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Now or Never: Long-Term Care Strategy is a podcast for all those seeking answers and solutions in the long-term care space. Too often we don’t fully understand the necessity of care until it’s too late. This podcast is designed to create solutions, start conversations and bring awareness to the industry that will inevitably impact all Americans.
Elizabeth Miller: So a lot of
times stress can be related to
some kind of worry well naming
what the worry is and then
trying to take a step or an
action towards that worry. You
know, if you're worried about
the companionship if you're
worried about safety, like
what's one thing that you could
do to try to mitigate that but
then trying the different things
on like, it's you know, I
started saying the beginning
about how it was like a game for
me where I would just like pay
attention to what people were
talking about that was making
them feel like that was a stress
relief. And I thought, well,
people talk about this all the
time. Let me try this or let me
try that.
Caroline Moore: Welcome to Now
or Never Long-Term Care Strategy
with Kosta Yepifantsev a podcast
for all those seeking answers
and solutions in the long term
care space. This podcast is
designed to create resources,
start conversations and bring
awareness to the industry that
will inevitably impact all
Americans. Here's your host
Kosta Yepifantsev.
Kosta Yepifantsev: Hey, y'all,
this is Kosta. And today, I'm
here with my guest, Elizabeth
Miller, certified Care
Consultant and founder of The
Happy Healthy caregiver, a
resource hub, podcast and
community of caregivers growing
and sharing tips, resources and
support to create happier and
healthier lives for caregivers.
Today, we're talking about how
to care for the caregiver. To
start, will you tell us about
happy, healthy caregiver, how
you became a family caregiving
advocate and what attracted you
to this industry?
Elizabeth Miller: Well, it
wasn't necessarily something I
intentionally set out to do. It
was a need that I saw through my
own personal experiences of
being a family caregiver. So I
cared for my parents who had
chronic comorbidities. And also
I have an older brother that has
a developmental and intellectual
disability. So I've seen
caregiving from many parts my
entire life, but things really
started spiraling from my
husband and I in 2014, when we
were working full time, and we
were raising our own children,
and caregiving for our family
members started to really take a
priority and we were losing our
minds. And I kept kind of
turning for places to go that
could help me provide support
and resources to help me through
this really difficult season of
my life. And I was coming up
empty.
Kosta Yepifantsev: It's
astounding, because you would
expect that, you know, something
as important as providing like,
care for a human being, you
know, it's like doing your
taxes. There's an h&r block on
every single corner, right? But
there's really nothing out
there. So when you made that
realization, like I'm on my own,
like, what do you How did you
climb out of that hole?
Essentially? Yeah,
Elizabeth Miller: I mean, my
personality is definitely like a
roll up your sleeves and figure
it out. Yeah. So but I at first,
I didn't go there first, I was
just starting to kind of wither
and lots of tears and
frustration. And then I thought
this is this is not how I want
to live my life. And I'm also
very, you know, it's apparent
that little people are watching
me on how I'm living my life and
potentially modeling that. So I
just started writing was
basically what I was doing to,
to help provide some emotional
relief for me and kind of just
process what was going on in my
life, it was something I had
studied way back in college, and
then have always been trying to
write and do something as a way
to kind of heal and process
things. So that was my first
kind of endeavor in it. And then
it became kind of a little bit
of a game I was playing with
myself, frankly, about like,
Okay, if I want to I see these
people that I'm caring for that
have made different lifestyle
choices that have put me in, in
this situation. If I keep
putting myself last on this
list, I'm going to keep I'm
going to essentially repeat the
same cycle for my for my kids,
and my husband and I had this
intentional conversation and
really decided that that wasn't
something that we were willing
to do. So we had to try on
different things that were self
care for us so that we could
tell a different story.
Kosta Yepifantsev: Yeah, I mean,
was it a significant transition?
Like, has your life changed?
dramatically since this
experience?
Elizabeth Miller: Yes. It
changed my career, frankly.
Right. So I did it and strategy
made a really nice living doing
that. And I immediately thought
when I started, became a primary
caregiver for my mom, like, I've
got to figure out how I can have
full time flexibility. This is
not this is not sustainable. For
me. This is not viable. And that
was where the business ideas
started is like, Look, I'm not
the only one in this situation
at the time. I didn't know but
there's you know, 53 million
plus caregivers, just us alone
family caregivers. So but at the
time, I just knew that this was
something that was going to come
into people's lives. But now Now
it's my full time job since
2021. And there's a growing need
for it. You know,
Kosta Yepifantsev: it's that's
15%. Right? Yeah, that's, that's
15% of the US population. Yeah,
I
Elizabeth Miller: think it's one
in one in five. Wow. Yeah.
Kosta Yepifantsev: Yeah. 20%, I
guess, wow, a
Elizabeth Miller: lot of people
are, you know, 60% of caregivers
are working. Yeah. And that's
where, you know, being a
caregiver and being a caregiver
on top of that. So, you know, it
was definitely like I had added
another part time job on to my
life. And that was even with my
mom in an assisted living
community. You know, that is a
misnomer, that there's not a
caregiving role for those
people, there's still a
significant caregiving role, and
a massive expense, right. So the
even more of the reason why I
needed to keep working. And you
know, I'm excited that employers
are paying attention to really
investing in their employees who
are working family caregivers,
trying to provide the support
and resources to help them.
Kosta Yepifantsev: Absolutely.
And so you touched on a few
things that you did like riding,
having those intentional
conversations with your family,
to promote your own self care,
what other things can you offer
our listeners, so that
caregivers can find balance and
also emphasize self care for
themselves?
Elizabeth Miller: I think at
first, you know, I thought a lot
about physical self care, like
eating right and exercise. But
it's self care for caregivers
goes way beyond that. It is
about you know, asking for help
creating your care team of
people doing things that are
going to help simplify your
systems that you have how you
care, and put those into place.
That's so it's not just the
physical self care, it's you
know, emotional through
meditation and yoga and writing,
it's spiritual, it's social,
through connecting with other
caregivers practical through
getting your care team set up,
setting boundaries, all kinds of
things. So you know, when when I
say happy, healthy caregiver,
like it's not necessarily about
those weekends away and the the
respite that we all are kind of
craving for, but really the
intentional things that we can
do in our everyday life to kind
of microdose self care so that
this can be a sustainable
journey.
Kosta Yepifantsev: Can I ask you
a question? That's kind of I
don't want it to be complicated,
but it may come out complicated.
So I've never been a caregiver.
But I do have kids, right. Yeah.
Yeah, I mean, I have so
obviously, in the in the
business that my wife and I own,
you know, I've worked on shift
before, and I've provided the
same tasks. But being a
caregiver for a day is much
different than being a caregiver
for years and years and years,
right. I have kids, four of
them, that are eight and
younger. So it's a lot of work.
And I understand as you're, as
you're explaining it, I'm
thinking to myself, like, yeah,
those are all things that I also
have to do for myself, like, you
have to find time to exercise
you have to find time to be
grateful and be happy and be in
the right mental state. So this
is why I feel like this question
may be somewhat complicated.
When you spend so much time
taking care of your children,
raising your kids just to arrive
to the stage in your life where
you were expecting some freedom,
I guess. And you then end up
having to take care of your
parents, without many resources
at all similar to I mean, is it
fair to say that there's more
resources for kids than there
are for for the elderly, for the
elderly, individual?
Elizabeth Miller: I mean, I
think for sure, because people
people go into that role, first
of all, like, usually not by
accident. But there's so many
books, and there's so many
things and it's so a time of
celebration, right? When you're
when you're having a bringing a
child into the world, and people
are identifying role, right with
the role of being a mom or being
a dad, whereas being a family
caregiver isn't something that
necessarily people are owning
that role. And then I think if
they are kind of unwilling to
accept that role, then it is
more difficult to find the
resources and support that are
gonna help them and you know, I
think to your point, yeah, is
there resentment of course, and
I think that there you know, one
of the things we don't talk
about sometimes is a lot of the
negative emotions that go are
with caregiving. And yet yes,
and like there's a lot of joy
that comes in that caregiving
moments to like, I mean, I had
the the gifts of spending a lot
more time with my parents and
And during their final act of
life than I potentially would
have they, you know, just
something suddenly happened to
them before they, they passed
on. So it's, it's both I think,
I think very, it's not often
that there's like a, you know,
really solid answer on some
things, but it's really a
cornucopia of different
emotions, and they all happen
within the same day, just as you
know, I think in some ways
similar to parenting, but I
would say the one main
difference is that, you know,
eventually your kids are going
to be more and more independent.
And they're gonna go off into
their own and, you know, unless
there's some kind of as a
special needs situation there.
But with your older adults, and
a lot of the folks that we're
taking care of, it's usually the
opposite, where, you know, it's
kind of as good as it gets on
day one. And then things can
continue to decline, which is
even more of a reason why we
have to proactively have these
conversations and set ourselves
up for sustainable success.
Because it's, it gets harder.
Kosta Yepifantsev: Yeah. And you
need to set those expectations.
That was a fascinating
explanation. I always love doing
these shows, and like, I, you
know, you, you do so many of
them, and you think, Okay, well,
I've figured it out. And then
you hear something like that.
And you're like, Wow, I never
really thought about that. It's
really interesting perspective.
So I want to know, though, in
your opinion, what do you think
is the greatest challenge that's
facing caregivers today?
Elizabeth Miller: I think that
we're being asked to do a lot,
you know, we are, we can't wait
kind of for the government to
kind of figure out the answers,
because it's a very slow
process, and very few people
qualify for Medicaid. And, you
know, the, the, the number of
faces I've seen of people where
they first are finding out for
the first time that Medicare
does not pay for long term care,
it is shocking to people Yeah,
to say that, again, though,
Medicare does not pay for long
term care. Like, it surprised
me, and it surprises people. And
it's hard to get on Medicaid,
like even my mother in law, she
got denied so many times, and
all she had was her social
security check, which was like
$800, and that my husband and I
were scratching our head, and
we're like, who gets approved
for Medicaid if if she can't get
approved. So it's so the
struggle with caregivers that is
that you know, more people are
wanting to age in place at home,
which I think you know, if you
and I have the choice, when we
get older, that would be our
choice, right to be at home as
long as possible. So that we
cannot do that. And but who is
bridging the gap then for to
make that possible is this
growing segment of people,
family caregivers, who are also
contributing to the workforce,
who are also, you know, raising
responsible independent kids
someday. And so it's a lot of
being asked, and it's a big
strain. And so what I'm hoping
will happen is that there will
be more resources for caregivers
where we can either get paid,
you know, get paid for the care
that we're providing at home,
and have more respite
opportunities, because we all
are desperate for a break. It's
really, really hard situation.
Kosta Yepifantsev: And it's an
what's what's interesting about
that statement specifically is
it's not that family caregivers
are shocking the work of being a
caregiver, they're not saying
like, I'm the odd one do, I'm
not going to do it, you pay for
it. They're not saying that
they're like, Okay, listen, I
will do it. But I mean, you
know, usually
Elizabeth Miller: financial
assistance. Yeah, somebody's
family is usually stepping up.
I'm one of six kids. And I will
say we are not all on the same
page. Oh, yeah. So there's
always usually,
Kosta Yepifantsev: within the
family, yes, there's typically
somebody. And so that means for
every fit for every nucleus of a
family or nuclei of a family,
you're gonna have somebody that
is going to be the primary
caregiver. That person has, I
mean, probably can't work full
time. Sometimes, in instances of
like individuals who have
Alzheimer's or dementia, they
may not even be able to work
part time. And, you know, to
hire a caregiver to hire another
human being to care for another
human being you gotta it's
expensive, because you're paying
a person, right? And you're not
a business. You're just a
family. Right? And so it's, it's
astounding to me and it's
similar to like, whenever during
the pandemic when they started
to pay for for, for daycare, you
know, they made daycare free, or
they provided some type of
subsidy, like why not use that
exact same method to be able to
help family caregivers have the
funds to be able to feed you
know, their themselves and their
families. And I mean, you could,
you could reduce the amount of,
of resources that taxes the
industry, and you can create
what I believe is really the
only skill illusion technology,
which is what about next is one
serious one. But a real solution
is more multi generational
families. That is probably the
key to solving this problem. But
it's going to come from policy
change. Yeah,
Elizabeth Miller: I mean, that's
how it used to be, right, we
used to have these multi
generational care. But the big
difference there is that we
didn't have people living as
long, you know, we didn't have
the, the cost of the way. Things
are today with gas and food
where most, most people have to
have a dual income family in
order to, to have that same
lifestyle that we grew up
having. And people are living
longer, right, like medicines
and think, you know, it's it's a
yeah, we've got some
advancements and health and
things that are happening. But
that's a long time that people
can can try to fill the gap. And
I do caution people from, you
know, I speak for a lot of
employers, and I think sometimes
the first instinct can be like,
Oh, I gotta quit my job, I gotta
do this, and maybe, you know,
try it, you know, slip into it,
try FMLA and things like that if
as you can, because otherwise,
we're also creating this same
systemic problem, right? Like,
if I don't work, and I don't
have the money, like, who's
gonna pay for my care when I'm
like, it just gets worse?
Kosta Yepifantsev: That's right.
Well, it is a it is a very
complicated really diving. And
Elizabeth Miller: there's an
answer, though, I do think that
that's a start. And there are
some states that do pay their
caregiver that you know, it's
not it's a, it's there's a
process in place. I know,
Colorado is one of them. Georgia
is not one of them, where you
can, you know, pay an informal
caregiver. But it's, it's, it's
to everybody's benefit, right to
keep these people out of the
hospital systems out of it. So
if we can kind of come together
and figure out some kind of
solution, I think, I think it's
probably not like a one answer
solution. It's a bunch of
different things. And I'm
encouraged that, you know, while
the government is figuring out
what they what they've got going
on, there are a lot of companies
and peep startup companies that
are really trying to attack this
problem. Sure,
Kosta Yepifantsev: absolutely.
And so on the on the note of
startups, what role is
technology currently playing and
helping caregivers manage their
responsibilities? And how do you
see it being used in the future?
Elizabeth Miller: I mean, I
think there's a lot of ways I
say that technology really is
part of the care team, you know,
so it's your family, friends,
home care technology, like it
can help you simplify things,
you know, everything from, you
know, meal delivery services,
to, you know, ordering your
groceries, having having
different tasks done for you,
there's a lot of apps that are
out there that can help you
communicate with your care team.
And also, request help that way.
So remote monitoring, I think is
another way where caregivers are
getting a peace of mind,
particularly like, not everybody
lives with their person, right?
Like maybe they live close by or
across the country, a long
distance support caregiver. And
so there's ways that you can
kind of keep tabs on your loved
one through technology and have
that peace of mind without
physically being there, which is
nice.
Kosta Yepifantsev: Yeah, there's
a couple of companies in our, in
our geographical area in the
southeast of the US, that uses a
combination of sensors, passive
monitoring. And a lot of it is
based around data collection.
And so like, for example, as
you're describing, like with,
you know, somebody that's caring
for their mom or dad, and they
live in a different state, even,
you know, you can use these
data, these data centers, Chair
alarms, you know, or bed
sensors, Chair sensors. And if
somebody's sitting in a
recliner, the entire, you know,
for like six hours straight, and
you can read that data, you
know, obviously something may be
right, and you could, you know,
maybe have a wellness check or
something like that happen. But
I believe in my opinion, that
technology is a quintessential
application to solving the lack
of caregivers that are available
to pay it because there's a lot
of for that for the people who
don't have family to care for
them. Because what I've noticed,
working in this industry, is
there are many people that are
on the Medicaid side of things,
who are completely alone. And as
a provider as a company, we step
in, essentially to become their
natural supports, and try to
provide the best quality of life
possible and yeah, there's not a
lot of yeah, there's not a lot
of people were stepping up and
wanting to be caregivers
nowadays.
Elizabeth Miller: No, it's a
tough, it's a tough position to
be in. And you know, there's
also this whole thing about
socialized isolation. So
particularly if people don't
have somebody that is, you know,
checking in with them
frequently, there is some
technology even that is trying
to handle that we're like they
can have a conversation beyond
Alexa, but like learning
people's behaviors and having
conversations with, you know,
some sort of a robot type of
thing.
Kosta Yepifantsev: Well, there
are Yeah, it's like a Rosie or
something or Rosa. So I was
listening to NPR and one A, and
they actually, were profiling a
nursing home. That launch some
type of like, robot that tell
jokes. Yeah, you can ask tell
jokes and delivers meals and
stuff.
Elizabeth Miller: Just, you
know, hey, do you want to listen
to some Frank Sinatra, like,
they kind of learn your
behaviors, the one I know of is
called le que is the same type
of thing, but lots of different
things there. So I'm excited to
see you know, particularly my IT
background, like I love kind of
when these two, the my worlds
are colliding. And there is a
lot of opportunity, and we're
gonna need technology to help
bridge that gap gap for sure.
Kosta Yepifantsev: Yeah, well,
we can have a whole show just on
technology alone in this space.
So but let's get we're gonna
we're gonna side back to slide
back to caregiving. As a
caregiver, how do you manage
stress and avoid burnout? And
how did these feelings normally
manifest?
Elizabeth Miller: Well, it's a
roller coaster, right? Like
they, there's, I think most
caregivers kind of like their
first go to is to kind of like,
well, I'm just going to do more,
I'm going to do more, and then
you kind of figure out that
that's not sustainable, and all
the systems start to break down.
And I think there's a lot of
different ways that you can kind
of manage stress, but for me,
and for other people listening,
like self care looks differently
for all of us, like, I know, for
me, it's, it's about like,
what's going to give me energy,
what's going to provide peace of
mind. And really like naming my
worry. So a lot of times stress
can be related to some kind of
worry, well naming what the
worry is, and then trying to
take a step or an action towards
that worry. You know, if you're
worried about the companionship,
if you're worried about safety,
like what's one thing that you
could do to try to mitigate
that, but then trying the
different things on like, it's,
you know, I started saying the
beginning about how it was like
a game for me, where I would
just like, pay attention to what
was what people were talking
about that was making them feel
like that was a stress relief.
And I thought, well, people talk
about this all the time. Let me
try this or let me try that. And
you won't know until you try it
on what works for you. But some
things could be you know, think
about your five senses, you
know, aromatherapy, you know,
getting outside in nature,
listening to music could be
writing could be journaling, and
I think the point is, is like,
it doesn't have to be you know,
15 minutes, 30 minutes, it's
like little incremental things.
I really challenge people when
they say they don't have time
for self care, because it's not
an all or nothing thing. There's
we all have to create the time.
It doesn't just doesn't happen.
Kosta Yepifantsev: Yeah, you
know, you've really created an
incredible resource for
caregivers and prospective
caregivers alike. You walk us
walk us through happy healthy
caregiver and its most commonly
utilized resources.
Elizabeth Miller: So it's
evolved over the years right up
front, a lot of spaghetti to see
what sticks and best way to do
and so you know, a bit I became
a certified caregiving
consultant because I wanted to
help myself and coach others. So
I do offer complimentary
coaching for an initial session.
The podcast is is full of
resources. I mean, I believe
that family caregivers are the
experts in caregiving and family
caregiving. So that's what
you'll find on the happy healthy
caregiver podcast is over 150
episodes sharing caregiving and
self care tips. Speaking is
something that is really a main
way that I monetize my business.
So speaking with groups of
employee resource groups,
affinity groups, different
organizations that are
celebrating what caregivers are
doing. And then I love to
collaborate with partners who
are trying to put their brand
out in front of the world you
know, the technology companies
and so forth. We talked about I
want to be that that conduit to
really fast track caregivers to
the to the resources so that
they're not fumbling and
stumbling over Yeah, are there
things that I can really kind of
pull them up and be like, Okay,
we've got this. So those are
some of the things that I that I
provide through happy healthy
caregiver.
Kosta Yepifantsev: I love that.
Why do you think that more
people don't embrace technology?
Like just something as simple as
the is having a conversation
like electronically as opposed
to face to face like a two way
iPad, right like why I, a lot of
times people like feel ashame to
call somebody on an iPad as
opposed to going in person. And
if they, if they're out of
state, especially like, that may
be the only form of
communication, except for maybe
some unique periods when you
know they're visiting. Right?
Why do you think that caregivers
are ashamed of taking care of
the easier
Elizabeth Miller: caregivers or
the care recipients? I mean, I
think it could be either, right?
Like they gotta kind of in the
middle, I would say that that's
moving in the right direction
that more people are open to it,
I think they just don't have the
time to research. So you know,
somebody's listening to this,
and they're more of a support
caregiver for somebody who's a
primary family caregiver, then
that is something like at a
distance as a support caregiver
you can do for somebody is like,
figure it all out, and then just
show up with the system and be
like, Hey, I found this thing.
Like, let's, let's try it and
see if this works. You know, I
went, you know, I want to help
you figure this out. But some of
it, I think, is pride. And just,
you know, people are stubborn,
and trying new things can be a
fearful thing. Maybe it's a fear
of privacy for some things.
Sure. So, I think it just
depends.
Kosta Yepifantsev: Yeah, what do
you what do you typically tell
people who are financially ill
equipped to handle taking care
of an aging parent or taking
care of themselves? Who may be
aging? And have no like, what do
you tell them is like the first
three steps, aside from
obviously, what you would do
internally for yourself as a
caregiver, but how do they get
through that?
Elizabeth Miller: I mean,
there's some things they can do
that don't cost anything, right,
like there's some things are
connecting to support for
themselves, is a way because
nobody's going to understand
your situation like another
family caregiver, and you can do
that virtually, or there might
be an in person, group that
because they're gonna help
problem solve that for you. So
that's free, frankly. And then,
you know, gathering your care
team, if you're thinking that
this can be a solo caregiving
job, it can't be. And so there
are some resources that I
provide for people to really
divide and conquer their
responsibilities. And, you know,
maybe there's things that they
could do to barter with people
to, to trade for services,
sometimes a reduced rate for
respite care, like there's some
day programs for folks with
dementia that can be very
affordable for an all day
education. And then of course,
you know, maybe they have
somebody that has a veteran
there, there could be some
veteran benefits that they could
get, or, of course, they can
look into the the Medicaid route
for things. Yeah, I know, for
me, like, I'm looking ahead,
like, I'm 51 years old. So like,
I'm thinking about, like, how
are my kids going to pay for my
husband? You know, how are they
going to handle this situation?
If we don't have enough money
to, frankly, pay for it? So one
of the things that we did
proactively is we got something
on our life insurance called
Living benefit, which I didn't,
wasn't aware of. But that's
something that you know, if
certain things are true, that we
could maybe we can draw upon
this life insurance policy,
because you know, long term care
insurance is expensive, and it's
not something that is extremely
expensive, particularly when
you're over 50. So it's, yeah,
it's not, you know, it's not a
sustainable, what would you add
to that coast? I'm curious.
Kosta Yepifantsev: Well. So what
I typically tell people, and I
am very, I'm very pragmatic,
because obviously being in this
industry for for a while, like,
I know what works and what
doesn't. And usually what
happens is everybody wants
Medicaid, because, well, I don't
want to I don't want to put
everybody in that in that
bucket. But most people if they
knew what Medicaid paid for
Pate, what Medicaid would pay
for and what it provided in
terms of long term care
services, they'd be like, Yeah,
I want it. What do I need to do?
You know, and Tennessee is a
asset relinquishment state. I
don't know if Georgia is but in
Tennessee, if you want to apply
for Medicaid and you have
assets, they'll let you apply,
but you have to sign all your
assets over. Okay. Yeah, so
like,
Elizabeth Miller: I don't know
exactly what we have left. Yeah.
Which
Kosta Yepifantsev: is why
Medicaid is so complicated,
because there's 50 different
approaches to it, right? Which
is another like that's, that's a
third podcast that we can do so.
So there's a huge bargain that
you have to make if you want
Medicaid, which is essentially
you give up all your
generational wealth, and you may
end up giving it up anyway if
you're paying for long term care
out of pocket, but the long and
short of what I'm trying to say
is what I tell most people is if
you actually have a loved one
who is who has suffered a
significant medical Levant. A
lot of times if you can. If you
get placed into a nursing
facility, you can transition to
Medicaid within that facility
through their social work
services. And it's, it's, you
got to really have a stomach for
it, though.
Elizabeth Miller: Yeah, there's,
it's a process, you know, yeah,
no matter what you haven't been,
it's a process,
Kosta Yepifantsev: right? You
have to be almost like, I can't
take care of my mom or dad
unless I have help. And and you
can't literally you cannot
deviate from that message.
Because the only way that you're
going to get Medicaid or get any
kind of support, because you
know, those social workers at
the nursing homes know
everything they know all the
programs and how they operate,
and they know how to access
them, and they have all the
contacts. But unless you're
saying, like, they're gonna stay
here, and you can't bill for
those services, because their
Medicare days have run out, and
they're not on Medicaid, and we
don't have anything to pay for
them out of pocket. They won't
do anything to find, you know, a
solution to what becomes their
problem. And that's what I do. I
tell people, I tell people to
leverage everything that they
have to try to get Medicaid.
It's a crazy, it is crazy
advice. But if
Elizabeth Miller: why not? The
communities maybe that you were
I might want to live in will
accept Medicaid, either. So
that's your doubts currently,
you've got to kind of like lay
out all the options. I think
another underlying underutilized
service that is available, if
somebody is really, you know, in
a chronic situation, maybe
potentially has six months or
less to live is hospice, I think
a lot of people, and that is
something that Medicare will
typically pay for is hospice
services. And I think that is an
underutilized service.
Kosta Yepifantsev: Yeah, and I
think, correct me if I'm wrong,
but also palliative care,
Elizabeth Miller: palliative
care, yes. Is, is treating the
symptoms. And you can have that,
at any, it doesn't have to have
that six months or less. But I
will say like, my mom lived for
two years on hospice, she was
reevaluated, you know, every
6090 days. Could she have
castaways in the next six
months? Yes, she could have you
know, she was bedridden the last
two years of her life? Oh, wow.
So it's it? You don't know
unless you ask the questions,
right. And everybody's situation
is different. But I think that
there's not enough education
around palliative care and
hospice care. And again, that's
where like, the free thing of
support, like if you get plugged
in, you will hear it all because
you're learning a whole new
vocabulary and a set of terms
that have never, you know, it's
not a book you've ever wanted to
pick up before. Like it's,
Kosta Yepifantsev: and I think
the best thing, and you said it
earlier in the show, the best
thing that people need to know,
at an early age is in this will
keep them you know, at least
abreast of the fact that they
need to prepare in some
capacities that Medicare doesn't
pay for long term care.
Elizabeth Miller: That's what's
your, what's your plan here?
Exactly what is your plan to
have those courageous
conversations now like to have
them now. So that when you you
can avoid the headaches as much
as possible, later and allow
people the privilege like I'm so
grateful, right that my parents
had, first of all the financial
means to pay for their care,
right? And secondly, the all of
their paperwork in order it made
us as their kids. We were
allowed to just kind of be in
that moment. Like it was still
terrifically hard and
emotionally draining. But thank
goodness, we didn't have to make
those types of decisions about
Yeah, what what they want it
like it was very clearly
indicated, and we can simply
follow directions and really
focus on being present and
handling the crisis of the day.
Kosta Yepifantsev: Absolutely.
There is one more thing before I
wrap up there is a disability
trust, I think it's called I had
I had a friend of mine who's an
attorney here in town and we
talked a lot about disability
trust. So it's a real technical
episode if you want to check it
out. But you can get a
disability trust at an early a
yes. And if there is a look back
period for Medicaid in your
state, which most states have
five, three to five year look
back period. The Disability
trust kind of interjects and
says Whoa, you don't need to
look back period because all of
this money is in a trust and so
the state can't touch it and you
still qualify for Medicaid and
your your assets are protected.
So that's that's another Yes
Elizabeth Miller: party special
needs. I know my brother has a
special nice dress which is
which I'm grateful that was, you
know, again, smart dad that set
that up for my brother, you know
who's now approaching his 60th
birthday and we have we're his
caregivers, right the siblings
now for him so he is he does
have that I don't know the all
the ins and outs of the of the
special needs trust, but I do
know that it's it's something
that is really helpful in our
situation for us care.
Kosta Yepifantsev: I am curious
about something though, like,
what? What, um, it's a little
bit taboo. But I think it's a
really important conversation.
What should we do when
personally providing caregiving
supports for our loved one is no
longer an option?
Elizabeth Miller: I think we all
have to think that through right
is like, what, what is our
boundaries of what we're willing
to take on and impact like, I
know, for me, like even even my
brother's situation, like it
wasn't an option for him to come
and live with with us because I
had a young daughter and
sometimes he could be
inappropriate, it's so you have
to kind of figure out your
boundaries on that and, and know
what you need to be true. Like,
I knew I needed to keep working.
So for mom to move, she needed
to live in an assisted living
and what my role was, was going
to be like, but to have those
conversations because it's, and
we all have different strengths,
right? Like I will say,
honestly, like I'm, I'm a way
better advocate for family
caregivers, than I am a hands on
family caregiver for my my
family members. And that is
because like, I'm kind of a
tough love caregiver. Like I was
that person with my mom, like,
Come on, Mom, you can do that
for yourself. Like, knowing that
really, she's part of her, she
was a part of her own care team.
And that while it might be
easier for me to do things, for
her, it was part of her
occupational therapy or physical
therapy to do it herself. And so
I would constantly say to her,
you need to meet me halfway. I
don't think that makes me a bad
caregiver. It just like I might
not have that altering gene as
much like I'm like, let's figure
this out. Let's do this
together. Whereas like my older
sister is the, you know, epitome
of what anybody would want her
to be their caregiver. She's
amazing. She cooks amazing. I'm
not a great cook, like all of
that. So
Kosta Yepifantsev: I love it. So
we always like to end the show
with a call to action. What's
your advice for anyone that is
struggling today as a caregiver
and feels like they need help?
Elizabeth Miller: I would we
touched on these already, but
like the first thing is to seek
support. And you can set up a
complimentary coaching call with
me. We can talk through that you
can google it in your area, the
name of your town, caregiver
support, see what comes up. In
don't wait too long. I think
people wait till there's a
crisis. I'll do that when like
no do it proactively do it when
it's not a crisis so that you
have all your options in place
you have your people in place so
that when the crisis happens,
then it's just going to be
something that's more easily
resolved that way. And then as a
as a follow up to that to like
schedule your time for yourself
like it's you're not going to
find it you've got to create it
and so just put it as a wellness
appointment for yourself on your
calendar of what that what that
can look like and have it
something so that you can look
forward to having it
Caroline Moore: Thank you for
joining us on this episode of
Now or Never Long-Term Care
Strategy with Kosta Yepifantsev.
If you enjoyed listening and you
wanna hear more make sure you
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Long-Term Care Strategy is a
Kosta Yepifantsev production.
Today’s episode was written and
produced by Morgan Franklin.
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Kosta? Visit us at
kostayepifantsev.com