Season 4, Episode 7: Love, Logistics and Long-Term Care
The Financial (and Emotional) Realities of Providing for Aging Family Members
Ugh. This is hard.
So many of us are sandwiched between our kids and our aging parents with difficult decisions coming down the pike. We invited Julie Latson, an expert in helping families figure out what their options are when a family member starts needing care, including navigating how it’s going to get paid for, to walk us through what this all looks like.
This is the episode where we realize we have no idea what our own definitions of “quality of life” mean, much less how we could decide that for someone else.
Planning for family care isn’t just about money (although, I mean, it can be hella expensive). It’s also about getting and giving information about our wishes (and our family members’) now, before they’re needed in an emergency. I believe Julie’s quote was: “If you’re thinking about it, it’s time to start planning.” Uh oh.
The bad news is it turns out we’re all aging and will eventually die.
The good news is that Julie provides great info to help guide us through the process:
Why you should review your medical power of attorney - and what happens if no one really knows your wishes.
The real costs of in-home versus facility care ( “I want to stay home at all costs” is a major financial planning red flag).
Practical steps to take before a crisis hits, from family meetings to understanding insurance coverage.
This is all real, and hard, and a bit overwhelming. So, come do it with us.
Oh! And Julie recommended some great resources:
Here’s the Aging Life Care Association to find your own Julie
Age Your Way by Debbie Pearson R.N.
The Age Your Way workbook that goes along with the book.
Being Mortal by Atul Gawande
FYI: Julie has moved on from her position at CareFor.
Ask us your dumb investing and finance questions, or just say hi! on our Ask Us page!
We have the social medias!! Here’s our Instagram and Facebook and LinkedIn.
This episode was edited by our co-producer Kelly West. Music by Bad Bad Hats and Devmo.
Transcripts for Season 4, Episode 7: Love, Logistics and Long-Term Care
Caitlin [00:00:03] Welcome to Women on the Verge of a Financial Breakthrough, where we're figuring out finance one dumb question at a time. I'm Caitlin Meredith, a mediator and coach based in the Bay Area.
Sara [00:00:18] I'm Sara Glakas, investor, advisor, and founder of BlackBarn Financial, and the Austin Women's Investing Group, which you can find on Meetup.
Caitlin [00:00:26] Can you think of a woman who could use a little money motivation and send her this episode? And please, if you can, leave us a review. They help more women find the show and make us feel like a million dollars. Pretext.
Caitlin [00:00:41] Oh
Caitlin [00:00:47] So today we have Julie Latson who Sara recommended because you work for a care company. You're like the person we all need when we're looking for care for a loved one. Is that, did I get that right, Julie? Absolutely true, yeah. Okay, I'm gonna let Sara introduce you but I thought maybe you could introduce yourself. Like what is your official title? What do you help people, families do? Sure.
Julie [00:01:12] So, I'm Julie Latson. I'm the Director of Strategic Partnerships with CareFor. And CareFor is a private care management agency that does serve as medical power of attorney. We do guardianship work. We have private caregiving services. And we're actually about to jump into the hospice space as well. So, we do a lot of different pieces. A lot of people do not know what care management even means, they've never heard of it. So hopefully we can expand on that as we talk.
Sara [00:01:51] Yeah, I mean, so I was introduced to Julie through some mutual professional contacts, and I feel like as a financial advisor, maybe not the number one, but the number two or number three question is often how like what happens if I'm not able to care for myself or like what do I do if I have to expect to care for aging parents or. Children or someone right like most people have a very real concern for how financially but also just from like a practical perspective like how do you prepare for then actually help care for the people around you and so I'm so fortunate to meet Julie and just the way that she described what she does and what options are available to people out there I just thought like We have to have her on the podcast because know it's all about like what's available what's the information that we need to make decisions going forward or how can we set our expectations that there are actually services out there that can help us as we're trying to figure out what we might need to navigate in the future. So I'm so excited that she's able to join us today.
Caitlin [00:03:04] Yeah, especially for those of us that are in the sandwich where we have, well, everyone has aging parents. We're all aging, everyone is, but like where we still have kiddos in elementary school and also are looking at like what's our role and how can we support our parents as well. So I think from that perspective, I'm especially interested, but. As Sara points out people, there's a lot of loved ones in our lives that might require care for the longterm. And if they're not working, what does that look like if we're lucky enough to be able to financially contribute or just like help with logistics and management and knowing who the helpers are in this space.
Julie [00:03:47] Most definitely. And that's exactly what we do. And we are part of a network of other agencies that provide similar service. So we're Austin-based, but nationwide, there are these types of companies that are out there to help families. When families start accessing the healthcare system, and certainly with anything slightly complex, it's pretty quickly realized that it's a very segmented healthcare system. And so having someone serve in sort of that quarterback role where they can come and understand what's going on with a family and then help them put the pieces together in a coordinated way to where you're not feeling like you're always behind the curve, brings families a lot of peace of mind to feel like they, one, understand, you know, what is the diagnosis, what may actually be going on. And then two, what are the resources, both through insurance and then through private pay that can surround that loved one with additional support to help their health care journey go far more smoothly than if they didn't have someone who was familiar in the health care space available to them. So it's usually... When families find us, they're often in crisis mode and we tend to get the I wish I would have found y'all you know six months ago versus finding us earlier on and really with the financial planning space, getting that understanding that people like us exist. So as you're planning out your future years financially then we can kind of come walk alongside and help. What that health care piece looks like and what do you want, you know, for your life as your health needs change? And how does that align with what you're setting up from a social perspective, from a financial perspective, all of those pieces really holistically?
Caitlin [00:06:01] Is that what the medical power attorney piece is? Like can you describe or define like what is medical power of attorney when it's not your loved one or someone?
Julie [00:06:12] Yeah. So as people get older, the goal certainly is to take another look at your medical power of attorney document. And when we're younger, we're naming our spouses, potentially, or siblings. As you get older you really need someone who's at a different generation to serve in that capacity.
Caitlin [00:06:34] And
Julie [00:06:34] And so if people either never got married, they're widowed, they did not have kids, they don't trust their kids, whatever the case may be, we're a professional organization who will serve in that capacity. So whether it's primary or secondary medical power of attorney, the idea is that you have these conversations with the clients that we're serving to one, understand in their medical history. And then two, get a download of wants and wishes and desires for what their aging journey looks like. And so once that initial download is done, we are just checking in with our clients once a year to make sure nothing has changed. What I wanted in my 30s maybe looks different than what I may want in my 50s or 60s for health care, and certainly what would look different for me when I'm in my 90s. And so having those conversations year after year until if when the time comes that they're no longer able to make decisions for themselves, we would be able then to step in and we're not guessing what people want. We've had these conversations so we can execute their wishes to provide them what they would have chosen for themselves as healthcare events happen. And I do think it's very unique because oftentimes when people go to do Are there legal documents? They're naming people, I would say most people don't even know that they're named in legal documents. And they certainly have not had the conversations of what this person would want. So pretty much anybody who's been named, you know, is guessing at what they think, you know, based on relationships and all of that. And that's great. But we we dig into that more deeply because we don't want to guess and our care managers are mostly registered nurses. So, you know, we have that clinical background to say, well, this is what I would choose, but that's my choice, right? So that's not Sara's choice and not Caitlin's. You know, we all have our own thoughts about how we would like medical care, how we would like to age and what we'd like to see happen. So that is what that program looks like.
Sara [00:08:51] Yeah, I mean, that's interesting, because I imagine that the people who are named as power of attorneys, kind of like you said, like if I had, I mean, Caitlin and I know each other pretty well, right? And I can kind of imagine being like, you know what, I'm just going to name Caitlin. Like she cut the cord, she gets me. We haven't actually had that intimate conversation on that topic, at least, right? And so even though you might in your head say like, oh, this person knows me better than anyone. It doesn't mean they actually have the information they need to cut the cord or plug the ventilator back in, right, you know, if it comes out of the socket. And so it's, that's really interesting to think about that I might just like Casually put Caitlin down as my medical power of attorney without just under the assumption that, yeah, she knows me. She knows what I am.
Caitlin [00:09:44] Yeah, and also that it would be so obvious that I'd put you in there. So I wouldn't even tell you. Of course, the emergency contact for a daycare center. Like, yeah, whatever. The people I talk to, my top three contacts, I'll put them in. But it's a big responsibility should the event arise. And then also the details of it, which I think you're so right, Sara, we've never talked about like. What does it look like if I, like what is quality of life for me? What's quality of like for you? And also, would the other, like would your husband know that I was named? Like it's not just me knowing, but other people knowing like, hey, the lady with sharp elbows is coming in and she's gonna be making the decisions for you. Anyway, Julie, I know this isn't, wait. You help lead people through like making those designations, communicating about them, and then also giving people all the information they need, whether it's you or the other people in their life about what they'd want. I remember doing this when I was pregnant and the questions my attorney was asking me, I was like, oh my God, it was so in depth that things that I had not, not only had I not considered them, but I was, like, you know, like I don't wanna think about that. I'm never
Julie [00:11:09] going to die. Yeah, we don't need to think or talk about any of these things because I'm very healthy. But that's even in what you were just describing with Sara. Take that even a step further. Like, so do you know Sara's allergies? Do you know if she still has her appendix? You know, do you know these things? And it's very interesting, even working with couples that have been married for years and years, what they have not had conversations on. And I'll give you an example. So my dad had a health event over the pandemic, and he had COVID and he ended up passing away from COVID. But when we were at the hospital, we were having a conversation with a doctor and the doctor said something about my dad being pre-diabetic. And we're like, no, he's not, you know, he's no diabetic. That man was pre-diabetic, my mom didn't know. My dad had not told anybody. And so the only reason why we figured this out was because he was on a medication that he filled himself because he was, you know, spry and doing all the things like we never would have known. And in that moment, just learning all of those pieces and realizing what we didn't know. It was this like ding for me, where I work in the health care space, I should have known better, and I didn't. And then being in that moment where you're emotional with your family member, you know, there's a lot of history there and family dynamics to have like a neutral third party be like, okay, let's, let s hone in on this together and work, you know work through this on behalf of this person. It takes that. It takes that pressure off of children. Even if we're not serving in a medical power of attorney capacity, but just like that planning part or helping to execute on the back end, it really does provide a lot of peace of mind to families that they've seen the totality of the picture and they're making the best educated decisions for the person.
Sara [00:13:23] I mean, I wonder, Julie, like, as people are going through this, what do you think is the first thing that people should think about when they realize that someone in their life might start needing additional care? So with the stereotypical circumstance being like, my parents are getting older, and I think it's time to start thinking about the next stage. What's the what's the first thing? That people should do when they come to that realization. Ignore it. No, please. Please don't. Pretend it's not happening.
Julie [00:14:04] I mean, I'm a planner by nature and I know not everybody is by that, you know, thinks in that same way. But if you're already having those thoughts, that means you need to start formulating a plan, because whatever is going on is likely not going to go away. And most people don't want to be caught up in a crisis situation where you're already in the trenches trying to get yourself out of it. So I would say two things. One would be some sort of family meeting to just have a conversation and address whatever it is that is going on. That's probably one of the most difficult things to do, just because of family dynamics and what people are willing and not willing to talk about. And those are conversations that we help families facilitate often. Again, that neutral third party just to pull those questions out and make sure we're all aligned in what's going on And then two, having that financial conversation. What are our resources? What does the cost of care look like? You know, when does it make sense to introduce support services? What is covered by insurance? What is not? And just starting to have this conversation so people can really understand what may be ahead. And so it's not a big surprise when things need to get implemented. Often. People need to implement things far earlier than when they actually do, unless there's just this like really robust family health, you know, family care system. But people are spread out these days. We don't all live in the same town anymore and families are working, you know multi-generational. And so there's a lot of dynamics and pieces that need to be put together and to be said out loud together and have just really good conversations about. You know, what's going on. Communication, communication, communication.
Caitlin [00:15:59] It's so interesting, Julie, because I'm a mediator, and I do a lot of helping adult siblings with estate planning, and after the fact, like, disagreements or miscommunications, stuck places where adult siblings are trying to manage after the act, and so their parents don't have voices in the decision-making. Often the parents are like divide it equally or something that's super vague and you know, or like just make sure to be fair. So I come from the point of like this communication about personal possessions and how to preserve relationships by having these conversations earlier. So I hadn't coming into the conversation with you, I hadn t thought about so much of the overlap between those conversations like managing health. I had a family member who was hospitalized, it was last spring for six weeks, and in the beginning, the whole focus is like, oh my God, what's the diagnosis? How are we managing in the hospital? Is this gonna be two days? We never expect it to be six weeks. And then there becomes a shift to like, ooh, coming home is gonna look like something very different than it was before the hospital. And then you really are planning in a crisis, but the crisis has kind of passed because your person is like stabilized enough to go home. But then you're like, wait a second, what now? Like we can't just go from 24 hour hospital care to like nothing, but what are the intermediary steps? And as you say, like, what are even our choices here? So I can really appreciate. How those decisions are usually being made, certainly in my family, and it's very expensive. And when you don't have any time to compare options, you just go with whatever the first one is to like make, they say discharges on Tuesday, like whatever we need to do to make that happen. And without the forward planning, it's really hard to navigate efficiently or economically, I would say.
Julie [00:18:13] Well, and I think you said two things there that resonate with me is one, you do have choices. So oftentimes people when they're in that crisis mode, whether it's toned down because we've now got a diagnosis but we're pending a transition home or somewhere, in all that time, there's always choices. And I think it's very important for families to know and really execute the right to make choices. But then two, like what are the financial implications and social consequences of the decisions and what would that person want? I think having, I don't think, I know having someone in that space walk alongside families. One would start the conversations as soon as someone has admitted to that hospital, which is really when that should start. As soon as we know what's going on, someone's stable, those conversations need to be happening. And so then when we get to that, you're discharged on Tuesday, there's a plan and everybody feels good about the plan and you've had the opportunity then to make choices about where we want to go, what types of support, what's going to be covered by insurance, where is out of pocket going to come from, and what does that really look like so people can be more prepared. To prepare too soon for some of that is futile, right? So today where I would recommend sending my loved one for rehab nursing care may look very different where in a year from now where I recommend sending them because there's so many changes in the healthcare system. Literally constantly. So having someone real time in those moments is very helpful.
Sara [00:20:08] Taking back a step, and Caitlin, I'm sure you have some input on this too. I mean, so what are some tips and tricks for launching into having a planning style talk with especially your parents?
Caitlin [00:20:25] Listeners, Sara has a deer in headlights appearance.
Sara [00:20:28] To her right now? Well, I actually ask because that's one of the questions I get asked a lot, right? Which is, how do I even start? And it's usually from a financial perspective. How do I have this difficult conversation? Like, can my parents pay for this? Am I going to pay for it? Is no one going to to pay it? We're just going to white knuckle through it and fingers crossed. But I think that initial either laying the groundwork or launching and then having a constructive conversation is where a lot of people run into redblocks. Yeah, they get stuck.
Julie [00:21:07] For sure. And then they don't do anything, which is worse than not having the conversation. Right. I think everybody knows their family members best to know what would potentially work and not work. But one of the things that we try to lean in is, and particularly if it's an adult child that's trying to engage their parent in getting more organized around that, because really it's the adult child who's going to pick up everything and try and carry things along. So making it less about the need to make decisions today, more about, I want you to feel empowered about what's gonna happen to you if something changes with your health. And so what I would like to know is, what do you want? We know people who can help us have these conversations that really can help document what you want. And you can understand what all of the options would be. So that way, if there comes a time where we need to help you make some choices, we would know what you wanted. The issues that stem with aging is the loss of control. Right, so you start to lose more control. Over your health, people lose the ability to drive, loss of independence, it's very scary for people and it would be scary for me certainly too. So giving them that control back and having ownership of what you want this to really look like I think is very important for older adults to be able to express that. And if there is a tinge of Well, my brother and I have very different thoughts about these things and or mom and dad every time we try and talk about it, you know, they get into a fight or it just it becomes overwhelming. That's really when like getting a neutral third party in there to facilitate these conversations is very helpful. Our founder, her name is Debbie Pearson, she's a registered nurse. She founded Care4 25 years ago, but she actually wrote a book called age your way. And it's just a, it's full of stories and really good tips and tricks and things like that. But the really cool thing that she did after she wrote the book was she created a workbook that goes along with the Age Your Way book because it's like, okay, great, in theory all of these things and this is why you should plan. But then she created book to really help people page by page, like these are the things that we need to be working through. And documenting and having conversations about, you know, and some of it is going to be more important to me than it would be to you. And so people can really look through that book and the pieces that make the most sense for them to dig in, dig in. And it is also a really good tool for the adult children to say, you know, I want you to take a look at this. But this section is the part I'm really worried about. So like if we could even just have a conversation on this part, that would really give me comfort to know what I need to do for you and what you would want. So that's what I would just lean in with like the independence that they still have and that what their wants and wishes are are very important. And so instead of letting kids and family guess, like, you know, we want you to tell us.
Caitlin [00:24:35] Of people don't have these conversations. Yeah, it's interesting. I lead workshops on the personal possession side based on this curriculum from the University of Minnesota called who gets grandma's yellow pie plate. And one of the things I found interesting in these workshops is from older generations, they say, I try to start these conversations, but my kids shut me down. They're like, You're never gonna die. You're healthy. Look at you. You are 75 years young. Like they're really trying to minimize it, which of course has to do with their own fears of their parents' mortality. Like there's a lot going on there. They're not just trying to like, they're not trying to take away their parents voice, but it's very threatening, those conversations. And then the younger generation that's like, oh my God, when I look at my parents' house, there's so much there. They don't wanna talk about it. And I feel like there's that underlying sort of power struggle that can be. Unintentionally sort of triggered by starting those conversations. And so I'm always trying to think of openings. And one of them is, we all know, like the neighbor family or the friend of the family where something happened. And I think those make really good openings to be like, God, mom, what would you have wanted in that situation? You know, it really got me thinking about wanting to do you right. And not have like not be in a fight with my brother after what what do you think should have happened there or something and so using it as an entryway not like okay give me the keys but as a family we are like what how can we do it the right what's the right way for us and also just because someone can be prickly the first time to not just like let it go Just be like, oh. Yeah. This isn't a good time. I probably brought it up at a wrong time. I'd like to talk about it though. So maybe there's some other time in the future and then keep trying. I love your plug for a neutral third party because that's where I'm always hoping like, well, if we had talked about this before you had read all that, you know, when the decision were being made, it might've gone a different way.
Julie [00:26:54] Well, and timing is so important, just like you said. And I think using those situations where there's a current event that has happened that can warrant having that natural conversation, Christmas probably isn't the time. And so understanding where y'all are at, the time that would be needed to dedicate to it, and then having that relational experience. To start having those conversations, I think is very important.
Caitlin [00:27:27] There's also milestones like I know when I was having my baby was the time I finally went to an estate attorney There is going to be other milestones in my life that I can be like family I'm getting my affairs in order like here are all the things i'm trying to figure out for myself Could we have a meeting so we could talk through so I can Help think through for myself and maybe we could use it as a time to like tell each other What's important because it's not just one directional like I could be in a car crash tomorrow and my parents would be responsible. So also taking the time while people, everyone is vital in making decisions to kind of reinforce the horizontality. The hor-a-sontality. That was very impressive.
Sara [00:28:16] I know
Caitlin [00:28:18] The mutualness, the reciprocal nature of caring for our family members. And none of us know who's going to be the one that needs care. Even aging doesn't prevent, you know, or mean that someone won't be taking care of a younger family member. So also kind of taking the heat off the older generation, too, by being like, here's decisions I'm trying to make, too. And I would love your support. And maybe we could like take turns. I love the workbook idea. And I do wanna plug the Who Gets Grandma's Pie Plate. It's also a workbook that families can use for personal possessions in the family to kind of start those conversations.
Sara [00:28:57] Can I plug a book, too? I recently read the book. Maybe you guys have already read this. I recently red Being Mortal by Atul Gawande. And I think that part about where he's talking about the process of having this conversation with people in a medical crisis, one of the ways to have the conversation is to have them describe what they want their life to look like. And then that would lead to the interventions that you would possibly do. So I think I remember there's a story about. Someone who said, as long as I can eat ice cream and watch football on TV, then I want to keep going, right? You're like, oh, that's actually very helpful, right, because as long as the medical intervention gets you to that point, then it's the right medical intervention, right. And I'm thinking like, okay, now if I'm 45, if I could say, I want to be able to hear my children talking to me, that's a pretty wide range of outcomes, right but if. Conscious and able to hear my children talking to me even if I can't speak or I can see or I can't you know breathe or whatever it is like that as of now is important to me that leads to really good information for other people to use on how they can help me navigate that and of course it will change over time but having it instead of going through the list that I think attorneys, like, do you want to be on a ventilator? Do you want to be on life support? Do you what, you know, like those things where it's like, I don't even really know like what that is or what it entails. Like thinking about the outcome after the case is very helpful.
Caitlin [00:30:34] So that was my plug for being mortal. Julie, another thing that came up for me, actually this is for both of you, when my family member was in the hospital, is I'm freelance. So I could adjust my schedule. Like it wasn't ideal, but I really had so much flexibility to like do what needed to be done. And it occurred to me that if I had had a nine to five job, I would have had to take leave. And I wouldn't maybe have known. What the leave was, like, was I going to get paid for that? I know FEMLA. But that seems to me as a part of that process of figuring out ahead of time, like what would that look like? When would I take the time off? Would I say, okay, a week in the hospital and then wait for the discharge to do that? And that has a huge, that's different than paying for a care organization. And that's sort of the adult offspring. Figuring out what can I financially manage in terms of support, airplane tickets, rental cars, like what does that whole package look like? I'm wondering if you walk people through thinking through that piece.
Julie [00:31:41] And I mean, you know how it is with healthcare, like you never get sick on Monday at 10 a.m When you can easily reach your physician it is You know Christmas Eve at 2 a.M And everybody's off for a major holiday weekend, and it's you know after hours. It's all of the things that are inconvenient to everybody including the person who's still yes and Just family's ability to drop everything and go, it can be limited. So, you know, there's organizations like ours where absolutely we can have boots on the ground, BIs, ears for families, things like that. But sometimes too, especially, I mean, honestly with anybody, depending upon the person, just that fear of being alone in a hospital with like no family there for whatever period of time, that's really where the separate services of like private caregiving. Can really come into play for families and give a lot of peace of mind at a lower cost, where a caregiver can be with someone wherever they are and be that conduit for families. So that way, when the doctor comes in, the caregiver can call the family and just say, hey, the doctor's here. Can you hop on? Or if they're transitioning from a hospital setting to another setting. That continuity of person who knows what it was looking like in the hospital versus what it's looking like at home until the family can get there. Those little pieces can make such big differences and it's minimal cost for peace of mind when families can't rearrange everything to to get there quick and timely. And the other thing too is Sometimes people will go into the hospital and not notify their family. Uh, it happens often where, oh, uh, Oh, I got a call. It was a mom or it was a daughter and her mom, she, she was saying something. She's like, Oh she'd been to the hospital like twice and the daughter had no idea, um, that she had had, like she was having multiple falls, you know, EMS had been to her house to help get her up off the floor. You know, they don't want to bother the kids. We don't wanna bother anybody. And so, you know, working. Ahead of those instances or directly with that person to know that there are people that can't like that's what they do they're there to be available to help be with people during those times um can bring a lot of comfort and then just take that stress level down for everybody involved.
Sara [00:34:25] How do you go about incorporating a new person in that case? So like a representative from CARE4, like how does a family go about incorporating that person into their new life? It seems like it's almost like maybe not quite to the level of a member of the family, but it seems like having a personal assistant or an au pair or something who's just now around in a situation where they haven't been around before. Can you give any guidance as to what that might look like?
Julie [00:34:54] I honestly very different depending upon the situation. So when there's an urgent issue, you know, that piece can be introduced rather quickly and it can be more than what anybody thought it was going to be. So just, you know longer timeframes with somebody there and then that transition home, you at that point they're so grateful to have somebody there that it seems to be slightly more receptive you know to having someone there because they've seen or they have had the feeling of what it's been like to not have somebody there but that can be a very jolting introduction not everybody wants to have somebody you know with them all the time that type of thing when you've got someone who's got a progressive disease like dementia parkinson's something like that the introduction of that type person early on is just so crucial for a lot of reasons. One, respite for the caregiver, the spouse, the partner, a family, whoever that is. And then two, to then over time build that relationship with that person who's receiving the care because the care needs will continue to increase. And that familiarity of having someone there who they can trust and know is really very crucial. So it looks different for different people. Um, but I would say if there is a healthcare professional saying, I think you should engage these services, the chances are they're, they're a hundred percent on book. Like that is your checkbox to say, I need to reach out and investigate it. Even if it's a minimal, you know, you don't have to have 24 hour care. You can have someone in your home for four hours, one day a week, just to make the introduction. But it provides so much relief over time. It is well worth it in the long run
Caitlin [00:36:51] I think that piece that you brought up about caregiver fatigue is so real. And I know that when my family member was in the hospital, like we were all fried, like we were on there for all the doctors rounds, trying to track all that coming up with different we'll put it on the whiteboard. No, we'll have a family notebook. No, well, put on an app like just organizing the information so we could share it while we were all so fatigued too and remembering everything. So having that neutral person there who's also set up. So whoever is at home with a person returning from the hospital gets a break too, because their sleep, everything in their life is turning upside down too so that there's a system in place for them to be able to get a break, especially if they're a breadwinner. Or are the financial manager for the family. Like you need to have sleep and focus to be able to do those things well.
Julie [00:37:51] I think the overnight caregiver is the most, one of the most valuable attributes to the healthcare system because people do not realize, you forget what it's like not to sleep. It's like, go get yourself a puppy and you will quickly remember how awful it is.
Caitlin [00:38:12] March 2020!
Julie [00:38:15] You know, and so then you're in the crisis and then you still have like life going on and but feeling like you need to be there all day, you know all the time, it's a lot. So even if you can like strategize on when to have somebody there so that way you know that they're safe and taken care of and you've got your eyes and ears there but you can actually sleep and you know take care of what you need, to take care, of it makes a ton of difference.
Caitlin [00:38:43] And you're gonna be there for the long haul. So it's not like, oh, just get through this day, this week, this whatever. It's like, how is this sustainable? What's the marathon piece of this instead of the sprint?
Caitlin [00:38:56] Mm-hmm.
Caitlin [00:38:56] Absolutely. From a financial planning perspective, I'm curious from both of you, like me as a freelance, should I start, in a previous episode, I was told I'm not supposed to put my money in hidey holes. Supposed to be just like such a mature allocator that I never have to worry. But if I were to put money in hiding holes, like I am curious what. It feels like the first one is figure out the information. What will insurance cover in terms of caregiving, transitions, what as the adult offspring, if we're talking about my parents, what financial support could I possibly offer? Like what are the question, the money questions and planning piece that both of you see? I guess I'm speaking of our generation now just because that's what I'm in. Across the board? Is there such a thing of, is it just knowing and listening to this conversation or action, you know, if a health event isn't happening currently?
Julie [00:40:03] I mean, you know, have I ever really dug into my own personal health plan? No, honestly, I know better. Um, I just don't access the healthcare system that often to like have ever paid attention, but, um, it's, it is very interesting. Once you get to the age of Medicare, people really believe Medicare will cover everything, which is a great idea, but it just is not reality at all. And so I do think kind of like what you mentioned before, like add a milestone, taking a moment to understand like where we're at and then what may be ahead would be a really good timing to gage of what benefits you would have access to, what does that really look like? And then thinking for yourself, is that what I want or does what I wanted tend to lean more into the out of pocket supportive services that I really need to be far more prepared for than maybe what I am. So at home care, one on one care for someone to be in the home is the most expensive care available. And so if someone is wanting like, I want to stay at home at all costs, which is a lot of people, I mean, they need to Be prepared to pay to stay home without the reliance. Of other people what that cost really does look like. And I can tell you today for Austin area, it's upwards of $25,000 a month for private 24-hour care in the home. Now, you can certainly do less than that with shorter hours, but full-time care in the house is the most expensive. And that's really what most people want. So I think just having that touch point with a healthcare expert, whether it be us or anyone else, I think those pieces where you're really starting, you're touching base with your financial planner, your wealth advisor, these people who are helping you organize your funds is a really good time to have a touch point with like a care for or another care management firm to be like, okay, this is what I'm planning for. What is our healthcare picture really look like? Because if it doesn't match, You may need to go back to the financial side of things and figure out what you need to be doing. That number is so.
Sara [00:42:29] I mean it was just to piggyback off of that I think where I start with with most people who want to see like like what it could cost is okay like let's say you left your home and there was a diagnosis of dementia and you end up needing full time memory care in a facility easily 10,000 a month right but in that case you're living somewhere else so you know if it's just you then okay you can Maybe if you own your house, you can sell your house. You go from one household to another household. And so maybe the expenses aren't duplicative. But coming back to Julie's point, if you want to stay in your home, which means you cannot sell your home and you want or need even part-time care and then certainly like 24 hour care, the amount of assets you need to have outside of your home are very, very high, like very large amounts. Or if one person has a dementia diagnosis, and one person ends up in memory care, but the other person still needs to live in the house, right? Then you have the double costs. And it makes it nearly impossible to plan for if a person comes in with non-negotiables. I will stay in my home. All cost, right? And we're not even going to have a conversation about does this make sense financially? I can't find any place that would meet any of my requirements for where I'd want to live. It does make it very, very challenging because like anytime we're doing financial planning for whatever catastrophic situation you can imagine. The numbers get so large so fast that people get like kind of shut down right you can't even like imagine what the number is and so then it kind of falls back into this. Fear of the unknown what's going to happen to me it's so it is that it's very very difficult but those I think are the numbers that you can kind of base case think about. I'm gonna go live somewhere for some period of time and maybe it's ten thousand dollars a month. Or I'm going to stay at home. And if I have three shifts of nurses coming to assist me, that's three full-time employees that you are now needing to pay for. And the costs are very, very high.
Caitlin [00:44:58] Yeah, I think, I know we have to wrap up right now, but I was just thinking also about how I had this idea that the hospital had all the answers for you. Like there'd be this like magical fairy godmother social worker, I could be a fairy godfather too, coming into the room being like, family, let's plan next steps. Or that the doctors would be like, hey, I'm gonna be involved with the care going forward. Only to learn our medical system has changed so much that when you're in the hospital, you're their patient. When you leave, you are no longer their patient, so there are so few through lines and definitely not at the hospital them being like, well, this is what this costs and this is this costs. So you are really left to be like, are you gonna bring the car up to the front here? Like their interest is very short-sighted in my experience, you know, they're doing what they do. And relying on like invisible other people to do what they do for those transitions and certainly not telling you, okay, if you want to stay in your home, it's $25,000 a month just to pay for care. That's not like your mortgage and your food and all that stuff. That's just paying for the help. That's a really different situation.
Sara [00:46:19] And I will say, I'm sure Julie can offer more color around this, but that catastrophic outcome is not the base case for most people, right? Like there is kind of an element, I think, for most people, which is like. Almost can't really plan for like the catastrophic outcome. Right. Right? So it's like the base case outcome of would I rather have someone come in 20 hours a week to help with stuff? What does that cost? Is that better or worse or expensive, more expensive or less expensive than moving to to a senior living facility. That where that's part of it I'm leaving my home but it's less expensive if I go someplace where they have those services built in right because again like once you kind of get caught in the catastrophe planning the numbers just spiral. Out of control but usually it's somewhere in between right where you can do like real planning in the in between stages right like at what caught at what point does option be become more palatable than option a. And at least having some idea of what those monthly amounts are for your financial situation. I think.
Caitlin [00:47:34] Is really helpful. Yes. And where a family discussion would be necessary because if the parents can't pay, are other people around that could help with that? Or no. So that's an open discussion needed just there.
Julie [00:47:46] No. Well, and I was going to say back to your example, Caitlin, about the, you know, you've got the social worker at the hospital and you're hoping they come in and do all of these things. And then also to Sara's point of like, you know, planning for the catastrophic, when you're in that situation where you do need to come up with some sort of plan, having a professional help guide you in that moment is truly so critical because the other thing that you're trying to do is you're, you're you're Okay, we know maybe us going home is the end. Like that's our goal, right? And we can get there. But for us to do that safely right now, this is what's required.
Caitlin [00:48:28] Mm-hmm.
Julie [00:48:29] To prevent a rehospitalization, to not have the right support set up when you get home to where something worse happens, or you've now injured your caregiver, spouse, you know, trying to do things that really didn't make sense. And so there's a balance between when you spend your to get the support when it's critical that you need it. And then long term planning, which is, you know, this is a blip in time, we need to spend money to get us to where we need to be today. But really, if we do this, we'll actually save money in the long run, because I'm less likely to go back to the hospital, I'm more likely to help, and you know injure my spouse or my family that's trying to help me all of these things. And so there's a lot to consider when you're in the midst of it. And it certainly can be very overwhelming to get that like personalized approach to like what all the options are and how to execute it. Who do you call? Cause the hospital will just give you a list.
Caitlin [00:49:36] Yes. Speaking of which, people that aren't in Austin, what should they Google looking for an organization or a company like yours care for?
Julie [00:49:45] Yeah, so we provide services in Austin and San Antonio, but anywhere nationwide, we're a part of that organization called Aging Life Care Association. And so if you Google Aging life care association on the main page, it says, find an expert. And to be listed on this site, you have to be credentialed. So these are people with tenure in the industry that have gone through the credentialing process with this organization. So if there's an area that we don't serve, we typically will go to the website specifically out of state. You can put in a zip code. You can search by radius of that zip code and find someone in your area to help you with this.
Caitlin [00:50:25] Oh, that's so helpful. OK, well, thank you, Julie. Was there any last thing you wanted to ask, Sara? I think we'll have to do a part two. Oh, yeah, part two during season five. Do we after we digest this piece? And after we play on a really fun retirement community that has built in care, but it's a fun place, the kind of place we would want to go. Like, let's try to envision. Yes, other. Environment that we want it so we can leave our homes and have something to look forward to.
Julie [00:50:57] I'm gonna go live at a winery, so y'all come join me.
Sara [00:51:06] Did you have a question about investing or finance? Send it to us in an email or voice memo on our website, womenontheverge.com. Hey, we want our.
Caitlin [00:51:15] Listeners to know that economic abuse can be subtle, but it's a serious form of control. Watch out for partners who limit your access to money, sabotage your job, or rack up debt in your name. If this sounds familiar, you're not alone and there's help available. Please learn more at TheHotline.org or call 800-799-
Sara [00:51:39] Our podcast is edited by our co-producer, Kelly West, with music by Bad Bad Hats and Devmo.
Caitlin [00:51:45] I know, the first thing you notice is that I'm covered in gold
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