What Boards and Managers Need to Know About Residents Aging in Place

If your community is well run, chances are you have residents who have remained in place for decades but with more condominium and HOA owners choosing to age in place, the services you provide and the manner in which you operate your community naturally must change. 24 hour access for caregivers, nurses, and aides and the need for uninterrupted electricity to power life saving devices all bring new concerns. So, what should boards and managers do when care becomes part of the everyday community association lifestyle, and how can families avoid a crisis-driven scramble to ensure care for loved ones?
 
 In this week’s episode, host Donna DiMaggio Berger sits down with Jacque Scherfer, Vice President of Best Care Nurses Registry in South Florida, to map out what in-home health care actually looks like, from ADL support with a home health aide to private duty nursing for complex medical needs. They also get candid about continuity of care, why the same caregiver can be a safety net, and the signs families should watch for like falls, medication issues, and slipping hygiene. Along the way, they talk cost, long-term care insurance, elimination periods, and why Medicare usually isn’t the answer for ongoing custodial care.
 
 These in-home solutions also come with a host of condominium, cooperative and HOA realities: parking headaches, security access, privacy boundaries with worried neighbors, and hurricane season planning when someone relies on daily support. Donna and Jacque also share what legitimate screening looks like, including Level 2 FBI background checks and license verification, plus why “hiring privately” can backfire when coverage collapses.

Conversation Highlights: Conversation Highlights:

• What in-home healthcare really involves—and how it supports aging in place
• Early signs it may be time to consider in-home care for a loved one
• The most common services families seek from in-home caregivers
• The benefits and challenges of community living for seniors
• How caregiver schedules work and what communities should expect
• How reputable agencies screen, train, and staff caregivers
• What boards and neighbors should know about background checks, licensing, and insurance
• Common issues in associations involving caregivers—parking, access, and building logistics
• How boards and managers can reduce friction between caregivers and staff
• Warning signs of elder abuse and financial exploitation every community should recognize
• The risks of hiring caregivers independently vs. through an agency
• What role boards and managers should (and shouldn’t) play when residents are struggling
• Emergency planning: what happens if caregivers can’t reach clients during disasters

Related Links:

• Podcast: Are “55 and Older” Communities Still In Demand? What Must Be Done to Preserve Your Senior Lifestyle? An Engaging Discussion with Mark Friedman, Becker & Poliakoff
• Resource: Home Care FAQ
• Article: 55+ Communities – Do I Still Need a Survey Every 2 Years?

Transcript

SPEAKER_01 0:01

Hi everyone, I'm Attorney Donna DiMaggio Berger, and this is Take It to the Board, where we speak condo and HOA. Today we're talking about a topic that touches almost every community association sooner or later, but one that boards and managers don't always know how to navigate. That's the needs of an aging resident population. Communities aren't just buildings, they're collections of people at different stages of life. Understanding how to support residents as they age is becoming an increasingly important part of community association leadership. Across Florida and throughout the country, many people are choosing to age in place, remaining in their homes and condominium communities rather than relocating to assistant living facilities. That often means bringing professional caregivers, nurses, or aides into the home to provide daily support. While this arrangement can allow residents to maintain their independence and dignity, it can also raise important questions for condominium and HOA communities. Just who are these caregivers? Are they considered guests or service providers? How do buildings address issues like security access, parking, elevator use, and background checks? And what should Ford know about supporting residents who may be dealing with serious health challenges while still respecting privacy and autonomy? To help us explore these issues, I'm joined by Jackie Scherfer, the Vice President of Best Care Nurses Registry in South Florida. Jackie brings 15 years of nursing and management experience to the agency. Best Care provides in-home care services, including companion care, post-op care, and private duty nursing. The agency focuses on personalized care to help individuals remain in the comfort of their homes. Her team has seen firsthand how communities, families, and caregivers interact and sometimes collide when care needs arise. Today we're going to talk about what community associations should understand about in-home health care, how boards can approach these situations thoughtfully, and how residents and families can better prepare for the realities of aging within shared communities. So with that, Jackie, welcome to take it to the board.

SPEAKER_00 2:08

Hi, thank you for having me. And I've got a little bit more than 15 years. I try to uh I worked hard for my nursing, so it's close to 30. And I've got to be.

SPEAKER_01 2:19

Oh wow, I cut I cut your experience in half.

SPEAKER_00 2:22

I was I was actually younger with that. So um, but yeah, and I have been running the family business for the last 24 years. We've been in business since 1980.

A Family Story About Staying Home

SPEAKER_01 2:35

So as you heard in the introduction, and this is a topic we haven't yet covered on this podcast, Jackie. I want to start out sharing my own family's experience with aging in place. So I'm the third of four children. My mom just turned 93. My dad will be 97 on August 1st. And they live in Weston and they've had a home in Weston for 30 years and they love the home. But my siblings and I, a few years ago, we wanted them to check out a beautiful, I won't name it, but a beautiful uh assisted care living facility in Weston. I'm sure you probably know the one I'm talking about. It's gorgeous, it's expensive. And we just wanted them to go take a tour of the place because we were concerned. At that point, my mom and dad were just still living independently. Um, and we felt they needed more assistance. I will tell you the day of the tour, I got a call from my mom and she faked a heart attack on the phone to get out of taking the tour.

SPEAKER_00 3:39

Oh my gosh.

What In Home Care Includes

SPEAKER_01 3:40

You have to know my parents to understand the way, the way the DiMaggios operate. But that being said, she was short of breath. I said, Mom, I'm hanging up. She said, Donna, I can't make it today. And she's she proceeds to actually go into this whole act of being short of breath. I said, I'm hanging up and calling 911. And then suddenly her breath got strong and she said, I just don't want to go. So she did wind up going, and ultimately it was not a fit for her and my dad. And so they are still in their home in Weston, their single family home. They've got great neighbors, and they now have in-home care four days a week. I think it should be a little bit more. It's only four hours a day, four days a week. Uh, but this topic is one that I've wanted to explore because so many of my friends have aging parents, and we're all kind of going through these mechanics of thinking what's best for them. So I wanted to ask you, starting now, what exactly does in-home health care involve?

SPEAKER_00 4:36

Okay, so it can be as high of a level of skill as physical therapy, skilled nursing, meaning an RN or an LPN. And on the other end of it is assistance with ADLs, activities of daily living. And that is usually a certified nurse's aid or a home health aid. So that it can be everything from taking care of a patient on a ventilator at home with round-the-clock nursing, to similar to what your parents are getting, a nurse's aid couple hours a day, a couple times a week.

SPEAKER_01 5:14

So my parents are still mobile, but I see that maybe changing in the next couple of years for sure, certainly with my father. Right now, the aide will come and do errands, you know, drive them around. Do many of your aides also perform those services, like driving somebody to appointments and absolutely.

SPEAKER_00 5:33

They can take them to doctor's appointments, grocery shopping. Um, if they're going to outpatient rehab, they can do that as well. I even have caregivers that go back and forth. They'll go up north with them and then come back down to South Florida during the winter. I've had caregivers go on cruises with clients. I always say, whatever schedule or service the client is looking for, we do that. We even have caregivers that are pet friendly. And I brought that into play a couple of years ago because I always would hear the stories. The adult children, they live out of town, they're across the country, and mom or dad still has their dog or cat, and they talk about getting rid of it. And I hate to see that. So we even have caregivers that are pet friendly and they will assist in the care of that pet so they can keep it in their home.

SPEAKER_01 6:32

Oh, I think that's a great service. And you kind of read my mind because that I had actually jotted a note down that I wanted to ask you if some of your caregivers also extend care to any pets in the home. Yes. So you've answered that question. I did not even think about that that you could have a consistent caregiver accompany someone when they are traveling. Oh, yes. And I would, and I would think, Jackie, that consistency is important for elderly people. I know my parents have gotten very attached to their care caregiver. She's like a member of the family now.

SPEAKER_00 7:04

Yes, and that's one of the things that we do, I think, is important is important being a nurse. Um, I always say I'm a nurse before I'm a business owner, and continuity of care is extremely important, especially with the elderly, because a lot of times my nurses' aides that are in the home that have been taking care of these clients, it could be for a couple of months to several years, they will pick up on little nuances or changes in that patient sometimes before their own family or their physician does, because they are with them every day.

SPEAKER_01 7:46

Oh, that makes sense. And that I'm sure provides a level of comfort to the out-of-state feeling that was knowing that there's somebody there watching mom and dad. And sometimes it's not mom and dad, sometimes it could be an adult child, you know.

SPEAKER_00 8:00

Yes, that is correct. Because we do, we don't um deal in pediatrics, but I do, I have had clients that have are young, 18, 19, 20 with disabilities that we've done. We did have one case that we did take care of him from birth. He had round the clock nursing care. You know, for about 25 years we took care of him.

Caregiver Training And Continuity

SPEAKER_01 8:27

Wow. I think this has to be a calling for somebody who goes into this. How did you get involved first in nursing?

SPEAKER_00 8:35

Well, in nursing, uh, my mother and both of her sisters were nurses. Um I did not want to be a nurse. I was on my way to go to veterinarian school, and uh I had a bachelor's in biology and livestock production. And then I decided, you know, I'm having a good time in Nashville. I think I'm gonna go to nursing school. I wasn't ready to buckle down. So that's what I did. I um finished and ended up with a bachelor's in nursing, came home, um, worked at Mount Sinai for a period of time, then ran an outpatient uh surgical center, and then stepped into the family business about 24 years ago. I have a business partner, and um we grew up together, and his father and my mother, two separate companies, started the home care company in 1980. So we stepped in, both of us, about 24 years ago, and we've been running it ever since.

SPEAKER_01 9:41

I imagine your nursing background, Jackie, helps when you're hiring caregivers. So you mentioned you've got a variety of caregivers. You, and if you could just walk us through it, registered nurses, licensed nurses, and then some caregivers, I imagine, don't have those certifications, but they have other qualities that make them suitable for this line of work.

Schedules From Short Visits To Live In

SPEAKER_00 10:03

Correct. Yes. We we have RNs and LPNs, which they provide a skill. I have on a few occasions people want a registered nurse or an LPN hourly in the home. I have a few that will do it, but you know, I try to talk them out of it because it's really overkill unless there is a reason for that skilled nurse to be in the home, to do an IV, to do wound care, to fill a pillbox, something like that. So majority, I would say, of our um caregivers, they're CNAs, certified nurses aid, or an HHA, was which is a home health aid. And they are both the same uh as far as skill level, assisting with activities of daily living, getting bathed, getting the client dressed. They do have some basic skill. They all know how to take blood pressure, pulse. They're all CPR certified in CPR. And they're there to really provide that's what the majority of elderly really needs. They need that type of care, they need that ADL assistance.

SPEAKER_01 11:22

What's the typical schedule for a caregiver? Like I mentioned a few minutes ago, my parents have somebody come four days a week, four hours a day. But I will tell you that's because that's the minimal.

SPEAKER_02 11:35

Right.

SPEAKER_01 11:35

And my mom still thinks they only need the minimal. But how do you how do you work out a schedule?

SPEAKER_00 11:41

Yes. Well, we're we are a little bit different than the some of the other home care companies. We do not require a minimum. If I have a client that wants one hour a day, one day a week, we will provide that. So the schedule could be anything from a couple of hours a day, a couple of days a week, like your parents are getting, to round the clock care, two 12-hour shifts, round the clock, seven days a week, 365 days a year. We also have what is known as a live-in. So if the client does not need two 12-hour shifts, but they need someone there to maybe be there at night in the middle of the night. If they have to get up and go to the bathroom once, we have a live-in. And that caregiver actually lives in, they're there around the clock. The only caveat to them is anyone with any type of dementia or Alzheimer's, that doesn't work because they really do have to have enough hours of uninterrupted sleep to safely care for the client the next day. So we do have that option.

SPEAKER_01 12:56

Jackie, that would be one person living in the home. Where do you find somebody who wants to go live in someone's home?

SPEAKER_00 13:04

We do, we do have caregivers that do that. Yes. Yes. And they need time off too. Yes. So what most of the time we start it off, you know, with the same person. And then when it gets to a point where they the majority of the time, when a live-in needs um a break or they need coverage, it's they're leaving to go visit family. So we will put someone in to do that coverage, or some live-ins will want to work Monday through Friday, and then we have a different live-in on Saturday and Sunday. But we keep it very limited to two people to create that continuity of care. I don't like a revolving door, especially with elderly. They need to have the same person. There has to be routine, um, things like that. So that's how we do live-ins.

SPEAKER_01 13:58

When my parents' caregiver, you know, goes on vacation or calls them sick, it's a little unsettling to them. Yes. And sometimes my mom will say, we don't need anybody today. They need somebody every day, but Right.

SPEAKER_00 14:12

Right. And we're very good with coverage too, because emergencies do arise and we do have caregivers for coverage as well. Because we have some clients, they can't be left alone.

SPEAKER_01 14:26

Yeah. But I have to ask, Jackie, 24-hour care, let's say, do you have to be can only the Uber wealthy afford that level of care?

SPEAKER_00 14:36

Well, here's here's where it falls down into finances. Either there is long-term care insurance that people purchase usually in their late 50s. Because I've been doing this for so long. We, my partner and I and our spouses, we all purchase policies at 40. Um, long-term care or out of pocket. Those are the only really two entities that cover this type of care. Government programs such as Medicare, Medicaid, it does not cover this custodial type of care. And the coverage that it does do in the home, it's it's short-term and it's very minimal. There are few programs through Medicaid that are long-term care programs through traditional insurance, United, Humana, AVMed. We are contracted with United for that Medicaid long-term care program. But those groups are very small. Most of them are closed. You do have to apply for it, and it's very minimal. So if you if you have the the disability, the long-term disability coverage, does it work like Social Security where the longer you wait to have it kick in, the more No, these are these are private long-term care policies that you purchase. And the people that are using these policies now, they bought them 30 years ago. So the policies were really great that were written back then. A lot of them, care starts on day one. It could be cover$350 a day with an inflation rider on it. So by the time the client is using the policy 30 years later, it has increased over time with inflation. And the majority of my clients using their long-term care insurance, it does cover quite a bit of the care. So there's minimal out of pocket. Now, as time is going on compared to what I was using 15 years ago, these policies are getting smaller and there have they have elimination. A lot of them I'm seeing now today have anywhere from seven to 90 days elimination. So they have to pay out of pocket for the elimination period, and then the policy kicks in.

SPEAKER_01 17:14

Well, explain that to me. What do you mean by an elimination period?

SPEAKER_00 17:17

Okay, so if you have a policy that pays$200 a day, but when the policy was written, there was an elimination period for seven days. That patient pays out of pocket for seven days. On day eight, I no longer bill them. I'm billing the insurance company. And we're a little So it's like a deductible check. Correct. Correct. It's an elimination period. You have to pay out of pocket. I'm not seeing so many more seven-day eliminations anymore. I'm starting to see the 90-day eliminations. Oh. But now most policies today, that's what they they have, a 90-day elimination.

SPEAKER_01 17:58

Do any of them just stop if you live too long? I mean, because again, we we now have more centenarians than ever before. Do any of these policies just cut off at a certain date?

SPEAKER_00 18:09

Sometimes these long-term care policies, there's a million ways to write them. Uh, some are good for two years, some are based on a sum of money, and some are lifetime. Lifetime policies you cannot get anymore. So the people that are well into their 80s, they have those lifetime policies. So that policy covers them for the remainder of their life.

SPEAKER_01 18:36

And you and you're saying that in the marketplace, those aren't.

SPEAKER_00 18:39

The marketplace, those they're they're very few and far between today.

SPEAKER_01 18:44

So you really have to self-insure to know. I mean, and and some people are doing that. That's that's actually kind of my plan at some point, is uh, you know, put away enough and and basically self-insure. Because as you said, the policies have gotten, the premiums have gotten quite high.

SPEAKER_00 19:01

They are, they are, and that's why at 40, um, 16 years ago, I said to my partner, I said, we're getting policies today. And that's what we did, because it is costly to age in place at home. And from a nursing perspective, and there's a slew of studies out there, it is the best place for people to age is in their home. The only thing that prevents it is finance.

Why Home Can Be Healthier

SPEAKER_01 19:30

Well, let's talk about that because again, this is take it to the board. We've got a lot of people living in condominiums and cooperative buildings and HOAs. I'm seeing more and more of this as an association attorney, that there are, you know, elderly people, many of them often living alone. Um sometimes it's a couple, but more often than not, it's it's somebody living alone, and they do have a caregiver coming into the unit or into the home. You just said, Jackie, that this is the healthier option. You believe it's the healthier option. Talk to me about that. Why do you think it's healthy?

SPEAKER_00 20:02

Well, why do I think it's healthy? I I used to do a lot of home care visits. So I've been in and out of assisted living facilities, nursing homes all over South Florida, plus visiting people in their home. And for me, and as I am getting older, I have a different perspective on it. Um, I think the home is it's where they've been. They might have lived there for 20, 30, 40 years. All of their stuff is there. And there's really no difference as far as a skill set taking care of someone in their home versus in an assisted living facility or nursing home. Like I said before, we've managed patients on ventilators, feeding tubes, and all that kind of stuff. So that is the home is the best place to be. Infection rate is lower. Um, and as people get older and age, they're not as social as some of these facilities are marketed. Um, now some people are. Some people I always say to people, if your mother or father is a very social person, then they probably will do well in a place like that. Um, but the majority of them that I've seen, you know, it's the kids live in California, they think it's best to sell the home or the condominium and move mom or dad into the assisted living facility. It wasn't a their choice to do that. Even with memory problems and cognitive impairment, patients that age in place in their home, if they start to develop cognitive issues, dementia, Alzheimer's, and then they are picked up and moved out of their familiar surroundings. Sometimes that can cause a pretty rapid decline. So I think if someone wants to stay in their home, forgetting the finances, I think it is a good place to be because, you know, plucking them out of their home that maybe they say hi to a neighbor occasionally, but they're in their home, they're around their surroundings, they might read their book, watch a little TV, and then the day starts all over again. That's the routine they've had. So plucking them out of that and putting them into a facility with lots of crafts, activities, and people, a lot of times I saw patients in their room. They weren't doing those things.

SPEAKER_01 22:41

Just what you laid out has been my experience with both my parents and my mother-in-law. Um, my parents, they just did they they could never fit into that kind of regimentation. So, you know, breakfast is served from seven to let's say 9:30, 10. My parents don't get up. I'll call my mom and they're having breakfast at noon. I'm like, that's not brunch, mom. Right. They're yeah, their hours are whatever they want to make them. And there is just no way they could have fit into a regimented schedule that look, they're running a business in these facilities. So they need people to be doing things at a certain time because they've they're paying staff to be there. Now, my mother-in-law did move in, but I have to tell you, Jackie, that packing up, like you said, a home with all these belongings and the memories, that so weakened her before she made the move that by the time she was supposed to go into independent living, she really was no longer independent. And I wanted to ask you about that because with my mother-in-law, she probably waited too long to go into an assistive care facility and she was a social person. My parents almost waited too long to get home in care, uh, in-home health care. What is your recommendation to people to not wait too long to make these kind of decisions when they still have plenty of time and more runway in front of them?

Signs It Is Time For Help

SPEAKER_00 24:10

Right. So I think the the main thing is whether it's family, direct family, or a friend or a neighbor, you know, there will be signs you'll start to see. Maybe their mobility falls. That's one of the things we look at. You know, if mom or dad, they're over the age of 65 and they've had two falls since the beginning of this year, each fall creates an increased risk for another fall. So mobility issues, hygiene, you know, looking at them, you know, if they're not really keeping up with themselves like they used to. Going into the home, we do that sometimes. I might have a son or daughter that lives in New York or California. They may see their parent once or twice a year, and they just they sound a little declined on the phone. So we do send out an RN to go out and assess the situation. So they're not keeping up with things around the house. Uh there, you know, the laundry, things like that. And our caregivers do do that. They do assist with lighthousekeeping. So it's looking at that medication. Maybe they're mixing up their medicines, they're not taking them like they should. So it it really is individual. It's not, you know, set at a certain age. My mother is 89, she is still doing her own thing. She just drove to Orlando and back, you know. So it just depends. My father, I did not have to put home care in until he got close to he was over 90. And he had a few falls, and I didn't want my mother falling, trying to help him. So we got round-the-clock care for him. And he got to stay at home, and that's where he wanted to be. And he passed away at home. So that's what he wanted. I'll do the same for my mother. And, you know, it's really an individual basis.

SPEAKER_01 26:16

I agree. I guess it's your it's how you frame this conversation, Jackie. So I used to think about longevity. And I know in in some of these nursing homes, they'll keep them alive, but they're not necessarily happy. And now my my perspective has shifted. I'm I I want them to be happy, and they're absolutely going to be happiest in their home. My mom's still cooking, and I and I tell my siblings, she's likely going to go out in a blaze of lasagna. She's going to be pulling this little 90-pound woman's going to be pulling the lasagna pan out of the oven, and that's going to probably be it.

SPEAKER_00 26:51

Yes.

SPEAKER_01 26:52

But she'll be happy.

SPEAKER_00 26:53

Yes. And that's that's the whole thing, you know. I always say we are in business to keep people in their homes. And a lot of times there's a misconception that if they get a caregiver in, that it's going to take away their independence. And it really doesn't. I tell them it is going to promote your independence because they're going to do some of those extra activities that are tiring you out that potentially could put you at risk for a fall. And a fall over the age of 65 is not good. And a hospital admission, that's not either good for our elderly, you know, people. So I say the aid's not going to take any independence away. It's going to allow you to stay in your home.

SPEAKER_01 27:42

You're absolutely right. Spend your the time you have on the stuff you love, not the mundane chores, but now that you're older, have become more challenging. And also I do find, Jackie, that a lot of the older people I speak to, uh, they don't want to spend the money on themselves. Right. Okay, so they're they're guarding that inheritance and what and I and I understand that, but I always tell my parents, you earned it, spend it yourself.

SPEAKER_00 28:09

Yes. And a lot of times with situations like that, there's plenty that is there to provide the care for them. And, you know, I do have some that only want four or five hours a day of care. And that's fine as well if that's all they want to do. Um, because the other issue becomes, you know, someone at least going in every day and seeing them. Because we do have a lot of elderly that don't have any care. And sometimes they may or may not have family. I'm finding more and more people that they're not married or they were married and they no longer have their spouse with them, but they never had kids. So there's really nobody keeping an eye on them. And at least if you have someone going in, it may not be around the clock, but someone is going in every day. They're making sure that they have food, they're making sure they're eating, that they're getting cleaned up, you know, things like that.

SPEAKER_01 29:10

You know, everybody's read about the epidemic of loneliness, being experienced not just in this country, but worldwide. And we do have uh a growing number of people, elderly people living in these communities, and they're all alone. It is it is very sad. And we've had some ghoulish stories of people who have passed away in their units. And it really wasn't discovered until well, the neighbors reported certain things, noticing certain things. That um to your point, if if you have routine caregivers coming in, that's one less worry, one less thing to worry about.

SPEAKER_00 29:48

Right. And it, you know, I do. I have it's I have some patients that are in their mid-70s to late 70s that are very declined and have round the clock care, 10, 12 hours a day of care. And I have some that are 93 that they're only getting, you know, four or five hours of care a day. But that aid is going in there every day. And so there's someone that's going in there and checking in on them.

Condo And HOA Realities

SPEAKER_01 30:17

So, Jackie, can we talk about the challenges for elderly people living in shared ownership communities? I'm thinking about, you know, a condo or cooperative building, somebody may have purchased on the 18th floor when they were in their 40s. They're now in their 90s, elevators go out, electricity goes down, and those individuals may be on, you know, machinery that requires electric. I'm thinking about even parking structures where it's hard to get where they're narrow, hard to get in and out if they're still driving. In our HOAs, there's a lot of maintenance requirements for the homes. The roofs have to be cleaned, the lawns have to be cut, the garbage cans have to be brought in and out. What have you seen in particular in terms of the people aging in place in these types of community associations?

SPEAKER_00 31:08

Yes, we I have not, we do take care of and have for over 40 years taken care of people in high rises. We don't have the snowbirds like we used to have. 25 years ago, 30 years ago, we had a lot of people that came down in the winter and then went north um for the summers in the warmer months. Um, we don't see much of that anymore. These people do live year-round. We personally, our company has not really had any problems with you know clients with mobility and getting out of a building and things like that. We haven't really had anything like that, even with hurricanes and things like that that come through. The majority of my clients, the caregiver, stays with them because they choose to stay.

Hurricane Planning And Evacuations

SPEAKER_01 32:06

Well, I wanted to ask you that. So we, you know, we're heading into a six-month hurricane season here in Florida, starts June 1st. So if you do have a client who's not on 24-hour care, but let's say they're getting six to seven hours of care a day, but a storm is coming, the caregiver has to get to their own home. What happens in that event?

SPEAKER_00 32:26

A lot of times with that, we our caregivers will actually stay with their clients. I would say good majority of the time. The only other situation that we have, there could be family that comes and takes them up north until after the storm or takes them somewhere else or brings them to their house until the storm is over. But a good majority of them, the caregivers stay with them. We do, when we do go out to the home, there is for each county, there's, you know, paperwork, and we have to introduce the client to it that is evacuation. And if the client feels the need to have an evacuation plan, the county does offer that. We give them all the information and they sign up for that if they want that. I can't recall any of my clients wanting that. The majority of them will decline that and they make their own plans, but a good majority of our caregivers stay with the client.

Privacy Nosy Neighbors And Parking

SPEAKER_01 33:31

Oh, well, that's reassuring. Yes. Have you ever, since we're talking about associations, have you ever had an issue with a nosy neighbor who wants to know use?

SPEAKER_00 33:41

Oh, yes, all the time. And a lot of times, I will even get a phone call from that neighbor wanting to know, you know, what is going on. They might see, you know, our logo or something like that. Of course, you know, we follow HIPAA, so we don't discuss that stuff. But I have had neighbors call me concerned about their neighbor. They might be elderly, they can see that they've declined, and they will sometimes initiate the care getting started. They'll reach out to a family member or they'll go and talk to their neighbor and they'll connect me with it. So we have had to deal with that. But as far as neighbors, you know, um having a problem with the caregiver, or they don't like a caregiver coming in, I can't say that I've ever had a problem with that. I've never really had the biggest problem we have with buildings, especially more east towards the beach, is parking. And I was I knew you were gonna say parking. Yes. But you know what? I have to be honest. The majority of the buildings that we provide care in, they're very accommodating. And they're very accommodating with the caregiver. So a lot of times they'll find a spot for the caregiver to park. Sometimes the family does have to pay for that valet parking. That's part of it. But I've never really had a problem with that. It's it they seem to be very understanding.

SPEAKER_01 35:22

I am very happy to hear that. And I think attitudes have shifted because I can recall, oh, I would say about 20 years ago, when you would have people aging in place. I remember one board in particular said, We're not a nursing home. Right. Now I don't hear that. And I think that's because the boards have gotten very old. Yes, yes. And I think their time is coming. But I remember clearly a board saying, We're not a nursing home. These people need to leave.

SPEAKER_00 35:54

Right. And that, you know, I think that has changed a little bit because I used to do a lot of visits when I was out in the field and during doing nursing visits. And, you know, look, they gave me a hard time on where I was going to park, and you can't park here. And I'd have to sometimes park two blocks down the street on Miami Beach and walk to the patient's house. And like I always said to him, I said, don't forget, I said, if you're lucky, you're gonna get to this point one day. So, you know, it, but the majority of the time, the buildings are great. They they are very accommodating. And, you know, some of those people have lived there 20, 30 years, they've paid their association fees, they've done all that. You know, they're entitled to stay and and be in their home. So, but I don't I don't ever come really come across that.

Could Associations Offer Nurse Checkups

SPEAKER_01 36:44

Yeah, and that's and and that's really reassuring to hear because I do think attitudes have shifted significantly. And I think we're gonna see a future shift I want to ask you about. I read a story, I think it was about a year and a half ago, and it was a community not in Florida, where it was I think it was about 40 to 50 homes, and the association had made the decision to hire a licensed nurse to come once a week and make a check of the people in the homes who signed up for it. This was being rolled out as another service. Like maybe they have uh, you know, entertainment at the clubhouse, or they get, you know, different kinds of services or amenities. And this was one of the amenities as their people had grown older that this board and the association decided, okay, we're gonna make it easy for people to age in place in their homes.

SPEAKER_00 37:39

I think that's that's one of the things. Have you heard of this trend? I I have not. Now, um, I do know, you know, I'm not very familiar with the villages and those places that are up more towards the middle of the state that are 55 plus communities. Um, they do have some things like that. I have a an aunt um that is a nurse. It's it's funny, my aunt and my mother, all of them, they're in their 80s. They all keep their license. They pay it every two years and they keep it renewed, and they do their they do their continuing education, and it's good for them to do that. So my aunt is in a community up there near Ocala, and there are actually quite a few retired nurses in that community, and you know, it's not official, but they are really good eyes and ears for people that are starting to fail and not able to care for themselves. But I think that's a wonderful, you know, idea, especially in communities that start to age.

SPEAKER_01 38:44

Yeah, I think I could do a whole episode just on the villages and what's going on up there.

SPEAKER_00 38:49

Oh, yes, that's quite a place.

A Care Story With A Hard Lesson

SPEAKER_01 38:52

Yeah, I'll put that, I'll tuck that one on my. Do you have a story from your work that really illustrates the impact that good caregiving can have on someone's life?

SPEAKER_00 39:03

Yes. Um, well, I've got hundreds of stories of my caregivers being in the home and catching things before they got more advanced. Again, their education is basic, but they can do pulse, they can do blood pressure, they can take a temperature. There was one situation that actually involved me. I had a, it was a my partner family friend up in Philly. Both the parents live down here in South Florida, and they were concerned about them. They were starting to age. She was concerned with her mom, her mobility and things like that. So I said, I know you don't want the service. The father was, he thought he had it all under control, taking care of his wife. And I said to him, I know you don't want this, but based on your age, based on your wife's age, I said, if you don't take this aid, at least let her come there and help her with bathing, dressing, getting something to eat. I said, you're gonna end up falling, breaking your leg, trying to help her not to fall. And exactly one week later, that's exactly what happened. So they both ended up with care. And I had him on until they both passed away. And he said to me, he said, you know what? Every time I talked to him, he said, You're right. I should have listened to you. And I joke and I say, When the nurse tells you something, that's when you should be listening. Forget everybody else and the doctors and all that. I said, But when the nurse tells you that, it's usually right.

SPEAKER_01 40:39

You know, I may uh I may have two challenging people for you. Yes. And they live in Weston. We'll talk after the episode.

SPEAKER_00 40:47

Yes, yes, absolutely. And I'm right here, I'm right across the street from them.

AI Robots And The Human Touch

SPEAKER_01 40:52

So perfect. Perfect. A home visit. So you've been so generous with your time. I do want to ask you a question because I ask a lot of my guests about AI and how it might impact their industries. Do you foresee robot caregivers in our life? We're younger, so in our lifetimes, are we going to be taken care of by robots?

SPEAKER_00 41:14

Um, I'm gonna hope not. Um, my husband gives me a hard time because as you can see, I use plug-in headphones. Um, I don't, I don't think it's going to work. I I see bad things with a lot of it. I think AI is good for some things, but I just you have to have that personal touch. You know, like I I tell my kids, I'm not a big texter, definitely not a big emailer unless it's something documentation or or work-related. I tell them we don't communicate through texting. We're still humans. We might have all this technology, but we're still humans, and humans react doing what you and I are doing. We're using a device and seeing each other, but talking and hearing the inflection in people's voices and, you know, body language and all that. So I don't I don't see that happening. I some people may adopt that, but I think people in general are gonna still want the human involvement.

SPEAKER_01 42:22

I know I human a human caregiver. I think by the time we're ready for it, I think there will be robot caregivers, but probably the human caregivers will cost more. So we just have to ensure we just have to make sure we can afford it.

SPEAKER_00 42:37

Yeah, that's exactly right. That's what's gonna happen. It's gonna be, you know, I hate to say it, but it will be the haves and the have-nots. It's just like going and seeing private care in another country and then seeing socialized care. And um, you just don't get the same. It's like having a PPO or an HMO, you know.

SPEAKER_01 42:58

So, Jackie, what steps can families take to ensure that they're hiring a legitimate and trustworthy caregiver?

SPEAKER_00 43:04

Yes. So any licensed home health care company or nurse registry, that all of the caregivers are fingerprinted with a level two FBI background check. And besides all of the other documentation that's required by the state, we have to have either their certificate with their license number on it, um, same with RNs and LPNs, and they are all checked through the Board of Nursing to make sure that their license is active and there's no discretion on their license. And with home health aids, we do call the school, we make sure the school is certified with the state, and then all of their other documentation, Social Security, driver's license, CPR card, all of

SPEAKER_01 44:00

That so for all the people listening who think they want to cut out the middleman and hire their own caregiver, they're really taking their chances.

SPEAKER_00 44:09

Um, in South Florida, yes. If you are in Kansas, I would say go for it. But in South Florida, I would not do that. I could write a book on the stories that I've heard. So no, I would not do that.

SPEAKER_01 44:23

And that's probably true in other urban areas, heavily populated areas as well. That you've got to be careful. I'm sure you've had this issue come up of your wonderfully screened caregiver, and a client perhaps tries to hire them directly.

SPEAKER_00 44:45

You know what? That's a very good question. I don't think I've personally dealt with it. I know my partner has, but the only contract we do have is between the caregiver and the client. They cannot hire that client. We have a contract that is legally binding. And, you know, I believe it's after 180 days of being off service. If they want to hire them at that point, then they can. Or they can do a buyout. But we do that's the plus of having an attorney for a business partner.

SPEAKER_01 45:20

Yeah, I don't want to talk about the two people I know who tried to do that. Um I hope they're not listening to this podcast episode.

SPEAKER_00 45:29

Yeah. So you, yeah, we do have a con we do have a contract with that. And most of the caregivers, I have to say, they they probably are approached a lot. But, you know, they like working with an agency because or a nurse registry because there is coverage. It's on the up and up.

SPEAKER_01 45:49

It's and it's more organized. Yes. Because again, if it's somebody that's just your direct employee, let's say, right, they can't be there 24-7.

SPEAKER_00 45:59

No, and a and a lot of times I will pick up cases where they did go and hire because someone in the building knew this person, and then they leave them for a week at a time, and the daughter's having to come down, stay with their parents, and take care of them. So, you know, there's a lot of problems with doing that.

Where To Find Best Care

SPEAKER_01 46:20

Jackie, you have provided so much great information. Thank you for joining us. Where can people find you?

SPEAKER_00 46:26

They all they have to do is get online and put in best care, nurses registry. Um, and we are from the Orlando area all the way down through Dade County.

SPEAKER_01 46:39

That's great. Thanks for joining us.

SPEAKER_00 46:41

All right, thank you.

SPEAKER_01 46:43

Thank you for joining us today. Don't forget to follow and rate us on your favorite podcast platform or visit ticket to the board.com for more ways to connect.