59.511 So if someone does need something in the middle of the night, a nurse 00:11:59.511 --> 00:12:02.751 or a care staff will come in and assist them and then all the other 00:12:02.781 --> 00:12:06.611 things, the meals, housekeeping, laundry, amenities, activities, 00:12:06.611 --> 00:12:08.211 all the fun stuff too is included. 00:12:08.556 --> 00:12:11.476 Candace Dellacona: So it's much more structured than an independent living 00:12:11.476 --> 00:12:16.836 facility, and I guess families probably have a bit more faith in the fact that 00:12:16.846 --> 00:12:21.566 that structure which is licensed by the state of New York or whatever state I'm 00:12:21.566 --> 00:12:26.396 sure you happen to reside in, and those employees adhere to certain levels of 00:12:26.416 --> 00:12:31.046 care and provide a certain level of care pursuant to the license that they have. 00:12:31.411 --> 00:12:35.861 That's really interesting in terms of, an independent or an assisted living 00:12:35.871 --> 00:12:42.681 facility, are there telltale, well, if you are at this point, you really can 00:12:42.691 --> 00:12:47.951 not consider an independent living, you talk about being able to employ people. 00:12:48.196 --> 00:12:51.566 Maybe not employed by the independent living facility or sending people 00:12:51.566 --> 00:12:53.536 in to do the medication management. 00:12:53.546 --> 00:12:57.476 What's the sort of breaking point where you say, well, this person really 00:12:57.486 --> 00:13:01.946 should not continue in an independent living that really an assisted living 00:13:01.946 --> 00:13:03.366 is more the appropriate choice? 00:13:04.076 --> 00:13:05.236 Beth Weeks: That's a great question. 00:13:05.266 --> 00:13:07.086 And I'm going to answer it with an anecdote. 00:13:07.426 --> 00:13:09.356 So I have a lovely client. 00:13:09.686 --> 00:13:10.636 His name is Jay. 00:13:11.361 --> 00:13:15.301 And he has enjoyed tremendously living in an independent living 00:13:15.301 --> 00:13:16.611 community for many years. 00:13:16.951 --> 00:13:18.391 He moved there before I met him. 00:13:18.731 --> 00:13:20.301 But it was the perfect choice for him. 00:13:20.311 --> 00:13:21.671 He's a social guy. 00:13:21.861 --> 00:13:24.921 He was pretty independent, but he was having some mobility issues. 00:13:24.941 --> 00:13:27.221 He lived in a walk up apartment with his partner and wasn't 00:13:27.221 --> 00:13:28.481 able to navigate the stairs. 00:13:29.111 --> 00:13:32.661 So he was really the poster child for independent living because he could handle 00:13:32.971 --> 00:13:34.781 all of his activities of daily living. 00:13:35.061 --> 00:13:38.911 He just can't handle stairs and meal prep and housekeeping and laundry. 00:13:38.911 --> 00:13:39.931 And he was lonely. 00:13:39.941 --> 00:13:41.451 He was isolated in his apartment. 00:13:41.921 --> 00:13:47.081 But he had a medical event that changed his life and his care needs 00:13:47.571 --> 00:13:53.571 to the point where he required nurse assistance with an ostomy. 00:13:53.581 --> 00:13:58.151 He now has a colostomy and he's not able to manage that on his own. 00:13:58.171 --> 00:14:02.011 And due to the nature of colostomy bags, especially new ones, as you're getting 00:14:02.051 --> 00:14:07.286 used to caring for one, there can be some accidents or unexpected events with that. 00:14:07.626 --> 00:14:12.626 And he felt more comfortable being in a setting with a nurse on staff 24/7 who 00:14:12.656 --> 00:14:17.496 could respond in the moment to provide care for his ostomy and he wouldn't have 00:14:17.496 --> 00:14:22.706 to wait for a home care person to come in or worse, have to go out to a hospital. 00:14:23.061 --> 00:14:24.551 Candace Dellacona: Yeah, that makes actual sense. 00:14:24.581 --> 00:14:27.111 It's a great anecdote to illustrate for our listeners 00:14:27.111 --> 00:14:28.551 the difference between the two. 00:14:28.561 --> 00:14:29.841 So I appreciate that. 00:14:30.331 --> 00:14:34.971 Obviously, and we'll circle back, but the next level of care is a skilled 00:14:34.979 --> 00:14:38.828 nursing facility, which is quite different than an assisted living facility. 00:14:39.148 --> 00:14:43.138 Skilled nursing facilities are facilities that despite the fact that 00:14:43.198 --> 00:14:47.798 we call them skilled nursing facilities really provide a lot of custodial care 00:14:47.878 --> 00:14:52.878 which is different than needing assistance with you refer to the ADLs. 00:14:53.148 --> 00:14:56.688 And for our listeners, those are activities of daily living and 00:14:56.688 --> 00:14:58.088 there are seven or eight of them. 00:14:58.308 --> 00:15:01.608 But the activities of daily living generally are eating, bathing, cooking, 00:15:01.608 --> 00:15:06.378 cleaning, transporting, using the bathroom and those sorts of things. 00:15:06.378 --> 00:15:11.038 And once they reach to the level of a skilled nursing facility, what is 00:15:11.038 --> 00:15:15.368 the difference between the assisted living facility and one entering 00:15:15.368 --> 00:15:16.808 into a skilled nursing facility? 00:15:16.808 --> 00:15:21.588 And is it always necessary, Beth, to go into a nursing home when residing 00:15:21.588 --> 00:15:22.718 in an assisted living facility? 00:15:22.718 --> 00:15:24.808 Is that where everyone's going to end up anyway? 00:15:25.963 --> 00:15:28.933 Beth Weeks: I am so glad you asked that because I get asked this question 00:15:28.933 --> 00:15:33.483 a lot with people having, they assume what I'm going to say, which is 00:15:33.493 --> 00:15:36.573 yes, everyone needs a nursing home and the answer is absolutely not. 00:15:37.213 --> 00:15:38.513 Candace Dellacona: I love that answer by the way. 00:15:38.573 --> 00:15:40.253 Beth Weeks: I'm a little bit passionate about this. 00:15:40.253 --> 00:15:43.633 We're very fortunate that we're in this sort of Renaissance period of 00:15:43.633 --> 00:15:48.613 assisted living where communities are offering higher and higher 00:15:48.613 --> 00:15:51.013 and higher levels of care safely. 00:15:51.358 --> 00:15:52.518 By their own staff. 00:15:52.618 --> 00:15:56.278 Where people are able to live in an assisted living community who might 00:15:56.278 --> 00:16:00.418 need a catheter, who might need an ostomy, who need a mechanical lift to 00:16:00.418 --> 00:16:05.058 be able to get in and out of bed, who are chronically in need of the use of a 00:16:05.058 --> 00:16:07.238 wheelchair and they can't self propel it. 00:16:07.618 --> 00:16:12.713 These are people that 20 years ago, they would be in a nursing home where 00:16:12.713 --> 00:16:14.623 they'd be home with 24 hour care. 00:16:14.673 --> 00:16:15.573 Candace Dellacona: Absolutely. 00:16:15.623 --> 00:16:20.433 Beth Weeks: So now we've got these great options out there that are really getting 00:16:20.433 --> 00:16:24.093 hip to the fact that because people are living longer and longer and other disease 00:16:24.103 --> 00:16:29.043 processes are now being diagnosed earlier and earlier people live with these chronic 00:16:29.053 --> 00:16:33.063 illnesses like Parkinson's disease for much longer than they have in the past. 00:16:33.063 --> 00:16:36.063 And they need a lot more care as they progress through their illness. 00:16:36.553 --> 00:16:42.203 I wish I had a specific statistic, but I can say in my over 20 years of working 00:16:42.203 --> 00:16:48.973 in this field, the people that usually quote need a nursing home was because they 00:16:49.518 --> 00:16:53.118 exceeded the guidelines of the current assisted living where they live, which 00:16:53.148 --> 00:16:55.378 nowadays is not really an issue anymore. 00:16:55.438 --> 00:16:55.718 Candace Dellacona: Sure. 00:16:55.728 --> 00:16:56.128 Yeah. 00:16:56.238 --> 00:16:59.768 Beth Weeks: Or going back to that phrase I used earlier, an unprecedented medical 00:16:59.798 --> 00:17:01.788 event, that's not a normal part of aging. 00:17:02.908 --> 00:17:05.558 There are certain things we plan for as we get older, but 00:17:05.558 --> 00:17:07.103 nobody plans to have a stroke. 00:17:07.833 --> 00:17:11.559 And the outcomes of a stroke are unpredictable and sometimes can 00:17:11.559 --> 00:17:15.649 lead to things like needing a tracheostomy or needing a feeding tube. 00:17:16.116 --> 00:17:19.576 Those are examples of things that cannot be safely cared for in an 00:17:19.576 --> 00:17:23.176 assisted living community and would necessitate a skilled nursing facility. 00:17:24.356 --> 00:17:30.526 The other not so great reason for someone to move to a skilled nursing facility in 00:17:30.526 --> 00:17:36.556 New York is because we don't have a great Medicaid assisted living model here, and 00:17:36.616 --> 00:17:40.566 as people outlive their money or they worked in a field where they didn't have 00:17:40.566 --> 00:17:44.516 a retirement fund and they don't have, or they had some emergency where they 00:17:44.526 --> 00:17:48.516 had to use their money for something else, there's not a great plan for those 00:17:48.516 --> 00:17:53.606 folks not in the metro area anyway for them to be able to go to an affordable 00:17:53.606 --> 00:17:55.476 assisted living facility under Medicaid. 00:17:55.836 --> 00:18:00.966 So we do see some folks end up in skilled nursing facilities because Medicaid 00:18:00.976 --> 00:18:03.366 is a payer for that type of care. 00:18:03.946 --> 00:18:07.996 Candace Dellacona: That's the perfect segue into, the cost and I think 00:18:07.996 --> 00:18:11.116 that, A, people are living longer. 00:18:11.166 --> 00:18:17.686 And B, I think because of that, there are people in generations older than ours that 00:18:17.686 --> 00:18:20.356 didn't expect to live as long as they did. 00:18:20.956 --> 00:18:22.266 Or they have, or they are. 00:18:22.546 --> 00:18:28.026 And, while it's amazing that they are living past what they anticipated would 00:18:28.036 --> 00:18:32.146 be their lifespan from a financial perspective, it can wreak havoc in a 00:18:32.146 --> 00:18:35.936 family's sort of existence to figure out how to pay for these things. 00:18:35.946 --> 00:18:39.746 So I think first and foremost, our listeners should know Medicare does 00:18:39.746 --> 00:18:43.056 not cover any sort of long term care. 00:18:43.516 --> 00:18:48.656 Medicare is not something that anyone can turn to for long term 00:18:48.716 --> 00:18:53.666 home care for any sort of assisted living facility or for a nursing home. 00:18:53.676 --> 00:18:58.626 Medicare does not cover any long term housing options. 00:18:59.076 --> 00:18:59.996 That's number one. 00:19:00.461 --> 00:19:04.461 Number two, I think it's really important that, especially people in 00:19:04.471 --> 00:19:08.581 our generation, Beth, where we're maybe one generation removed, hopefully two, 00:19:08.811 --> 00:19:13.191 from thinking about our long term care options, but, long term care insurance 00:19:13.581 --> 00:19:19.151 does help pay for the cost of assisted living facilities, independent living 00:19:19.151 --> 00:19:20.851 facilities in some circumstances. 00:19:20.861 --> 00:19:25.441 So it's really important to think about how to cover the costs 00:19:25.601 --> 00:19:27.861 so that one has more options. 00:19:28.371 --> 00:19:33.731 What would you say, Beth, the average cost of an assisted living facility 00:19:33.731 --> 00:19:35.831 is here in the New York City area? 00:19:36.795 --> 00:19:41.715 Beth Weeks: That's a really tough average because yeah, in this renaissance that I 00:19:41.715 --> 00:19:48.775 alluded to we've seen these ultra, ultra luxury communities pop up, that come with 00:19:48.775 --> 00:19:54.344 price tags, starting just for an apartment at, 13, 14,000 dollars per month. 00:19:54.694 --> 00:19:59.384 But if you really were to break down when I give somebody in Manhattan 00:19:59.434 --> 00:20:03.224 a good starting point for assisted living, not including care services. 00:20:03.224 --> 00:20:05.644 So not including if you need help with bathing or dressing 00:20:06.034 --> 00:20:09.744 or toileting or feeding you're starting in a studio apartment 00:20:10.004 --> 00:20:13.004 around like 70 to 7, 300 per month. 00:20:13.519 --> 00:20:16.349 And that's not going to be in a setting that offers a 00:20:16.349 --> 00:20:17.959 very, very high level of care. 00:20:18.099 --> 00:20:22.909 If you do need a lot of care services, your starting rates are more in the 8, 00:20:23.069 --> 00:20:27.359 500 to 8, 900 dollar per month for just the apartment, the studio apartment. 00:20:27.999 --> 00:20:30.839 Candace Dellacona: So when a family thinks about an assisted living facility, they 00:20:30.849 --> 00:20:32.369 have to think about sort of two things. 00:20:32.369 --> 00:20:34.359 The actual cost of the residence. 00:20:35.024 --> 00:20:38.464 And the level of care that your loved one needs, which could really 00:20:38.464 --> 00:20:42.554 be all over the board and can really significantly add to the expense, right? 00:20:42.864 --> 00:20:43.364 Beth Weeks: Yes. 00:20:43.714 --> 00:20:48.574 So when we are helping people evaluate that go through that problem we're 00:20:48.574 --> 00:20:52.324 looking at the types of communities and how they bill their care. 00:20:52.324 --> 00:20:55.854 So some communities bill their care sort of an a la carte tiered 00:20:55.854 --> 00:20:57.524 system where they have levels. 00:20:57.974 --> 00:20:59.884 And each person's level can be very, very different. 00:20:59.884 --> 00:21:00.534 I often get that. 00:21:00.534 --> 00:21:02.464 Well, what's included in level one care? 00:21:02.554 --> 00:21:04.544 Well, it depends on, what Mr. 00:21:04.544 --> 00:21:06.594 Smith needs to be ready to answer that question. 00:21:06.594 --> 00:21:07.884 So level one care for Mr. 00:21:07.884 --> 00:21:12.634 Smith could be, he just needs somebody to come in in the morning to help him 00:21:12.634 --> 00:21:16.194 get out of bed and then somebody else to give him his medications and that 00:21:16.194 --> 00:21:18.084 might cover his services under level one. 00:21:18.644 --> 00:21:19.254 But Mrs. 00:21:19.254 --> 00:21:24.609 Smith, his wife, might need someone just to take her to the bathroom in the middle 00:21:24.609 --> 00:21:25.889 of the night, and that's all she needs. 00:21:26.349 --> 00:21:27.509 And that could be her level one. 00:21:27.779 --> 00:21:33.969 So some communities now are offering all inclusive models where all of their care 00:21:33.969 --> 00:21:38.839 and medication management services are bundled into that base rate, which is a 00:21:38.839 --> 00:21:43.929 really great deal for somebody who either needs a lot of hands on care help now, 00:21:44.119 --> 00:21:48.339 or we project that they're going to need it in the near future and make sure your 00:21:48.359 --> 00:21:50.919 costs a lot more predictable as you age. 00:21:51.121 --> 00:21:54.421 Candace Dellacona: Predictability of cost is a big deal because when you're talking 00:21:54.421 --> 00:22:00.441 about a senior or a family that's trying to financially help support that senior 00:22:00.451 --> 00:22:05.884 or at least, perhaps enhance their options by contributing to the cost of the care. 00:22:06.244 --> 00:22:11.004 I think you're right that at least being able to navigate what's in store so that 00:22:11.314 --> 00:22:15.674 a person doesn't run out of money that you can budget and you're not forced 00:22:15.684 --> 00:22:21.974 into, a long term nursing home situation and leaving a community that you now find 00:22:21.984 --> 00:22:26.758 is your home, which is what one hopes an assisted living will become for a senior. 00:22:26.758 --> 00:22:27.318 Isn't that right? 00:22:27.838 --> 00:22:28.558 Beth Weeks: Absolutely. 00:22:28.558 --> 00:22:32.238 And it's not to be crass, but Paul and I call it one and done. 00:22:32.388 --> 00:22:35.998 That's our goal is we want people to move one time. 00:22:35.998 --> 00:22:37.868 Moving is traumatic at any age. 00:22:37.898 --> 00:22:38.918 I just moved. 00:22:39.378 --> 00:22:42.498 And I think I'm still going to need some therapy to get over it, so 00:22:42.618 --> 00:22:48.267 complicate that by this decision being motivated by probably some event. 00:22:48.622 --> 00:22:49.642 Or some trauma. 00:22:49.882 --> 00:22:51.112 It's emotional. 00:22:51.152 --> 00:22:52.202 People are vulnerable. 00:22:52.212 --> 00:22:56.272 Sometimes they're making this decision while wearing a hospital gown, lying 00:22:56.272 --> 00:22:59.172 in a bed, and they're making this decision that way, which is a terrible 00:22:59.172 --> 00:23:00.532 way to make a major life decision. 00:23:00.552 --> 00:23:04.532 Candace Dellacona: Or having lost a spouse of 50 plus years and thinking 00:23:04.532 --> 00:23:09.242 about their own mortality and their own fragility, and it's so important that when 00:23:09.242 --> 00:23:13.412 family members start these conversations with their loved ones, they think about 00:23:13.482 --> 00:23:15.522 it, all that it symbolizes, right? 00:23:15.522 --> 00:23:16.952 It's the loss of independence. 00:23:18.347 --> 00:23:21.947 Beth Weeks: A perceived loss of independence, sometimes it's not 00:23:21.947 --> 00:23:26.357 actually, but it's that perceived, and they're losing, losing your home. 00:23:26.527 --> 00:23:30.857 That's a loss, losing the ability to make decisions on your own. 00:23:30.857 --> 00:23:31.497 That's a loss. 00:23:31.507 --> 00:23:35.257 So when we help people through this process, we're really looking at as 00:23:35.257 --> 00:23:39.147 much as we can trying to predict that this can be the place where they spend 00:23:39.507 --> 00:23:40.767 the rest of their life if they choose. 00:23:41.487 --> 00:23:42.177 Candace Dellacona: Absolutely. 00:23:42.207 --> 00:23:45.347 One of the things that you mentioned is that New York, unfortunately, doesn't 00:23:45.357 --> 00:23:49.597 have a great model for Medicaid to pay for assisted living facilities. 00:23:49.597 --> 00:23:54.697 I did some reading in anticipation of our conversation today, and what I 00:23:54.697 --> 00:24:00.312 actually found out is that nationwide there really are only 18 percent of the 00:24:00.312 --> 00:24:04.932 people that are in assisted living look to Medicaid at all to help cover the cost. 00:24:05.322 --> 00:24:08.542 And I think that figure is going to continue to be reduced as our 00:24:08.542 --> 00:24:12.132 Medicaid programs from state to state are slowly chipped away. 00:24:12.132 --> 00:24:16.432 So it really is important that people of our generation that are watching 00:24:16.432 --> 00:24:21.747 our parents go through decisions like that, that we also prepare ourselves for 00:24:21.757 --> 00:24:23.807 the cost, which could be significant. 00:24:24.227 --> 00:24:28.507 I think that, one of the things that I really appreciate about what you and 00:24:28.507 --> 00:24:34.497 Paul do, Beth, is when you meet with a family, you talk about what they can 00:24:34.497 --> 00:24:39.037 actually afford so that they're not going to the creme de la creme and thinking, 00:24:39.037 --> 00:24:40.617 Oh, this is, I could live with this. 00:24:40.637 --> 00:24:46.097 And then realizing there is no way that they could possibly afford that 00:24:46.097 --> 00:24:48.917 level of maybe concierge assistance. 00:24:48.927 --> 00:24:52.667 For our listeners out there, one of the greatest things about Beth and 00:24:52.667 --> 00:24:55.827 Paul and what their organization does with Senior Living Consultants of 00:24:55.827 --> 00:24:57.517 New York is they don't charge you. 00:24:57.897 --> 00:25:01.917 They do all the research and they are paid by the assisted living facilities. 00:25:01.927 --> 00:25:06.307 So, they are able to give you an unbiased view of what your options 00:25:06.307 --> 00:25:09.487 are in doing all that research, which takes a lot of time, Beth. 00:25:09.507 --> 00:25:13.247 How many assisted living facilities would you say that you and Paul 00:25:13.257 --> 00:25:17.397 have visited in New York since you started your organization? 00:25:18.067 --> 00:25:19.077 Beth Weeks: That's a great question. 00:25:19.077 --> 00:25:23.297 We spent the first six months we were in business just visiting communities. 00:25:23.367 --> 00:25:28.087 So it's over a hundred that we visited and we continue to visit . That's 00:25:28.087 --> 00:25:30.977 something that's very important to us. 00:25:31.047 --> 00:25:34.377 People often ask me, what's your favorite assisted living community? 00:25:34.377 --> 00:25:36.207 And I say, I don't have one. 00:25:36.527 --> 00:25:39.897 And the reason I don't have one is number one, it's specific to the person. 00:25:39.927 --> 00:25:43.227 Cause what's best for me, isn't best for somebody else necessarily. 00:25:43.587 --> 00:25:48.487 But things change in these communities, staffing turnover. 00:25:48.822 --> 00:25:53.422 There can be negative feedback related to care, related to meals, 00:25:53.642 --> 00:25:55.752 related to the amenity services. 00:25:56.332 --> 00:25:59.332 So we are in these communities on a regular basis. 00:25:59.332 --> 00:26:03.012 We have relationships with leadership, with the nurses, sometimes with the 00:26:03.012 --> 00:26:07.262 direct care staff, we stay in touch with our clients sometimes long, long 00:26:07.272 --> 00:26:12.872 after they move into communities because it's not a straight line and nobody 00:26:12.872 --> 00:26:18.987 should be making these recommendations based on geography and budget only, 00:26:19.197 --> 00:26:22.247 you have to know what's going on in these communities and sometimes 00:26:22.247 --> 00:26:23.657 communities come off of our list. 00:26:23.977 --> 00:26:27.027 And we have those tough conversations with leadership about why. 00:26:27.157 --> 00:26:32.567 And until they meet our level of satisfaction and safety we, don't 00:26:32.607 --> 00:26:36.447 necessarily work with them or we tell our clients why we're not recommending a place 00:26:36.447 --> 00:26:40.467 if they ask about it so that they can go in with their eyes wide open if they 00:26:40.467 --> 00:26:43.797 choose to proceed with a community that we may not be recommending at the time. 00:26:44.352 --> 00:26:45.252 Candace Dellacona: Which is super helpful. 00:26:45.252 --> 00:26:49.942 One of the things that, you point out is how important it is to set your eyes on 00:26:49.942 --> 00:26:55.102 a place and really go into the community and not perhaps read, reviews online 00:26:55.102 --> 00:26:58.822 that could be a year or two old and not reflective of current staff changes. 00:26:58.832 --> 00:27:00.502 So that's super important. 00:27:00.892 --> 00:27:05.552 The last thing I want to talk about, Beth, that I love about this industry and the 00:27:05.552 --> 00:27:09.982 way that it's headed is that particularly in New York, there are specialized 00:27:10.002 --> 00:27:13.672 communities popping up all over the place to really cater to different 00:27:13.922 --> 00:27:17.462 communities and different ethnicities and languages and all those sorts of things. 00:27:17.462 --> 00:27:21.422 And in fact there is a community that was started in Queens. 00:27:21.642 --> 00:27:25.782 And I believe if I recall correctly, it was started because a physician 00:27:25.882 --> 00:27:30.882 couldn't find the right place for one of his parents and they were Indian 00:27:30.882 --> 00:27:35.122 speaking and I think they were calling it the India house that was opened in 00:27:35.122 --> 00:27:39.392 Queens to cater to certain communities, the way that they cook and their 00:27:39.392 --> 00:27:41.522 traditions and those sorts of things. 00:27:41.542 --> 00:27:44.052 What do you see in terms of the future of the industry 00:27:44.052 --> 00:27:47.822 with these sort of subspecialty facilities popping up all over? 00:27:47.822 --> 00:27:51.467 Beth Weeks: Well it's a really exciting time, that more seniors 00:27:51.577 --> 00:27:55.607 are, people are living longer and longer and the traditional models 00:27:55.647 --> 00:27:57.537 in some cultures are falling away. 00:27:57.537 --> 00:28:00.597 Historically Asian families live together. 00:28:00.597 --> 00:28:01.577 I grew up in Asia. 00:28:01.577 --> 00:28:05.352 I am not Asian, but all of my friends grandmothers lived with them. 00:28:05.552 --> 00:28:08.302 Their grandparents lived with them or they lived with their grandparents. 00:28:08.312 --> 00:28:11.102 But now we are seeing more diversity in senior living. 00:28:11.152 --> 00:28:15.762 And people of that generation are more open to communal style living. 00:28:15.812 --> 00:28:20.232 While we don't have as many that are popping up that are specifically geared 00:28:20.302 --> 00:28:24.742 the entire community geared towards one culture or lifestyle we are seeing 00:28:24.742 --> 00:28:29.832 communities get more hip to the fact that they need to be catering to all sorts of 00:28:29.832 --> 00:28:36.962 different people and training their staff, not just on care delivery and safety 00:28:36.962 --> 00:28:42.192 protocols and fire drills in the building, but cultural awareness and sensitivities 00:28:42.192 --> 00:28:48.892 and we're seeing communities that are endorsed by SAGE or endorsed by LGBTQ 00:28:48.892 --> 00:28:54.872 communities because they're training their staff to work with the older out adult. 00:28:55.172 --> 00:29:00.432 Or the older adult who may not be out, but has shared with you that he or she is gay. 00:29:00.842 --> 00:29:02.692 So it's really we have a new awareness. 00:29:03.022 --> 00:29:06.972 But I think as we progress and more communities open, because the 00:29:06.972 --> 00:29:10.292 demand is there, as you said in the statistics you were quoting early on, 00:29:10.542 --> 00:29:14.432 I think we will see more smaller kind of boutique communities opening up. 00:29:14.812 --> 00:29:19.552 Candace Dellacona: I had some folks from SAGE on last year, and I'm happy to 00:29:19.552 --> 00:29:22.962 provide a link to our listeners if they want to listen to that, but organizations 00:29:22.962 --> 00:29:25.632 like SAGE are providing that training. 00:29:25.902 --> 00:29:29.772 So many assisted living facilities are bringing in these organizations 00:29:29.782 --> 00:29:33.812 like SAGE or particular cultural organizations to educate the staff 00:29:33.832 --> 00:29:35.262 so that people are more comfortable. 00:29:35.582 --> 00:29:39.592 Ending on that theme of not only living longer, but really living 00:29:39.592 --> 00:29:41.412 better and finding the right place. 00:29:41.912 --> 00:29:45.272 I'm so happy, Beth, that you were able to spend some time with me 00:29:45.272 --> 00:29:47.882 today and impart some of your wisdom. 00:29:48.222 --> 00:29:52.262 Really, this has just been so enlightening for me, and I'm really thankful for 00:29:52.262 --> 00:29:54.032 all of your guidance and expertise. 00:29:54.582 --> 00:29:55.362 Thanks for being here. 00:29:55.622 --> 00:29:57.352 Beth Weeks: Oh, thank you so much for having me, Candace. 00:29:57.352 --> 00:30:00.752 This is wonderful and happy to have been asked and I really enjoyed it. 00:30:00.802 --> 00:30:01.162 Thank you.