Reimagining Care Delivery: Toward A More Perfect Health Care System

What would a more perfect health care delivery system for older adults look like? Howard Gleckman, an Urban Institute Fellow, journalist and the author of Caring for Our Parents, will talk about where seniors now get care, who pays for it, how to plan for care an elder may need, and the importance of family communication Presented by Reston for a Lifetime in partnership with the Positive Aging Community.

https://howardgleckman.com/

Chat Transcript

12:02:12     From  Margie McWilliams : This is Margie McWilliams, the newest member of Bonnie Elliott's team with CarePatrol of Central MD & Loudon, VA.Thank you for this resource

12:02:39     From  Steve Gurney - ProAging Community : https://www.restonforalifetime.org/

12:03:18     From  Steve Gurney - ProAging Community : Through its programs, services and resources, the national Village to Village Network empowers Villages in formation, energizes functioning Villages, serves as a Village commons to connect its members, and champions the Village model as a leading best practice for healthy and vibrant aging. Village members remain connected to their communities, with reduced isolation, increased independence and enhanced purpose of life. https://www.vtvnetwork.org/

12:06:42     From  Steve Gurney - ProAging Community : Just a reminder you can ask as many questions as you like or make comments on this topic.  Just use chat or the Q&A button.

12:12:48     From  Steve Gurney - ProAging Community : We will have a discussion on PACE on July 18 stay tuned to registration

12:15:19     From  Louis Tenenbaum : I can’t agree more, Howard, at the need for a comprehensive management SYSTEM.  Please see also https://www.giaging.org/documents/mmi-aging-place-study.pdf

12:19:52     From  Steve Gurney - ProAging Community : PACEFinder: Find a PACE Program in Your Neighborhood https://www.npaonline.org/pace-you/pacefinder-find-pace-program-your-neighborhood

12:19:54     From  ESTHER GREENHOUSE : Here is a resource for planning “Enabling by Design:  Leveraging Home Features for Physical and Financial Independence in Retirement” https://silvertogoldstrategies.com/wp-content/uploads/2022/11/Enabling-by-Design-Esther-Greenhouse-CSA-journal-article.pdf

12:20:11     From  Steve Gurney - ProAging Community : JCA helps older adults in the Greater Washington, D.C. region maintain independence, dignity, vitality, and self-respect. https://accessjca.org/

12:21:12     From  Margie McWilliams : I find that if someone has gotten into their 50's without a significant nest egg or plan to pay for care needs in their "senior" years, they are too embarrassed to ask for help.  I have met many, many people who are living on Social Security income alone, and have no savings to speak of. Many also don't have a POA or anyone in their life willing to serve in this role.  We need a safety net for and ways to help these people.

12:21:31     From  ESTHER GREENHOUSE : The American Senior Housing Association has a section for Consumers with lots of helpful resources https://www.whereyoulivematters.org/

12:22:39     From  Steve Gurney - ProAging Community : Senior HelpLine: 240-290-3311 or 703-652-1515

12:22:47     From  Steve Gurney - ProAging Community : Email: SeniorHelpLine@AccessJCA.org

12:23:18     From  Steve Gurney - ProAging Community : UCLA Alzheimer’s and Dementia Care Program https://www.uclahealth.org/medical-services/geriatrics/dementia

12:24:35     From  joy loverde : Hello to Howard. My book

12:24:39     From  ESTHER GREENHOUSE : To enable successful Aging in Place use the AARP Home Fit Guide https://www.aarp.org/livable-communities/housing/info-2020/homefit-guide.html

12:25:19     From  joy loverde : "Who Will Take Care of Me When I'm Old?" is critical for planning. Buy at Amazon.

12:26:36     From  Steve Gurney - ProAging Community : Who Will Take Care of Me When I'm Old? https://a.co/d/dNhFWuB

12:27:31     From  ESTHER GREENHOUSE : To find a professional to help you modify your home or build new, find a Certified Aging in Place Specialist (CAPS).  The CAPS program was created with AARP and the American Occupational Therapist’s Association.  You can find a pro in your region here:  https://www.nahb.org/nahb-community/nahb-directories/professionals-with-home-building-designations-directory#sort=@lastname ascending&f:Designation=[CAPS]

12:27:55     From  ESTHER GREENHOUSE : CAPS professionals must sign a Code of Ethics.

12:30:06     From  Elizabeth Nolte : What services could $100/d cover when the daily  nursing home cost is so high?

12:30:11     From  Louis Tenenbaum : The catastrophic program would be incorporated or required info or incentives ( price breaks, etc.) for planning or home mods, etc….The items Howard has suggested.

12:31:38     From  Catherine Twitmyer   to   Hosts and panelists : How are children supposed to manage care for their parents when they have too much for Medicaid, but not enough to cover $500/day for care.

12:34:00     From  Steve Gurney - ProAging Community : Building Your Personal "Village" For Your Solo Aging, Aging in Place, Affordability and More!  https://www.retirementlivingsourcebook.com/videos/building-your-personal-village-for-your-solo-aging-aging-in-place-affordability-and-more

12:34:14     From  Annette Shinafelt : Steve, when I view this program after the original broadcast,  how do I get to the chat comments?

12:35:06     From  Steve Gurney - ProAging Community : We are recording this and the chat will be available at the link at www.proaging.com

12:35:26     From  joy loverde : It's about people. Not technology.

12:37:56     From  Catherine Twitmyer : Are there any special resources for dementia/Alzheimers in particular?  I get calls regularly from children with parents with these conditions who cannot afford a care setting at $12k+/mo.  This is going to become a huge problem for our country.

12:38:22     From  M. Eileen Roehr   to   Hosts and panelists : Unitarian Church is Reston also has Caring Circle that provides many supports congragation

12:38:32     From  Teri Bond   to   Hosts and panelists : You can have all of those pieces in terms of family and friends but the long term care facilities can’t keep trained staff….it is the inconsistencies  in staffing and care that do not allow the success you talk about. We really need honest critiques of facilities and care. So wish you would share information on the facilities that you think work well and why. That is what I was hoping to get from this webinar.

12:39:59     From  Steve Gurney - ProAging Community : From M. Eileen Roehr to All Panelists 12:38 PM

Unitarian Church is Reston also has Caring Circle that provides many supports congragation

12:40:59     From  Louis Tenenbaum : Caregiving is like a three leggwd race. You are tied at the hip. If either party goes down, you are out of the race.

12:41:26     From  Teri Bond   to   Hosts and panelists : And to be clarify I am talking about memory care…from my experience Assisted Living can be really good but Memory Care is challenging for all particularly a loved one that has lost their ability to speak. They are dependent and vulnerable…and need caring and trained staff that pays attention to that resident’s needs as they can’t advocate for themselves..

12:44:44     From  M. Eileen Roehr   to   Hosts and panelists : Insight Memory Care in Fairfax. Has many free trainings and support groups on line

12:44:59     From  Steve Gurney - ProAging Community : Dementia Action Alliance (DAA) is where people come together to connect, form friendships, exchange ideas, learn, and create a better community in which to live with dementia. https://daanow.org/

12:45:11     From  Steve Gurney - ProAging Community : From M. Eileen Roehr to All Panelists 12:44 PM

Insight Memory Care in Fairfax. Has many free trainings and support groups on line

12:45:27     From  Steve Gurney - ProAging Community : https://www.insightmcc.org/

12:46:14     From  joy loverde : The number of dementia-friendly accredited cities are growing.

12:46:16     From  ESTHER GREENHOUSE : Success story:  we designed and built a home that enabled my mother to retain as much of her physical + financial independence as possible.  Along with our caregiving, the home enabled her to delay moving to a facility by 5-7 years—saving the family $500,000.  https://silvertogoldstrategies.com/reducing-caregiving-demands-long-term-care-costs-by-design/

12:47:58     From  Steve Gurney - ProAging Community : Tackling the Caregiving Crisis by Design with Esther Greenhouse https://www.retirementlivingsourcebook.com/videos/tackling-the-caregiving-crisis-by-design-with-esther-greenhouse

12:48:56     From  Steve Gurney - ProAging Community : Communicate, Organize and plan, so important. 

Such amazing information when you explained that Caregivers lose as much as $300,000 that's three hundred thousand dollars in their life time because of having to stop working or work part time. 

Can you talk about caregivers not having any money or savings for retirement You say Make a financial plan. 

You say So where is the money going to come from? 

How do you do financial planning with stressful demands of being caregivers.

You said many elders are having to accept the cold harsh bitter truth of reality that as a frail senior

as you age

you may get 

no help at all 

many frail seniors have

died alone with no help and no one to help you and were only found when mail person delivering the mail noticed that they smelled something uncomfortable odors coming from the home

at least begin to plan and begin to take care of yourself enough to look at this situation 

even though you have no resources

Thank you so much. Helpful  wisdom

12:50:43     From  Steve Gurney - ProAging Community : Locate a Green House home https://thegreenhouseproject.org/find-a-home/

12:50:48     From  Margie McWilliams : I've worked in two skilled nursing communities & two assisted living communities, YES - Howard just hit the nail on the head!  Pay attention to staff ratios (required to be posted on each unit), and how staff are interacting with each other, residents, and anyone on tour!

12:51:27     From  ESTHER GREENHOUSE : I am looking forward to the day when long term care staff are paid a living wage throughout the US. We have been discussing their low wages for over 30 years.

12:51:46     From  Morris Klein : But facilities have been resistant to laws requiring minimum staffing

12:52:10     From  Leslie McTyre : This theme needs to be continued with long term intention.  From the politics inherent in the solutions to the technical and operational areas that have been touched on, we are not in a position to deal with the emergency now and when the climate catastrophe this harder older adults will be sacrificed more easily than even now.  What can we do to kick off a movement that results from this discussion?

12:52:18     From  Margie McWilliams : I'm in many skilled nursing communities daily now for my work at CarePatrol, and things since COVID are so, SO challenging.  That said, good care communities are out there. That's why I have helped many friends and family members with the task of finding care.  It's also important to remember that no where is perfect, ever.

12:53:17     From  Margie McWilliams : Didn't know that about Manor Care. Steve!

12:53:23     From  Louis Tenenbaum : ABSOLUTELY!  The staff takes it’s lead and approach atmosphere is created from the top, but you can feel it from the staff. Do they like and feel good about their work?

12:53:42     From  Teri Bond : Yes I was totally surprised to learn that Maryland does not have standards….just what the facility says is needed.

12:53:53     From  Margie McWilliams : ????

12:54:06     From  Margie McWilliams : There are State and Federal standards

12:54:59     From  Steve Gurney - ProAging Community : Anonymous Attendee 12:53 PM 

Prostate Cancer and other medical tests, changes with tests, recent articles and news stories about aggressive medical treatments and surgery treatments when careful surveillances and planned monitoring. 

They mention especially men and prostate cancer the treatments have changed so much, but many primary care doctors and other staff do not know about changing care plans. 

Do you have any comments and information about these life changes in care plan?

12:55:14     From  Teri Bond : Thinking required in person training…not on line…is very important to make sure staff gets it!

12:56:51     From  Steve Gurney - ProAging Community : Report exposes major gap between consumer expectations and community offerings in senior living https://www.retirementlivingsourcebook.com/proagingnews/report-exposes-major-gap-between-consumer-expectations-and-community-offerings-in-senior-living

12:58:10     From  M. Eileen Roehr   to   Hosts and panelists : You are sooooo right about being part of community!!!!

12:58:19     From  Margie McWilliams : Yes! Cookies always help/

12:58:47     From  ESTHER GREENHOUSE : And thank the staff for caring for your parent.  We did this and were sad to hear from staff that they are never thanked by family or the administration.

12:58:49     From  paula david   to   Hosts and panelists : Perfect example Steve....I was never the drop the kid off kind of parent and am horrified at the thought of doing that to my folks.

12:58:51     From  Teri Bond : I have to say that even when you check all the staffing out…it changes and you have no control. Both the facilities that my husband has been at (yes I moved him because of those changes) have had 100% turnover. He had a guardian angel for his 1st year at his new facility but when she left things have gone terribly downhill. The director is great so she is my salvation.

13:00:08     From  Margie McWilliams : It's also hard for helping professionals to get into skilled nursing homes to talk to care planning team members and offer assistance. During the Pandemic, they realized how many interruptions they got, and since re-opening to the public and "vendors", they are rarely or never available and don't return calls or emails in a timely manner. Same with Hospitals.

13:01:00     From  joy loverde : Steve... the buddy system must be intergenerational.

13:01:45     From  Annette Shinafelt : Don't you also need to consider whether you have Medicare or Medicare Advantage in selecting a nursing home that you want?

13:02:14     From  Teri Bond : It’s not just about the money though..having friends help is great social interaction and keeps your loved one engaged.

13:02:57     From  Ann Sloane   to   Hosts and panelists : Sadly, a family member I knew had to find new care in a crisis when Manor Care closed the place where she was living, on short notice!!!

13:03:26     From  ESTHER GREENHOUSE : During Medicare enrollment, make sure the plan you pick is in network for the facility.  Someone told me this and we saved $15,000 in one year.

13:03:56     From  Margie McWilliams : So much great info and valuable resources. I've already been sharing the link to the recorded webinar re: Building Your Own Village with many Facebook Groups.

13:04:40     From  Morna Moher : Thank you for your time and sharing of resources. As the daughter of aging parents, this will be helpful for me as they navigate the coming years.

13:04:45     From  ESTHER GREENHOUSE : Thank you! Phenomenal!

13:04:59     From  Leslie McTyre : Thank you all!!