Nancy May, Eldercare Success: Hello, everybody.

Welcome to another episode of Doing it Best With Eldercare Success.

This is going to be a really informative session because I am here with Lynn

Smargis, who is a senior care advisor and consultant to helping those of us

who are looking for a place for our mom and dad to live in a community.

Understanding how those types of individuals like Lynn works is so

important to the quality of care that our folks get, the types of

facilities that we're introduced to, and even understanding how to

work with a professional like Lynn.

And I have some bias on some certain things that we're going

to talk about, and Lynn and I have discussed those in advance.

And, and she understands because she's got some concerns about how that, I'll

say, placement industry works as well.

But on that note, let's dive in real quickly.

And Lynn, thank you so much for joining me here today.

I am thrilled to have you here as a guest because this gives us sort of a

A look behind the curtain, I would say.

Lynn Smargis - Guest: Yes, and thank you, Nancy, for having me come on

because this is actually a topic I really have to educate my clients on

because, you know, most of the time when people call me, it's the first

time they've ever used a senior advisor.

Nancy May, Eldercare Success: Well, and we all see those ads online, just

call and it's free and everything else is going to be just hunky dory.

Well, maybe not so.

And why don't we just dive into the aspect of what should somebody first do when

they're a little concerned that mom or dad may not be able to live on their own

and are looking for a new home for them.

Let's call it that,

Lynn Smargis - Guest: Yes.

And, um, before I answer that question, Nancy, one of the things I want to really

briefly touch on is a lot of seniors and their adult children are always really

worried about moving their parents from their, home they've been living in for

40, 50 years into retirement living.

And I totally understand that.

But one of the things I always educate my clients on is that you have to

look at it When mo the, this move in, in this sort of mindset, right?

Like you grow up as a kid and you're in your parents' home and then you get

married or you don't get married, you go off to college and you move and then

maybe you get married or find someone down the line and then you move again,

and then you might move into a bigger house 'cause you have kids, and then

you might move into a smaller house because then you don't have kids.

Well, this is just another stage in the step.

It doesn't mean.

That your parents are just going to just sit around and wait to

pass, This is not what that is.

what happens at that point in their life is really up to your parents and how you

can support them, to be as independent as possible based on, what their health

challenges are, things like that.

but to get back to your question, first thing you need to do if you

see that your parent is declining, there's actually a few different

things depending on your circumstance.

One is I always recommend my clients to, you could go to their GP, but one

of the things you might want to do instead of going to their GP is to find

a gerontologist to, Consult with you and to do an evaluation of your parent.

And the reason a gerontologist would be better than a GP is because

gerontologists specialize in senior care.

Now that might not sound like a huge difference, but the thing is,

is that seniors present different things, like specifically infections,

a lot differently medically than somebody who is not a senior, right?

Like children will present things differently then an adult.

And so you want to go to a gerontologist because you don't want

somebody to misdiagnose your parents.

I actually had that happened to a client and they misdiagnosed her mom with

dementia and she didn't have dementia.

But now that's on her medical record and you cannot get that off.

So you want to get an accurate diagnosis.

The next thing I would do or do in conjunction with this is to

say, tell your parents, Hey, I'm really concerned about you.

I want to make sure I can support you.

Let's sit down and go over all of your documents you have, like life insurance,

veterans benefits, social security, like what is their income per month?

What do they have?

What type of financial resources will they have?

What other resources do they have or not have?

So, you really need to get a good holistic picture of where they're

sitting, both financially, emotionally, and medically, before you can even

make the first step, to do something.

Because unless you have all of that information.

to give to even a senior advisor, if you're wanting to hire a senior

advisor or wanting to go with a senior advisor, you're, you are not going

to have the information you need to place your parent in the right place.

Retirement living, especially, if they think they're forgetting, but

Dementia is a huge deal.

and so is diabetes.

Diabetes is another big one.

especially if it's unmanaged.

So I, I would recommend that would be the first thing I would do if my

parents were in that situation today.

Nancy May, Eldercare Success: you bring up multiple aspects, but I

think the biggest to start with, well, the first two biggest is to really

get a proper diagnosis of what their current situation is and, You're right.

Adults or seniors do present differently in their medical

situations because dementia may not necessarily be, what they've got.

It could be a reaction to a prescription that they're on.

Things change over time, and just because mom or dad have been on, let's

say, I'll use this as an example, it may not be the best one, but like blood

pressure medicine, and all of a sudden, now they're having a reaction to it.

Our chemical systems do change and we do have reactions to medications over

time as our blood gets thinner, our bodies get more frail, and other things

interact and they may be on different medications that are now interacting

with one another that you don't even know about because now they've gone to

multiple pharmacies to get what they need.

So that's critical and I agree with you.

Once dementia is on, on a diagnosis.

It's very difficult to get off.

Lynn Smargis - Guest: Yes.

And, and with any medical diagnosis that actually happened with my daughter, they

gave her an incorrect medical diagnosis and she can't get that off her chart.

And every doctor reads that.

Nancy May, Eldercare Success: And it may not necessarily be accurate.

So, that's, I would say a huge problem with our whole medical system as well,

but that's probably for another podcast.

Lynn Smargis - Guest: a whole nother series.

Yes, yes.

Nancy May, Eldercare Success: all the documentation as far as legal and just

as important, More important, I would say, when you're going into a care

facility or any kind of continued care or care home, Is really understanding

the financial situation because care facilities can ask you to leave after

they've exhausted all your finances.

And most will not admit that.

I would say 99.

9 percent of them will never admit that.

They'll always say, Oh, well, we can figure things out.

Well, yeah, figure things out.

the lack of beds has to do with Medicaid, not Medicare For And anybody listening,

I just want to let you know that scare tactic that a lot of facilities will use

saying, Oh, you got to go now because we have a bed and we don't have any more.

It's predominantly because they have, they're only required to

have a certain percentage of beds.

per facility based on the number of rooms or beds that they have.

many people call it heads in beds scenario.

But, as listeners know, I am not a fan of care facilities, but I do understand,

I mean, full disclosure, I do understand that not all of us have the luxury

of being able to keep mom and dad at home with the support that we need.

And it's not so much that the price or the cost of care or service is

that much different in the long run.

It's just that it takes a little bit more time.

So, anyway, I'm drifting off the discussion.

Lynn Smargis - Guest: There's so many side roads we could go down

Nancy May, Eldercare Success: Oh my God, we could be, we could be on here for

a year talking about this, but I'm not going to burden everybody with that one.

so now let's say I've decided and mom and dad have agreed that.

I can't take care of them anymore.

I can't do the support for them to give them the help that they need.

It would be best for them to make that transition into a place that they have

access to community, to events, to activities, and somebody who's there

just in case in the middle of the night.

an accident happens.

And I think that's probably the biggest advantage if you do not have 24 or seven

care at home is to know that if there is an accident or there's some issue

or there's some fear thing that goes on because there's night terrors and other

things that can go on based on again it could be a prescription, it could be

a dementia thing, it could be anything that's going on that somebody who's alone

or even Worried about a health situation could get frightened up in the middle

of the night and not know who to call.

So what happens when I've decided or mom and dad and I have decided

that this is the next step.

I need to call and contact somebody like you.

What's the best step I do?

Do I type in my name into a website saying, Please call me and all of a

sudden I'm barraged by all sorts of people who have never really even toured

a facility that, they may be recommending.

Lynn Smargis - Guest: Yeah.

I would recommend you can call and ask questions, but do not give anybody

your information because there's a couple different, quote unquote,

Nancy May, Eldercare Success: Well, I'm gonna stop you right there.

What kind of information are you talking about?

You're talking about my

Lynn Smargis - Guest: any personal information.

Nancy May, Eldercare Success: anything.

Lynn Smargis - Guest: not your mom's first name, not your first name,

anything, because there are a variety of quote unquote services out there

that said they will refer you, but what they really do is just take your

information and just send it out to 10 different places, and all those places

will call you like within three days.

So it's really stressful,

Nancy May, Eldercare Success: It won't even take three days.

It'll take five seconds.

Trust me.

I do secret shopping of care facilities.

Lynn Smargis - Guest: it does.

And then I find the adult children are just super frustrated, of course, because

who just wants to get sold to, right?

I don't want that.

Nobody wants that.

And, that's typically what they do.

And so once you put your information online and the director of a community

gets your information, then you are considered an independent.

Family and then you go, you could go and tour that facility.

But the problem is if you hire a senior advisor down the line, because you're

really stressed because all these communities have all these different

roles and all as far as financial and like who they'll take, who they won't

take And medical and all these things.

And then say you tour three facilities and you've given your name to ten

and then you call a senior advisor.

Well, that senior advisor won't be able to help you because once you put your

name into a system, the senior advisor won't be able to get paid because we get

paid from the communities and there's this really stupid rule and it's in

no other vertical that I've ever seen is that whoever contacts the facility

first gets the commission for the senior moving into the community, and

I think that is the dumbest rule ever.

I feel like the family should choose who they want to, represent them.

And so if you decide it's time to start looking into it, go

online, just look around, do not put your information in anywhere.

Look on the websites, look up reviews, but don't put your

information in and don't give them your mom's name, your dad's name.

Like any of your family names, because um, once you do, then you are in

their system and then that senior advisor can't get paid to place

you in that retirement facility.

Nancy May, Eldercare Success: Is that a state or is that a contractual,

Lynn Smargis - Guest: that is a national thing as far as I know.

Every senior

Nancy May, Eldercare Success: That's a national thing.

That's a, wow.

Lynn Smargis - Guest: every senior advisor I know in every state has, has

run into that issue more than once.

Nancy May, Eldercare Success: Well, I think that's a situation

that's up for a lobby debate.

That's, the big companies are the ones that have the power to be in that one.

And that's wrong.

basically you sold your right without even knowing that you have

sold your right to some strange organization who is now marketing

you and your personal information without you necessarily knowing,

unless you're reading the fine print.

And even still, they may not disclose it in the fine print.

Lynn Smargis - Guest: Oh yeah, they do, but it's like, you know,

nobody reads it, and they also sell your information to other people.

So it's not just giving it to communities, they sell it.

So there is actually a, I think it's a congressman from Pennsylvania who is

right now making a move against one of the really big players that do this, because

he says it's unethical, basically, what they're doing, and a conflict of interest,

and so he's actually making political moves against one of the organizations

that do this, because it's just wrong,

Nancy May, Eldercare Success: Yeah, we're not purposely saying the names because I

don't want to be held liable against that.

It's very easy.

there are at least two major players in this space right now.

So, um, I will give you an example of what happened to me in my Secret Shopping.

Now, both my parents have now passed, So, There's nothing to be sold, at least as

far as their situation, and I'll go in and say, well, I'm caring for my Aunt Sally.

Or whoever it is.

And one woman, went through some financial information.

Look at, I was so appalled by the the, the amount of information that

she wanted that I said, I'm not comfortable sharing that information.

She came down to wanting to know a social security number.

She wanted to know pensions about insurance.

Did they own a home?

Did they not own a home?

And the list went on, including.

investments, the, I mean, it went down to the penny of what kind of questions

she was asking financially on the phone.

And then, she says, well, okay, what is your budget?

And I gave her a budget, I said, of, I think it was 3, 500 to 4, 500.

And she goes, oh, okay.

Well, that was kind of condescending.

I

mean, it

Lynn Smargis - Guest: so sorry.

You don't meet our criteria, Ms.

Nancy.

Nancy May, Eldercare Success: Right, right.

You're not, well, you're not willing to pay 100, 000 a

Lynn Smargis - Guest: not good enough for our community.

Nancy May, Eldercare Success: it's this, this tactic, the emotional

tactic that they use even so subtly.

And then she says, well, here's a, based on what you can afford.

Well, thank you, you know, SOB.

Lynn Smargis - Guest: Right?

Nancy May, Eldercare Success: thank you, bitch.

I might blank that one out.

But, anyway, So, she said, here's a facility, and now, I was in the area

where we live, so I was particularly interested to see what she would tell

me, and, one I know is horrible, one of the others that she gave me was the place

that I took my parents out of, which was considered one of the nicer ones in

the, it was a very lovely place, I mean, lovely, it was, looks are deceiving.

Let's put it that way.

And, and I said, no, I wouldn't put my dog in that place.

I'm familiar with it.

And her response was, Oh, really?

The brochure looks so lovely.

Lynn Smargis - Guest: of course.

The brochure looks lovely.

Nancy May, Eldercare Success: so that means that she's in some other state.

I have no idea where she is and she is just selling the names in the list.

Well, hell, I can do that if that's what I want to do versus making an appointment.

Why do I need her to do that?

Lynn Smargis - Guest: An eighth grader can do that.

Nancy May, Eldercare Success: Yeah, yeah, probably a third grader can do that.

But even still, the reason why I mention this is because I think it's

so important for those of you who are listening to really understand, as

I refer to this, is the tricks and the traps of the aging care business.

And that's not just with care facilities, it's with everything.

But yeah.

so Lynn, let's explain, let's really cover some of the things that you actually do

to help people go through this process, including making sure that they've

selected the right place based on their finances, but also based on the quality

of care that they want, because finances are one thing, but if the quality of

care and service is not there, which is a challenge for many of these places,

because they just don't have the staffing.

to get there and pressures from management continue to grow because

many of them are public companies.

And you, I'm just letting you know, you, the family member is not the customer.

The main customer and concern of these facilities that are public

companies are the shareholders.

I'll leave it at that and let you go from there.

Lynn Smargis - Guest: Okay, great.

Thank you, Nancy.

Yeah.

and that is true.

And, one of the reasons why I really tried to get my families to,

tour places that are owned, still independently owned, which there's

not very many of them because a lot of them have sold to bigger companies.

but.

On your thing of appearance, I 110 percent agree with you.

I have families all the time.

So I live in, my farm is in McMindle, which is a town that's

an hour south of Portland.

And we're right in the middle of wine and hazelnut country.

So a lot of people know this area.

It's actually a really big, retirement area.

A lot of people like to come here because it's like, it's rural.

It's really nice.

It's suburbs, but it's just a really nice lifestyle.

Like you have everything you want here.

And then if you want to go into Portland, you can.

It's, The reason why I moved here two years ago, I loved it.

Like, I'm probably

Nancy May, Eldercare Success: I'll bring my glass of wine when I go tour

facilities and that there the twain shall

Lynn Smargis - Guest: We actually have a facility called Vineyard

Heights and it's wine themed.

Nancy May, Eldercare Success: I love it.

All right.

Great.

I want to die with a glass of wine in my hand.

Lynn Smargis - Guest: Right?

Like, that's not bad.

Yeah, that is not a bad proposition.

Nancy May, Eldercare Success: maybe a case and a straw.

Lynn Smargis - Guest: Yes, if you ever want really good

wine, come out to McMinnville.

You can go to any supermarket and buy cases of wine very easily,

and, and all sorts of things.

And Pinot is our, signature wine here.

So if you love Pinot, come out to McMinnville, Oregon.

You will have the best Pinot experience you have ever

Nancy May, Eldercare Success: This is probably the best

conversation I've had so far.

Wine and aging care.

I always joke with people, I say everybody wants to come to McMinnville

to retire just for the wine.

That sounds like a good place to

Lynn Smargis - Guest: Right, it's not a bad plan, I can tell you that.

But yeah, but getting back to the appearance thing, I

absolutely agree with you on that.

One of the places we have here is called Hillside.

and Hillside is a nice place.

There's nothing that I, that has red flag, I call it red flag wrong.

if you walk into a place and you're like, oh, that's a red flag.

and, but people know it because it's the biggest place in McMinnville.

So we, the McMinnville has a population of 35, 000, to give you some context.

We have 8, 000 people.

Eight Senior Retirement Living Places in McMinnville, which

is a lot for this small town.

But because it's a big retirement area, people build retirement places here.

And so anyway, almost every client that wants to look in McMinnville

was Oh, I want to look at Hillside.

I want to look at Hillside.

Like repeatedly, because they know it because they see and they're

like, Oh, it looks so beautiful.

It's like, yes, it does look beautiful.

And there are a lot of independent cottages there.

And there are advantages to living in Hillside.

However, Hillside is a, What's known as a CCRC, which is a Continuing

Care Retirement Community.

And for those of you who don't know what that is, that is a community that has all

levels of care from independent living, assisted memory care, skilled nursing,

which used to be called nursing homes.

And now they call it skilled nursing facility and rehab.

The advantage of that is no matter what level of care you

need, you always have it there.

So you never have to move out of your community.

The disadvantage is, is you have to put it.

up front, a large fee, anywhere from 50, 000 to 2 million, depending on the

location, the community, what they're offering you, and it really varies.

Of course, like the bigger cottage you want, the more

upfront fee you have to pay.

and down the line, if you decide you don't like it, guess what?

You've just lost that huge chunk of deposit you put there, and then

you have to move and pay a new registration fee somewhere else.

That's not going to be that much.

So, a CCRC is different from, Just what I call a regular retirement community,

a regular retirement community, which usually has like independent and assisted,

or it'll have assisted and memory care, or it might have a different combination.

You usually have to pay a registration fee of anywhere from 1, and that's a one

time fee, and then you have like your regular rent and care on top of that.

So it's a way lower cost.

Upfront Cost, and I always tell my clients, like one client I

toured, they were, they're like, oh, I want to go to Hillside.

I'm like, okay, I will tour you on Hillside, but I will let you know

right now up front that I never suggest a continuing care retirement

community to any of my clients who have less than an eight figure savings.

Because, and the reason is, is because it's not that you couldn't afford it

if you had a seven figure savings, but if you did get in there and you decided

to move somewhere else, it's That's going to take a huge chunk of your

retirement money off the plate that you have no control over getting back.

And so I don't want to see my clients be in that situation if for some reason they

decide they don't want to be in a CCRC.

And so that's why I always say don't go looking at CCRCs unless you have

an eight figure retirement savings.

Because then if you do make that mistake, it's not going to

hurt as much in your pocketbook.

Nancy May, Eldercare Success: I'm going to stop you right there a second.

Have you heard of people who are in CCRC, Continued Care Retirement

Communities, who have been asked to leave because they have, run out of assets?

Lynn Smargis - Guest: I have not,

Nancy May, Eldercare Success: Because that's what the upfront fee is typically

about, is to make sure that you don't,

Lynn Smargis - Guest: Right.

So what I have been told by a couple, two or three different directors of

CCRCs is they said, if you run out of assets, we will keep you here.

However, if you run out of assets because you gamble them or you

become, addicted to alcohol and you're just spending it on alcohol,

then they, then that nullifies that.

But if it's just like cancer or whatever, and it really drained your, your

funds because of medical or something else that was not something, that

was unnecessary, then from what I've heard, I, they will keep you there.

I have never heard of anybody getting kicked out of a CCRC because they

couldn't afford it, but again, it may have happened and I just don't know about it.

Right.

Nancy May, Eldercare Success: many of them will say, upon your passing, if

there is money left over in that poll, 80 percent of that will go back to

your heirs or to your beneficiaries.

My response to that is good luck.

Lynn Smargis - Guest: Well, yeah, so here's the thing I always tell my clients.

If you're going into a CCRC, before you sign anything, take that

paperwork to an eldercare attorney.

An eldercare attorney specifically, not just a general attorney, but an eldercare

or someone who deals with estate planning.

And have them read it over, because you want to make sure that there's nothing

in that paperwork that is, going to bite you in the butt, so to speak, later on.

and so I always tell people that don't sign anything unless you've taken that

to an attorney, because it's going to be well worth your 1, 500 or 2,

500, whatever it is, for them to just review that contract for you and make

sure there are no red flags in it.

Because again, like my dad used to say growing up, and I always used

to be like, oh dad, you're so silly.

Absolutely true.

The only two things that are guaranteed in life are death and taxes.

Nancy May, Eldercare Success: Well, the other thing too is, attorneys are not

necessarily designed or I would say design is the wrong term, but attorneys are not

necessarily financially astute, which is rather interesting to, to think about.

And my experience working in the corporate world for so long and contracts

and at high levels in the boards of directors and whatnot, is that their

skill is really in telling you what not to do, not how to do something well.

So, what we do here is we do review care facility contracts so people

understand, so they actually can look at where the hidden traps are.

An attorney's not going to know what's going to happen behind closed doors

when they don't, they may know that facility, but they don't know necessarily

what those details might be to you.

Like a change in a contract rule where all of a sudden now there's a

higher price and you only have, let's say, disposal income of, 10, 000 a

month and now your brought it up to 15, 000 a month or 30, 000 a month

where my parents were ended up being.

It's like, wait a second.

So understanding what questions to ask and where the rules change

along the way is critical to anybody at this point in, in life so that.

We don't, I would say we really don't get it taken advantage of, or as

I like to say, you don't get screw glued and tattooed along the way.

Lynn Smargis - Guest: Right.

Yeah.

And to your point too, that's one of the

Nancy May, Eldercare Success: Like mom doesn't need a tramp stamp.

Lynn Smargis - Guest: Right, exactly.

That's one of the things I really do for my families is I ask all of those

questions because I'm in the industry, so I know the questions to ask that my,

my clients may not know to ask because, you know, they're just looking, they're

stressed, they've been taking care of their, they may have been taking care

of their parents for years at this point and they're tired and exhausted.

So I'm really big on advocating for my families and asking all the questions

and I will tell them if something doesn't look right at a community,

I'll be like, if I were you, what?

My personal advice is I would not go here.

Nancy May, Eldercare Success: Now you're unusual because not every

senior care advisor who gets paid by the facility would necessarily do that

Lynn Smargis - Guest: oh no, but I, I like, honestly, Nancy, I couldn't sleep

with myself at night if I didn't do that.

Nancy May, Eldercare Success: Well, this is why I'm bringing this up,

and you work only in the Oregon area.

That's your territory right

Lynn Smargis - Guest: Yes, but I can actually refer people to a

senior advisor anywhere in the U.

S.

because I'm part of a nationwide certified senior advisor membership directory.

So if somebody has a parent in like Boston, Mass.

I can refer them to someone there.

But getting back to your thing, one of the things I tell people that a lot of people

don't know is that these communities when they make their policy, there's no

like Federal regulation and things like that, govern all these, every community

makes their own individual policies.

So you go to one CCRC, they're, what you get back and what their rules are

completely different from another one.

So don't ever assume you go to one CCRC and you're like, oh this looks

okay, and then you go to another one and it's going to be the same.

They're, Their financial requirements and financial guidelines and rules they

make up are, can be completely different.

So don't ever assume that one facility is the same as another facility unless it is

a facility that's run by like Brookdale.

There's like a bazillion Brookdales and they pretty much all have the same

Nancy May, Eldercare Success: And they've been through some major lawsuits, as well.

So, do yourself a favor and do investigate, litigation, the name of the

facility and understand who the parent company is because many of them are

also what I call stacked corporations.

So the service that is, is under the name of the company or the organization or

the facility that you may be going into.

Could be owned by several different multiple layers of LLC or, or LLPs

based on the situation because this is a hot investment area for a lot of,

funds and groups that are out there based on the size of the population

and what's happening down the road.

And you just know that if there is a situation where you feel that you

want to sue because of a result of a wrongdoing, it is going to be next to

impossible to get at where the money is.

Lynn Smargis - Guest: and yeah, so one thing too is if you want to check online,

you want to go to your state ombudsman which is spelled o m b u d s o I mean,

yes, Ombudsman, I, I have to look up the origin of that because that, I, that word.

Anyway, and each state is regulated by the, like each place is

regulated by the state you live in.

So, like California's laws are going to be different than Oregon, they're

different than Tennessee and Florida.

So, you really have to go on your state, the state website that your

parents could be placed in if you live out of state and find out, not

just, the number they have, right?

But you have to, look at what actually happened, because some, one

place might have five, but it's not

Nancy May, Eldercare Success: Oh, violations, right?

Lynn Smargis - Guest: right, sorry, violations, but they might, they might

be really minor, as to, like, one place might have two, but they were both abuse.

So, those, I would say, those two with abuse, I would be way more

concerned about than the five or six that had, minor things happen.

Nancy May, Eldercare Success: we did a podcast with the

National Ombudsman Association, the head of that, a while back.

I'll put a link in the episode notes to that.

As well as several, we did with two major attorneys who were dealing

with litigation issues for family.

The thing there to understand is that even with the ombudsman, an ombudsman can only.

enforce the, the medical requirements.

of a resident.

And you as a family member cannot make that complaint.

Your parent, the resident, has to make the complaint if there's an issue.

And many, many people are scared to death of making a complaint

for fear of retribution.

And that depends upon how the, Facility is managed, and you don't know what's

going on as far as those relationships go with management when you're not there.

As it relates to litigation, that's a whole nother format, because most

of your contracts out there, you will be signing a, an arbitration

clause, not a right to sue.

And arbitration cases are not public, the results of the arbitration, the outcomes.

So, major things can happen, and you may never know about it.

And my feeling is that the best way to find out about those is

to really dig deep and find out who's been there, what's going on.

Talk to aides and people who work there.

Find out who's there.

You will, I'll, my term, not theirs, but a person who works at the lowest level of a

facility, will squeal like a pig and tell

Lynn Smargis - Guest: And so will the residents, so will the

Nancy May, Eldercare Success: Right.

Well, and residents may not necessarily tell you everything because again,

they may be afraid of something or it may be a bad day or there may

be something else that's going on.

But yeah, you want to really do your, your homework and don't make

these decisions when you're all of a sudden in a situation in a hospital

and the hospital is telling you, you need to put mom in a care facility.

Or at a, or you're at a rehab and now you only have two weeks to get out and

figure out what you're going to do.

Do not make these decisions under duress, please.

this, this really should take several months to decide what

to do and how to do it well.

Lynn Smargis - Guest: Yeah, and one of the things too, if you do find

you need like care really quickly and you don't know what to do, a really

good option that I give my clients is, what's called Respite Care.

So We have in Oregon what's called Adult Foster Homes, and I, it's a weird name,

but basically what it is, is a residential home that has five or six bedrooms,

and each senior has their own bedroom.

You can always go and find a really nice, Place like that for two or three months

until you can actually sit there and think about do we want to do like, think

long term so you can put them somewhere for respite care for one to three months.

and in the meantime, they're getting the care they need in a smaller home.

It's much better because, it's a smaller home.

It's more intimate.

but one of the things I do for my clients is I will go in and.

I tour the communities like before I have bring my clients in 99 percent of the time

sometimes there's a place that fits and I haven't toured it but I'm up front with

my clients I call and talk to the director I don't just look at the brochure ask

them all the questions and if I feel like it's a good fit to tour I'll tell them

hey I called and talked to the director.

I haven't physically been to this place yet, but I think this is a good place

to tour and we'll set up an appointment.

Um, but one of the things I do is I will go in to be like 15 minutes before my tour

appointment and I'll sit in the waiting room and I'll look around and I'll see

what people are doing, how they're doing.

And one time I was at a community and there was a group of seniors just sitting

around in the, you know, in the area.

I was talking and I was like, hi, how are you doing?

Just chatting with them.

And I said, Hey, I want to have a question for you.

What do you think of the food here?

And one of the

Nancy May, Eldercare Success: Oh, good question.

Good question,

Lynn Smargis - Guest: and one of the senior ladies goes,

Oh my God, it's horrible.

I wouldn't feed it to my dog.

I was like, Oh really?

I'm like, why don't you like the food?

She's like, it's terrible.

It has no taste.

It's disgusting.

And then she goes, Oh wait, do you work here?

I said, no, I'm an independent advisor.

I don't work here at all.

I said, so I just want to say, I'm like, thank you for your opinion.

I really appreciate that.

I ask people like, like, how do you like your care here?

Like, what do you feel about it?

And I had one gentleman in a different community say he

absolutely loved the community.

He was in a different community and it was too restrictive.

They're like no TV after 10.

Like it was, it was all this and he's like, and I moved here and he's like,

it's like a breath of fresh air.

the people are friendly.

I feel like the staff really cares about you.

So I always go in ahead of time and talk to the seniors because the

seniors will tell you everything.

Nancy May, Eldercare Success: Well, yeah, they have the time, they're living it.

They're experiencing it all the time.

And yeah, that's important.

No TV after.

Lynn Smargis - Guest: right?

I thought that

Nancy May, Eldercare Success: parents are not children.

Lynn Smargis - Guest: Yeah, I know.

Nancy May, Eldercare Success: it's not

Lynn Smargis - Guest: it's not a dorm room.

Nancy May, Eldercare Success: hope it's not prison, but in any

case, that's not what you want.

The other thing too is that if you need to make a decision very quickly,

there is absolutely no reason why you can't hire an agency for a short

period of time to do 24/7 care if it's needed in your parent's home for them.

typically you don't get the same aid on each shift.

You can ask for it, but that's not, that's not typical because the agencies

are so desperate themselves also for aids and caregivers, as are the facilities.

So that's an important to know, but that is an option to be aware of.

And like I said, don't make a decision, that you're going to

regret in a very short period of

Lynn Smargis - Guest: I will tell you if you decide to have someone come

into your house, because my my mother in law did that and she had 24 7 care.

She spent all 20, 000 a month and they did not get her up enough to move

and she ended up getting a bed sore.

So always ask the agency, how often do you get my parent up to move around?

Or how often, if you're, if they're bedridden, how often

are you going to turn my parent?

If they don't say every two hours, then find somewhere

Nancy May, Eldercare Success: Well, and that's going to

happen in a care facility too.

So we're not just going to blame the aides or the agencies, but, in those

particular cases, especially since you get the care in your own home, get a camera

Lynn Smargis - Guest: Oh,

Nancy May, Eldercare Success: up to your phone.

And, uh, most facilities, this is interesting.

Most facilities will not allow you to put a camera in your parent's

residential apartment because it's not yours, but in a way it is.

So, my attitude is, screw it.

Where there's a will, there's a way.

Lynn Smargis - Guest: right?

Yeah.

And yeah, and the thing, especially at home, you can put video cameras in

every room and have them all connected.

And then you can see them in real time.

So you can see and record what is actually going on in your parent's home with the

caregivers themselves and seeing are they really telling the truth when you call to,

see what's going on and things like that.

But yeah, I mean, I, I think in home care is great.

I, for me in Oregon, not a lot of my clients can afford that

because it's just really pricey.

Nancy May, Eldercare Success: but it's also a different quality or level of care.

One on one versus, One resident to 17 aides.

So that's just something to understand going on.

But, before we close out, are there any major things that you think people

need to, consider before they make this decision to go into a care facility, Lynn?

Lynn Smargis - Guest: Yes, um, and it actually applies to Medicaid.

So one of the things I have clients call me and they say, oh, you know,

we have, limited funds, so we're going to put Mom or Dad on Medicaid.

There's a couple things I want you to know your listeners know about

Medicaid, that not a lot of people know about because this scene is changing

so fast, especially within the past year or two, it's changed incredibly.

Um,

Nancy May, Eldercare Success: And it changes by state by state because

Medicaid is a state funded, service.

So just understand that.

Lynn Smargis - Guest: Right, I will tell you one thing, you do not want

to be on Medicaid in California.

That is a nightmare, like, that is a nightmare in a bad dream.

Like, that's, it's, I, oh my gosh, you don't want to be

on Medicaid in California.

but here's the thing with Medicaid.

So, in the past, more facilities in Oregon and other places would accept

Medicaid patients, like, just directly on Medicaid, because the acuity rating,

which is, like, how much staff you have to have to each resident, was more lenient.

So, maybe before, it was, like, you needed.

One Aid for 10 People.

Well, now they need, the acuity rating in Oregon in the past year has changed.

So now you have, you need more caregivers for the same amount of people you

have at your retirement community.

So what's that going to do to the money, right?

Like you can't accept more people on Medicaid now, because medicaid

Especially for assisted living, it doesn't cover the cost of care.

So you have to balance, if you don't want to go out of business, you have to balance

your books and say, okay, well, we can only accept X amount of people on Medicaid

in order to be able to pay the caregivers so we can meet our acuity rating.

And there have been places in Oregon that have unfortunately had to shut

down because they didn't have the money to meet that acuity rating

because they had too many people on Medicaid and vice versa, right?

Like there's a lot of different reasons.

anyway.

The point being is that before you jump on the Medicaid bandwagon, first of

all, I will say, don't let your parents gift any money to anybody, because

everybody thinks, oh, my parents will just gift the money and they'll look poor.

Medicaid does a five year look back, and a lot of people don't know that.

I had a client come to me and said, Oh, well, we're going

to put our dad on Medicaid.

I said, the first thing I always ask people is, has your dad or mom gifted any

money to anybody in the past five years?

And she said, well, yeah, my mom gifted each of us a quarter million

dollars before she died two years ago.

I said, you're not, your parents never going to get on Medicaid.

And she's like, why?

And I say, you cannot gift money and get on Medicaid.

Like there are certain things you can spend money on.

It's called a spend down, but they have to be medical in nature.

There are some things on your home.

It varies by state.

So you always have to check into your state.

Specific state regulations.

I am not a Medicaid expert, but the general information, I know in dealing

with my clients is a lot of clients get stuck, but the only option they have is

to take their parent into their home to take care of them 24 7, because they were

planning on putting them on Medicaid.

but mom or dad gifted money to somebody.

And, now they can't get on Medicaid because they gifted money to somebody,

of course, right before they passed away or right before they got sick.

and it's even if like they're married and the husband or the wife gifts

it and the other one's left behind, it still affects the other person.

It's not like.

Oh, mom gifted it so it only affects mom.

No, it will affect dad if dad is left behind and vice versa.

So please know that before you do anything, with Medicaid.

And the process is super, super stressful.

I always refer to a Medicaid spend down specialist, who just,

yeah, just charges a flat fee.

Because if you go and you apply for Medicaid and A, you don't realize there's

a spend down Like, restrictions, or B, someone's gifted money, and then you've

gone through that process for months, and then they deny you, and then you have

to appeal the claim, and then mom and dad still waiting to get on Medicaid,

like, and they're still running, there's, then maybe now they're out of funds.

So be especially careful.

If you want to do Medicaid, You can do it, but it's, there's a

lot of hoops to jump through.

And the other thing is, is, is it's extremely hard, especially to find memory

care for someone who is on Medicaid.

Nancy May, Eldercare Success: Because the facilities don't want to take you in,

and that's where the fear tactics are as far as the amount of room that they have

Lynn Smargis - Guest: Or another, another snafu I came into is one

of my clients right now is doing what's called a, like the spend down.

And they have two years of, Funds to spend on assisted living.

So I was doing all this research, calling around all these places

to see who would fit this family.

And one community said, well, we'll take the Medicaid for assisted

living, but we don't take Medicaid once they get into memory care.

And this person has dementia.

And I'm like, well, okay, that does my client no good because clearly

they're not going to get off Medicaid when they get into memory care.

Nancy May, Eldercare Success: No.

and sadly, I have known, a number of people who personally, the adult children,

the caregivers, overseeing their parents, who have suffered financially and gone

into bankruptcy themselves as a result of some of the challenge, the financial

challenges the parents have had, because they either got on Medicaid too late, or

whatever the list might be, and we'll, we'll have to do a whole separate show

on this, but I did do an episode recently on how to get paid for caring for mom and

dad using some of the Medicaid ruling, but again, state by state, and it is

very restrictive, and you are not going to beat a path to the bank with a check.

By any means in what you're going to get compensated to do so.

So, this is not a means to an end.

It's not even a stopgap.

It's just a, thank you, here's a, here's somebody to go buy

a coffee at Dunkin Donuts

Lynn Smargis - Guest: insurance against that, if you are, like,

I just turned 52 last week.

The best insurance against that is the Buy Long Term Care Insurance,

and that's what my husband and I are doing right now for us.

Nancy May, Eldercare Success: Well, and even then, you have to be careful because

long term care insurance businesses have gone out of business in the past

and there are restrictions to the type.

Well, there is a lot of complexity I'll put in the type of long term care

programs and products that are out there.

So, do make sure that you're, you're looking into what's going to work

for you and for somebody else.

But I agree there are a number of ways to do this and But on that note, to be a

little bit more positive and uplifting, there is help out there and somebody

like Lynn, and I would recommend Lynn in Oregon for what she does because she

really is, I would say, family centered and family centric in making sure that

she helps you make the right decision, not necessarily the right decision for her

or she's going to get compensated because if we're not doing well with our folks,

how is anybody else going to do well?

Lynn Smargis - Guest: Yes.

Nancy May, Eldercare Success: So on that note, Lynn, thank

you so much for joining me.

I appreciate

Lynn Smargis - Guest: Well, thank you for letting me come on here and share what

I do, Nancy, and, pass along some of my advice and experience to your listeners.

Nancy May, Eldercare Success: Absolutely.

Take care, be well, and don't forget to get the book, How to Survive 9

1 1 Medical Emergencies, a step by step guide before, during, and after.

And guess what?

If mom and dad are in a care facility, you're going to still need to know what

to do when the 9 1 1 system is out, or even better yet, when the facility calls

9 1 1, because they are going to the hospital alone, and there's a boatload

of stuff that you're going to want to do to make sure that they get out alive.

Take End of story on that one.

Go to howtosurvive911.

com for that book and other information.

In the meantime, if you like this show, which I hope you do, please

give it five star rating at any of your podcast listening platforms.

Better yet, go to eldercaresuccess.

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And don't forget to share it with a friend, a family member, or even

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Take care and be well.

Bye bye.