Why is policy change necessary to improve the plight of the direct caregiver. Robert Espinoza,  the Vice President of Policy at The Paraprofessional Healthcare Institute (PHI) talks with me today about the the reasons behind the present and ever growing shortage of direct caregivers. We discuss:

• low wages
• poor training standards
• no room for advancement
• inadequate supervisory roles

Why should you care about it?  Your parents (or yourself) are likely going to require some kind of care at some point. If you can't afford private pay, you are not going to be able to find someone to care for your parent (or yourself). So who's going to do it? You or your kids...which potentially means leaving your job. And that opens up another whole can of worms..

Home care is one of the fastest growing occupations in America. With ~50% more workers needed by 2026, these are among the most needed jobs of the future. The problem is the median pay is $10.49/hr. It is going to take policy changes at the state and federal level to fix this. And it's going to take making our voices heard to affect this change.

Robert and his team at PHI are not just complaining about this. They are working to become part of the solution. They are doing research and consulting with long term care providers to develop large scale, multi-year initiatives to transform home care jobs. And they take part in the public education process. Check out their website for resources you can use to help start a conversation in your community and learn more about their #60caregiverissues. And follow them on Facebook and Twitter

To me, understanding long term care insurance is like understanding Medicare. There are a lot of moving parts and you need an expert to help you navigate the process.  My conversation with Honey Leveen, the self proclaimed "Queen of LTCi" really helped me get it. One of my take aways was that it is necessary to have long term care insurance; as much as you can afford. Some is better than none. Because with none, you are at the mercy of the government (Medicaid) or a burden on your children. And if you are honest with yourself, you don't want either.

There are two different kinds of LTCi and many moving parts to a policy, which can be manipulated to help you get the best bang for your buck. You need to know that the earlier you plan, the cheaper this insurance can be for you. Children can also take out a policy for their parents.

A long term care policy is your (your parent's) passport to dignity, options, and access to care when it becomes necessary. It  can provide for comprehensive care FOR ALL CARE IN ALL SETTINGS, which includes in home care,  not just medical facility based care like assisted living or nursing homes. And there are very defined triggers for when someone can qualify for benefits. If you have an expert help you navigate the process, you can minimize the challenges associate with making the right decision.

The sooner you sign up for a policy, the lower the premiums are. The average age of a purchaser is mid to late 50's, but you need to consider that the longer you wait, the more likely you are to develop a medical condition that can affect your ability to qualify for coverage, or the rate at which you qualify.

Please talk to your parents and consider for yourself, what are the ramifications for my family if I don't have a LTCi policy? And do some research on  what Medicaid will cover.  If you can get a Medicaid bed in a facility, do you want to be there? We have a generation of people about to retire and most will eventually need some kind of care. Be prepared. Many will be your parents. Are they/you ready?

Check out Honey's website for resources to help you understand. And reach out to her with questions or to help you obtain a policy for your parents or yourself. 

Dr. Roger Landryand his cohorts at Masterpiece Living are on a mission to change how our society thinks about our senior citizens and the trajectory of aging. As a career flight surgeon in the USAF as well as a preventative medicine physician, it has been his life's work to keep people healthy and performing at their best.

He, like many of us, understands the importance of this. Not only for the aging individual, but for our society as a whole. Through the work of The McArthur Foundation it has been determined that lifestyle and the choices we make have the biggest impact on successful aging. And that it is never to late to make changes to improve our trajectory. He says that social isolation and sedentary lifestyle increase your likelihood of developing heart disease, cancer, and dementia. He discusses all of this in depth in his book Live Long, Die Short.

We do not have enough systems in place to foster social connectedness and movement for our oldest citizens. That is going to need to change if we are to provide for our aging population. By providing these resources, we can directly impact healthcare costs. And Dr. Landry believes this is what it is going to take to get political movement.  None of this is rocket science.  He stated that healthcare costs are the single greatest threat to our nation. And soon, one in 5 people will be over age 65, so things are going to get worse unless we get this figured out. So start talking. And start moving. It's good for you.

Let's talk Age in America. With those who are aged. That's what Meg LaPorte is doing. Meg is a freelance journalist and PR and communications specialist who founded Age In America a blog which she calls her passion project. She is interviewing seniors and asks them questions like: "What is it like to be ____(insert age)"? "Do you wish you were younger?" "What is the best/worst thing that has happened to you in your life?" You might be surprised at the responses...

We talk about what we perceive as gaps to be filled as our aging population increases. Some of the issues we agree need addressing are:

• a lack of gerontologists to care for the increasing number of seniors
• the lack of support for unpaid caregivers
• a need for new models of caring
• low wages for the most important paid caregivers in this population--CNA's and PCA's

And she provides a couple of resources worthy of checking out:

Generations United whose mission is to improve the lives of children, youth, and older people through intergenerational collaboration, public policies, and programs for the enduring benefit of all.

Connect The Ages is on a mission to connect 5 million students and young professionals to multidisciplinary career, internship and volunteer opportunities with older generations by 2025.

Lisa Betts-LaCroix is a podcaster, speaker, actor and dancer. She is also a busy wife and mother and a loving daughter. Lisa's vibrant, healthy mom was diagnosed with pancreatic cancer at the age of 78. She's talking with me today about her experience as a caregiver as she, her father, and her mom's best friend cared for her in the final stages of her life.

Lisa offers insight into her family's hospice experience, the support of other family and friends and offers some words of advice about frequent flyer miles, having the tough conversations, and taking pictures.  She candidly discussed how scary it was to her to face death and dying because she had never been exposed to it so intimately before. And said that reading about death helped her with the process. She read: A Good Death   Being Mortal

She had wonderful things to say about The Temmy Latner Center for Palliative Carein Toronto and their home care doctor, Dr. Sandy Buchman

Lisa is the host of the podcast The Super Power U podcast.You can find it all things her at lisabl.com

Diane Omdahl is a registered nurse and a medicare expert. Through her company, 65 Incorporated she uses her extensive experience to provide seniors and their family members with unbiased advice regarding Medicare enrollment guidelines.

Through our conversation today, she made it very clear that there are many things to consider before signing up for  Medicare, as your choices at 65 may not be appropriate for your needs at 75. Paying for expert guidance prior to enrollment can save you thousands of dollars and/or costly mistakes that can be irreparable.

Things that factor into Medicare choices and when you should sign up:

• working after age 65
• employer having  more or less than 20 employees
• HSA's
• Cobra
• spouse continuing to work
• drug plans
• medical history

You'll find a library of resources on her company's website that can educate you, but I think there is probably nothing better than seeking out expert consultation for your parent(s) or your individual needs. Links to resources:

65 Incorporated

Facebook: @65Incorporated

Twitter: @65Incorporated

LinkedIn: 65 Incorporated

Ryan Cook is a certified aging in place specialist, a licensed real estate broker, contractor, and former president of the Boston Chapter of The National Aging in Place Council. He  talks with me today about what membership in The National Aging In Place Council can mean to consumers when they are looking for vetted service providers and what services he (and others like him) can provide. He also offers some sage words of advice.

He has personal reasons for starting down this path. His background is serving our country in the United States Coast Guard and  a career as an Engineer. But an experience with an aging loved one prompted a change of focus. Ryan shares his story in this episode.

Links to Ryan:

FB:@expectfirstclass

FB: @onthelevelconstructionMA

[email protected]  (c) 508-659-5152

The National Aging In Place Council

Toni is a 40 year-old woman with a career. She is also a wife,  a Mom,  and  a daughter. Three years ago, she never imagined that she would also be a caregiver to her now 69 year old mother.

Toni shares her story with us. The things she had to figure out the hard way, the challenges they still face, and the bright moments through all of it. She and her Dad have figured out a way to navigate the ups and downs. They have a "new normal".

And she admits she is lucky. She had professional resources through her work as a behavior specialist working with disabled adults to point her in the right direction. She also has a supportive work environment. And with (finally) the approval of her Mom's Medicaid application, they are able to have 24/7 care for her at home. Words of wisdom...PAY FOR THE ELDER CARE ATTORNEY!

But that doesn't mean it's easy. Listen to her story. She really wanted to tell it in the hopes that it helps someone else know they are not alone.

Places she suggested to check in your local community for help:

With Medicaid application: Your local library

For Support groups: Senior Center or Adult Day Care Center

And the best thing to have for a loved one who isn't able to transfer: An electric reclining chair!

A great resource for information on Alzheimer's is Jean Lee. Here's a link to our talk and her resources:

Alz Authors

Scott Williams is a patient advocate. In fact, his title is Vice President of patient advocacy at EMD Sorono. He has both personal and professional reasons for his passion for supporting caregivers. He has faced the challenges of being not only a patient being supported by a family member, but also as a caregiver providing care for a family member. He is so involved in patient advocacy, that he has given a TED talk about it.

The three biggest challenges he faces as a carer are:

• the strain of the logistics and planning of the long distance caregiver
• the sacrifice of your own health/wellbeing
• juggling/managing your own work/life/caregiver time

He feels, and I agree, that the challenges of caring for our aging society, is one of the largest healthcare issues of our time. Listen and hear about what his company is doing for their employees to support them in their roles as informal caregivers, and how they are taking a global look at how we can better support informal carers. 

I firmly believe that he and his team are on the right track. The system we have in place is not only inadequate to provide  the amount of care that our aging population is going to need, but it is also not providing the KIND of care they(we) want. If we don't start advocating, LOUD AND CLEAR, we are going to miss the boat. Please join us. We need a village. In fact, we need LOTS of villages.

Links to resources:

embracingcarers.com

The International Alliance of Carer Organizations

EMD Sorono

All I can say is advanced care planning is the moral of the story. Not only for today's episode, but in general. The concept of advanced planning is not rocket science. We do it for vacations, weddings, and other fun things. But it's even more important when planning for old age, the potential for infirmity, and death. Everything your parents have worked their entire life for is at stake.

Todd Lutsky is an elder attorney and an expert in elder law and all things regarding asset protection. He gives us an elementary education on terminology, and provides great examples of why it is SO important to consult with an elder law attorney to talk about how best to protect your assets. He defines Medicaid Planning, Life Estate Planning, Medicaid Qualified Annuities, as well as Medicaid Income Only Irrevocable Trusts, to name a few.

All I can say is one of THE most important episode I have produced thus far. "The Greying of America" is real. And impending. Are you going to stay silent because these subjects are "personal" and "none of my business" or  speak up and start helping your parents negotiate the later stages of life in a way that is beneficial and protective of their lives of hard work? Why shouldn't asset protection be as important as your next vacation?

Links to Todd and additional resources can be found here:

The Legal Exchange

Cushing and Dolan, PC

National Aging in Place Council