Baby Boomers Radio: Recent Episodes
Ed Bejarana
What is Baby Boomers Radio? Baby Boomers Radio (BBR) is a monthly audio magazine designed for seniors looking for wholesome entertainment, valuable information, and a connection to the world. BBR is comprised of a collection of quality audio podcasts that cover an ever-growing number of topics – all relevant to the Baby Boomer generation. In fact, BBR content presented by baby boomers for baby boomers.
Why Baby Boomers Radio? As the baby boomer generation shrinks, the American marketplace is losing interest in catering to their needs. BBR is filling the gap in providing quality, wholesome entertainment and information just for Boomers. From story-tellers and historians to gardeners and chefs, BBR provides the content Boomers want, when they want it...whenever that is!
Who is the target audience? Baby Boomers, of course! BBR caters to adults anywhere in age from their late 50s and up! These folks are engaged in the world around them and have a thirst for knowledge and entertainment. They are also the wealthiest, most active, and have the most disposable income for food, apparel, and retirement programs. They’re not ready to stop learning or stop enjoying life. Our listeners are the people who have helped build America and have reached the age where they prefer wholesome and helpful programming that celebrates Baby Boomer status!
For the past 27 years, ITM Trading & Lynette Zang have been helping individuals uncover the truth about complex Financial Banking, Currencies, and Economic Systems while building strategic and tangible Gold & Silver portfolios to withstand any economic crisis for their clients.
Questions about protecting your wealth with Gold & Silver? Schedule a Free Strategy Call with Lynette's team or Call 866-264-7788
To learn more about Lynette and ITM Trading, please visit itmtrading.com. ITM Trading YouTube Channel & Beyond Gold & Silver YouTube channel links.
Baby Boomers Radio is a listener supported production. To learn more about supporting the program, please visit babyboomersradio.com/support.
John K. Ross is the founder of one of the largest boutique estate planning and asset protection law firms in Texas, Ross & Shoalmire, P.L.L.C. Founded with the singular goal to be the best resource in the community for Estate Planning, Elder Law, and Asset Protection, John’s team now covers over 40 counties in Texas and Arkansas.
To learn more about John and Ross & Shoalmire, please visit www.rossandshoalmire.com/.
You can also hear John on the Big Picture Retirement Podcast - bigpictureretirement.com.
Baby Boomers Radio is a listener supported production. To learn more about supporting the program, please visit babyboomersradio.com/support/.
John K. Ross is the founder of one of the largest boutique estate planning and asset protection law firms in Texas, Ross & Shoalmire, P.L.L.C. Founded with the singular goal to be the best resource in the community for Estate Planning, Elder Law, and Asset Protection, John’s team now covers over 40 counties in Texas and Arkansas.
To learn more about John and Ross & Shoalmire, please visit www.rossandshoalmire.com/.
You can also hear John on the Big Picture Retirement Podcast - bigpictureretirement.com.
Baby Boomers Radio is a listener supported production. To learn more about supporting the program, please visit babyboomersradio.com/support/.
Quick Tips for Starting an Indoor Herb Garden: bit.ly/3zw8UwG
Growing Vegetables from Seed: bit.ly/3fnd7fj
How to Create Rosemary Plants from the Produce Aisle: bit.ly/3Wh4TpY
Interested in creating your own podcast? Zenith Exhibits Studios provides affordable podcast production services. Recording, Editing, Hosting, AI Transcription, and Publishing included for one low monthly price. Visit www.zenithexhibits.studios or call (208) 209-7170 to learn more.
Quick Tips for Starting an Indoor Herb Garden: bit.ly/3zw8UwG
Growing Vegetables from Seed: bit.ly/3fnd7fj
How to Create Rosemary Plants from the Produce Aisle: bit.ly/3Wh4TpY
Interested in creating your own podcast? Zenith Exhibits Studios provides affordable podcast production services. Recording, Editing, Hosting, AI Transcription, and Publishing included for one low monthly price. Visit www.zenithexhibits.studios or call (208) 209-7170 to learn more.
Throughout America, many seniors and boomers are seeking assistance around the home. Millions of developmentally disabled people also need a little extra help with daily life activities. Baby Boomers Radio is bringing these stories to our network to help people know there are service opportunities for anyone who needs the help.
HDE Home Care provides job training and in-home caregiving services for the Portland Oregon metro area. HDE has joined the Baby Boomers Radio network to share their story with our listeners.
To learn more about HDE Home Care, please visit hdehomecare.com or call (503) 686-9079.
If you hear about a service offered through HDE Home Care, but don’t live in or around the Portland Metro area, then reach out to us here at Baby Boomers Radio and we’ll try to help get you connected with a local resource. Email hello@babyboomersradio.com.
To learn more about Humana and your Medicare plan options, please visit humana.com.
Do you have a product or service that benefits seniors or boomers? Would you like to advertise on Baby Boomers Radio? Call Ed at (208) 209-7170 to learn more about the affordable ad rates we offer. We don't take just any ad, it must be compatible with people 55 and older but advertising on a growing podcast like Baby Boomers Radio is an excellent way to build new and long term relationships with people. Call today or email hello@babyboomersradio.com.
Story Links:
5 Ways Over-the-Counter Hearing Aids Will Be Different From Prescription Hearing Aides: https://bit.ly/3CtoUBE
Mimi Rogers Returns in New ‘Bosch’ Show: https://bit.ly/3rv0Nfu
Baby Boomers Radio is a listener supported production. To learn more about how to contribution a few dollar to help, please visit babyboomersradio.com/support.
Story Links:
5 Ways Over-the-Counter Hearing Aids Will Be Different From Prescription Hearing Aides: https://bit.ly/3CtoUBE
Mimi Rogers Returns in New ‘Bosch’ Show: https://bit.ly/3rv0Nfu
Baby Boomers Radio is a listener supported production. To learn more about how to contribution a few dollar to help, please visit babyboomersradio.com/support.
Overwintering and Nesting Habitat for Pollinators and Beneficial Insects, Xerces Society PDF: https://bit.ly/3StclM6
Compost in the Fall Garden: https://bit.ly/3rlF1ea
Coeur d'Alene Coop Growing Garlic Series: https://bit.ly/3fApVP6
Source for Seed Garlic (planting bulbs): Mountain Valley Garlic https://www.mountainvalleygarlic.com/
Interested in creating your own podcast? Zenith Exhibits Studios provides affordable podcast production services. Recording, Editing, Hosting, AI Transcription, and Publishing included for one low monthly price. Visit www.zenithexhibits.studios or call (208) 209-7170 to learn more.
Ecclesiastes 5:3 (MEV)
For a dream comes when there is a great burden, and a foolish voice when there are many words.
Sponsors:
Interested in creating your own podcast? Zenith Exhibits Studios provides affordable podcast production services. Recording, Editing, Hosting, AI Transcription, and Publishing included for one low monthly price. Visit www.zenithexhibits.studios or call (208) 209-7170 to learn more.
Baby Boomers radio is a listener supported production. To learn more about helping the program financially, please visit babyboomersradio.com/support.
Baby Boomers radio is a listener supported production. To learn more about helping the program financially, please visit babyboomersradio.com/support.
I use bit.ly to shorten links to make it easier for you to click over to the articles I reference on the show.
Link to The Greatest Music Stories Ever Told: https://amzn.to/3Ta6dJC
Life Expectancy in the U.S. Just Had a Historic Drop: https://bit.ly/3eLj3hN
Scientists Discovered an Antibody That Can Take Out All COVID-19 Variants: https://bit.ly/3QGvPLJ
How to Boost Serotonin, Your Happiness Hormone, Naturally: https://bit.ly/3LhtEx6
The Greatest Presidential Stories Never Told link on Amazon: https://amzn.to/3AgxNMx
The New Mood Music, an article published in AARP in the Upfront/Listen section of the August/September edition. https://bit.ly/3dOC0Qb
A Look Back at America in 1977, by Nancy Herrick, published in Reminisce Magazine: https://bit.ly/3dDRztG
Sponsors
For your computer repair and computer network needs, call Joe with F1 for Help at (208) 687-0183. Visit www.f1forhelp.net for more information.
Do you have an event to promote? Zenith Exhibits Studios provides non-profit and campaign advertising at very reasonable rates. With channels covering political, business, health, and seniors, we have ways to reach tens of thousands of new customers through podcast advertising. Call Ed at (208) 209-7170 to learn about advertising opportunities through Zenith Exhibits Studios.
https://bit.ly/3Tvfyf9 How to Make a Low Tunnel to Extend Your Garden Season
https://bit.ly/3RmZjin Ripe for the Picking: A List of Climacteric and Non-Climacteric Fruits and Vegetables
https://bit.ly/3AEnO3X How to Tell When Green Tomato Varieties are Ripe
Interested in creating your own podcast? Zenith Exhibits Studios provides affordable podcast production services. Recording, Editing, Hosting, AI Transcription, and Publishing included for one low monthly price. Visit www.zenithexhibits.studios or call (208) 209-7170 to learn more.
Baby Boomers Radio is a listener supported production. To learn more about contributing to the program, please visit babyboomersradio.com/support.
The Greatest Science Stories Never Told link: https://amzn.to/3q1Q1MV
Link to the main story article, What It Feels Like To Downsize, Link: https://bit.ly/3RdTuUo
Link to the second story, 20 Tips You Need When Cooking With An Instant Pot, Link: https://bit.ly/3x3Q3YX
Ed’s sweet meatloaf recipe: 2 pounds of beef, about a quarter cup of breadcrumbs, two table spoons of Worchester sauce, one egg, a quarter cup catsup, and a quarter cup of brown sugar. It only takes about 20 minutes in the Instant Pot.
Baby Boomers Radio is a listener supported production. To learn more about making a small contribution to the program, please visit babyboomersradio.com/support.
Pastor John Bagorio spends a few minutes talking about during the meanwhiles in life.
Sponsors:
Interested in creating your own podcast? Zenith Exhibits Studios provides affordable podcast production services. Recording, Editing, Hosting, AI Transcription, and Publishing included for one low monthly price. Visit www.zenithexhibits.studios or call (208) 209-7170 to learn more.
You can link to the articles on Apple News with the links below.
How States Helped Lower Prescription Drug Costs, published in AAPR on August 18, 2022 by Emily Paulin: Link: https://bit.ly/3T6NZZg
Speaking on Social Security…there was another article in AARP published on August 10, 2022 by Andy Markowitz that talks about this year’s potential cost of living adjustment (or COLA as it is known). Link: https://bit.ly/3Kd824m
The Greatest Music Stories Never Told: https://amzn.to/3Ta6dJC
Baby Boomers Radio is a listener supported production. To help support the show or leave a tip, please visit babyboomersradio.com/support.
Link to the 7 Reasons You Should Retire Already article: https://bit.ly/3QKjyWM
Link to the 5 Best Things to Buy in August article: https://bit.ly/3PoBx4c
Link to The Greatest Stories Never Told book on Amazon: https://amzn.to/3JXEKGR
Today’s episode is brought to you by Zenith Exhibits Studio. To learn more about Zenith Exhibits Studios, call (208) 209-7170 or email info@zenithexhibits.com
How to Grow Tomatoes: A Primer (Part 1) https://thecoeurdalenecoop.com/podcast-10-how-to-grow-tomatoes-a-primer-for-success/
Growing Tomatoes: Part 2 https://thecoeurdalenecoop.com/podcast-11-how-to-grow-tomatoes-part-2/
How to Prevent Disease in the Garden: https://thecoeurdalenecoop.com/simple-steps-to-prevent-disease-in-the-garden/
Here is the link for tomato diseases:
https://thecoeurdalenecoop.com/how-to-identify-common-diseases-in-tomatoes/
How to Identify Common Insect Pests in Tomatoes
https://thecoeurdalenecoop.com/how-to-identify-common-insect-pests-in-tomatoes/
Interested in creating your own podcast? Zenith Exhibits Studios provides affordable podcast production services. Recording, Editing, Hosting, AI Transcription, and Publishing included for one low monthly price. Visit www.zenithexhibits.studios or call (208) 209-7170 to learn more.
Baby Boomers Radio is a listener supported production. To learn more about how to support the program, please visit babyboomersradio.com/support.
Ed talks about how an Instant and buying in bulk can help you and your friends save money grocery shopping.
Baby Boomers Radio is a listener supported production. Please visit babyboomersradio.com to learn more about supporting the program.
How to Prune Your Tomatoes to Keep Them Healthy: https://thecoeurdalenecoop.com/how-to-prune-your-tomatoes-to-keep-them-healthy/
Photos and descriptions of common tomato issues: https://thecoeurdalenecoop.com/podcast-11-how-to-grow-tomatoes-part-2/
Here is a link to How to Grow Tomatoes Part 1: https://thecoeurdalenecoop.com/podcast-10-how-to-grow-tomatoes-a-primer-for-success/
Interested in creating your own podcast? Zenith Exhibits Studios provides affordable podcast production services. Recording, Editing, Hosting, AI Transcription, and Publishing included for one low monthly price. Visit www.zenithexhibits.studios or call (208) 209-7170 to learn more.
Pastor John Bagorio talks from the book of Samuel and the meaning of the phrase It’s Darkest Just Before Dawn. Another meaning of the phrase “It’s darkest just before dawn” describes the fact that bad events often come in clusters. They seem to get worse and worse until it doesn’t seem like it can get any worse, then the cluster ends and things rapidly get better.
Sponsors:
Interested in creating your own podcast? Zenith Exhibits Studios provides affordable podcast production services. Recording, Editing, Hosting, AI Transcription, and Publishing included for one low monthly price. Visit www.zenithexhibits.studios or call (208) 209-7170 to learn more.
Dr Mary Peebles-Turner visits with Baby Boomers Radio to talk about how dental health impacts our regular health. We talk about how some medications cause dry mouth and what seniors can do to help avoid costly dental problems. We discuss ways to keep up your dental health based on different mobility challenges. We even talked about what drinks we should avoid to help stretch our dental investment dollar.
To learn more about Dr. Mary, please visit her dental practice website at broomfielddentist.com.
Baby Boomers Radio is a listener supported program. To learn more, visit babyboomersradio.com/support/.
Barry Rutten with WealthDefense Group shares his insight on money management and investment strategies during recessionary times. He shares his thoughts on how best seniors and Boomers can weather these financial challenges no matter if you are living on the fixed retirement income or if you are getting close to transitioning to retirement status.
To learn more about Barry and WealthDefense, visit wealthdefensegroup.com.
If you like what you heard, please subscribe to Baby Boomers Radio. If you feel like Baby Boomers Radio is a channel you’d like to support, please visit babyboomersradio.com/support. Pledging $3 a month helps Baby Boomers Radio cover the expenses to put on this program. $3 doesn’t sound like a lot, but when multiplied by a few hundred listeners, then $3 is perfect! Thank you for any support you can give.
Rx for a Broken Central Tomato Stem: https://thecoeurdalenecoop.com/how-to-repair-a-broken-tomato-plant-stem/
Oh snap! Did you accidentally break off the main stem of your tomato plant? Well, all is not lost, check out this blog post with photos to learn how to do a little first aid and hopefully, put things back together again!
Interested in creating your own podcast? Zenith Exhibits Studios provides affordable podcast production services. Recording, Editing, Hosting, AI Transcription, and Publishing included for one low monthly price. Visit www.zenithexhibits.studios or call (208) 209-7170 to learn more.
Dr Baktari and Ed talk about the impact COVID-19 has had on the healthcare system and what sort of precautions people should take when traveling.
To learn more about Dr. Jonathan Baktari, please visit baktarimd.com.
Baby Boomers Radio is a listener supported program. To learn more, visit babyboomersradio.com/support/.
Pastor John Bagorio talks about how important it is to choose who you listen too for life decisions because there is no plan B to life.
Sponsors:
Interested in creating your own podcast? Zenith Exhibits Studios provides affordable podcast production services. Recording, Editing, Hosting, AI Transcription, and Publishing included for one low monthly price. Visit www.zenithexhibits.studios or call (208) 209-7170 to learn more.
Alive Ventures is a venture capital business focused on improving the world for seniors. John Zapolski and Ed talked about how they came about to create the program and how it works. We also talked about how seniors could get involved and how entrepreneurs could capitalize on the vast senior marketplace.
To learn more about Alive Venture, please visit aliveventures.com. To get involved in their online community, visit joinalive.co.
Baby Boomers Radio is a listener supported production. Please visit babyboomersradio.com/support/ to learn more about supporting the production.
https://thecoeurdalenecoop.com/vegetable-plant-family-chart/
The Vegetable Plant Family chart will help you with your crop rotation plan!
Interested in creating your own podcast? Zenith Exhibits Studios provides affordable podcast production services. Recording, Editing, Hosting, AI Transcription, and Publishing included for one low monthly price. Visit www.zenithexhibits.studios or call (208) 209-7170 to learn more.
Pastor John Bagorio talks about procrastination and what it has caused people to miss out on.
Sponsors:
Baby Boomers Radio is a listener supported production. To learn more about becoming a supporter, please visit babyboomersradio.com/support/.
John talks about how and when to enroll in Medicare to avoid the Medicare late enrollment penalty. He shares information about which forms to complete and where to take those forms for best possible enrollment speed.
John talks about forms enrollment forms CMS-40B & CMS-L564 and how to fill out the important fields where to send the forms and how soon before your 65th birthday they should be sent.
Got questions? Want to talk with John? Visit nwmedicareadvisors.com or call (503) 313-4160 or email john@nwmedicareadvisors.com.
Baby Boomers Radio is a listener supported month audio magazine designed for seniors. To learn more about supporting the production, please visit babyboomersradio.com/support/.
In this episode I share information about a popular Amazon con the scammers are using to rob seniors and boomers. I review how it works and how to avoid getting taken by the bad guys.
Check Episode 17 & 18 from session one when we talked with FBI agent Schoffstall about elder scams and abuse.
Baby Boomers Radio is a listener supported production. Please visit babyboomersradio.com/support/ to learn more about supporting the production.
Want to get the most out of your garden this year? Of course you do -- and I'll share my tips on how you can with succession planting. With a little pre-planning and preparation, succession planting produces more food from your garden, extends your harvest time, maximizes garden space, and provides a continuous supply of vegetables over a longer period of time. Even in small gardens!
Baby Boomers Radio is a listener supported production focused on helping seniors combat loneliness. To learn more about how to support the program, please visit babyboomersradio.com/support/.
Donna-Marie shared stories about growing up in America in the 50’s and 60’s, the stories her parents shared, the lessons she learned from early life, and how those lessons influenced how she raised her children. Bonus: Donna-Marie shares advise for her great grand children—a great lesson for us all!
Baby Boomers Radio is a listener supported production. To learn more about becoming a supporter, please visit babyboomersradio.com/support/.
Author Sarajane Giere sits with Baby Boomers Radio to talk about her life and new book and the struggles she had as a military wife and the wife of a commercial pilot. We discuss her love of art and writing as a child, how she met her future husband, and how their 50 plus year long marriage survived a diagnosis of ALS.
You can purchase the book My Pilot on Amazon, Barnes & Noble, or Kobo.
You can learn more about Sarajane by visiting her website at sarajanegiere.com.
Baby Boomers Radio is a listener supported production. To learn more about supporting Baby Boomers Radio, please visit babyboomersradio.com/support/.
Pastor John Bagorio talks about the challenge of church attracting men to the word that leads to their miracle.
Would you like to support this style of podcast programing? Baby Boomers Radio is a listener supported program and through small contributions we are able to provide quality content designed for seniors and boomers. Please visit Support Baby Boomers Radio to make a secure online contribution.
Jim Flaherty sits with Baby Boomers Radio to talk about his life experiences and his new book Dear Old Friends. Jim and Ed talk about how to keep the spirit alive at the young age of 86. Jim shares his secret to energy and life balance.
To learn more about Jim, visit jamesbflaherty.com/
To read Jim’s book Dear Old Friends, visit amazon.com/dp/B09MJGH2DZ/
Baby Boomers Radio is a listener supported production. To learn more about supporting the program, please visit babyboomersradio.com/support/
John talks about Medicare Part A through D and explains how each part works, costs involved, and things to keep in mind when picking your plan.
Would you like to support this style of podcast programing? Baby Boomers Radio is a listener supported program and through small contributions we are able to provide quality content designed for seniors and boomers. Please visit Support Baby Boomers Radio to make a secure online contribution.
Ed Bejarana & Jim Hollingsworth talk about Jim’s editorial in the Coeur d’Alene Press regarding the primary elections kerfuffle of recent months. We discuss how it use to be acceptable for people to discuss politics, but now taboo. We talked about how to over come this dilemma.
Jim also shared information about his new book, Abortion Compassion, available through Amazon. Every life is precious, no matter how small. This book provides a dramatic picture of life from conception to birth. No matter our situation can we at least give these little ones the most precious thing of all, their lives?
Baby Boomers Radio is a listener supported program. To learn more, visit babyboomersradio.com/support/.
Show notes:
- Podcast #5 How to Interpret a Seed Packet: https://bit.ly/32TJf44
- Seed charts (downloadable PDFs): What Seed to Start Indoors or Direct Sow; When to Start Seeds Indoors; and Seed Germination Optimal Soil Temperature
- Seed starting info: The Couer d'Alene Coop's Garden Seed Series.
Pastor John Bagorio talks from Ezekiel Chapter 22 Verse 30 and how the act of being a good man is a dying art today.
Sponsors:
Interested in creating your own podcast? Zenith Exhibits Studios provides affordable podcast production services. Recording, Editing, Hosting, AI Transcription, and Publishing included for one low monthly price. Visit www.zenithexhibits.studios or call (208) 209-7170 to learn more.
John Pereira with NW Medicare Advisors sits down with Baby Boomers Radio to talk about what is new in Medicare for 2022 and how to take advantage of the still open enrollment period.
Got more questions or would just like to talk further with John, visit nwmedicareadvisors.com or call (503) 313-4160
Sponsors:
Interested in creating your own podcast? Zenith Exhibits Studios provides affordable podcast production services. Recording, Editing, Hosting, AI Transcription, and Publishing included for one low monthly price. Visit www.zenithexhibits.studios or call (208) 209-7170 to learn more.
Les Atchley with Atchley Financial sits down with Money Talk to talk about inflation and what Boomers on limited incomes can do to protect their nest egg from inflation.
To learn more about Les and Atchley Financial, visit atchleyfinancial.com or you can can them at (208) 664-1900.
If you like what you heard, please subscribe to Baby Boomers Radio. If you feel like Baby Boomers Radio is a channel you’d like to support, please visit babyboomersradio.com/support. Pledging $3 a month helps Baby Boomers Radio cover the expenses to put on this program. $3 doesn’t sound like a lot, but when multiplied by a few hundred listeners, then $3 is perfect! Thank you for any support you can give.
What's all the buzz about native bees and how are they different from honeybees? In this podcast, I'll visit with my special guest, Kara Carleton, Coordinator of the Idaho Master Gardener's program and native bee enthusiast, to discuss why native bees are so important in our gardens and what you can do to bring more of these hard-working, yet docile insects into your landscape.
Show Note Links:
- UI Extension Pollinator Resources and Plant Lists
- Idaho Master Gardeners Pollination Project Garden
- Crown Bees (great info and native bee keeping supplies)
- Xerces Society Pollinator Resource Center
Did you like what you heard? Please consider becoming a patron supporter of Baby Boomers Radio. Visit babyboomersradio.com/support and choose one of the monthly support options. As little at $3 a month when multiple by lots of members help outset the costs of producing a show like this.
Pastor John Bagorio shares a reading for Esther chapter 4 versus 14 thru 17.
Sponsors:
Interested in creating your own podcast? Zenith Exhibits Studios provides affordable podcast production services. Recording, Editing, Hosting, AI Transcription, and Publishing included for one low monthly price. Visit www.zenithexhibits.studios or call (208) 209-7170 to learn more.
David shares his life experience traveling around the world and building a financial nest egg through multiple recessions. As a financial manager in Bend, Oregon, David’s ideas on how to recession proof your retirement are easy to understand and simple to implement.
To learn more about David, visit davidrosell.com or rosellwealthmanagement.com. You can also call his office at (541) 385-8831
Are you ready to get growing? In this podcast we'll talk about the benefits of growing your own vegetables from seed and I'll help you decipher all that great information you'll find on a seed packet or in a seed catalog. From understanding terms like hybrid to days-to-maturity, you’ll be primed to begin growing your garden from seed!
Here are the show notes for today's episode.
Learn all about growing from seed! Read the Gardening Seed Series of articles here:
https://thecoeurdalenecoop.com/category/gardening/seeds/
Interested in learning more about the difference between organic seed and conventional seed? Read "Why Organic Matters" here: https://thecoeurdalenecoop.com/why-organic-seed-matters/
Interested in creating your own podcast? Zenith Exhibits Studios provides affordable podcast production services. Recording, Editing, Hosting, AI Transcription, and Publishing included for one low monthly price. Visit www.zenithexhibits.studios or call (208) 209-7170 to learn more.
Christmas or Thanksgiving Cactus? How to Tell: Is it a Christmas cactus, Thanksgiving cactus or an Easter cactus -- or is it even a cactus at all? Learn more about this often confusing plant and how to care for them.
Interested in creating your own podcast? Zenith Exhibits Studios provides affordable podcast production services. Recording, Editing, Hosting, AI Transcription, and Publishing included for one low monthly price. Visit www.zenithexhibits.studios or call (208) 209-7170 to learn more.
In today's episode Master Gardener Candace shares the one vital chore that should be done each fall -- and that's amending the soil. Learn the importance of adding compost and leaf mold in the fall, as well as how to make both types of amendments for your own garden. Love your soil and it will love you back!
Link to Left Mold: Solid Gold for Your Garden
Composting Basics: Adding compost to your garden in the fall is a great way to replenish the soil and ensure a healthy growing environment in the spring.
Interested in creating your own podcast? Zenith Exhibits Studios provides affordable podcast production services. Recording, Editing, Hosting, AI Transcription, and Publishing included for one low monthly price. Visit www.zenithexhibits.studios or call (208) 209-7170 to learn more.
In Episode 2 of Gardening in the Coop, Master Gardener, Candace Godwin offers several ways to extend your gardening season through late fall -- and possibly to next spring! She also shares the how-to's of planting fall garlic.
How to Grow & Harvest Garlic: https://thecoeurdalenecoop.com/how-to-grow-and-harvest-garlic-its-easy/
How to Extend Your Gardening Season with a Low Tunnel
https://bit.ly/3ispy7U
Sponsor link: University of Idaho Extension Kootenai County Idaho Master Gardener Program https://www.uidaho.edu/extension/county/kootenai/garden
Interested in creating your own podcast? Zenith Exhibits Studios provides affordable podcast production services. Recording, Editing, Hosting, AI Transcription, and Publishing included for one low monthly price. Visit www.zenithexhibits.studios or call (208) 209-7170 to learn more.
Rex Grace from Grace Insurance and Ed talk about the new Baby Boomers Program Understanding Medicare and then discuss issues surrounding medicare and traveling.
Sponsors:
Interested in creating your own podcast? Zenith Exhibits Studios provides affordable podcast production services. Recording, Editing, Hosting, AI Transcription, and Publishing included for one low monthly price. Visit www.zenithexhibits.studios or call (208) 209-7170 to learn more.
Pastor John Bagorio shares his story about an old woman who testified her faith.
Sponsors:
Interested in creating your own podcast? Zenith Exhibits Studios provides affordable podcast production services. Recording, Editing, Hosting, AI Transcription, and Publishing included for one low monthly price. Visit www.zenithexhibits.studios or call (208) 209-7170 to learn more.
In this first episode of The Coeur d’Alene Coop, Master Gardener Candace Godwin shares her secrets for ripening green tomatoes faster on the vine. She also discusses some great fall garden ideas.
Here is the link to the recipe for the Green Tomato Cake: https://thecoeurdalenecoop.com/got-green-tomatoes-this-recipe-takes-the-cake/
Interested in creating your own podcast? Zenith Exhibits Studios provides affordable podcast production services. Recording, Editing, Hosting, AI Transcription, and Publishing included for one low monthly price. Visit www.zenithexhibits.studios or call (208) 209-7170 to learn more.
Tom sits with Katherine and Daniel from Panhandle Health District to discuss the Senior Companions program, available in part with their partner organizations AmeriCorp and Area Agency on Aging to help with senior independence.
Senior Companions website: seniorcompanionsidaho.org
AmeriCorps website: americorps.gov/serve
Area Agency on Aging: aaani.org
Phone number: (208) 415-5177
nationalservice.gov
Panhandle Health District website: panhandlehealthdistrict.org
Fit-n-Fall program: https://panhandlehealthdistrict.org/fit-fall-proof/
Panhandle Health District phone number: (208) 415-5270
A portion of this program has been sponsored by Joe at F1 For Help. F1 For Help, for all your computer related issues in and around the North Idaho Region.
Tom & Ed highlight important information from previous episodes and share some stories about how the podcast has already helped people make important decisions.
A portion of this program has been sponsored by Joe at F1 For Help. F1 For Help, for all your computer related issues in and around the North Idaho Region.
Deep dive into things you should look for in a facility when thinking about placing a love one for care.
Links:
- www.alz.org
- How is Alzheimer's Disease Diagnosed?
- Treatments
- Plan for Your Future
- Alzheimer's & Dementia: Help & Support
- Upcoming education programs
- Support Groups
- Stages & Behaviors
- Resources for Alzheimer's/Dementia caregivers during COVID
- Dementia Road Map
- Dementia Safety Kit
- Alzheimer’s Association – Washington State Chapter Website
- Alzheimer's Association - Washington State Chapter Facebook Page
- Alzheimer's Association - Washington State Chapter Blog
- Alzheimer's Association - E-Newsletter
- Care Options
- Choosing a Residential Care Facility
Research
A portion of this program has been sponsored by Joe at F1 For Help. F1 For Help, for all your computer related issues in and around the North Idaho Region.
Tom & Joel discuss things to consider when making a decision on placing a loved one in a caregiving facility. They explore facility options, costs, and considerations to avoid transfer trauma.
Links:
- www.alz.org
- How is Alzheimer's Disease Diagnosed?
- Treatments
- Plan for Your Future
- Alzheimer's & Dementia: Help & Support
- Upcoming education programs
- Support Groups
- Stages & Behaviors
- Resources for Alzheimer's/Dementia caregivers during COVID
- Dementia Road Map
- Dementia Safety Kit
- Alzheimer’s Association – Washington State Chapter Website
- Alzheimer's Association - Washington State Chapter Facebook Page
- Alzheimer's Association - Washington State Chapter Blog
- Alzheimer's Association - E-Newsletter
- Care Options
- Choosing a Residential Care Facility
Research
A portion of this program has been sponsored by Joe at F1 For Help. F1 For Help, for all your computer related issues in and around the North Idaho Region.
Alzheimer’s disease and other dementias gradually diminish a person’s ability to communicate. Communication with a person afflicted with Alzheimer’s requires patience, understanding, and good listening skills. Many of the challenging behaviors associated with Alzheimer’s and other dementias come from the deteriorating brain and communication issues caused by that deterioration. Today our Podcast will focus on the importance of using Communication Strategies in Alzheimer’s and Dementia Care.
Links:
- www.alz.org
- How is Alzheimer's Disease Diagnosed?
- Treatments
- Plan for Your Future
- Alzheimer's & Dementia: Help & Support
- Upcoming education programs
- Support Groups
- Stages & Behaviors
- Resources for Alzheimer's/Dementia caregivers during COVID
- Dementia Road Map
- Dementia Safety Kit
- Alzheimer’s Association – Washington State Chapter Website
- Alzheimer's Association - Washington State Chapter Facebook Page
- Alzheimer's Association - Washington State Chapter Blog
- Alzheimer's Association - E-Newsletter
- Care Options
- Choosing a Residential Care Facility
Research
A portion of this program has been sponsored by Joe at F1 For Help. F1 For Help, for all your computer related issues in and around the North Idaho Region.
Alzheimer’s disease and other dementias gradually diminish a person’s ability to communicate. Communication with a person afflicted with Alzheimer’s requires patience, understanding, and good listening skills. Many of the challenging behaviors associated with Alzheimer’s and other dementias come from the deteriorating brain and communication issues caused by that deterioration. Today our Podcast will focus on the importance of using Communication Strategies in Alzheimer’s and Dementia Care.
Links:
www.alz.org
How is Alzheimer's Disease Diagnosed?
Treatments
Plan for Your Future
Alzheimer's & Dementia: Help & Support
Upcoming education programs
Support Groups
Stages & Behaviors
Resources for Alzheimer's/Dementia caregivers during COVID
Dementia Road Map
Dementia Safety Kit
Alzheimer’s Association – Washington State Chapter Website
Alzheimer's Association - Washington State Chapter Facebook Page
Alzheimer's Association - Washington State Chapter Blog
Alzheimer's Association - E-Newsletter
Care Options
Choosing a Residential Care Facility
Research
A portion of this program has been sponsored by Joe at F1 For Help. F1 For Help, for all your computer related issues in and around the North Idaho Region.
Tom & Paul discuss ways minimize taxation on retirement dollars and how one dollar can do the work of many dollars, thereby leveraging your wealth. They discuss the Linked Benefit Annuity Hybrid, Linked Benefit Life Insurance Hybrid, and Accelerated Benefit Rider on Life Insurance
Tax quote from the Helvering v. Gregory case in the Second Circuit, later affirmed by the Supreme Court, Judge Learned Hand, that “anyone may arrange his affairs so that his taxes shall be as low as possible; he is not bound to choose that pattern which best pays the treasury.”
A portion of this program has been sponsored by Joe at F1 For Help. F1 For Help, for all your computer related issues in and around the North Idaho Region.
Paul Elliott
Elliott Capital Management
Paul@elliottcm.com
(208)659-7887
elliottcapitalmgmt.com
Tom & Tina discuss the option of Adult Family Homes as a living option for seniors. They discuss the types of services and the benefits of a more individualized living environments, and also challenges presented with COVID-19.
Tina Jewitt
Cedar Gardens Adult Family Home
http://www.oslongview.com/Cedar-Gardens-Adult-Family-Home.html
A portion of this program has been sponsored by Joe at F1 For Help. F1 For Help, for all your computer related issues in and around the North Idaho Region.
Part 2 of 2 - Tom interviews Eowyn Sallis from the Rockwood South Hill Retirement Community located in Spokane, WA. Tom & Eowyn discuss the various amenities available to residence with an eye towards helping seniors understand the importance of planning a head for your retirement years.
Eowyn Sallis
Director of Marketing
2903 E. 25th Ave.
Spokane, WA 99223
T: 509-536-6701
www.rockwoodretirement.org
www.rockwoodatwhitworth.com
Part 1 of 2 - Tom interviews Eowyn Sallis from the Rockwood South Hill Retirement Community located in Spokane, WA. Tom & Eowyn discuss the various amenities available to residence with an eye towards helping seniors understand the importance of planning a head for your retirement years.
Eowyn Sallis
Director of Marketing
2903 E. 25th Ave.
Spokane, WA 99223
T: 509-536-6701
- www.rockwoodretirement.org
- www.rockwoodatwhitworth.com
Tom and Stacey discuss the role of a guardian ad litem, requirements and qualifications, roles and responsibilities, and important things to know when hiring a professional guardian.
Stacey Bollinger
Halo Guardianship Services
Certified Professional Guardian in the State of Washington
If someone wanted to learn more about guardianship…
- Washington State Certified Professional Guardians - https://www.courts.wa.gov/guardianportal/ & https://wapg.org
- ”Local Guardians” in an internet search
- Elder Law Attorneys
Today we are going to spend some time discussing medication administration. Many times entry into the senior healthcare system is a result of errors in medication administration. Perhaps failure to take the prescribed medication can result into a trip to your physician’s office or more often the emergency room. Tom discusses options using the Hero Medication system with Joey Neal, Vice President with HERO.
To learn more about the HERO, visit www.herohealth.com - use wallpaper50 to save $50 off the initiation fee for signing up with HERO.
A portion of this program has been sponsored by Joe at F1 For Help. F1 For Help, for all your computer related issues in and around the North Idaho Region.
Steve Laforte & Maryruth Butler from Cascadia Healthcare join Tom to discuss skilled nursing and longterm care options for seniors.
You can learn more about Cascadia Healthcare by visiting www.cascadiahc.com
Sponsors for today's episode:
F1 For Help - The very best in local computer technical support - visit www.f1forhelp.net
Dr. Sudhur Isharwal
Dr. Isharwal attended medical school at PT B. D. Sharma PGIMS. He spent two years as a postdoctoral fellow at the University of Pittsburgh, with a research focus on prostate cancer development and progression. Having completed his fellowship training at the Cleveland Clinic, he was part of a Clinical Research Scholars Program at Case Western Reserve University and completed his Urology residency at the University of Nebraska. A Board-Certified Urology Oncologist, Dr. Isharwal is currently on staff at Oregon Health Sciences University in Portland, Oregon. Dr. Sudhur is also an assistant professor. He has also authored several research papers and has presented his work at multiple national meetings.
Attachments/Links:
American Cancer Society - https://www.cancer.org/cancer/prostate-cancer.html
Prostate Cancer Foundation - https://www.pcf.org
Dr. Sudhur Isharwal
Dr. Isharwal attended medical school at PT B. D. Sharma PGIMS. He spent two years as a postdoctoral fellow at the University of Pittsburgh, with a research focus on prostate cancer development and progression. Having completed his fellowship training at the Cleveland Clinic, he was part of a Clinical Research Scholars Program at Case Western Reserve University and completed his Urology residency at the University of Nebraska. A Board-Certified Urology Oncologist, Dr. Isharwal is currently on staff at Oregon Health Sciences University in Portland, Oregon. Dr. Sudhur is also an assistant professor. He has also authored several research papers and has presented his work at multiple national meetings.
Attachments/Links:
American Cancer Society - https://www.cancer.org/cancer/prostate-cancer.html
Prostate Cancer Foundation - https://www.pcf.org
Tom, Tim & Ed discuss computer and cell phone issues that can lead to elder scams and cyber abuse and way to protect yourself on the internet.
Corey Kennan from Home Instead Caregiving joined Tom for a discuss on the option to bring a caregiver into the home to help with day-to-day living. Tom and Corey touch on some critical things to consider when hiring an employee to help with you or your parents.
A portion of this podcast was sponsored by F1 For Help, visit f1forhelp.net for more information and to support our sponsor.
Understanding the person you are potentially hiring to provide care for a loved one is one of the most important decisions you will make. Tom and Shanti discuss things you should look out for when considering hiring someone.
A portion of this podcast was sponsored by F1 For Help, visit f1forhelp.net for more information and to support our sponsor.
Tom and Shanti discuss the important considerations when hiring a caregiver to take care of a loved one. From costs, paying practices, insurance, and legal matters; understanding the process of hiring a caregiver is very important.
A portion of this podcast was sponsored by F1 For Help, visit f1forhelp.net for more information and to support our sponsor.
A great fiduciary can provide valuable meaningful help at important time of your life. Tom and John discuss the important aspects of this critical role for seniors as they age as well as pitfalls to avoid senior exploitation.
A portion of this podcast was sponsored by F1 For Help, visit f1forhelp.net for more information and to support our sponsor.
Part 1 topics:
• Why seniors are targeted
• Romance Scam
• Grandparent Scam
Part 2 topics:
• Government Impersonation Scam
• Social Media Scam
• Sweepstakes Scam
• Why seniors might not report being scammed
• What to do if you are scammed
• Home Repair Scam
• Family Caregiver Scam
FBI reference material for scams and elder fraud:
https://www.fbi.gov/scams-and-safety
https://www.fbi.gov/scams-and-safety/common-scams-and-crimes/elder-fraud
http://www.ic3.gov
A portion of this podcast was sponsored by F1 For Help, visit f1forhelp.net for more information and to support our sponsor.
Part 1 topics:
• Why seniors are targeted
• Romance Scam
• Grandparent Scam
Part 2 topics:
• Government Impersonation Scam
• Social Media Scam
• Sweepstakes Scam
• Why seniors might not report being scammed
• What to do if you are scammed
• Home Repair Scam
• Family Caregiver Scam
FBI reference material for scams and elder fraud:
https://www.fbi.gov/scams-and-safety
https://www.fbi.gov/scams-and-safety/common-scams-and-crimes/elder-fraud
http://www.ic3.gov
A portion of this podcast was sponsored by F1 For Help, visit f1forhelp.net for more information and to support our sponsor.
Understanding home hospice care can be an important end of life decision. Greg Pang and Tom discuss the benefits and options involved.
The demand to stay in your home is growing because Baby Boomers are more independent as a generation. They demand more independence, they demand to stay at home. So Home health services have been growing like crazy over the last 15 years. Tom and Greg Pang discuss options for seniors.
Greg Pang, President & CEO
Community Home Health & Hospice
www.chhh.org
has served with Community since September 2005. A native of Washington State, he has almost 30 years’ experience providing compassionate, community-based care. Greg’s prior experience included home health and hospice services provided by Good Samaritan Home Health & Hospice in Puyallup, WA and Group Health Cooperative in Seattle, WA
Greg earned a bachelor’s degree in speech communication and a master’s degree in health administration at the University of Washington (Seattle, WA). Certified as a home/hospice care executive, Greg is published in professional journals and has presented at national, state and local conferences. He is passionate about providing community-based services to the growing elderly population so they may “age in place” and remain in their homes as long as possible.
Greg serves on the board of the Home Care Association of Washington.
Show TranscriptWelcome to it's just wallpaper, a podcast dedicated to providing solutions for seniors and families dealing with life changing health and living conditions. Your host Tom Deutsch is a graduate of Columbia University School of Public Health and administrative medicine. Tom brings 43 years of executive experience working for the care and well being of senior citizens with credentials and licenses as a nursing home administrator, life insurance agent with a long term care endorsement, professional guardian and court appointed guardian ad litem in over 1500 cases. Tom brings a lifetime of knowledge to help you and your family make the best decisions you can. And now from our studio in Coeur d'Alene, Idaho, here is Tom Deutsch.
Welcome to it's just wallpaper. My name is Ed Bejarana. And I am the producer of the program. In this episode, Tom and I will revisit the information we've covered so far, and get a personal take from Tom, on how these episodes should help seniors make life focused decisions. Good afternoon, Tom. Thank you for joining me today on this special episode.
Well, it's uh, as always, it's great to be with you. As you know, I retired a couple of years ago, and have been trying to find a forum to share information and my life experiences to help our seniors and their families. It is gratifying to receive the support that has been forthcoming from our guests that had been willing to share their expertise and enable me to continue this work
well in the program. So far, at least from my vantage point, has been just going great. Tom, for the listeners who may not have been listening since we went live on October 1. Can you share a little bit about the name? It's just wallpaper?
Absolutely. As our listeners know, and for new listeners for many years, I work behind the desk of multiple health care facilities. I personally witnessed potential patients and their families make placement decisions based upon decorative items such as wallpaper, rather than what really mattered. Can the appropriate care be delivered? Perhaps another way of saying it would be the decision was made based upon who had the best mousetrap and example. At one point in my career, my wife and I owned and operated four adult family homes. A son and daughter toured our home as they struggled with the placement decision for their mother. In the end, they selected another facility. As I knew the family, I asked them, Why did they choose another home instead of the one that we ran? They told me that they like to shower better. Our main shower was a prefab unit and my competitors was tiled.
Tom, we went live with two episodes with Kerry Espinosa, the first entitled Medicare Part A, B, C and D. And the second one titled Medicaid Advantage plans and Medicare supplement plans explained with Medicare open enrollment season that started on October 15. I'd say those episodes were timed perfect. What were the big takeaways for the listeners? And what feedback have you received from those who have listened?
And I think the major the major takeaway is that the consumer has to make very important decisions that will affect their health care delivery. As a Medicare consumer today during open enrollment, my mailbox is flooded with advertisements, television is filled with commercials and my phone is ringing. You need to ask questions and not be influenced by a sales pitch that perhaps you don't really understand. I had a friend call me and told me that he was going to switch to an advantage plan because they had dental. He told me his wife had had a root canal the previous year, and they had to pay for it out of pocket. I told them the first call the plan and asked whether root canals were a covered expense. The plan he was looking at may only have covered perhaps annual exams and routine cleaning.
Medicare is one of those very confusing parts of life. I know every Medicare insurance agent in America hosts seminars and Medicare. But I hear from so many agents that they struggle to get people to attend. Why do you think seniors are more open to listening to a podcast sharing information about Medicare?
Well, I think today the odd So, first answer is the COVID environment that we live in. The seminar type programming that we had for so many years is just not working. I believe the podcast presentation is by far safer, and then presented within a concentrated timeframe. The listener can take the information, play it again if necessary, and begin to formulate questions to make sure they are purchasing the product that works for them.
I'm going to jump around a little now. Episode Four was titled Are you ready? The importance of legal documents and your guest was attorney Rebecca Iman. She was also your guest on episode nine. When his elder Guardian Guardian ship necessary in Episode 10, you can't give it away senior financial considerations when planning for long term care. All three episodes were fascinating to me, and I'm I'm not up the retirement age. But what are the big takeaways you feel our listeners gained from these episodes?
Well, you know, the biggest takeaway is to get your planning in order. Again, look, and we both know I'm not an attorney and I can't give legal advice. But I have seen time after time, the emotional and financial toll taken by not having documents properly prepared. This should prevent questions as to who you want in charge of your decision making. This should prevent questions as to who you want charge for decision making. Should that be necessary? what your thoughts are on end of life decision making? How your real estate should be handled? And who should be in charge.
You have lots of experience helping seniors with long term care in your 40 years. What do you feel is the biggest failing of our health care system for seniors?
I would venture to say that there is too much misunderstanding as to what Medicare will pay for a long with a real lack of understanding the real cost of long term care.
Now episodes five and six were with nurse practitioner Mary Buckland and YouTube discussed how to recognize and monitor ongoing clinical warning indicators for seniors. What do you feel was the important takeaway for our listeners,
the major takeaway is stay involved with your parents care, and to be proactive and be a proactive good observer. Go to the physician appointments, monitor their medication, look for signs of poor hygiene and nutrition, do a home safety evaluation. Should there be a need for placement continue to stay involved and be a good historian, especially in today's dynamic healthcare delivery system.
I shared the story of my mom dying from complications brought on by Alzheimer's. Having watched my mom make the transition from a vibrant, well educated, strong woman to the frail woman with no memory of her past or the people around her. I know the warning signs to watch for a critical at least in my book. Right after nurse Mary Bucklin you had Dr. Steve mark, come on and talk about dementia testing and care. What do you feel was the big takeaway from those episodes,
as emphasized with nurse Mary Bucklin and Dr. Steven? stay involved, educate yourself. There are things that can be done to make life simpler and less complex. With the dementia patient. It is critical that family be there, understand the illness, seek professional guidance and make the very tough decisions. I know that my own parents had a better quality of life with my brother and I involved and providing oversight
so much of life for children of elder parents who struggle with health issues. It's juggling two priorities. On one hand, we have our work and family at home and then we have a parent or loved one who might need full time long term care. Your latest guest was Ed Stone who talked about long term care insurance. What was the big takeaway from that episode you feel our listeners should note
bottom line. If you have insurance, especially Long Term Care Insurance, you have choices. Long Term Care is only Going to get more expensive. And we see evidence of that every day, the time to buy it is not when you recognize the impact of clinical science of aging, when you can't get coverage, if you can afford it, talk to an agent about options. I am 72. And my wife and I bought that insurance 20 years ago.
Tom, you truly have a heart for health care? Do you miss working full time?
Let's turn the question around. What I enjoy now is to be able to continue to help. I was recently at the store and was approached by a friend whose father was in the hospital. As discharge was imminent, the family was at odds with what to do. I was gratified that I was brought into the conversation. And I could make suggestions.
So what do you hope to accomplish with this podcast,
it is my dream, to continue to bring useful information forward to enable seniors and their families to make appropriate decisions the first time.
So looking ahead, we are going to be talking about home health care, hospice, patient advocacy, and dozens of other topics. Thinking about those folks who are either struggling with health issues themselves, have children who have parents starting to show signs of health challenges on the horizon. What are your suggestions on how they should use this podcast?
And I think that these folks that are listening, should use these podcasts as a stepping stone to ask more questions, and perhaps further use the links that we are providing to ask more information.
And I and I didn't give Tom any advanced warning on this question. And he's looking on the paper now because we're going off a script. But Tom, let me ask you kind of a personal question. When you approached me to do this podcast originally, you you want it to disseminate knowledge. And I kind of sensed that it was almost as much for your own. I don't know if health or sanity is the right way to put it. But it felt to me like this podcast production was just about as therapeutic for you, as it is the the seniors that you're looking to help, can you kind of shed some light in my on the mark here,
I think you're totally on the mark. I you know, I retired about two and a half years ago, and, you know, frankly, became somewhat stagnant and, and bringing the various guests to the program, I'm learning again, and I'm learning that the marketplace keeps changing, there are many new concepts that are being considered, we're going to be talking to a manufacturer of a medication distribution machine that helps seniors to make sure they take their meds on time. We have excellent speakers, I've had the opportunity to interchange with becoming aware of new vocations within the health care delivery system. So I mean, if anything, this is just give me more purpose, and more opportunity to help people,
you know, and I always say, when folks ask, yeah, I have a bookshelf full of books, I do a lot of electronic books, I read constantly, I'm learning constantly. And I, I always say to my friends that when I when I end the thirst for knowledge, I know that's when it's my time to move on. Being a podcast enthusiast, I look at the opportunity to gain knowledge from people and you seem to have these connections to some of the greatest knowledge in the industry. How are you able to use those relationships you've built over a 40 year career and and chart out a education program for your listeners.
I think it just began with the the first podcast, and then I get energized. And I think of a segue on to the next podcast. And then from there, I think about the next podcast and and some of the folks that have come to help. And the guests that we've had have given me ideas for other podcasts. And so at this point, we have podcasts planned well into 2021 at this point, and we're just sitting here in the middle of October. And
I also look at right now during covid pandemic, people, especially, you know our age and older they're really feeling isolated. In assisted living facilities, they're being separated from their family members with limited visitations, limited outings, limited exposure, I felt kind of the underpinning in these first 12 episodes that we've done. That it, it's more than just a dissemination of knowledge. You have a tone of friendship of kinship, your guests. They have a tone of sincerity of caring. Did you plan on that? Or was this purely accidental? Do you see the the potential for this podcast, transcending the education and really becoming an opportunity for seniors to expand their connection into the world? Absolutely.
And I have just been struck by the support I've gotten from the folks that have been helping us.
Well, thank you, Tom. It really has been a joy. You know, it's a lot of work to produce a program like this. But they say that if you do a job you love you never work a day of your life. And I truly do feel that way. Do you have any final words that you'd like to share with the listeners,
ask questions, always ask questions. If you ask the question. You'll know that you're doing the right thing.
Well, thank you, Tom. And thank you to you the listener, thank you for tuning in. Thank you for taking the time to share these episodes with your friends with your family. We can only reach more people if you take the time to make that connection. Thank you and have a good day.
Thank you for tuning into. It's just wallpaper. Please share this episode with your friends and help us reach more seniors needing help with health critical decisions. Visit it just wallpaper.com to catch up on past episodes or find us on Facebook at it's just wallpaper to ask a question.
In the second of two episodes, Edward Stone gives further definition to the long-term care products and discusses future growth and costs.
Cost of Care Calculators:
Mutual of Omaha
Nationwide Insurance
Show Transcript
Welcome to it's just wallpaper, a podcast dedicated to providing solutions for seniors and families dealing with life changing health and living conditions. Your host Tom Deutsch is a graduate of Columbia University School of Public Health and administrative medicine. Tom brings 43 years of executive experience working for the care and well being of senior citizens with credentials and licenses as a nursing home administrator, life insurance agent with a long term care endorsement, professional guardian and court appointed guardian ad litem in over 1500 cases. Tom brings a lifetime of knowledge to help you and your family make the best decisions you can. And now from our studio in Coeur d'Alene, Idaho. Here's Tom.
Welcome to it's just wallpaper where my guests and I aim to provide our listeners with thoughtful information and resources to enable them to make the best decisions the first time. Today we are going to discuss Long Term Care Insurance. Joining me from his home in Vermont is Ed stone. This just don't work for Crump Life Insurance Services, where he's responsible for managing existing producer relationships, and building new relationships through referral and marketing initiatives prior to joining Crump insurance and spent 16 years managing the sale of long term care products, as regional sales director and regional sales vice president with two major insurance carriers. Prior to that he spent seven years as National Sales Manager for a national brokerage agency. Before I welcome Mr. Stone, I would like to give you a recap of where we were, when we last spoke with him, we had got a really good overview, which I would encourage you to visit of the insurance industry, and long term care insurance industry. And we also talked in depth about the cost of care. Ed gave us two or two to three different calculators that are available to us where you can get a good idea of cost of care in the community or your community. And we'll provide this on our website as part of our program. So having said that, welcome, again, Ed Stone.
Thank you, Tom, pleasure to be with you.
What I'd like to do is talk about the most common product that you see sold in the long term care market today,
for sure, there's really three different types of products that you find out in the marketplace. There's what we call traditional long term care. There's what we call linked benefits, or hybrid asset base. And you may hear one of those three terms. And then there are products that are annuity based long term care. The traditional Long Term Care is the product that started the whole industry that we were talking about in our last session. It's a product that is a pure health product, it has no other features to it, you use it strictly for you know, for the long term care services. It doesn't develop any equity in it or anything like that. There are ways to join policies together between couples etc. and paths, you know, unused benefits to each other when you when you pass away or something like that. The industry has has morphed into a second area called hybrid products. And these basically were designed based on a life insurance policy with long term care features. And these particular type of products. The major reason for it is the long term care, ability to use money to be used for long term care. The secondary reason is, with the ones I talked about a moment ago, a lot of people said, well, gee, what if I have this policy for 30 years and step off the curb? get hit by a bus, I wasted all my money. There's nothing you know, nothing back. So the insurance industry said okay, we're pretty certain from our research that if you live long enough, you'll die haha. Well, let's build it on a life insurance platform charged more money because theoretically, there's a death benefit if you never use it, or if you only use some of it. And also, if you wanted to cash it out, there's some money you can get back. So those are the two main ones. But what we're seeing now is really very interesting. Because there's always been a product in the insurance industry called an annuity. Some of the listeners may have an annuity. an annuity is basically a sum of money that sits in an account the insurance company grows tax deferred, which is great and grows and grows and then you can cash it out. You got to pay taxes on anything not given tax and legal bites here. Of course, you can you pay taxes on a new game, or you can even turn it into a lifetime income. Well, believe it or not the federal government actually wants you to do something about your long term care potential long term care needs, they are our friends. Because they pass something back in 2010, called the pension Protection Act pretty easy to remember pension Protection Act. And in that act, they said, money that goes into a long term care annuity, if it's used for long term care services, the money you put in, and any money that it grew to comes out income tax free, as long as you're using it for long term care. So this has opened up a whole new part of the market. Because the other two products you have to have never be able to pass underwriting gotta be healthy enough to pass underwriting. annuity products are pretty much in your sign the application, some of them may ask a few health questions or even a nursing home etc. So what we're finding is folks that can't get the traditional policies or the hybrid are now taking some what I call lazy money money that's sitting in a CD or under the mattress that they're going to use for long term care down the line. And they're leveraging it because they get more money for the long term care services than they would if they just paid dollar took dollar for dollar out of whatever it was in. In terms of what's being sold the most right now or purchase the most, it is a hybrid product. And that has to do with a number of factors, including the the mistakes we talked about last time on the old product that's kind of made people a little skittish about products where you know, that were underpriced and could have raised increases. Plus, a lot of people are saying, look, you know, I may never need this. So let me let me at least hedge my bet a little bit with some life insurance. If I don't ever use my long term care, annuities, though, I think they're going to be something that you're gonna see a lot more people looking at, because the money sitting there, and they'd like to leverage it and do do better on their taxes. long answer to a short question, but that's kind of where it is.
Now, is there inflation protection built into these policies?
They're not built in, but you purchased them as an add on rider. And we tell people, you know, if you're under 70, you probably want to look at an inflation rider. Because the average claim age today and remember what the definition of average is, of course, half half and a half. The average claim age today is about 83. So if I was 60, I got probably 2025 years before I might incur a claim. Now the thousand dollars I have today, I'll get a check for 1025 years, but what's it going to buy? So we really encourage younger people to consider inflating the policy just keeps inflating, inflating, inflating till you go on claim and then it actually continues to inflate after you are on claim. But that's more
Yeah. But at this point, that's an add on to the policy.
It is an extra cost. I think it's an option on the car, you got white walls you got paid for.
Right. And that's something our listeners should be mindful of. What about triggers? Suppose you know, you just can't walk into a care facility doesn't the carrier has to agree that that's what you need?
Yeah, that's that's a very interesting part. Because a lot of what I hear clients say is I don't want to do by this because I read about this little lady who had a policy nursing home policy for 30 years, she went to file a claim and the big bad insurance company, you know, beat her out of her money. And that's absolutely true. Until 1996 in 1996, again, our friends in Washington this time I'm calling our friends, our friends in Washington standardised how claims are triggered. And it has to be what's called a tax qualified has nothing to do with tax deductions, but a tax qualified Long Term Care Plan. As the standardized triggers on all the carriers, it works like this. Tom, your doctor says to Xyz insurance company due to illness accident are just getting older, you can no longer do to have your six activities of daily living. These are what I call the first 20 minutes of your day, eating dressing toileting, transferring continence and feeding yourself. You do these things before you know it, you're off on your way out the door. Your doctor says the insurance company he can no longer do two of these six, and we expect it to last at least 90 days. So this isn't Tom stepped off the curb, broke his ankle, got a calf was on crutches for three weeks and this gets better. This is chronic. So if that occurs to have 690 days, you start to get your money so to speak. Or if you're diagnosed with a diagnosed cognitive disorder, Alzheimer's, dementia, you start to get your money. So it's there's there's no physical they'll put you on treadmill make you lift a bunch of weights, it's strictly your doctor telling the insurance carrier in my medical opinion, Tom can no longer do two of his six activities due to this. That's how it works pretty simple now
so Add, when people are considering their part this these policies, can they also negotiate waiting periods, like 30 days to get benefits? 60 or 90 days? So how does that work?
Yeah, absolutely a real good analogy is your car insurance, you can have a $200 deductible 500,000. So you have a wreck, you pay the first 200 500 1000, then your car insurance company kicks in starts paying right? You can do the same thing with your long term care policy, you want it to kick in immediately. As soon as those triggers are verified, you can have a zero day, you can have a 30 day, 60, day 90 day. And the company says if you got 90 days, as soon as you start on claim, and you start to get you know, you have 90 days of that you pay yourself then we'll start paying out of your policy. So yeah, it's obviously the shorter the waiting period, the more expensive because you're putting the company on the hook even sooner.
Do you have to constantly re qualify for benefits?
that varies by carrier? But the short answer is yes, all of them ask you to what's called recertified that you still are unable to do to have six ADLs are cognitive and obviously cognitive, nobody seems to be getting better from it. So most of the carriers want to see every six months or a year a statement from your care provider that, you know, Tom still is unable to do to have his six or he's still cognitively impaired.
The next question that comes to mind is, what is all of this cost? Can you give us some ideas about what long term care insurance costs today? recognizing that there's so many different ways to go on policy?
Mm hmm. Yeah, there is definitely a custom design suit. That's what I tell clients that it's, you know, it's not one size fits all what Tom need that may need something different, when Tom wants has benefited at once it's sooner, etc. and that all affects the cost. The other thing I like to tell people, I'm going to ask the question, but the other thing I like to tell people is, it can be whatever you want it to be. In other words, this isn't a a benefit purchase, it's a money purchase, whatever you can put into your budgets today, and your projected retirement income to paper, to have an insurance policy, the carrier can cut can come back into a benefit plan based upon that budget, you can pay it off in a single time, you can do it over 10 years, 20 years, you can pay on for lifetime as a number of different ways. And that obviously all effects, you know the cost of the the monthly or annual premium. But to give you a kind of a ballpark a $200 a day three year benefit period, another policy that would pay for, you know, up to three years, for a couple 860 with some inflation, you know, to make sure it grows, you're probably looking for traditional long term care that first one, somewhere around five to $6,000 a year for the couple. For the ones that have the life insurance where you could live die or quick get money or give money if you pass away or cash out, you probably add about 40% of that premium for a couple. But again, as I'm giving you a really, really wide ballpark figures here, because it has nothing to do with areas of the country what, but the policy costs in California, costs in Connecticut type of thing. There are a few states where there's some small variations in premiums, but it's pretty much standard premiums across the country. It just comes down to how much you want when you want to start and how long you want to last. And you want to put in a track player on the car and mag wheels and everything else and I'm going to cost you.
So let's talk about premiums and whether or not they stay level. And that's sort of a loaded question, because we talked off Mike earlier. And we were talking about the fact that my wife and I purchased Long Term Care Insurance some 20 years ago. And over time, we've seen a bump in rates. So what can you tell? And I would imagine that and we've seen a higher bump in rates more recently than we've had in the past. So throwing that on the table. What can you tell our listeners?
Well, there's a number of things you can do. There are products out there that the premium that you're quoted that is issued at the time, usually the policy is guaranteed never to go up. It's locked in what you see is what you get it can they can't come back and say gee, we made a mistake, we need more money from you. There are ones that say we do reserve the right every year to go to the insurance department in the state and show them justification actuarial justification that we need to raise premiums, and it's up to the insurance commissioners in the state. And I can tell you that it varies by state. Some states are what I would call incredibly consumer protective. Some states are more lenient towards the insurance company. Having said that, it's getting tougher and tougher. Because of some other regulations that were put in place for insurance companies to to lowball their premiums and then expect to be able to walk in the door to your insurance department and get a rate increase. So that's what's led to a lot of the higher prices on the products from, say, 10 years ago. But it can be done. They can't pick on you, because you had a claim, or you got older, they can't pick on, on, you know, several people, but not everybody else. If they get a rate increase improved in the state, it's for everybody in the state that bought that same policy that you have. So they can't you know, it can't they can't come in and pick on men or women or, you know, young or old. Everybody in the state gets the rate increase. Yeah, that's how it's working. And yes, it's been a lot more lately, a lot lately.
Yes, I will second that. So what are the steps necessary to obtain coverage,
you fill out an application with your agents, they they will do a, they'll do several things that are kind of behind the curtain that are electronically done. One is what's called an MIB medical information bureau search. They're just looking to see if you have any applications out there with other companies, or if you did, and where they declined, and why would they decline. They also do and this is really important for folks to know, they do what's called a prescription drug database search. Every time you get a prescription filled it at CVS, Walgreens, or Kmart, or whatever, or even through your mail order. It's in a database. So the insurance companies are looking at your application, they're comparing it to what they see on your database. And if you didn't tell them something that they see in the database, they're going to call big timeout and do a whole lot of investigation.
Did they do cognitive testing,
that was the next thing. They they're all doing what are called telephone interviews. Now, depending upon your age, first of all, they last about an hour minimum. based on your age, they may just go through the application, verify the information, you know, ask you what day, what day it is, what month it is, etc. But at the older ages, and I'm going to say older ages being 59. and above, they're going to do a pretty significant cognitive screen. Because the largest percentage of claims today are not for a broken hip. They're for a broken brain. cognitive disorders are the ones that are scaring the bejesus out of the underwriters, because you can fix a broken hip as brains broken, we haven't figured out how to fix that yet. So you can be perfectly healthy, but need lots of care. And obviously going on plane, these cognitive screens can be pretty in depth, they can make you think that you're the dumbest thing that ever stood up on two feet, the types of questions even if you got a PhD in microbiology or something. But the it these are tested theory, not theories, but tested tests that they know, give them a baseline for recall, which is really the big problem and the recall starts to go. That's when things go south, so to speak. They don't put you through physical Jonathan, run on treadmill, you don't have to give blood or urine that sort of thing. It's pretty much the AP cognitive test, the prescription drug database search, that sort of thing.
So next question. You know, what happens if your insurance company goes under? Are they insured? Or is there protection?
Since you've asked the question I can answer as a licensed agent, I can't lead with this. I can't use this as a sales inducement that's illegal in all 50 states. But there is something it's not the FDIC, there's something called the life and health guarantee fund. Every state has a life and health guarantee fund for life insurance and health insurance products. It's funded by the insurance company. And how they fund it is it's based upon a percentage of the premiums that they collect in that particular state their tax for lack of a better word. It is an attack, but they're they're done for X amount of money every year goes into this fund. So it's all the company life and health. So let's say Acme insurance company, unfortunately, went bankrupt. The first thing that happens is the State Department of Insurance takes them over throws out the guys that ran it in the ground for whatever reason, puts other people in to try and rehabilitate it. If it's clear that they can't rehabilitate it, that it's going to go under, they then take all the assets of the insurance company and put them out in the market. And carriers come over and say, Well, let me look at this block of long term care insurance. Let me see how it was underwritten. Let me see the claims. Let me see the premiums. If they want to buy it, they'll make an offer. It may be 50 cents on the dollar of what it's actually worth or maybe whatever. If that doesn't work, if it's so bad that nobody wants it. It then becomes part of the life and health guarantee association that actually becomes the people paying the claims. But there's a maximum amount like FDIC is $100,000 per account or something. Every state's different but most of them are around $300,000. So if your policy had $300,000 or less Benefits. And that company went under, you'd be making your claim and the life and health care fund would pay it. That was 500,000. They paid 300,000 and you lost the 200,000. So it's again, it's not a government agency. It could go away. But it's been there for quite a long, long time.
Mr. Stone, we run out of time, I want to thank you for this great podcast, you've given the listeners as well as myself, some great tools, some great, great education. And I thank you again for being with us.
I appreciate the opportunity to talk about what I think is a very important subject for for everybody here in our country. Appreciate the type thing.
Thank you for tuning into. It's just wallpaper. Please share this episode with your friends and help us reach more seniors needing help with health critical decisions. Visit it just wallpaper.com to catch up on past episodes or find us on Facebook at it's just wallpaper to ask a question.
In the first of two episodes, long-term care specialist Edward Stone gives us a history of long-term care insurance, relative costs of the product, and current costs of care.
Cost of Care Calculators:
Mutual of Omaha
Nationwide Insurance
Show Transcript
Miranda Hamilton 0:00
Welcome to it's just wallpaper, a podcast dedicated to providing solutions for seniors and families dealing with life changing health and living conditions. Your host Tom Deutsch is a graduate of Columbia University School of Public Health and administrative medicine. Tom brings 43 years of executive experience working for the care and well being of senior citizens with credentials and licenses as a nursing home administrator, life insurance agent with a long term care endorsement, professional guardian and court appointed guardian ad litem in over 1500 cases. Tom brings a lifetime of knowledge to help you and your family make the best decisions you can. And now from our studio in Coeur d'Alene, Idaho. Here's Tom.
Tom Deutsch 0:42
Welcome to which just wallpaper where my guests and I aim to provide our listeners with thoughtful information and resources to enable them to make the best decisions the first time. Today we are going to discuss Long Term Care Insurance. Joining me from his home in Vermont is Ed stone. This just don't works for Crump Life Insurance Services, which is where he is responsible for managing existing producer relationships, and building new relationships through referral and marketing initiatives. Prior to joining Crump insurance, Ed spent 16 years managing the sale of long term care products as regional sales director and regional sales Vice President for two major insurance carriers. Prior to that he spent seven years as a national sales manager for a national brokerage general agency. Well welcome Ed stone.
Ed Stone 1:45
Hey, Tom, thank you. Good to be with you. Thank you,
Tom Deutsch 1:48
well, before getting into the insurance product themselves, I believe would help to get an overall history of the long term care industry. When Long Term Care Insurance took off, how many companies were in the market compared to today?
Ed Stone 2:04
Well, at the height of the long term care insurance industry, we probably had about, oh, maybe 100 or so carriers out there, marketing, long term care insurance, varying degrees of success or varying degrees of size of their companies, about 100 or so at the height of it maybe 1015 years ago,
Tom Deutsch 2:25
can you give us a little bit of history about how this whole long term care insurance industry started?
Ed Stone 2:31
Sure, sure. Back in the probably the early 70s, you had products called nursing home policies. Some of them were called home health care policies. And these were put out as just a flat, per diem reimbursement type of product, need to go to a nursing home, will give you up to $50 a day, as long as you're in the nursing home, as long as you know, whatever amount of policy benefits you had purchased. Same thing on homecare, if you need people to come into your home, we'll reimburse you for $50 a day. Those types of policies were pretty broad in terms of how you can get them and the definitions within them. But I'm going to say in the early 70s, they started to get a little more sophisticated as different forms of, of care. In the long term care industry service industry started to evolve, where you had assisted living facilities, starting up home care, adult daycare, things like that. So the insurance companies looking at the demographics of the baby boom generation. And you know, at that point in time, the greatest generation getting into their 70s, they started marketing products that were what we call comprehensive that would cover you from the home to the nursing nursing facility. So it became much more of a structured industry. And they started to put in things such as how you would trigger the benefits. They were very specific and how you would trigger benefits when you were trying to collect on your policy where before was just kind of open ended here. You show us that you're going to nursing home, and we're going to send you the 50 bucks a day, that type of thing. So it's just like a lot of the insurance industry became more sophisticated as the need evolved for services. That'd be the easiest way to explain it. Tom,
Tom Deutsch 4:26
in an earlier question. You said when things started out, there were about 100 companies in the business. Where are we today? And why?
Ed Stone 4:36
Well, there's been a contraction in over the last 10 years in the industry. We're probably down to a dozen 15 carriers who are significantly in the business of marketing long term care products to the American public. What went wrong was just kind of a perfect storm of mistakes that were made whenever a new insurance Our product is developed. The actuary, those are the guys with the visors that do all the pricing of products have to look at the different risk factors out there, and price their products based upon potential usage potential number of claims per thousand people how long those claims are going to be there, the long term care product was a brand new product that really hadn't been invented, for lack of a better word. So the actuaries would look at what they thought would be similar products, and start to use some of that data to do their formulas to come up with the pricing and the benefit structures. The underwriters, the people that would look at the look at the applications from the clients look at their medical histories, they were, they weren't really underwriting it in ways that we now know, in retrospect, they should have been. So they were making some assumptions also, from an underwriting standpoint, as to medical care, and how that would work. So there was a number of things that occurred over the last probably 1520 years, that started to manifest itself in claims that were much higher than the actuaries had predicted. That was one factor. Part of that was 30 years ago, 40 years ago, if you were diagnosed with cancer, the doctor would pretty much say, you know, Tom gets your affairs in order, you don't have long to go, right. But today is a cancer as an example, cancer diagnosis isn't an immediate death sentence. people survive cancer, but they can be chronically impaired. So several factors led him to the carriers, making horrendous pricing errors. And also starting to understand from the new data that maybe this wasn't the type of market they wanted to be in for the risks that was involved. Things such as what we call the insurance industry persistency.
Ed Stone 7:06
Every time you price a product, no matter what it is, you assume, at the average time of a claim would occur, you're assuming that x percentage of people that bought the policies back then would not have the policies in force at the time in normal, normal time of claim or the curve. So not knowing that they looked at a lot of other products, similar type health products, and they assume the latch ratio. Well, what they didn't know till for about 25 years was when people put a long term care policy in force, they had a tendency not to let it go. And today, the average what we call lapse ratio for long term care policies is around one to 2%. In other words, about hundred people bought a policy, we're now projecting that 9899 of them will have the policy in force at the time that most normal claims occur. So this scared the jeevers, as I like to say, out of the actuaries, and then obviously then scared the bejeebers out of the financial people that run the insurance companies. And they said, you know, this is not what we bargained for back 30 4050 years ago, we're just going to stop selling this product, we'll, we'll take care of the claims on the ones that we sold. But a lot of the carrier's just said, This is not for us, it's not our main type of business. So we lost a lot of carriers, a lot of branding people that got into it got out. Now, I think it's important for your listeners to know that those companies that wrote the business, and those policies are enforced and you're paying their premiums, you know, they're gonna pay the claims. You know, they they have adequate reserves under their mattress, so to speak money under the mattress to pay claims, even with some of the pricing errors that they made. So, it's a long answer to a short question. But basically, it was kind of the confluence of a lot of factors that were unknown. That came back to say, to say, look, you know, we're not gonna stay in this market, the ones that are in it, they're, you know, they're, they're solid, they understand that they've, they've seen the mistakes that were made, and they have, so to speak, price those mistakes into the premiums that you would be shown today. 10 years ago, it might cost you $1, so to speak, that same plan today would cost you $2 Why? I'm not saying it only cost $2. But why? Because they now know that they should have been charging $2 for the same thing 10 years ago. So that's kind of where we are.
Ed Stone 9:41
That's that's that's what went wrong.
Tom Deutsch 9:43
a long answer. But really a great answer. No, that really helps us understand where the where the market is today. Now before discussing the actual insurance products that are being sold today, I thought it might be judicious of us to take a look at what the cost of care is in the marketplace. And I also believe that our listeners know that the market is going to change by cost, depending of course, upon where you live and upon services. Yeah, so let's start with the basics. It really nobody, nobody really wants to leave home, and they're gonna dig in and the battle is on it when you ask people to do that. So basically, has the industry developed any parameters for what actual care costs in the home? Now I recognize that some people need three hours a day of care, and some people need eight hours a day of care. Can you give us a throw out any parameters that you folks have developed?
Ed Stone 10:47
Yeah, as a matter of fact, there are websites out there that the consumers can go to what are called cost of care calculators. A couple of companies, I'll just mention off the top my head Mutual of Omaha has one out there, Nationwide Insurance has one out there. And you can Google it and find the the calculators and you plug in your state where you are. You plug in, you know, you know, today what the cost is? Five years, 20 years, assuming it's caught, not assuming the costs are going to go up. And it'll tell you things such as homecare, adult daycare, hospice care, assisted living, and even nursing home cares. So the tools are out there. But the the easiest way to describe it is it's expensive. I'm not trying to be flipped, but it's expensive. And it's getting more and more expensive. And the ability for there to be enough caregivers is the real thing that's concerning the industry. Because, you know, it's it's not the greatest, greatest type of job to have in terms of making a lot of money and being an easy job. So getting caregivers today is becoming trickier and trickier. Especially, you know, unfortunately, given the whole pandemic and the impact on caregiving is making it difficult. Now, all of that said, the the cost of cares is pretty consistent in some areas of the country. But I for instance, in preparation for this, I looked up a couple areas to give you some ideas. Let's say you're in California, and you want home health care, that's an A not not a not a nurse or a licensed, licensed practical nurse, just a home health care aide to come in. You're looking in the state of California about $28 an hour for you to have a somebody to come in, you know, do some light cleaning, you know, maybe do some laundry homemaker services. So 20, you know, let's say it's $28 a day, or $20 an hour, do the math three, four hours a day, five hours, it could be $100 a day, 500 a week, 2000 a month type of thing. And the Chicago say Illinois, it's about $25 an hour, New York, you know, the New York Metro, you're looking about $27 an hour. So the major metropolitan areas on the two coasts clearly are the most expensive. You know, here where I am in Vermont, it's not bad, because I'm out the middle of nowhere and provide but you get down towards Boston, you get down into Hartford, New York down the Washington corridor, very expensive. Same thing on the west coast. You look at San Francisco down through San Diego, very expensive. So what people a lot of times think about is, well, I'll buy my care, I'll get enough care for where I am. But they really need to be thinking about where am I going to be. It can work for you, it can work against you. So let's say someone from California is looking at Long Term Care Insurance today, figuring $28 an hour for home health care. But their plan is to retire to Baton Rouge, Louisiana. You know, Baton Rouge, Louisiana, you're looking at 20 $21. Now, that's a significant price difference. So what I tell people when I work with with advisors is don't just look at where you are today. 5560 years old, where do you perceive yourself being because that's what you want to plan for is not where you are today, but where you see yourself being because you might be able to get a lot less coverage for the place, you're going to have been spending a lot for the place where you are now. So home health care is the biggest expenditure or reimbursement of the insurance companies. I think people are surprised when I tell them that. But something like 65 66% of claims paid are for home health care, not for, you know nursing homes or assisted living. It's for home health care. So I think it's a situation that it's only going to get more expensive. I think you can look at about a three to 4% per year compounding, cost of care going up. But that's before maybe some of the impact of CO was going to hit where A lot of people don't go into the caregiving business anymore, it could that could really accelerate the cost of this stuff.
Ed Stone 15:05
You know, now the, the rates you've quoted are for agencies. And one thing we know people do is go out and independently hire someone. And of course, that's going to be lower. But let me share a story with you. You know, I was in the business for a long time. And we did hire my wife and I and my brother did hire someone to come in and take care of my parents. But at the same time, we had them on a payroll, and we purchased Labor and Industry insurance in the state of Washington don't sell and I. And so basically, we had one of the caregivers get hurt. And basically, there was a claim to the state of almost a quarter of a million dollars. Now had I not done that and had insurance. And this was then a private caregiver that I hired in without insurance, that claim could have been made against the estate. And it would have been horrific, and definitely impacted the quality of life for both my parents. So a lot to think about. And people often do not think about covering that caregiver and just kind of sneaking somebody in and paying them cash on the side. And but there are consequences to every action.
Ed Stone 16:24
Your home health care agencies obviously carry liability insurance for their employees, etc. But as you said, you are paying a markup when you go to a commercial agency, a for profit agency, that, you know, would be sending the caregiver into your home that money could last a lot longer if you were paying Betty next door type of thing. Right? You're absolutely right.
Tom Deutsch 16:44
Okay, what about costs, assisted living,
Ed Stone 16:46
assisted living? is running in California about what it's about 50 $600 a month? For a, you know, independent apartment type situation? Chicago metro area looked like it was around 4800. New York, Metro 5800, Florida, 4600. Louisiana again, 3600. So
Tom Deutsch 17:10
let me jump in here. Now that is you're saying this is assisted living? Correct? Correct. Okay. And that would and we'll get to what the product covers. But that is something that insurance possibly might cover with certain parameters. Yeah. Okay. Let's talk about nursing homes. What are the costs of care there? And I read it, but yeah, and I'm ready to brace myself.
Ed Stone 17:35
Very expensive. California, again, you're looking at around $300 a day for semi private room, not even, you know, your own room, semi private room about 300 a day. Chicago land area 223, New York, 394. Florida, central southern Florida 284. And, again, Louisiana, is kind of your economy place 180 a day type of thing. throughout the country, you're looking at national average about 220 a day. But you know, it depends upon where you are, and where you want to be. It's supply and demand. And they have the cost of, of facilities, building the facilities in the metro New York area a lot more expensive than Baton Rouge, Louisiana. That's why they're charging more in New York so expensive.
Tom Deutsch 18:22
And one of the things that I already got out of your podcast, besides staggering costs that have just jumped since I was in the business, is the fact that you have to anticipate where your parents are the person you're looking out for may eventually live. Because if the policy doesn't keep up with that you despite everything could still be in harm's way.
Ed Stone 18:46
Yeah, well, today, quite honestly, Tom, the ability to ensure the entire risk is getting to be almost almost impossible for what I would call your average citizen you know, your folks that have worked hard, put money away, have you know, have some assets a home etc. 20 years ago, you could you could buy a Cadillac plan and never have to worry about a dime out of pocket. That's part of the problem with the pricing. They didn't assume that so the pricing today has it become a coinsurance situation? That's what we tell people is your your total risk is x. How much do you want to self insure? How much of the risk Do you want to put off on the third party, the insurance carrier, we can build a plan around that that concept?
Tom Deutsch 19:29
Okay, as time has run out on this podcast, I'd like to thank Mr. Stone for being with us for this initial podcast, and he's going to graciously agreed to return on our next podcast we will actually dig in to who qualifies how you qualify for the various coverages and Mr. Stone I'd like to thank you for being with us.
Ed Stone 19:53
Thanks, Tom enjoyed it.
Miranda Hamilton 19:55
Thank you for tuning into, it's just wallpaper please share this episode with your friends. And help us reach more seniors needing help with health critical decisions. Visit it's just wallpaper.com to catch up on past episodes or find us on Facebook at it's just wallpaper to ask a question.
Attorney Rebecca Eyman discusses financial considerations when planning for long-term care.
Rebecca Eyman
Associate Attorney
rebecca@cwelp.com
(208) 765-3595 (office)
(208) 765-0515 (fax)
Coyle & Wytychak Elder Law
POB 1888, Coeur d' Alene, Idaho 83816
www.cwelp.com
Show Transcript
Welcome to it's just wallpaper, a podcast dedicated to providing solutions for seniors and families dealing with life changing health and living conditions. Your host Tom Deutsch is a graduate of Columbia University School of Public Health and administrative medicine. Tom brings 43 years of executive experience working for the care and well being of senior citizens with credentials and licenses as a nursing home administrator, life insurance agent with a long term care endorsement, professional guardian and court appointed guardian ad litem in over 1500 cases. Tom brings a lifetime of knowledge to help you and your family make the best decisions you can. And now from our studio in Coeur d'Alene, Idaho, here is Tom Deutsch.
Welcome to Woods just wallpaper. It is our aim through these podcasts to provide our listeners with thoughtful information and resources to enable them to make the best decisions the first time. Today, the name of our podcast is you can't give it away. When someone finds themselves in a situation in which they require post hospital care, or can no longer live at home, or need help at home. The foremost question is often who is going to pay for it. During our previous podcasts, we've discussed major health care benefits programs. For a quick review. Medicare, as opposed to Medicaid is a federal program designed to meet skilled care needs. This is generally for a short period of time, although maximum benefits could go up to 100 days. Examples of skilled care could include rehabilitation following a stroke, fracture, administration of IV medication to feeding or intensive nursing, the care must be delivered at a skilled nursing facility. In essence, the general rule is that you are going to get better. Medicare is not a long term care solution. Another not federally funded program is private pay, where care is paid for personally or by family members. We will be talking about long term care insurance and what's covered in separate programming. This now brings us to Medicaid, which in many instances is state specific program, the Medicaid program can assist those who qualify with what is called custodial care. This type of care is needed by individuals who could no longer live independently. Besides institutionalized care, there may be some limited benefit for care in the home. I have met many people who operate under the assumption that they can simply give away their money or sign their property over to others, and the government will simply take care of them. Today, we're again joined by attorney Rebecca Iman, with the quarter lane law firm of coil and whitey check elder law. Although there are guidelines specifically states, I have asked Rebecca to give us a basic general outline of qualifications. My understanding is there are two factors needed to be eligible. One is actual need, and the other is financial. Although at best, there are variations. I've asked Rebecca to focus on a single individual that has a home and Social Security. So beginning if eligible, how does the State agency Rebecca, look at this person?
So that your introduction was absolutely right, Tom, the state is going to look at both the medical need and the financial need of the individual. And it's it's a little bit easier just to look at an unmarried person because I will say that married couples the analysis is more complicated, but the state is going to ask first, is there a medical need for this person to be in some sort of long term custodial care? And second, financially, do they need support to pay for it? So that's sort of the the two step analysis taken by the state.
Let's talk about a person that has a home and I know there are all kinds of ways to go but let's say they own their home. It's debt free. They have some money in the bank. Let's say they have $10,000. And they're single, and they need to go into a care facility. And they now have made application. What happens?
So this is a really, that sounds like a really common scenario that could that could describe any one of my many clients who have found themselves struggling to figure out how they're going to pay for nursing home. So let's say just hypothetically this person has a medical need can be shown because I'll tell you, that's not usually the factor. Usually, it's pretty clear that due to medical issues, long term care is needed. So then the state's going to look at income and assets. So let's focus on assets first, because that's what your question presented. So this person owns his own home, and he's got some money in the bank. So every state, I will back up and note that every state has its own interpretation of Medicaid, which is a federal program applied by the states. Some states stick to social security rules when it comes to financial need, and others have their own limits. But I'll just describe Idaho's financial analysis, which allows for exempt assets and non exempt assets. So certain items can just be taken off the table when it comes to countable assets, and the home is one of those. So if a person owns a home, but is moving into the nursing home, they don't have to sell it to pay for care, not necessarily some other exempt assets or vehicle. Even if they can't drive, some irrevocable funeral and burial pre payment plans and a variety of other assets, then everything else is going to be fair game, those are your non exempt assets, your bank accounts, your cash on hand, etc. So this person has $10,000 in non exempt assets, because his home is exempt. In the state of Idaho, he can have 2000. So that means he's 8000 too high, he needs to spend down $8,000, before he can go on Medicaid. And if he's paying for nursing home out of pocket, it won't take very long before he spent that
in again, we're only looking at the state of Idaho, because every state we know is different. The person is now the single person is now in the nursing home. What happens to the house at one point does the sale is this is a house is there a trigger for the sale of the house.
You know, it is at least in Idaho, there's this sort of as long as there's a vague intent to return to the home, even potentially, hypothetically, they won't force a sale of the home. One thing and I might be jumping ahead a little bit is that the state will ultimately lien the home for any amount they've paid out in care and will want to get paid back after the Medicaid recipient dies.
Okay. So that that's a really, very important point, I want our listeners to know that if there is any possibility that the patient may return to the home, that the state is not going to force the sale of the home.
That's correct,
right. And However, if the state is paying for care, at a skilled nursing facility at an assisted living type situation where they're getting care, then the state ultimately is going to try to recover their out of pocket expense from that home,
right from the estate. So not not until after that person dies, but they'll hope to recoup that. So they can apply those funds towards someone else in need with the state put a lien on the house. Yes.
Effectively when the person goes in the facility.
Exactly. And although they can't recover against the lien until that person dies, they'll lean it to sort of hold their place in line so to speak. Okay, so, again, let's say this is our individual
is in the nursing home, and the individual has a will. And the will says I'm glad you're the attorney here, okay. The wheel says, I want to give this house to my son and daughter in law. How does the State look at that?
So the state is going to do two things. They're going to leave the house and one day we're getting slightly off the topic but let's have a quick primer and probate here. When the will is submitted to the court for a probate the state will appear as a creditor and they will expect to get paid back first before son and daughter In many cases, the state takes all of the equity in the house, and nothing is left. So that's a major downside for a lot of people in trying to decide how to plan for long term care. They don't want to give all their money that they saved up and their assets to the state, they want to give it to their kids. And in Medicaid planning, there are some tools you can use to try to achieve that goal.
Okay. So, again, the takeaway is that you may not have to give up the house while the patient is in a care situation. That's right. But the patient, the family cannot live under the assumption that they're going to get that house at the passing of the individual.
Yes. And I think it's better to come to terms with that sooner rather than having a nasty surprise when the state takes off with all of that money and leaves nothing behind for an inheritance.
So let us one thing I've found, in my practice, as a guardian ad litem, is the fact that the state only went back to the date of the formal application to the Department for coverage purposes,
went back to for terms of estate recovery.
Yeah, not for recovery. For example, let's say, and this could be state specific. But for example, let's say Mr. Jones, enters the nursing home January 1, and he's not real, and he doesn't submit an application. And basically, the his family members don't submit an application until March 1. In the state of Washington, which I came from the state's position was, they would only go back to the date of when the application was formally presented to them.
I understand, actually, that's a difference between Washington and Idaho, Idaho will let you go back retroactively, three months? Okay. So that would be a good thing to know, when you're applying for Medicaid is how far back can you go? because why not recoup a few months? If you can? I think it's because it takes so long to get documents together. Idaho gives a little little grace period there, and you can go back three months? Well, that's
actually a great benefit. Because I will tell you, when I was sitting behind the desk as a nursing home administrator, we would i would slightly lose my mind when the family would not get the information in. And every day that went by was a no pay. Yeah, you know, for the institution.
Yeah. And as my, as a Medicaid attorney, a lot of my day is spent following up with families asking them for documents that I need to submit, because when when the time for a Medicaid application comes, it becomes a scramble, and you need documents, you haven't, you don't know where they are. It's a lot. So it can be a real mad dash to get get your application filed. Okay.
And one of the things we covered in a prior podcast with you is, again, I want to underscore the need for the family to find that power of attorney to find that advanced directive. And if the patient is still competent to try to get those documents executed.
Absolutely. And if if you're doing a power of attorney, make sure that it authorizes your agent to apply for benefits for you and also reposition assets to qualify you because not all powers of attorney do and most people by the time they're applying for long term care aren't really in a position to apply for Medicaid themselves and need some help. Okay,
so let's talk about the five year look back. Can you explain that to our listeners?
Absolutely. So the date that a person applies for Medicaid, one of the questions on the application asks, in the past five years have you sold, transferred, given away gifted any assets. So any sales need to be disclosed? And it's okay to sell assets, lots of people have to sell things to pay for care. But what the state is looking for is assets for less than fair market value. A lot of people have figured out that the state is going to leave their house if they go on Medicaid. So they think I know what I'll do. I'll give my house to my kids problems solved. Well, not if you do it in the five years before you apply, because the state is going to assess a penalty because of that gift It's a penalty in terms of time, rather than money. But they'll essentially I think of it as like being in the penalty box at a hockey game, you get taken off the ice and you're you're in the penalty box, depending on how how much you gave away, you have to wait. Because those are funds that you could have used to pay for your own long term care.
Okay, so we want to reiterate that there is a five year look back period. And eventually, at the state scours records, I've seen it done,
they'll find out, they'll find
out, they'll look at bank accounts to look at transactions, and most of the time they find out and if you haven't been forthcoming, it's it's it's not a good place to be.
Absolutely, I would never encourage people to try to hide things from Medicaid, and I ask all my clients, are you going to be applying in the next five years? If the answer is no, maybe we have some time, you can reposition assets. But if if you're going to be submitting an application within the next five years, a penalty can really, really throw a wrench into those plans.
Oftentimes, and it's very sad, I have seen, let's go back to that individual that has $10,000 in the bank, and basically has been the victim of fraud, and basically got taken advantage of by scammers and maybe $10,000 is down to $2,000. And it's just gone. How does the State look at that?
Well, so I think there will this will be state to state but I understand there exceptions to the gifting rule for for people who are are defrauded or misled. So if the intent was not to give the money away to shield it from Medicaid, then there's not going to be a penalty assessed. Okay.
And again, I experience from Washington, you know, if the case was turned over to adult protective services, and they're able to substantiate, or the police are able to substantiate or the sheriffs able to substantiate that there's some evil intent done to the patient or individual. That makes it pretty good, strong case that that'll come out very well for the patient.
Right, right.
Okay. What can you tell us? Tell me about Medicaid annuities?
So, Medicaid annuities are exceptionally popular in some states. Essentially, what happens through that process is that an asset is transferred over into the income column, and I realized we focused a lot on assets. We didn't cover income, but some states do have a cap on how much you can earn some don't. But essentially, let's let's go back to our individual applying for Medicaid. But let's say instead of, instead of $10,000, he has $100,000. And he sees that he's very far away from qualifying for Medicaid and, and he can't give that money away, and he doesn't want to spend it on the nursing home, he can convert that hundred thousand dollars from a non exempt asset into a source of income by annuitize. it and then he doesn't have to spend it down and he'll get that back month by month in the form of some income. I will emphasize this extremely strongly, though, these need to be Medicaid specific annuities, only certain companies do them, they have to follow very strict requirements. And the Department of Health and Welfare must be the beneficiary of the annuity. It's not a way to avoid estate recovery. So don't just rush out there and get any annuity with your financial planner, make sure it's a Medicaid compliant annuity in your specific state. But other than that they can be a great tool for repositioning assets and preventing someone from having to spend down a large amount of liquid non exempt cash.
And we had we earlier we talked about somebody with private funds. Okay. How is the Medicaid and I don't know the answer to this. I'm asking you. Could it keep a patient private pay if the annuity was annuitized?
Yeah, possibly. Yeah. So if if the nursing home is is 5000 a month but the person's income is is 2500. And they could annuitize it that could potentially put them in a position to private pay every month and keep them off of Medicaid, which is truly better if you can stay off of Medicaid managed to pay through other means.
If you have a Disabled son that's always lived in the home. And you know, that our single individual took care of that individual. But now, dad's in the nursing home, but the disabled son is able to carry on in the home does a disabled son have to leave?
So that's a great question. And this is a major exception to the the penalty for transferring assets. There's a few significant exceptions, which would allow someone to transfer an asset to someone else. One big exception is a disabled child of any age, blind or disabled, they can be an adult child or a minor, they act in that case, they actually don't even have to be living in the house, the Medicaid applicant can transfer to the child or to a trust for his or her behalf. So that is a great exception to take advantage of it would prevent a disabled child from losing their home and then you could transfer without penalty. One other I'll mention is that if a child disabled or not moved into the home, and took care of the Medicaid applicant for two years, thus delaying the need to move into a nursing home, the state essentially sees that the house could be transferred to them to pay them back for those years. And so you could transfer the home to that child penalty free. So there's a few exceptions to this rule that can be very useful. And I encourage anyone applying for Medicaid with the home to pay for an hour of time with an elder law attorney and talk through some of these exceptions because there can be there can be great resources available and it's good to know everything before you get started. Again,
thank you for your counsel counselor, and we hope to have you back on a later broadcast.
Thank you so much. Thanks for having me.
Thank you for tuning into, it's just wallpaper. Please share this episode with your friends and help us reach more seniors needing help with health critical decisions. Visit it just wallpaper.com to catch up on past episodes or find us on Facebook at it's just wallpaper to ask a question.
Elder Law Attorney Rebecca Eyman will discuss the concept of elder guardianship and conservatorship considerations, the actual process, legal terms, costs, and on-going legal requirements.
Rebecca Eyman
Associate Attorney
rebecca@cwelp.com
(208) 765-3595 (office)
(208) 765-0515 (fax)
Coyle & Wytychak Elder Law
POB 1888, Coeur d' Alene, Idaho 83816
www.cwelp.com
Dr. Meharg discusses common testing methods for dementia with additional case specific inquiry to gauge the extent of the illness.
Steve Meharg, Ph.D., ABN
945 11th Ave
Longview, WA 98632
360-414-8600 x130
smeharg@cfmal.com
www.cfmal.com
Stephen S. Meharg, PhD, ABN, a neuro-psychologist defines dementia, discusses misconceptions and behaviors.
Steve Meharg, Ph.D., ABN
945 11th Ave
Longview, WA 98632
360-414-8600 x130
smeharg@cfmal.com
www.cfmal.com
In her second podcast Nurse Practitioner Mary Buckland discusses the risk of falls and prevention, proper nutrition, hygiene and weight loss, wandering and isolation. Nurse Buckland in addition offers meaningful suggestions to improve quality of life.
Senior Nurse Practitioner Mary Buckland
My contact info is mary@mhpnw.org
Show Transcript
Miranda Hamilton 0:00
Welcome to it's just wallpaper, a podcast dedicated to providing solutions for seniors and families dealing with life changing health and living conditions. Your host Tom Deutsch is a graduate of Columbia University School of Public Health and administrative medicine. Tom brings 43 years of executive experience working for the care and well being of senior citizens with credentials and licenses as a nursing home administrator, life insurance agent with a long term care endorsement, professional guardian and court appointed guardian ad litem in over 1500 cases. Tom brings a lifetime of knowledge to help you and your family make the best decisions you can. And now from our studio in Coeur d'Alene, Idaho, here is Tom Deutsch
Tom Deutsch 0:42
over the course of my career working in all venues of long term care. Time after time, I witnessed important decisions being made based upon impulse and non essential factors. Welcome to it's just wallpaper where my guests and I aim to provide our listeners with thoughtful information and resources to enable them to make the best decisions the first time when we visit our clinician or specialist as we age, it becomes increasingly more important that we be good historians of our health record, or can rely upon someone who is when I used to accompany my parents to physician appointments. I was amazed at what they told him and what they simply did not recall. Joining us today for a second podcast is nurse practitioner Mary Buckland. Mary Buckland is founder and president of mobile health care providers Northwest. She has extensive experience in internal medicine, family health care, urgent care, for ology hospice and palliative care. Mary, I want to thank you very much for coming back with us on this program.
Mary Buckland 2:04
Thank you for having me.
Tom Deutsch 2:06
on previous program, we talked about core comorbid factors that should be considered in this COVID-19 atmosphere and the impact it can have on the elderly. We also emphasize the need to have a good story and present when visiting a physician. Mary also discussed the need for clear and concise state planning documents for power of attorney and Advanced Directive. In this previous broadcast, we also talked about medication management. And now I'd like to talk about falls and the dangers that they pose to our seniors. What are your concerns with falls
Mary Buckland 3:00
Falls in seniors in and of themselves really increase the risk of mortality. Anytime somebody breaks a hip that can increase their mortality, even more. So the key to falls and reducing mortality is the key to is is the key to reducing or preventing falls in our community here in Vancouver worked very passionately on reducing fall risk in our seniors and before covid HIV we were constantly sharing information among many of the eldercare aspects of the conceit community to make sure we reduce those walls. A
Tom Deutsch 3:44
lot of our seniors, great great a majority of our seniors are not living in facilities and are living at home or in retirement centers. So what services are out there that can analyze and look at potential risks for seniors in this environment?
Mary Buckland 4:02
Very good question. Most physical therapy, home health physical therapy departments or programs will send us physical therapists out or an occupational therapist and they can look at the home and they can identify what areas or what things increase the seniors fall risk and they can work on making sure that the home environment is as safe as possible in reducing hazard of trips and slips and making sure that those obstacles are removed from the home to help reduce that risk.
Tom Deutsch 4:42
So what would be some examples of what I'm thinking about or throw rugs that are in the house? Obviously I you know, possibly if there's a two story home to try to try to move somebody downstairs so the stairs are not In the way you're presented danger, if possible, obviously, that's not always the case. But people should take a good hard look at what's on the inside. To prevent that various serious fall, that could be a best Sentinel event. For the senior.
Mary Buckland 5:20
Yes. throw rugs are a huge, huge factor in surfing. Everything that really needs to be remembered and many folks need to be reminded is the use of those mobility devices that help keep them on safer and upright such as walkers, canes. Sometimes people use wheelchairs, too, because they do not have good balance or their legs aren't strong enough to support them for periods of time. And certainly, analyzing somebody's care environment if if they can't traverse stairs safely, then trying to adapt to our environment where they can be an all in all on one level and reduce the risk of going up and down stairs is a very helpful intervention that can that can take place if possible.
Tom Deutsch 6:10
You know, one of the things you mentioned earlier is that I don't think our listeners and perhaps they do but really understand the impact of a fall on a fractured hip and how that can really shorten life and have a dramatic impact on our seniors.
Mary Buckland 6:28
Yes. Anytime we have somebody that falls and breaks a bone or requires surgery, anesthesia, hospitalization, changing care environment, such as a skilled facility, anytime somebody that is a senior citizen lands in the hospital from a such an instance that in and of itself increases their risk of becoming delirious, it's very common for for seniors to become delirious when they're hospitalized. And anytime we put the senior in the hospital, we are on the medical side, bracing ourselves to be prepared for if that delirium still develops that in in somebody that when they become delirious in the hospital that in and of itself increases their mortality risk, the longer that is that persists. And that's not even factoring in if they've had surgery to repair a broken hip, for example,
Tom Deutsch 7:27
you know, I'm not here to scare our listeners. But even in my own mother, she had an nst she based delirium, which in fact, never cleared and impacted her for the rest of her life. So
Mary Buckland 7:41
yeah, that can happen. That certainly can happen. And I'm sorry that happened to her.
Tom Deutsch 7:48
Let's talk about incontinence. And what you know, what possible steps we can do to mitigate incontinence are there things that are out there,
Mary Buckland 8:00
incontinence can happen it's an unfortunate and frustrating thing that we have to deal with. Many times stress incontinence can sneak in more, so we see it more so and ladies. Some of that can be managed with main just mild incontinence pads to help for those times when when somebody sneezes or coughs or maybe they wait a little too long and their bladders too full. And there are certainly exercises that can take place that your that your urologist would recommend to try to increase the muscle strength within the pelvic floor. And certainly making sure that the prostate health is is factored in for gentlemen to make sure that they can evacuate their bladder and make sure the prostate isn't too large. Those are all things that we look at. There are medications that can also be considered depending on the type of incontinence that somebody is dealing with. That can help if it's related to overactivity of the bladder. To help reduce that as well. I always recommend that we don't just dismiss incontinence as just incontinence. But for people to talk to their healthcare provider about what's going on, how the symptoms are presenting, and sometimes it warrants a visit to your urologist for further evaluation. If we think it's a structural problem. Sometimes people can actually see therapists that are trained in some of those exercises to help with your illogical health as well. So, my my message is don't dismiss it, openly talk about it and see if there is something we could can do to help with that.
Tom Deutsch 9:51
Thank you. Let's talk a little bit about hygiene and nutritional needs. You see a lot of patients In a clinic, and what are your concerns? Or what do you look at, from a hygiene perspective,
Mary Buckland 10:05
if I see, and especially if I've had a patient that I thought for a period of time, and I see that hygiene is starting to fall off, I have somebody that used to be very neatly groomed. And I see that maybe their clothes are more disheveled. And maybe their hair doesn't appear to be as well kept. Maybe I'm looking at their body. And I'm seeing signs that maybe they haven't dated for a while. And I want to know what might be contributing to that is there is a problem as simple as that, now that their arthritis has progressed to the point, they can't get up into the shower anymore. And they need an adaptive device to help them sour more easily. And is it? Is it something where there is a problem with the home where they actually don't have running water? I've had that happen before where people cannot provide the maintenance to their home, and they have problems and they don't have running water in the home? And I always want to know, with that person who is there talking cognitive changes, because many times people when they as they develop dementia, as it progresses they do not like today. So that is something that comes to the forefront of my mind as well. So really, looking at that, and, and questioning what is the reason for this neglect?
Tom Deutsch 11:33
You know, I had a friend that had a mother in a retirement facility. And it suddenly dawned on him that his mother, in fact, was not bathing. And apparently this had gone on for some time. So that's something certainly families should be aware of and checking unnecessarily just wait for the clinical visit. Now, you could in fact, at times order a bath aid to come out and help.
Mary Buckland 12:02
Yes, indeed, the key is if that if that person who will allow for the help, sometimes that can be a very challenging thing for birth as well.
Tom Deutsch 12:12
Let's talk about nutritional concerns, you know, proper eating proper diet, proper balance, some supplements, Can you discuss concerns you have for seniors with nutrition?
Mary Buckland 12:25
Yes. with seniors in their nutrition. I anytime I see one of my patients when they start to have a weight loss, and it's unexplained loss, weight loss or unintentional weight loss? That is a red flag to me. I want to know who is preparing your meals? Is anyone preparing your meals? Is there food insecurity? Or is this person? Was there the person that used to do the grocery shopping or the cooking? Are they no longer in the picture? They did? Perhaps did the person that prepared all the males into the grocery shopping? Did they die? I cannot tell you the times over the years that I've had patients. It primarily gentlemen, that never had to learn how to cook and never did those things. And when their spouse died, and they they did not eat appropriately. Also making sure that they have access to get food in the home making sure that they have adequate storage of that food in their home. Do they have a refrigerator? Can it be kept safe? in Berkeley, are they going out every day and eating fast food because it's safe, and it's something they can get sued? Because that certainly is a special concern as well. So they're all things that I look at with our seniors.
Tom Deutsch 13:42
What can you do from a clinical aspect with a patient that you believe has some real nutritional challenges?
Mary Buckland 13:52
I am, I am probably one of the biggest fans of meals on wheels. That is one thing that is out there. And not only do they deliver meals to our seniors, but they're also that social contact there that daily eyes and ears for those folks that may be living at home by themselves and they'll have other people around that can check on them. And that is very nutritionally complete food. And if you talk to any of your seniors that have had Meals on Wheels, they will tell you they give you enough food for at least two full meals a day even though it's only one. And that's it. It's very nutritionally sound.
Tom Deutsch 14:34
And basically you could go to your physician for referral for Meals on Wheels or contact perhaps your senior center. You don't need a script for that correct.
Mary Buckland 14:45
Anyone can get on a computer and send them a request for meals on wheels. Um, you can call them on it does not have to be a prescription from a medical provider. Now
Tom Deutsch 14:56
when we talked briefly off mic before the podcast You brought up social withdrawal and your concerns for that. Could you give us some your thinking?
Mary Buckland 15:07
Yes, of course. We as human beings are socially, we're social creatures, we, there's a few of us out there that may be those introverts or those learners, but for the most part, we thrive on being around others. social isolation, can be very damaging for a person's psyche. And it's very common for depression to creep in on seniors. And it's something that we should be screening for as medical providers and those around asking the simple question mom and dad are depressed, are you sad? The other thing that I am also very much aware of and I have also talked to many patients family members about is when they see that that person is not engaging with their external environment anymore. If you have somebody that used to be the social butterfly, and now they're not seeking out those activities, we should be asking ourselves, why is it because they're depressed? Are they having more mobility issues? Are they concern that they will not be able to keep up with the conversation? It is very imperative that we as human beings have that social interaction. And if even in this time, with COVID, it makes it even more challenging. But at least we do have technology. And we can have, for example, we're doing a lot of zoom meetings right now, where people can see their loved one on via technology, or we do a lot of window visits now where they can see each other at least through a window. We have to make sure that that our seniors are engaged in their environment. If they aren't, then we need to be asking why.
Tom Deutsch 16:53
Finally, I would like to have you address concerns with some of our seniors that wander Why do they wander? And what are the concerns you have and perhaps some of the remedies,
Mary Buckland 17:09
many times we have this syndrome as people develop dementia, and to be clear, dementia is a very generic umbrella term for all of those other types of dementia syndromes that fall underneath it. Alzheimer's, vascular dementia, Lewy body dementia, those are some examples. In the afternoon, this or that that person may become more confused. And their circadian rhythms, they they fall off, they're not regulated, it's very common in the evening and afternoon, for people to become more confused. It's also very common that if they are mobile, they are out and about. And many times they can stay within their yard or their their, their neighborhood. And it's one thing but as that progresses, many times they don't realize that they're not in their normal environment, and they become lost, or they have don't have a sense of where they are. And they can't remember where home was. I if we have anyone that we suspect they're at risk of that, or we're seeing the pattern of confusion, or maybe that impulse control is no longer there. They really react and act on those emotions of wanting to get up and walk or go away. There are door alarms that can be put into place. And there are different kind of locking mechanisms that can be put into place. There's also technology that can be placed to monitor the doors, if the doors are open, where you can actually have a visual of who is at the door since leaving. We're very fortunate there that there are so many more resources out there with the ultimate goal of being able to keep people in their homes safe as long as possible. Now, certainly in this instance, if you have somebody that was getting very confused in the afternoon or evening, then being by themselves is not not what I'm recommending. But if they lived at home with another family member. If we had those those types of systems in place, then we could assure our is certainly reduce their risk of getting out and wandering and becoming hurt or lost. Unfortunately, I think we see at least one or two cases locally every year where somebody got out and got lost in some of those cases they die.
Tom Deutsch 19:29
Mary Bucklin I want to thank you very much for joining us on these podcasts. The information you brought forward is certainly relevant and I am very hopeful that our listeners will be mindful and take your advice to heart. Thank you again.
Mary Buckland 19:48
Thank you. Take care, Tom.
Miranda Hamilton 19:50
Thank you for tuning into. It's just wallpaper. Please share this episode with your friends and help us reach more seniors needing help with health critical decisions. Visit it wallpaper.com to catch up on past episodes or find us on Facebook at it's just wallpaper to ask a question.
In the first of two podcasts, Nurse Practitioner Mary Buckland discusses clinician visits, defines the meaning of co-morbidity factors, Covid 19, senior driving and testing and additional considerations.
Senior Nurse Practitioner Mary Buckland
My contact info is mary@mhpnw.org
Show Transcript
Miranda Hamilton 0:00
Welcome to it's just wallpaper, a podcast dedicated to providing solutions for seniors and families dealing with life changing health and living conditions. Your host Tom Deutsch is a graduate of Columbia University School of Public Health and administrative medicine. Tom brings 43 years of executive experience working for the care and well being of senior citizens with credentials and licenses as a nursing home administrator, life insurance agent with a long term care endorsement, professional guardian and court appointed guardian ad litem in over 1500 cases. Tom brings a lifetime of knowledge to help you and your family make the best decisions you can. And now from our studio in Coeur d'Alene, Idaho. Here's Tom.
Tom Deutsch 0:43
Over the course of my working career in all venues of long term care, Time after time, I've witnessed important decisions being made based upon impulse and non essential factors. Welcome to which just wallpaper where my guests and I aim to provide our listeners with thoughtful information and resources to enable them to make the best decisions the first time when we visit our clinician or specialist. As we age, it becomes increasingly more important that we be good historians of our healthcare record, or can rely upon someone who is what I used to accompany my parents to a physician appointment. I was amazed at what they told him or what they simply did not recall. Joining us today from Vancouver, Washington is Mary Buckland, a family nurse practitioner. She's founder and president of mobile health care providers Northwest. She has extensive experience in internal medicine, Family Health, urgent care, nephrology, hospice and palliative care. Welcome Mary Buckland.
Mary Buckland 2:00
Thank you, Tom for having me.
Tom Deutsch 2:02
To me, it is a distinct pleasure that you have come on this program.
Mary Buckland 2:06
I'm happy to help.
Tom Deutsch 2:08
Again, when I used to accompany my parents to a physician appointment, I was amazed at what they told him and what they simply didn't recall. As we age, I believe we are less likely to recognize subtle, subtle, or even start changes in our health or behavior. So what are your thoughts on a company visitations? And what should family bring?
Mary Buckland 2:33
That is an excellent question. And the answer is two parts. The first thing that I asked seniors when they come to visit me in the clinic, is to bring a list of concerns. And it's not even necessarily maybe that senior citizens concerns but what other concerns that family may have about either disease process, medication management, how things are going at home, psychologically, how things are going, always keeping in mind that as we age, that depression is very common in seniors. And I am a huge proponent of bringing another set of eyes in here to those visits, because a lot of information can be covered in a very short amount of time. As we age, we need more time to take in information and process it. So having an extra set of eyes and ears there can be helpful for that the plan that is put into place. It's more effective and hopefully can be followed through on
Tom Deutsch 3:44
often from a care facility, a patient that is not covered by a clinician that comes to the facility is sent out to be seen. And often I've in my experience, they're sent out with a stack of paper and over an envelope and it's presented to the clinician should not the family if possible be present, to help the clinician understand what's going on,
Mary Buckland 4:11
that can sometimes be a very difficult situation to traverse it really depends on the level of involvement that that family member has. And sometimes I have patients families that even though their loved one is in an assisted living environment, they are very closely involved and they are visiting their parents very frequently are in are in constant contact with communicating with their care team. So in those cases, those are very effective visits and meaningful and can be brain a very fruitful and what we can get out of that. There are other instances where perhaps that loved one that person in the assisted living if you're in Vancouver, but many times I have them where they're those family members are on the East Coast or in the Midwest, and they can't be present for those visits, and they may not be as directly involved. In those instances. However, I strongly encourage that a routine caregiver who really knows that person is able to come and speak and advocate for any issues that they're having, and or what they have case manager there at the building, somebody that can really make sure that it is a comprehensive visit, and all those bullet points or concerns are addressed. While we have that person there in the clinic.
Tom Deutsch 5:37
Later on in our programming, we have an elder law attorney who's going to be with us. And she'll be addressing power of attorney and advanced directives. From your perspective, as a medical provider, how important are those documents,
Mary Buckland 5:55
if there is a statement that would say, describe my past in getting your advance directive, having those very important decisions made, while somebody is cognitively and physically aware, is very important month I see a lot of this in my work in palliative care. And when we have patients that we're taking care of that we haven't had, or they haven't had those very difficult conversations, or they haven't designated the power of attorney, or they don't know who they want to help be that ultimate decision maker, if they've lost their voice or their voice is centered for whatever reason, then it makes it very, very difficult for their medical team to make sure that they are laying out a plan that really follows through and respects that individual's wishes. So I am very, very passionate about getting those forms and documents in place as a means of direct advocacy for the for our patients.
Tom Deutsch 6:53
I couldn't help but do this podcast without talking about COVID-19, which is so prevalent and talked about throughout the world. You know, from your perspective, would you define for us what a comorbidity is,
Mary Buckland 7:17
when we talk about comorbid conditions. And those are other medical diseases, diabetes, high blood pressure, also called hypertension, and COPD, chronic obstructive pulmonary disease and obesity, in and of itself, we are designating as a comorbid condition and identifying that that puts people at risk of COVID. Taking over more readily, high cholesterol, dementia, heart disease, heart failure, all of those things lie within that comorbid state. And those comorbid diseases that can impact how readily or how vulnerable a person is to infection from other viruses such as such as COVID-19.
Tom Deutsch 8:10
Now we have really two sets of circumstances, we're going to have seniors that are in care facilities, or assisted living and retirement facilities that are basically or have to adopt the policy of that facility. And then, you know, for prevention and being safe. And then we have those folks on the outside who are living independently. Let's focus a minute on that population, what would be your advice in this environment, we're living in the people living in their own homes, as to what prevention is, and what safety practices they should follow.
Mary Buckland 8:54
Knowing your health risk factors, you know, optimizing your own health, making sure you take your medications the way you're supposed to. If you aren't feeling feeling right, if you're feeling ill, it is very important that you reach out to your medical team and a lot of people we noticed on the witness initially that this pandemic pandemic originally started, we really saw a lot of people that were delaying their health care, delaying seeking out care. And then as a result, by the time they did get the doors of their local medical provider, whether it be a clinic or the hospital, emergency room, they were very, very sick. And so certainly knowing what's going on with your body, of course, socially distancing, wearing a mask, washing your hands and staying away from places where there are a lot of people collected. One of the things that I've noticed and I've so appreciated is grocery stores, allowing for senior shopping times, you know, early in the morning, so they can Go in, get their groceries, get out of their homes, and have have some, you know, a different set of scenery, and still try to protect them from the risk of the COVID-19 infection. And then also really educating their family that they really serve families stay away if they're sick or not are having any kind of symptoms to help protect themselves from, you know, potential infections. One thing that we are finding is younger people don't, they can have it. And many times they are as symptomatic. And it doesn't seem to be as virulent as it is in seniors are those with other comorbid conditions?
Tom Deutsch 10:40
Now, I'd like to turn to the title for this podcast. And thank you for sharing your thoughts on the other topics, warning signs for seniors. And the first, the first one I'd really like to touch on is medication management. And would you talk to us a little bit about why it's so important for juniors to manage their medication and the you know, and what possible symptoms might you see if seniors aren't taking the meds, possible interventions and possible resources,
Mary Buckland 11:18
it can be very challenging when a person is on more than one medication. Another challenge is, we are certainly have not perfected managing medications or prescribing them in the medical world. Many times there is duplication of therapy, and that's the best, best falses to be placed on the shoulders of the medical team. Maybe because their electronic health records aren't communicating well, maybe because they there's a delay in getting that report when they saw their specialist. So there are certainly we need to recognize that. The other thing that we need to be very mindful of with seniors is many times we are giving them more information maybe than they can fully process once again, getting back to what we spoke about earlier, taking an extra set of eyes and ears with you. Many times if you're a person is going to their medical provider and that provider is maybe suggesting or has made changes in the medication plan that gets lost in translation. And then that person comes from the reception that is supposed to replace something else, and then that other medication does not fall off of their treatment plan. That can be very, very serious. And in many times it can result in somebody landing in the hospital. If you get too much blood pressure medication can cause you to faint, gets your blood pressure too low, you know, you could take an increased risk for falls. And there's other syndromes where we call it polypharmacy, meaning all of these medicines coming together and then making a cocktail, if you will, that may cause the person to become dehydrated, if they assume that take too much water pills, if you will, diuretics or they are not taking their potassium that they're supposed to be taken with their diuretic and their electrolytes get very low. So making sure that the patient has access to understanding what their treatment plan is. double checking those medications is very important. One of the things that I encourage family members to do is go through the medicine cupboard and see what's in the medicine cupboard. If you see something that is, you know, a year old on the prescription, then you should be questioning is should first of all, should it still be there in the in the medicine cupboard. But secondly, is this something that mom or dad should still be taking, and they haven't refilled for a period of time. Or another thing that I've seen quite often is, Oh, well this bottles empty. So I'm just gonna take these other pills and pour them in this bottle, but then it's not labeled appropriately, and then you have somebody taking a medication that isn't even in the proper bottle. It's always good to have somebody else. review that with that with that person and really keeping up to date medications as well.
Tom Deutsch 14:17
Now folks that are living in a retirement community are basically considered living in a retirement community and live independently, and there's no real oversight. And that's also true for people living at home. What is out there today from the pharmacy like bubble packing, or other mechanisms that are out there to ensure quality delivery of medication.
Mary Buckland 14:47
There are actual dispensing machines that you can actually put the person's medications in there and then it just it dispenses them at the appropriate time and also keeps track of When a medication is missed, so there's a record there. And many of these are are wonderful in the sense that they also can be linked to an application on your phone. And then that shows the activity and shows if medications are missed. That is a wonderful instrument to use and can also help when maybe mom and dad are living by themselves, but the family is concerned that maybe there needs to be a little bit more oversight, but allowing for independence in the meantime, the other thing, yes, the double tax tax that you mentioned, those are wonderful, then you can go through and say, okay, I've taken my morning mess, today's Monday, and then I have the afternoon mats, and you can look and see that those medications have been taken. The opposite. I think the thing that we all need to be aware of and not be falsely reasserted, is if you have somebody that's starting to develop some cognitive impairment, forgetfulness, dementia of some sort. And then if they are do not have an awareness about the day and the time, for First of all, I would hope that there was more oversight and more assistance in the form of that time. But anytime that hasn't happened, then I worry that those type of tools are not necessarily as effective and do not meet the needs of the person with where they're at in their disease process.
Tom Deutsch 16:24
So I believe and I can hear your passion that medication management is probably one of the real keys to keeping healthy, and perhaps staying out of the hospital and having an acute episode. Fair enough.
Mary Buckland 16:42
Yeah, then it's certainly it's certainly a very large piece and a big puzzle.
Tom Deutsch 16:48
like to bring up driving. I never forget the story where my mother was visiting California, and she was still driving. And my brother and I were both shaking her head, and she wanted to prove to me that she could still drive. So we got to my brother's car, and she got on the 405 freeway. And she just stopped in the second lane from the curb. And I said, Mom, you just can't stop here. And she said, don't worry about it, they'll go around me. So let's just talk about seniors and driving and concerns.
Mary Buckland 17:29
And yes, I think I can imagine that might have been alarming to be in that situation. I, I think that we are very lucky here in Vancouver, one of our local hospitals does driving safety evaluations for people that are post stroke, or even if we're just questing, cognitively if they can do that, but driving is a very complex thing it takes it takes reflexes, it takes memory, it takes action, it takes reaction, it takes proact, you know, practice thinking. And you have to have good visual and dexterity as well of your hands and your feet. And a lot of places do not have this that we have locally where they can do a mobility evaluation with a very comprehensive evaluation of the senses, the memory, the reactionary time, all of those things in which they identify if there are deficits, that could contribute to somebody not being a safe driver. Anytime I have somebody that of course, is post stroke, or if the if their family or are wondering if there is an issue or if I have been contacted even by local police, about a concern on an on a person on a on a patient, and then they can be referred and this can be done and it really is comprehensive. And if they can't, if the deficit cannot be repaired, if you will, with any kind of therapy, then that is a means that the medical provider can recommend that somebody driving privileges cease. And it's a very difficult situation we recognize the loss of independence is a huge thing as we age, but also recognizing that we have to keep ourselves and others safe is also a huge part of that conversation.
Tom Deutsch 19:25
Well thank you, Mary, for joining us for this segment. Mary Auckland has graciously agreed to return and discuss the other concerns she has with dangers for seniors. Thank you.
Mary Buckland 19:43
Thank you.
Miranda Hamilton 19:45
Thank you for tuning into, it's just wallpaper. Please share this episode with your friends and help us reach more seniors needing help with health critical decisions. Visit it just wallpaper.com to catch up on past episodes or find us on Facebook at It's just wallpaper to ask a question.
Elder Law Attorney Rebecca Eyman will help the listener achieve an understanding as to the importance of power of attorney and advance directive legal documents. Additional issues including capacity considerations, erroneous documents, relative costs, and proper safeguarding of documents will be discussed.
Insurance agent Carrie Espinosa reviews medicare supplement plans and the consequences of not having one.
Carrie Espinosa
Horizon Benefit Services
130 N. Genesee St
Waukegan, IL 60085
Licensed in IL & WI
Office Phone: 847-746-6115
Email: Info@horizonbenefitservices.com
www.HorizonBenefitServices.com
Link to article:
Prior Authorization in Medicare Advantage Plans: How Often Is It Used?
Reference Association:
National Association of Health Underwriters
Insurance agent Carrie Espinosa will review the various components of Medicare, scheduled dates to make changes to existing policies, associated premiums, and other considerations.
Carrie Espinosa
Horizon Benefit Services
130 N. Genesee St
Waukegan, IL 60085
Licensed in IL & WI
Office Phone: 847-746-6115
Email: Info@horizonbenefitservices.com
www.HorizonBenefitServices.com
Link to article:
Prior Authorization in Medicare Advantage Plans: How Often Is It Used?
Based upon my work in long term care over the last 40 years I have been fortunate to meet and work with many dedicated and talented individuals that are sharing their knowledge, passion and experience.
Produced by:
Ed Bejarana
Zenith Exhibits Studios
www.zenithexhibits.studio