When Memory Fades, Love Remains: Dementia & Medicare’s GUIDE

Every three seconds, someone in the world develops dementia — and behind every diagnosis is a family holding on to hope. In this powerful conversation, host Keith D. Terry sits down with Brian Braggs, Army medic veteran and franchise owner of Right at Home Peoria, and Tierney Burdett, a devoted family caregiver turned advocate. Together, they unpack the emotional, financial, and spiritual weight that dementia places on families — and how the Medicare GUIDE Program is reshaping support for caregivers across the country.

Listeners will hear how the program offers 24/7 nurse access, respite care at no cost, and a structured path for caregivers who have too often walked this journey alone. From personal stories of love and resilience to practical insights about navigating healthcare systems, this episode bridges the human and policy sides of one of today’s most pressing health challenges.

🎧 Key themes:

• Understanding dementia vs. Alzheimer’s
• How caregiving impacts families emotionally and financially
• Inside the new Medicare GUIDE Program for dementia care
• Why respite matters for caregiver survival
• Leadership and purpose in healthcare delivery
• The future of home-based dementia support and technology

📌 If you’re a caregiver, healthcare professional, or simply someone who wants to understand what’s ahead, this episode is for you.

Transcript

Setting The Stage: What Dementia Is

Keith D. Terry 0:00

Welcome to the podcast, The Next Big Thing. I'm your host, Keith D. Terry, a consultant, a coach, and a serial entrepreneur. The mission here is to teach, inspire, and to motivate. Today's episode is going to be a good conversation, and this one is close to home for millions of families across America and globally. Dementia is what we're going to be talking about. Dementia is one of the greatest healthcare and caregiving challenges of our lifetime. It touches families emotionally, financially, and spiritually. For decades, too many caregivers have faced it alone. But before we dive in, let's clear something up. A lot of people use the words dementia and Alzheimer's like they're the same thing. They're not. Dementia is an umbrella term. It is what we call when someone's memory, thinking, and daily life is impacted in a very serious way. Alzheimer disease is the most common type of dementia, but it's not the only one. There are other forms of dementia, like vascular dementia, dewy body dementia, a frontal temporal dementia. And I might be saying these words incorrectly, but the point I'm making is that dementia is vast, and there are a number of them. Here's the reality: no matter the type of dementia, dementia is progressive. It gets harder over time, and it doesn't just affect a person's diagnosis. It impacts the whole family. Like I said, emotionally, financially, and spiritually. And that's why programs like the Medicare Guide program, which we're going to be talking about today, matter so much. They just don't focus on the patient. They finally recognize the caregiver too. But help is here. The new guide, the new Medicare Guide program is reshaping how caregivers are supported, providing resources, guidance, and most importantly, hope. And today we're going to explore how this program is being brought to life by leaders right here in central Illinois. My first guest is Brian Braggs, an Army medic, veteran, former fire station rescue medic, certified dementia practitioner, healthcare administrator with over 20 years of experience. He is now a franchise owner with a company right at home, Empeoria.

Brian Braggs 2:17

First of all, thanks. It's good to be on the show. Thanks, Keith, for allowing us to have this opportunity to share this debilitating disease that 50 million folks are impacted by, about 6.9 million in the USA and 12 million American unpaid dementia care providers. That stems from about 18.4 billion hours of unpaid care. Well, my background, as you've indicated, goes back to when I was in the military as a combat medic. But early on, before that, my grandmother, who had Alzheimer's and dementia, when I was 11 or 12 years of age, I actually assisted her in her activities of daily living with that debilitating disease. And boy, so as a father of four, man, I enjoy spending time with family on my at the lake house and going on the boat and also going to movies and travel with my wife, Carrie. And um, we just enjoy spending time when we're not at work, and it's exciting to do that.

Keith D. Terry 3:14

Then welcome to the next big thing. My second guest is Tierney Burdett. Tierney, welcome to the next big thing. Now, share, tell us a little bit about who you are.

Tierney Burdett 3:22

I'm a mother, a wife. I'm a coach, an entrepreneur, and I'm from Peoria. Originally I was living up in the Chicago Lane.

Keith D. Terry 3:30

So, Brian, let's let's let's keep going and we'll come back to her. We'll switch things up a little bit. Okay. Talk a little bit about the caregiver realities. Let's talk a little bit about your healthcare journey over 20 years. How did your journey as a medic shape your approach to caregiving today?

Caregiver Realities And Hard Choices

Brian Braggs 3:48

So uh as a combat medic in the army, uh, we were on various training exercises, and our job to make sure that folks are uh good to go doing a training exercise. And if there's any injuries or traumas or medicals, it was my job to respond to those as an army medic. But then coming out of the military, uh becoming a civilian uh fire rescue uh medic, responding to different medical and traumas, uh, affording me the opportunity to provide that uh immediate uh care to patients that need them in their homes or at a commercial facility during that period of my career. And uh those things actually helped me to be prepared, be able to evaluate patients and provide uh adequate medical care and treatment to those different situations that they were coming up against. So um so it was a good experience.

Tierney Burdett 4:34

And a daughter, full-time caregiver now, um, from Peoria originally, born and raised, moved away up to Chicagoland for the last seven years, and now I'm back. You can find me in the gym. I'm at the gym goer, girls' basketball.

Keith D. Terry 4:51

Let's start with you. I want you to paint a picture of what caregiving really looks like.

Tierney Burdett 4:56

I was going back and forth, driving two and a half hours to come run my dad to all these different appointments and fighting all his battles. Well, for months I was driving back and forth and it just got to be too much. I couldn't be two places at one time. So we made that difficult decision that once the kids were done with school, that we would be moving back and moving in with my dad to help care for him his house. With mice. So we had to do we had to get the house livable before I would even move my family in. So I was doing things I'd never done. I learned how to installate a house. We had to pull it all out and re-installate it and deep clean it, and it was the grossest thing I've ever done.

Keith D. Terry 5:48

And how did you balance caring for your father?

Tierney Burdett 5:50

Not very gracefully, I'd say it was very difficult. I just to the occasion. And I asked for help. That was a hard thing because I'm used to doing everything and I would ask my family for support. I'm the only child, but who's close, like a sister.

Keith D. Terry 6:06

Let's talk about your father and the the realities of dementia. Did he remember who you were? Did do you know which type of dementia he did he have?

Tierney Burdett 6:14

Go off to all the doctors. It's never-ending.

Keith D. Terry 6:17

So you have to take your father to the doctor.

Tierney Burdett 6:23

You know, he hadn't been even the dentist, you know, he hadn't been to any of these appointments in years. So just even getting caught up on regular checkups and then all the testing, and then all the other doctors that were referred to us.

Keith D. Terry 6:36

Okay. And what surprised you most about becoming a caregiver?

Tierney Burdett 6:40

Draining it is. I I'm not very knowledgeable on you know, insurance and health care. That's not in my wheelhouse. So learning all this new criteria has been a lot.

Keith D. Terry 6:53

I bet it has been. I can share with you that as a caregiver of a child who had some mental health issues, it was tiring. And you know, hear the stories of people with dementia forgetting who you are, forgetting how to eat, how to walk, how to do certain things.

Tierney Burdett 7:09

But I'm trying to understand the realities of how it hit you and I had to guess the doctors, maybe even say late stages, but like just yesterday it was our wedding anniversary. And I said, Do you remember? I asked the whole family, do you remember where I got married at? And my dad said Illinois. And it it wasn't Illinois, it was in Minnesota. So I brought up all the pictures and you know, just didn't make them feel bad about it, but just, you know, showed showed them, Do you remember this? And our daughter daddy dance, and we hadn't.

Keith D. Terry 7:42

Yeah. Yeah. I'm sorry. You know, can you share a moment of connections? Is it are the moments of connection with you and your father getting more difficult? Move forward in this easy discovery.

Tierney Burdett 7:54

Kind of feel like a plant that was just uprooted out of the pot, and I'm being placed somewhere else, and I'm just getting watered and getting my roots developed here so I can continue to bloom like I was blooming up in Chicagoland. So I think it's easier. I'm um setting up my outlets like I got I had an amazing gym that I would go to and I could put my kids in the childcare for two and a half hours, and I had that time where was my time. That was for if I wanted to lift, I was lifting. If I wanted to sit there and take a breather, I did that. Now here I hadn't really had these outlets set up. So I'm continuing to get those set up. And yes, absolutely.

Keith D. Terry 8:32

Is it impacting your children and your husband?

Tierney Burdett 8:35

More resilient than me. I think I've had it the hardest. I've even actually broke out in shingles twice. It's been so much stress on me because I'm the one carrying the load. I'm the one, you know, facing my career, spending all my time gaining the knowledge that I need to make these important decisions for my family.

Keith D. Terry 8:55

Now, Brian, let's bring you into this conversation. Can you articulate other challenges caregivers might be going through?

Emotional Toll And Family Impact

Brian Braggs 9:02

Absolutely. As I had indicated, uh, alluded to earlier, um, this debilitating disease, no degenerative disease that impacts the brain has been a struggle and uh in so many cases a pandemic, if you will. When you think about caregivers who are upwarding from their careers like tyranny and having challenges with travel in between, whether it's one, two, three hours, sometimes between states, just to get to their loved one and provide that support and care, and then also get the care education and resources and supplemental information that they need in order to arm themselves to properly provide for their loved one uh that's dealing with this disease. And when we think about the state of Illinois, there's about 316,000 unpaid caregivers in the state of Illinois, and County Cook County is the number one county in the state that has the most caregivers, correcting the most patients dealing with this disease. And actually, Peoria County is number two out of 102 counties in Illinois.

Keith D. Terry 9:57

What's the most common challenge that that and this is for either one of you, what's the most common challenge that caregivers face? Now remember, I'm asking because there are a lot of listeners that just don't know what this is.

Tierney Burdett 10:10

I have been without my job for six months now. So that was a huge toll, having to cut back on the budget and emotionally I'm exhausted. Yeah.

Keith D. Terry 10:23

Anything you want uh else you want to add, Brian?

Brian Braggs 10:25

Yeah, I think in addition to the emotional stress and strain that they are impacted, the caregivers, I would say not only the financial part of it, but just the whole and I Keith, you alluded to the to it earlier uh to some degree, uh, when you asked the question of, hey, Tyranny, does your dad remember you? And then Tyranny responded, she pulled out some pictures. He thought the wedding was in Illinois, in fact, it was in Minnesota. You know, grappling over that fact, hey, I'm looking at my father, I'm looking at my mom, my dad, and they were at the wedding, they were involved in everything, and how challenging that would be for anyone to uh sit in front of their parents who would not recall one of the most monumental moments of their life in terms of getting married. That's a big, big deal. And so that emotional uh disconnect probably had a lot more breakdown for Tyranny, I would imagine, inside. But she held it together and she pulled out the photos and started sharing those photos with her dad to help him to recall. And the challenge is they may or may not recall that event. And um, and so just grappling over that whole idea that, hey, I'm sitting in front of my loved one, they don't remember, etc. But Tyranny did it so gracefully. In fact, she indicated she did not, you know, quote unquote want to embarrass him or make him feel bad, but she continued to just, you know, cherish the moment and um just bring bring those memories back in front of him through visual wonderful effect.

Keith D. Terry 11:50

Okay, last question on this human side before we move on. Uh, Tierney, can you talk a little bit about the impact to the other members of your family, his brothers, sisters, other folks, other extended family? Yeah. The impact of the mission is a very important thing. No one wanted to leave on those folks?

Tierney Burdett 12:05

Naperville, all our friends and you know, all the sports teams and everything they're on. So that was hard for them to adjust to a whole new school, new community. Seeing them seeing me like this, they always know mom is strong and has it all together. And, you know, I I think them seeing me struggle has impacted them.

Keith D. Terry 12:26

Okay. Well, Brian, you've heard we've talked about the personal side now. So let's zoom out a little bit. Well, I'm gonna come to you now, you know, and I want you to put your professional lens on and we're gonna talk about what you see. I've already asked you about your 20 years as a medic and what your approach. What drew you to write at home as a friend as a franchise operator in central Illinois?

System Gaps And Delays In Care

Brian Braggs 12:49

I was working uh in uh Naperville, playing for area, um, and owner operator of a multi-therapy practice, physical therapy, occupational therapy, feature lines pathology, and social emotional behavior that breeds 17 counties and was a part of that um that startup private practice, living those services in the home setting. And then also serving on the board for special education in District 308 and the district uh 202. And being a father of a special needs daughter was basically prepared me for this, for this field of uh providing care for folks who need it. What led me to Central Illinois was there was a franchise opportunity available. Right at home was was a part of that uh selection process. And then being in third, you know, at the time over 25 years old, 46 states, six countries, they had a phenomenal benefit program for veterans. And as an Army veteran, I took advantage of that. And uh the territory that was available was right here in Peoria. And so obviously I had to upwork myself and and uh wife and I relocated here to Central Illinois over the last uh five, five and a half years with them.

Keith D. Terry 13:56

Okay. And so, you know, now that we we're gonna zoom out a little bit and and talk a little bit about gaps that you see, what gaps do you see in dementia support before this new program kicked in?

Brian Braggs 14:07

And there's a lot of gaps. Number one, it's difficult for uh loved ones to um get access to specialty doctors and special test, mental tests. They've got to get to a neurologist, which is hard to book. Generally, those appointments are anywhere from two to three months out. Um, in the meantime, the the loved one is struggling with trying to manage these uh signs and symptoms of memory loss, sometimes incontinence, and then then having them to wear the pens and diapers and then being able to clean them up. And so hygiene care becomes a struggle. So during that career while they're waiting to get in to see a doctor, they know their loved one is not themselves because they're having trouble with recent memory, not episodic memory. So they're able to talk about when they were in high school and maybe when they were a teenager, but they cannot remember the conversation we just had five, fifteen, twenty minutes ago. And then they ask that same conversation to be repeated. And that becomes to a caregiver very frustrating. And so, so yeah, having difficulty finding uh getting access to their neurologists and a referral, generally that's a time delay, about two to three months out. And then between managing and trying to become the best caregiver for their loved one, and then struggling with the idea that they don't recall or remember the conversation just had a few minutes ago.

Keith D. Terry 15:21

So, from your perspectives, and then both of you can chime in, what do families underestimate most about dementia care?

Brian Braggs 15:28

I would probably say some families are to some degree um are in denial. You may have one family member that agrees that mom or dad is having some problems with memory thinking and making decisions, and then you may have other siblings or other family members that are so somewhat of uh in denial, right? Um they're having a bad day. They'll be fine. And so they instead of uh facing it on head on, they're they're in denial. And so it creates it creates dissension, tension, and debate amongst the siblings, especially when you don't have everyone on the same page as it relates to their loved one that's in front of them, that's having some some struggles and some challenges, right?

Keith D. Terry 16:09

Why do you think supporting dementia caregivers has been so difficult historically?

Brian Braggs 16:14

I would just say that our country has been at a all-time staking, not necessarily denial, but trying to find a way to support caregivers. And I think the challenge has been what what can be done as a country. And I think what came out of this most recent pandemic has created the opportunity for hey, we've got to do something, and we got to do something now. We we're we're 50 million folks globally, nearly 7 million in the U.S. It's the sixth leading cause of death in our country. And I think I did not know that.

Keith D. Terry 16:51

The sixth leading cause of death.

Brian Braggs 16:53

I didn't know that cause of death in our country. And so I think the government said, hey, we got to do something. And and out of that was birthed the guide program, guiding and improved dementia experience is what that stands for. And that program, Medicare in the history, uh, this is the first time in history that it's ever happened.

Why Caregiver Support Lags

Keith D. Terry 17:11

Um there's I'll throw something out just to be provocative. I think the system isn't set up to take care of of of the peripheral uh impacted people, meaning families. I really think when it comes to dementia and Alzheimer's and memory loss, people aren't prepared for that. Because, Brian, you said something pretty interesting. We it is now a certain amount of time, 15 minutes from now, if I forget this conversation, that's really, really impactful. And it's frustrating. And so the the tyranny is not the patient, her father is. So, you know, part of to me, the sisters isn't prepared to provide that kind of support. Let me ask this follow-on question. When we start talking about caregivers, are we just talking about the daughter, the sister, the wife of the patient, or are we talking about the nurse and other people? Is that part of the program too? Yeah, yeah, absolutely.

Brian Braggs 18:05

Anyone who is focused on the central health outcomes of a patient, i.e., family or i.e. health care provider, are part of that team. And that's called patient-centered care. And so you have the internal family, whether spouse, whether children, whether relative, even the neighbor is a part of that immediate team. And then you have the external team from the from the medical community that comes alongside and joins that team. And everyone that's a part of that collaborative effort is focused on patient-centered care for that individual that's struggling with physical neurodegenerative disease. Before this, what existed? Absolutely nothing. Uh prior to uh the guide program, Medicare guide program, nothing actually existed other than um families struggling and trying to jump over hoops and um break down barriers to get their loved one helped. One other part we need to probably uh bring to the table as well is the patient themselves may not realize that they are a patient themselves. As a matter of fact, folks who are struggling with this um early onset of dementia, or depending on what stage of the dementia process that they're involved in, or the type of dementia, whether it's Alzheimer's, frontal lobe dementia, gospel dementia, Lewy bodies, whatever that may be, that patient or that individual that's struggling with that challenge may not themselves believe, in fact, that they actually have a problem.

Keith D. Terry 19:39

Brian, I'm I just want to stop you there. That's a pretty powerful statement you just made. I think this is where it starts, the light bulbs start to come on for me. You know, my mom or dad is absolutely having a dementia moment and they're losing it. And they don't realize they're a patient, which could make it even worse because now they're fighting the son or daughter of the spouse in terms of going to the doctor. Are these the kinds of things that people are experiencing?

Introducing The Medicare GUIDE Program

Brian Braggs 20:07

Absolutely. Uh, I was just on a call this week, received uh call from a new uh a um a nurse practitioner who is in the healthcare herself as a daughter, and she's concerned about her mom. Um and her siblings, they're trying to come up with a strategy to discuss this concern they have with their mom. They know that she has memory loss, they know that she has executive decision type struggles, they know that she's not able to drive, they know she gets lost, and they're trying to come up with the best approach to sit down with mom and discuss these healthcare concerns because they're worried that moms may not necessarily agree with them. And so, yeah, we're spending time with families all the time trying to, if you in terms of trying to travel lightly and be strategic about how do we, how do we approach this with our mom or dad that's not necessarily in agreement with what is going on with them, their wives.

Keith D. Terry 21:03

So, how does uh right at home fit into solving this puzzle?

Brian Braggs 21:08

Well, one thing is the national provider, Pocket RN, who is a virtual nurse organization in 50 states, was looking for uh a national provider to be able to be on the ground in the home and provide respite care. Uh and they they chose right at home to do it because we had the larger reach across 46 states to do it. And basically our role with Park at RN is to be the respite care CNA, certified nurse assistant, or the home health aid doing that four-hour walk that this commission Medicare guide program had established and set up to give that primary caregiver a four-hour break once or twice a month throughout 72 hours in a 12-month calendar year.

Keith D. Terry 21:52

So I think you've set the stage, but I want to go through it again for my listeners who don't know exactly what the Medicare Guide program is. What you just said is that right at home is your franchise and you guys have a relationship with Pocket RN, but and you're rolling out a the Medicare Guide program. For my listeners, explain what the exactly what the Medicare Guide program is.

Brian Braggs 22:15

Medicare Guide program is guiding an improved dementia experience for the family, okay, providing respite care and relief for the primary caregiver of the loved one that has dementia or suspected signs of dementia, and then also giving that family 24-7 access to a nurse seven days a week, night, weekends, and holidays. If a concern or a question comes up, they pick up the phone, talk to a dementia care nurse, talk to a doctor, get meds so there's no more delay or waiting period or minimizes that for them. And fun fact is this is the first Medicare program to cover nationwide respite of folks who are diagnosed with dementia or have the suspected signs and symptoms of dementia themselves. Did you say respite? That is correct. Respite, R-E-S-P, I T E respite. And what that's it's a relieving the primary caregiver, giving them a break. And at the same time, there's no money out of pocket, no copay, no deductible. These are added services to Medicare card holders of the red, white, and blue Medicare card. There's no extra cost associated for those individuals who qualify for the program.

Keith D. Terry 23:35

So as we granulate as we go a little deeper, how does it work in practice? I'm a uh our role play. I'm a I'm a primary caregiver of my mother. Do I make a phone call? How do I process is relatively simple?

Eligibility, Access, And How It Works

Brian Braggs 23:49

One phone call to write at home or a Google search to write at home, Peoria, uh, would allow them to get access to us. We set up an appointment. And our memory care coordinator, in this case, is Tyrannate, who's on this call today. She will then get them set up for their evaluation and appointment. And number one, they have to be a Medicare, traditional Medicare card holder of the red, white, and blue Medicare card. Number two, there has to be some signs of dementia that the family is seeing and observing, uh, or they're diagnosed with dementia and it's on their medical chart. Uh, and at that point, uh, they will be set up for an evaluation by a dementia care nurse. And we sit back and wait for the approval for those 72 hours a year, and then once that's approved, right at home will then set up in-home care services for respite, respite care for that family.

Keith D. Terry 24:48

What makes this program different than other caregiver or respite initiatives? Well, the have there been others?

Brian Braggs 24:56

The biggest difference is there's about 368 providers that are a part of the Medicare Guide program, about 368 nationwide. The biggest difference is Pocket RN is the only national provider in 50 states. For example, let's say you're in Mississippi or you're in Michigan, there may be a handful that covers two states or one state or three states, but Pocket RN is in all 50. So that is the unique difference uh why they decided to partner with Right at Home, because Right at Home is in most states, as a matter of fact, 46 of the 50. And so that's why we have a much larger capacity to provide that in-home respite care for those who qualify and are approved by Medicare.

Keith D. Terry 25:49

What's been the response of families in central Illinois in your territory?

Brian Braggs 25:53

Well, the program is just now starting, just uh was starting at two on July of this this year, 2025. And so the program has not been going for that long. And so there's been pretty good response. We've gotten a few phone calls, we've got some appointments, and then also we're going through our our patient senses that we provide care for in central Illinois to identify those who are on the on the senses that may have signs and symptoms of dementia or nosed with dementia, and then going and to do those evaluations. So we're we're doing that right now, and the program is uh is uh taking off pretty good, actually. July 1 of 2025 is the first live uh period for Medicare to launch this program is when it went live. It's July 1, 2025. That was about a month and four days ago.

Keith D. Terry 26:44

I want to, you know, are you receiving the Pocket RN guide Medicare Guide program services now? Not yet. And so great, great setup for my question. So now that you are a bona fide caregiver, seeing a program like this and experiencing what you're actually going through, what to be able to get that for me to recharge will be tremendous.

Brian Braggs 27:10

How are they finding these programs? One, uh, because the program is is brand new, Right at Home has done between 30 to 40 um TV interviews across the country, NBC, ABC, Fox, National Public Radio, and continuing to do that as well as social media. And so obviously it takes time to get the um the traction word out, but we're doing everything possible to get that word out every day as gone track.

Keith D. Terry 27:36

The professional community, the the medical care providers, are they making room to promote this program? Or is there a little is there a deficit of information being disseminated?

Partnerships: Pocket RN And Right At Home

Brian Braggs 27:46

You know what? That that is a really good question. Because the program is fairly new, the word is getting out slowly, but it is getting out. And so the benefit to, for example, a memory care uh facility or an assisted living facility or an independent living facility for them, it's huge because those patients that are at those facilities, a lot of them are already Medicare traditional card holders. And secondly, for example, in a memory care facility that's 24 hours a day, seven days a week, night weekends, and holidays, for that nurse on duty in the middle of the night, she can make one phone call and she can get the support from a dementia team right in her pocket by one phone call. I mean, that's a huge benefit. They got a patient in the room that needs help, they need support. And now she has one-line contact to a dementia care team that can assist her in that memory care managing those patients that have struggles. Huge.

Keith D. Terry 28:40

And are you finding that it's easy to reach caregivers on social media?

Brian Braggs 28:45

You know, I think so. You know, our phones are ringing all the time. Uh we, we, we, we, our phones are answered 24 hours a day, seven days a week. And uh, you know, we're getting quite a few referrals all the time. And uh those referrals are coming from caregivers, they're coming from doctors' offices, they're coming from memory care facilities, they're coming from family members. So, yeah, I would I would say since this program is launched July 1, 2025, this year, which is about a month, just over a month or so ago, uh, we're getting a lot of traction actually.

Keith D. Terry 29:11

And so let's talk a little bit about capacity. I mean, you know, how many patients can can the program serve? You know, I don't think we as people get older in this country. I don't know how difficult it is to be diagnosed with dementia. I know there is a recipe. Tierney, you kind of alluded to it earlier. And Brian, you mentioned that, you know, you have to have a diagnosis or a real bona fide episode of some kind of loss in memory of some care. Is there a capacity component to what can be provided by this program?

Brian Braggs 29:44

The program is actually an eight year program. They did a pilot program in 2024, ran it for 12 months, and then uh rolled into the new year in 2025 and ran it for um five months, and then they decided to launch it live in July. There's a lot of tractions, a lot of capacity. And I think that's why dementia the model was deployed and Medicare decided to fully fund it. They didn't want to have anyone worried about extra cost or fees or co-paids. They really wanted to make this program accessible over the next eight years and then roll that back to here's the data, but what else can we do now? I mean, that program today is only covering 72 hours a year. Well, when you when you think about 72 hours a year, you kind of go back to Tyrion's response was how do you think this program would help you and your family? And she said the word tremendous. And when you hear the word tremendous, that means sky is the limit, right? And you have a primary caregiver that needs a break, they need a relief, they need to recharge, they need to be reinvigorating themselves so they can go back in and provide that care to their dad in this case. So their capacity is unlimited. We haven't even scratched the surface. What we do know is because there's 50 million people globally, because there's nearly 7 million, there's going to be about 14 million people between now and 2050. They've already did the calculate on the folks that will likely have a dementia at some point in their life. So this is breaking the ice. This is opening up the door to provide more and more support in the very near future, I would imagine.

Keith D. Terry 31:19

Yeah, and and I'm just curious, I would assume that some families are falling through the cracks here. And, you know, um, because they just don't know. A lot of people aren't aren't connected to social media or watching TV. And another unfair question is how many people do you think might be falling through the cracks?

Early Rollout, Awareness, And Reach

Brian Braggs 31:38

Well, you know what? That's a question that I'm not able to address. But what I can I can definitely tell you is from the area in which we provide care and service in Central Illinois, we do run across families all the time that number one, they didn't know this funding source was available. And number two, they're asking for help for their loved one that has these signs of dementia or diagnosed with dementia. The challenge that they're dealing with is in some cases, it's funding, right? Um, and the person definitely has to have access to funds to provide the care. As Tierney said earlier, it's it's it's quite expensive to get that access, right? So it's it's in some families, in in her case, are you know resigning from their career, moving into their parents' home because they realize that if they don't do that, their loved one would not get the help they need. And so that goes off to Tierney, her husband and kids that took a leap of faith and starting to see the the positive impacts it's having on her dad.

Keith D. Terry 32:35

So what an amazing, what an amazing um people want to um connect with you, your program, can you just how do they how do they reach you?

Brian Braggs 32:44

Well, yeah, the contact information is fairly simple. It's 309-364-6500 364. So that number can be texted as well. You just send a text to that number, 309-364-6500. You help with scheduling a dementia appointment. I want to know more. Or you can find us online anytime, rightathome.net forward slash pure. Writeathome.net forward slash pure.

Keith D. Terry 33:08

Right. What value does it working with someone like Tyranny who is actually going through it have on your team? What value does it bring to you, your company, and your team?

Brian Braggs 33:17

It brings a lot of value. Um, before we hired uh uh Tyranny, and before she agreed to come on with us, we didn't have a dedicated memory care coordinator. She's also an executive assistant here. We didn't have that person. This program requires a dedicated person. And in addition to that, uh the fact that she is a primary caregiver for her dad, who has dementia, is even an added advantage. She can actually talk to families and align with them. And she has something in common with them. And them being able to talk to her and her to talk to them provides a level of trust, transparency, and authenticity. And I think that's a huge benefit that um there's only one or two, but there's quite a few more. One thing we have not mentioned that I don't want to really put her on the spot, but Tyranny actually is a Hall of Famer here, basketball hall of famine Peoria. Uh, they won the championship. So maybe she can talk about that a little bit. But you know, she is coming back to her roots, where she was born and raised and became an amazing basketball star in Peoria. Peoria is proud of what she's done to accomplish the um the awards she did at the uh community college in town. So for now don't have her on the team.

Keith D. Terry 34:32

Okay, well, we'll we'll definitely come back to the to the hall of fame, which she did not mention in the intro uh at all. Had I I would have stayed there. And so, Tyranny, I want to come to you. You know, as as someone working with Brian, how do you bridge your personal experience, you know, your caregiver?

Tierney Burdett 34:50

I'll be able to be learning more from my dad, and I'm excited to help others get them connected. And going back to what you talked about on, you know, how many people are slipping through the cracks. Um, I'm on all these support groups online, and it is just astounding how many other people are going through the same thing, and we're all just learning from each other. And I'm excited to be working with Brian and right at home and be that person that someone needs, the caregiver.

Keith D. Terry 35:24

So you're in a really good spot. So this next question, I asked Brian some unfair questions. I'm gonna ask you a couple too. So, how do you, given where you are, make sure programs like this just don't exist on paper, but they can be truly impactful for for papers?

Tierney Burdett 35:40

I'm excited to dive in and get all these certifications and gain knowledge.

Capacity, Funding, And The Next Eight Years

Keith D. Terry 35:46

So do you think a certification is what's needed to make that I can help. Brian, you want to jump in on any parts of that? I mean, what what do you think is needed to make sure that this program is something just not on paper, but people can find out about it?

Brian Braggs 36:02

Because I'm, you know, would you say contact your primary physician, let them know that your your loved one has some concerns relating to their memory and you'd like to get more information about it. And Right at Home is actually I've been in the state of Illinois for 20 of the 30 years in existence, and there's about 13 locations throughout the state of Illinois, and um, Right at Home can be there to assist in that regard, as well as provide education and resources and tools to provide uh help for families that are have concerns. And uh, I would say that's that's probably the main thing. And in terms of folks who don't have access to the internet, but they have access to a phone and make a phone call, call us, call uh, you know, uh the primary care physician, and that's their access to the guide co-brand. And we'll be more than happy writing homes in the state. There's quite a few of us here in the state of Illinois.

Keith D. Terry 36:53

And that's kind of what I was alluding to. So if I understand correctly, there are no restrictions because I I'm not sure every primary care physician or caregiver knows about the write-at-home program or the Pocket RM program or the Medicare Guide. Or am I mistaken?

Brian Braggs 37:12

Every physician across the country that's in the healthcare space, actively practicing, should have some information. If they don't, their nurse can secure that uh online through Google and provide that information, just Google Medicare Guide program. And there's a plethora, unlimited amount of information available across the globe as it relates to this program. And um, they may not know the inner work is the details, and that's where Right at Home comes in. Uh, that's where Park at RA comes in. We're national providers, and that is the icing on the cake.

Keith D. Terry 37:48

That's excellent. Because, you know, listening to this, at first I was a little doubtful, but it sounds like this is a uh really great program. And you're and it started July of this year, correct?

Brian Braggs 38:00

That is that's correct. It started live uh July 1, 2025. It was piloted for 12 months in 2024. Uh there's there's so much traction that's been gained since then until now, and there is so much more beyond today. So much more.

Keith D. Terry 38:15

So we'll get into that because that's a bold statement, too. And it's gonna run for eight eight years till 2020 to 2033, is what I'm hearing you say. That that is correct.

Brian Braggs 38:25

So they've already completed one of the eight years, so seven years going forward. 2024 was the first year under their belt, and then they've got seven more years to go. Who knows? Medicare may make some changes in the middle to ramp it up a little bit. But today it's 72 hours calendar year, four hours per session for that relief to happen once or twice a month. But you have 24-7 access to that nurse in your pocket that you can call from Pocket RN to get access to questions, concerns, medications, challenges, symptoms, signs, whatever that patient may need in the middle of the night.

Keith D. Terry 38:59

That's really good. Any fear that the funding for this might go away, or it's already been funded for eight years?

Brian Braggs 39:05

Fully funded. Um I know there have been some Medicare cuts and some threatening. Yeah, this this one has have had some significant backing by uh leadership at the White House, and this program seems to be the sticker and stayer at this time, as we know.

Keith D. Terry 39:22

That's really great. So the package includes 72 hours of help for the calendar year. That's that's what's what's there. You now you alluded to they're gonna be adding more stuff in the future. You want to speak to that?

Practical Use Of Respite Hours

Brian Braggs 39:35

Well, look, it's because the program is new, um, and we have to anticipate changes. And so as those changes come about, we'll we'll inform people. But today, that's what the program is gonna consist of 72 hours a year, four hours per block. That could equal anywhere from 12 to 11 to uh 13 months of that, depending on how the family wants to use it. They get the freedom to use it any way they want to use it once they're in the program. They can use it as quickly or as slowly as they want. Probably 72 hours.

Keith D. Terry 40:08

Is there a recommendation of how I should use this? Is there a model that people can follow? Do you recommend a certain use pattern of this? 20 minutes a time, two hours a time? What's what recommendation do you have?

Tierney Burdett 40:21

Two hour slots. I'm not sure on that, to be honest. And I'll be learning that.

Brian Braggs 40:26

You know, they have to use it in a four-hour block per time, four hours at a time. But in terms of how quickly they can use those, whether it's within, you know, the first two weeks, the first two months, the first six months, is all I think dedicated upon the unique needs that family is suppressed with. In this case, uh he may have I only use this program once or twice a month for my family. That's gonna help me have a break because it's eight hours a month, and I have that divided out over the next several months. Another family say I only need four hours a month because that's gonna help me. I don't want anyone else here except for those four hours a month. So every family I think has their own unique dynamic situation that may call for a different set of requirements.

Keith D. Terry 41:16

I I I can only imagine every family has uh a different um dynamic and uh and lifestyle. So this is good to know. Thank you both for clarifying that. You know, you we've set the stage. So let's go back now to um to people. Let's bring it back to the to the to the to the families. Do you can you tell us about a family or veteran whose life has been changed by this program?

Brian Braggs 41:43

Yeah, I can. As a matter of fact, one of our employees who is on my staff, she's a registered nurse and have been here for over now. Her mom has dementia and she's in an assistant living facility. Um, and um this has significantly impacted her and her uh family and her mom. And um, she's very excited about it because she gets a break and she gets a second check because she's an employee here. Uh and uh Jen is uh, like I said, has been with us for uh for over a year now, and her mom uh is enrolled in the program and uh she's she did two checks. So a check here and a check from um Okay Medicare program.

Keith D. Terry 42:23

Can you share one lesson caring for your father's taught you about?

Tierney Burdett 42:27

I have to say unconditional love. You know, I'm learning that you know there's there's no conditions on what I wouldn't do for my father. He raised me and took care of me very well. And I feel like, you know, that's what God was calling me to do was to honor my father. And so that's what I'm doing.

Stories, Wins, And Human Moments

Keith D. Terry 42:49

Well, I I know that in on the mental health side, they would always say, hate the disease, love the child or love the person. And so, you know, my kudos to you on that one, even though I'm sure it was was uh difficult at times. Um, you know, really staying here on stories, because I Tierney, you you go home to a dementia patient and you're coming to work with other caregivers of dementia patients. Are there any story?

Tierney Burdett 43:16

I that my dad this journal. It was called Dad, I Wanna Hear Your Story. And it just asks a bunch of questions about his childhood and about parents. And the most recent touching story was I asked him, What's your best memory with me? And he said, Right now, you're protecting me and you're here with me. And that just really touched me that out of all the memories we've had, you know, he chose to say right now. And that's his way of saying, you know, thank you. And it and it touched me.

Keith D. Terry 43:49

Yeah, that touched me now too. I mean, this is pretty, pretty powerful stuff. Stories of motivation from you?

Brian Braggs 43:55

You know, my motivation stems from um early, as I mentioned in the top of the broadcast, uh, that my grandmother had dementia and Alzheimer's, and you know, that's my motivation is that God was preparing me to work in healthcare. And now I'm 56 years of age, been in healthcare over 25 years, of various goals and responsibilities, different settings. Um, and she was the spark that ignited the passion that Tyrion's talking about that has been driving me for the last 25 plus years in healthcare. And when I get up every day, when I go to bed at night, I get to do what I love to do every single day, that I live and breathe and move, that God has given me that opportunity. And this is a phenomenal process, if you will, because I I continue to learn, I continue to grow and develop. And if my grandmother was here today, I know she would be proud of me because when she got diagnosed with um Alzheimer's dementia, there was not a lot available at at that time, although a dementia was um it was 100 years old now. And um Alzheimer's is 100 years old now. So um, you know, back then she didn't have a lot of resources or access to it. They were still trying to figure out what it was and trying to understand, you know, how to how to manage it. But today, um, if she was here, she would be definitely proud of what I'm doing now as a direct result of her.

Keith D. Terry 45:16

You know, kudos to both of you. I mean, two very, very powerful stories. Now, let's shift gears um and go beyond caregiving and programs. And I want to focus now on the leadership lessons and life lessons. And so, Brian, I'm gonna come to you. And how does your military background influence your leadership today in healthcare and particular and in business and particularly the rollout of a program like this?

Brian Braggs 45:38

One thing the military has taught me, I would have said a lot, uh, sailor, soldiers, marines, and airmen and coast guard is poor preparation equals poor results. Good preparation equals good results. And so the constant evolving of learning about the brain and how the brain works and how it's responding to the tau protein and amyloid flight that causes this debilitating breakdown of the brain and shrinking it and that impacts the memory and thinking and walking and talking of an individual with this uh disease. We just gotta keep learning and learning and learning and being open to learning more and never giving up. Knowledge is power, but knowledge with power and not how knowing how to use it is dangerous. And so there has to be a balance. Being an academic resource, an educational resource for the community here at Central Illinois is what we pride ourselves on, my staff and our employees, and we're excited to be here at the brink of this program called Medicare Guide. And we're excited to do it. We get to do what we love to do every day.

Keith D. Terry 46:49

Are there any any any lessons that you want to share with my listeners about mission-driven work inside of dementia?

Leadership, Training, And Care Principles

Brian Braggs 46:58

It is affecting nearly every family at some point in stage of their life or currently having access to educational uh resources. One thing I did not mention, I failed to mention that the Medicare Guide program does provide um educational resources, training for the primary caregiver, access to tools and tips on how to respond to their loved one with that disease. One of the things that they encourage uh folks to do is make sure that if their loved one is saying something that necessarily not may not necessarily be um accurate, just go along with it. Because for them, it's real. Don't combat that. If they say they're seeing something in the sky and they're hallucinating, just go along with it. Uh for them, it's real. Um, and you're supporting them with that experience that they're going through at that time. And you will go further in that relationship. Uh it's a unique and different relationship than you've ever had before. And I know it might be scary and uh fearful, but it's okay. But for them, that's what they're seeing, that's what they're experiencing, and they want you to go along with them.

Keith D. Terry 48:02

Well, you know, that's important. I would love to have a show just on on that because I I know dementia has been around for you said a hundred years, but we're learning so much about the care of it and what it is, which is really, really powerful. What advice would you give them if they're interested in creating a business that can have impact like you guys are having in in your communities? Brian, having the money to start a franchise.

Tierney Burdett 48:31

Make sure there's a need and you be willing to serve. And you know, if you're able to serve a need, I think you'll be successful.

Brian Braggs 48:41

Brian? Yeah, I would I would I would second that. Be willing, have a heart of service, and you'll never work a day in your life, but it's gotta be connected to passion. And Tierney continues to say the word passion. I think that's uh that says a lot about not only who she is, but any idea that an individual may have has to have passion, has to have a heart of service. And of course, you can have a passion and a heart of service, but as Tyranny said, if there's no need to fulfill, then there's no idea that is even necessary. There has to be a need, there has to be path, and it has to be connected to a heart of service.

Keith D. Terry 49:19

We're gonna switch now to the final segment and we're gonna look into the future and we're gonna talk about the next chapter and the future of dementia care. First question is will AI have an impact based on what you guys are seeing right now?

Brian Braggs 49:34

Well, in terms of communications, I think AI is already doing that, and I think there's a lot more to be done. Um just to talk a little bit about some of that. Um, you know, today AI is helping uh healthcare providers uh and healthcare workers and families to get access to appointments faster. You know, and and it's able to do that um and set those appointments without distracting uh another human or pull that human away from another job or an activity that they're required or tasked to do. AI has come along and filled the gap in terms of answering the call, assessing the call, disposition that phone call, setting the appointment so that the company continue to grow and develop and conduct those appointments that are already set scheduled on the calendar.

Keith D. Terry 50:21

I think that's done a phenomenal where do you see dementia care heading in the next five to ten years?

Home-Based Care, Tech, And The Future

Brian Braggs 50:26

Well, um, what I what I can say is that um I think it's gonna be a much more advanced than what it is today. And I'll say that by saying this. When we had the um COVID pandemic, and I'm gonna correlate that with the future. What COVID taught us a lot as healthcare professional providers and its family members in this country, and one of the things it's taught us in the healthcare space is COVID was so disruptive, but that disruption created opportunity. What I mean by that is folks was coming to the hospital and they were taking up hospital beds for people to ICU. And so what was what was burnt out of that was hospital to home. Meaning now you can have a family or loved one who does not necessarily need to be in an ICU or take up a bed at a hospital when in fact the hospital can actually be provided in the own privacy of their home. That means iphine drugs, a nurse, uh a monitor, telemetry, vital management, nutrition management. And the doctor can also be brought into that home virtually to assess and evaluate that patient without ever getting in their car. Um and so I see dementia being a part of that. And a lot of those interventions are currently happening today. For example, the doctor who used to read the results of your MRI or your PET brain scan can now do that remotely as long as they have access to the internet. And that way there's no delay in those results. And now the prescription or the therapy plan for that patient can now be activated as a direct result of that technology. Five years down the road, there's gonna be a lot more care provided in the home than in this way, but that is definitely what's the future and impacts dementia uh patients getting care early. One of the benefits of that.

Keith D. Terry 52:21

And thus your your this impacts your business. So you see right businesses like right at home becoming a lot more needed in the in the equation of health delivery.

Brian Braggs 52:31

That is correct. Uh, instead of a patient having to get in their car or get dressed and and deal with the debilitating disease and the impacts of those signs and symptoms and not feeling well, uh services is called home-based primary care. We actually currently have that today, our veterans who qualify for that program. We do have some veterans on our case on our census today who does don't have to leave their home to be treated by their physician or by a lab tech or by uh a phobotomist uh to do some blood work, by a nurse, by a caregiver. They're all being delivered in the home today in some of our cases that we have on our census.

Keith D. Terry 53:06

Okay. Well, Tierney, I want to come to you. Well, same question, but from your side, five, ten years out, what do you see the impact or the need in for in dementia care?

Tierney Burdett 53:17

You asked earlier, too, what we underestimated and time and energy. You know, I really underestimated how much time that it would take out of my day to do all these things for my dad, like take him to the doctor. And to be able to save my time and energy having these, having the ability to have the nurses and everybody come to us, it's gonna be huge.

Keith D. Terry 53:40

And do you see, well, you know, it's kind of hard to look into. No one has a crystal ball. I think you are absolutely right, Brian, five to ten years out, things coming at home. This is this is about looking into the future. Anything else you see?

Brian Braggs 53:54

Well, I just think that care is gonna be far more simple, far more accessible, less troublesome, and far more access without patients having to leave their home for those who qualify for that program that will happen in the next five years. Look, it's being rolled out right now. It was burnt out of the the COVID pandemic, and there is huge results. There's continuous positive uh results being recorded about uh now, Brian, let me just stop you there for a second.

Keith D. Terry 54:19

You know, you said something interesting. You think care is going to be more simple. Why do you say that?

Brian Braggs 54:23

Well, because uh the access that people are struggling with today is that look, this program is only available to those who carry it away, white and blue card. I mean, that's uh that's not even a third or half of the population. Look, if if that program continues to have um good traction and great results, I think it doesn't matter what color of card you have. I think that's gonna be made available to not only Medicare uh, but also folks who uh have uh regular commercial uh type insurance at Nasigna Blue Paul Screw Shield. But that program today is not available to them. It only is available to the folks that actually have the red, white, and blue Medicare card. I think it's gonna be uh made available to the other uh card holders from a commercial standpoint of insurance, whether it's a PPO, Jim O, et cetera.

Preparing Families And Final Takeaways

Keith D. Terry 55:11

You you you said simple. I think it'll be easier if that's what you mean, but not necessarily simple. I, you know, tend to believe healthcare is complicated, will continue to be complicated, but uh, who who who am I? That's why we have these shows like today, and you obviously run a very successful business. And I just say I hope people are listening to this. Final question. How can families better prepare themselves now for what might be coming? Let's start with you, Brian. You start with her first.

Brian Braggs 55:42

Yeah, families need to be more advocates for themselves as a patient as well as for their loved ones. Don't wait after to tell you what you should do. If you suspect your loved one is having challenges with memory, challenges with recent, recent memory. That's that's not episodic memory. Episodic memory is talking about when they grew up as a kid, where they went to high school, the friends, the thing they could keep in contact with. That's episodic memory. Look, that that's not being impacted by dementia. It's the recent memory. Things that we talked about today, things that we talked about yesterday in the current week. That's that's the and start start being on the lookout for those signs and symptoms. Start asking those questions early with the primary care. Start participating with your mom or dad in their doctor's appointments, regardless if you're in state or not. Look, if mom or dad has an appointment, start collaborating with them and saying, hey, I want to be a part of your appointments. I'm gonna I'm gonna moot my schedule and I'm gonna be on the call with you and the doctor so that I want to support you more. I know I live out of state, I know I'm two, three hours away. Our parents and our loved ones need us to be far more participatory in the livelihood of their health care condition today.

Keith D. Terry 56:53

I well said, in my opinion. You would talk to my wife, my wife would tell you that I have uh some early signs of dementia now. I'm just joking. Journey, how can families prepare themselves? How are you preparing yourself for the future?

Tierney Burdett 57:09

Having a will, having a trust set up, you know, it's really inedible that you know it's a circle of life, it's it's gonna happen. Preparing, preparing for that with that, and you know, everything that Brian said was, you know, there's it's really not a playbook, but being prepared.

Keith D. Terry 57:27

Brian, I'll give you the final word. Anything you want to say as we close out this dynamic episode about God about absolutely the final words is be encouraged.

Closing And Listener Actions

Brian Braggs 57:37

You're not alone. We're here to help. Right at home is walking alongside of you. Give us a call, look us up on Google, call us 309-46500-309-364. Remember that number can receive text. Shoot us a text, say I'm interested in the program, have questions about Right at Home, questions about dementia, Google us, type us up.net forward slash Peoria. We're here to help. That's why we want to do it right with you in the home where your loved one is.

Keith D. Terry 58:06

Okay, Brian and Tierney, thank you both for joining me on the next big thing. Thanks for listening to the next big thing. I'm your host, Keith D. Terry. If you've enjoyed this episode and you'd like to support this podcast, please share it with others. Post about it on social media, or leave a rating and a review. To catch all the latest from me, you can follow me on my YouTube channel at Keith D.Terry. If you want to recommend a guest, please email me at info at terryperformance group.com. This has been produced by your host, Anne Jade Productions.