Aging Smart: Planning Your Life and Care Before Time Forces Your Hand (with Jacqueline Silverman)

Navigating Aging: Ensuring Independence, Safety, and Quality of Life

In this insightful episode of the LightAtTheEnd.com Podcast, host Kevin Berk sits down with Jacqueline Silverman, a certified senior advisor and founder of AgingAdvisoryServices.com. Jacqueline shares her wealth of knowledge on aging in place, addressing common challenges such as home safety and medication management, and explains the critical roles of Certified Senior Advisors (CSAs) and Certified Aging in Place Specialists (CAPS). The discussion covers proactive planning to maintain independence, the importance of having critical documents like a Power of Attorney, and the need for a supportive network. Whether you're planning for yourself or assisting a loved one, this episode provides invaluable advice on how to navigate the complexities of aging gracefully and safely.

00:00 Introduction
02:29 Challenges and Decisions in Aging
05:56 The Importance of Planning Ahead
15:14 Home Safety Tips for Aging in Place
25:16 Legal and Financial Preparations for Aging
29:40 The Importance of Medication Management
32:43 Cost Considerations for Home Care
36:28 Navigating Resources and Support Systems
40:20 Balancing Independence and Safety
49:44 Choosing the Right Aging Specialist
53:27 The D.N.A. of Aging in Place
54:44 Synergy Between Aging in Place and Senior Living
57:05 Mindset and Proactive Aging

Resources Referenced:
- LightAtTheEnd.com (our platform for guidance on end-of-life planning and support)
- AgingAdvisoryServices.com (Jacqueline's business site for aging-related consulting)
- Certified Senior Advisors (CSA) Certification - https://www.csa.us/
- Certified Aging-in-Place Specialists (CAPS) Credentialing - https://www.nahb.org/education-and-events/credentials/certified-aging-in-place-specialist-caps 
- Area Agencies on Aging - https://acl.gov/programs/aging-and-disability-networks/area-agencies-aging

Chapters

• 0:00 Introduction
• 2:29 Challenges and Decisions in Aging
• 5:56 The Importance of Planning Ahead
• 15:14 Home Safety Tips for Aging in Place
• 25:16 Legal and Financial Preparations for Aging
• 29:40 The Importance of Medication Management
• 32:43 Cost Considerations for Home Care
• 36:28 Navigating Resources and Support Systems
• 40:20 Balancing Independence and Safety
• 49:44 Choosing the Right Aging Specialist
• 53:27 The D.N.A. of Aging in Place
• 54:44 Synergy Between Aging in Place and Senior Living
• 57:05 Mindset and Proactive Aging

Transcript

0:00

Thank you for joining us on the LightAtTheEnd.com Podcast. LightAtTheEnd.com is a resource for those who wanna learn more about end of life topics, but don't know where to start. I'm Kevin Berk and I'm joined this morning by Jacqueline Silverman, a certified senior advisor and founder of AgingAdvisoryServices.com. Jacqueline, thank you so much for joining me this morning. I'm thrilled to be, uh, starting the day with you. Thank you so much. i'm very excited about having this conversation. So let's start by defining the acronyms a little bit. So there is a Certified Senior Advisor(CSA), which you are, and then there is a Certified Aging in Place Specialist or (CAPS), which you also are. So what's the difference between the two of them? Well, there, there are two great, trademarks, so to speak, for people to become aware of, um, regardless of what age and stage they're at, in their thirties, their retirement years, older age, So you've got a certified senior advisor, which is a certification, CSA, that's, it's a national certification and it's to train people to be knowledgeable and experienced in what we would say all aspects of aging. So you'll have people in the finance industry, insurance industry, healthcare workers, or people like myself who are working as consultants to work with older adults. we're wanting to develop really special skills, in what older adults need in particular at this sort of third chapter stage of life. Then there's the CAPS, C-A-P-S, Certified Aging In Place Specialists. that's a completely different thing. It was a program started by the National Association of Home Builders for their members. So think of general contractors and interior home designers, architects where especially now with this boom in the aging population, um, we need to create residences and facilities and environments that are safe and comfortable and usable by people as they age. so age-friendly environments. So I got my education as a certified senior advisor, and then I focus on aging in place, working with people to live safely and comfortable in the home of their choice for as long as they want, or as long as possible. with the idea of living life on their own terms, the idea of keeping your independence and your autonomy, one way to think about aging is, this idea of elderhood. So we have our childhood or adulthood or elderhood. and if we talk about being sixty years old and older, is when there are a lot of changes, natural changes that aging, balance, coordination, muscle strength, eyesight, hearing, all of those things affect quality of life, right? And, and your needs. So while people are at home aging, they're gonna find more challenges, more complex issues to deal with. And often, like for me in my practice, I'll work with a couple husband and wife, whatever the partnership is. And one wants to stay, one wants to go, we're retiring. Should we downsize? It's becoming hard to take care of the house should we move? There's that constant kind of back and forth, question. sometimes illness, accidents, all sorts of things affect where you are. So in my work as a certified senior advisor and aging in place specialist, we're addressing all sorts of challenges and questions. and the people I'm working with, can be solo agers, and that's a term that really defines somebody who is aging alone, maybe because they never had children, They're estranged from their children. Their partner has passed away. They've chosen to be single for their life, whatever the circumstance is. again, sometimes it's couples often one of the partners is becoming more of the caregiver other. And very often it's the adult kids who are calling me from all over the country saying, ah, I'm worried about mom and dad. You know, What do we do? What do we do? So, we really are looking at a broad palette and where I start is by going into the home and working with people where they are living often in the often where they think this is our and you know, meeting them where they are. And going from there. Okay....which is the whole journey, which is the work. I imagine that being thrust into the middle of a couple's decision particularly, or it could even just be a child and, elder parent kind of situation. That being in the middle of that must also be very challenging as you said, if one person says, okay, it's time for us to move to an assisted living community, the other one wants to stay where they are. For you to be brought in to mediate that, I suppose, must be very, very challenging in itself. It is, and I've grown so much. I've really been doing this work for about five years now, and it started maybe 20 years ago with the personal life, experience I was having, getting this kind of front row seat to aging with my own parents, with friends, seeing where the challenges were. when I meet with people, the first goal for me is to really hone in on what are the priorities? What do they want? What decisions are they trying to make? What are their wishes? What are their needs? What matters most now, what's gonna matter most five years from now, 10 years from now? Do people reach out to you most commonly after an event has happened? I guess I just wanna understand more about when people tend to get in touch. Yeah, yeah, great question. my vision in life is that people will be reaching for their aging advisor to plan before things happen. What I saw in my journey here is that people, say my mother, people over and over say, don't worry, I'll know. When it's time to make changes. I'll know. And they don't. Generally most people they're waiting has happened, a fall, a diagnosis you know, something, something awful, or just waiting too long. And at that point, that's when your options, that's when all that independence, all that grace and dignity that everybody wants in their lives starts to go away. Because of that waiting. I actually coined this the rookie mistake because I think we know... we look at our grandparents, our parents, our friends, we have role models of who has done aging well, where have people gone wrong and we have that choice. To in not waiting until, happens. But to answer your question, yes, people will call me because a loved one's in the hospital and they they fell, they broke a hip, they hit their head, they had a concussion, and now the hospital is discharging them. I can step in. a partner in a couple, one has been caring for the other maybe with the onset of dementia. And they're trying for months, even years, to do this on their own until they just can't anymore. And my phone rings. there's so many situations. I went to my parents' house and it's a mess. And there, there's food in the refrigerator that's two years old and I don't think they're bathing regularly. You know, all these things that happen as people age maybe, and it gets harder to take care of yourself at home. So. that's when people are calling and that's why, I mean, there's no one size fits all. it's one size fits one. I do have one story if it serves as a catalyst for folks. I spoke at a wealth management luncheon and one of the clients called me and said you know, i'm 70 something i'm very healthy. I did have a couple of incidents that gave me concern, but I wanna do everything I can So I was, I came in, kind of instead of having a concierge I became the concierge advisor. And we sat down and I learned about needs, wishes, goals. I saw, his home environment. I met kids area, and we what we could do in the home for risk mitigation, prevent how to make it comfortable, what to do if you ended what would you do if you needed full-time home care, to stay in your home fulltime, nursing care, all the options of the home. We even brought in an aging in to talk to him about this is where you could put a stair lift, a chairlift, an elevator, all sorts of things. we went out and we visited some and we met with some home. Care agency case managers to Say, this is what the options feel like if you are bringing in people into your home. To be aides and companions. So We explored this whole journey over a year and He said, a lot. I'm doing fine but as I need you. He knows I'm there. For him. I know his family. If he ends up in The hospital at three in the morning. I think what I'm talking about now might be something more and more we're gonna see in the future. folks that uh, and, and not being in this I'll know I was, not gonna leave. me out of my house with, uh, what is it, yeah, it just yeah, anymore. It yeah. it feels like that would take a pretty major societal shift to get to a place where people are having those conversations earlier. But how valuable would that be to get to a place where it was, it was normal to be working with someone, uh, an aging advisor, just as kind of a matter of course. before there ends up being an issue that you're, trying to solve for if it just became part of future planning. but it doesn't seem like that's really a very common thing, or at least not in the, the circles that I've had discussions in. Yes, i, I, I wanna put my rose colored glasses. wow. I can imagine that, actually. If we look at the costs healthcare and what's happening in the healthcare system as an example, one of the statistics i, I talk about is 70% of is based on So think about, you know, staying fit, staying hydrated, eating well, taking supplements. Staying mindful in how you live having aging advisors, filling that lifeboat, so to speak, having a trusted inner circle of people that know you and know your wishes, and know whether they're family, friends or professionals. So I think, the, the cost savings of not needing the doctor care, the medications, you know, the hospital stays lowering the needs maybe for professional home aides. And we can Talk more about all of the impact of that. in other cultures where families take care of each other through the generations, right? The quality of life. So much better. As you age. And unfortunately, society here in America is not so much like Mm-hmm. And I happen to have a sister that my 95-year-old dad is living with her and he's on hospice now, in fact, and he's having a beautiful end to his life because of that family structure. But that it can't always be like that. So we have to take ourselves and you know, the professionals, the aging advisors, there are other resources. Bringing those Into your life suit and then later makes sense. Yeah. I, I think also the, um, the idea that you brought up of having kind of a concierge service where you or someone else is available, has had the conversation, has gotten to know the person, what their needs and wants are, and then they're able to call on you and have this kind of pre-established seems very helpful. I imagine for this person that you were talking about in their seventies, that it was very comforting to know that even if they didn't want to make all the changes, right then they had it all outlined and they had the ability to refer back to that or to call on you if and when something happens sudden or otherwise. That was causing them to say, okay, well this, this, we've outlined this and it sounds like maybe there's a, a different step to be taken. Yes, absolutely. you know, we're looking at sort of this mission of creating an environment that you can stay safe and comfortable and happy in as your needs evolve and they're going to evolve. And when you look at people who do this best, speak, you know, they have a plan and having a plan means you've sat down and asked questions and talked, brought it to the kitchen to speak, and they start making changes, which hopefully after our conversation today, people will make some changes starting today. And, you know, I've always done way to observing and saying, I could make some changes in my environment and in my social network to support me. And then the third thing is asking We're so reluctant to do that. We wanna help. Right. I wanna help others. We're always saying, what can I do for you et cetera, et cetera. But when it comes to this elderhood, this aging thing you need partners in it. And If you look at the kind of support need, getting on into college, finding your partner, raising a family, all of these phases of life involve planning and changes and creating So let's talk specifically about the home and home safety. What are some of the, common safety issues that you feel like people need to address in their homes as they, begin to get onto that, that maybe that last third of life? Mm-hmm. Mm-hmm. And you know, and again, people are going into retirement in their home and thinking about downsizing or moving or, even moving into a senior community that's supported. Those are all really big questions. I start by saying your home itself can be If you think about, well, why is that? I don't know. Does something jump to Your mind? yeah, certainly. I think that, uh, stairs for one and, you know, the potential to, to leave appliances on, things like that I think just are the things that jump into my mind. All of that. And, um, I think stairs falls is like such a elephant in the room, right. And again, you know, where you don't have to be 80 or 90, right? We get to a point where, if we trip and fall, if you're coming out of the shower and your habit you find is to hold onto that glass door as you step out well, one day you may lose your balance and fall, and when you were 20, whatever happened, you might rebound more. Quickly than when you're 60. Absolutely. So, you know, Again, statistically. One out of four adults over the age of 65 fall In a year, once you fall once, you're gonna probably fall again in the year Why? because there might be underlying causes that are causing that fall, or you lose your confidence, It's sort of like having a car accident and then getting confident to drive again, right? So once a fall happens, there's sort of a effect. 70% of falls home over 65 and 80, 80% So just that alone, dictates, okay, what, how, what can we do about the home? And, um, starting with, you know, the environmental risks, behavior, risks, risks. We can talk about small fixes and big fixes. I start with kind of simple things that people can do that. Don't cost anything. Or you can Spend hundreds under a thousand dollars to fix. So, I think when we're looking at, aging in place and having an age-friendly home, unless there's a specific need happening, starting kind of high level, simple fixes, things that you can do for no cost, or let's say you're spending under a thousand dollars budget, right? Know that most falls happen in the bathroom, so let's start there. Um, having grab bars in the bathroom, in the shower is. I, you know, it doesn't even matter what age we are at this point. key is having grab bars installed and never considering a suction grab bar, at the point somebody loses their balance or slips and goes to that bar to grab it. If it's a suction bar, just the law of gravity. It's gonna pull off the wall. So, you want to look at installing grab bars, and in this day and age you can get, grab bars that match your decor. you can work with professionals that are going to put them exactly where you need them as your needs evolve, change those needs. But that's, that's a big one. if you are concerned about someone falling in a bathroom, 'cause maybe they get dizzy when they up and they may fall down on the floor. If you've got a bathroom where someone could potentially fall in front of the door and the door opens in, which it generally does, that person falls, they may be door. One of the kind of tips you could do is what we call a swing away hinge. You just simply change the door so it opens out and you can also use a hinge that opens the door wider. So if you need to help somebody into the bathroom, two people can get through a wider doorway without having to start to widen walls. So there are a lot of simple tricks when you start having worries or challenges, with being safe. Um, steps you mentioned the second place people fall is on steps. So make sure you have one handrail or add a second handrail. Make sure there are lights on those stairs, whether they're outside or inside your house. There's a switch at the bottom, there's a switch at the top, and you're turning those lights on. and behavioral things don't be walking on stairs in your stocking feet. We also talk about home maintenance as time goes on. Sometimes you lose energy to maintain the home. You just, it's just too difficult. It's too costly if you have sidewalks or steps where the surfaces aren't even and you can trip. These are hazards to your guests as well as yourself. So, you know, those are kind of, there's basic repairs. just anything you could do to avoid needing to get on a ladder in life, you know, let alone a step stool. Absolutely. How do you look at your environment and say, I'm gonna move things where they're more in reach now, so it's more comfortable for me to use them. Open up spaces, declutter. If there are power cords, crossing walking spaces. Take the time to change that. A lot of just environmental, behavioral, common sense things to do. You can modernize your home a lot by changing light switches to toggle switches. If you still have the kind that you, first of all, if you have dexterity issues, a toggles easier because you can punch it with your hand. Your elbow, handles doorknobs, changing those lever handles, you know, so you have a handle that, again, if you're carrying something, you could use your elbow to open the door. You don't need to turn a knob. again, there, you know, there are many simple things you can do to, to just make things more comfortable and safer. you mentioned leaving burners on things like that. When you're in a situation where someone in the home has cognitive decline, There, there are about a hundred items on my checklist to make a dementia sensitive safe home. But that this whole, um, area of smart home can start to play in earlier where you have safety devices on your phone or your app where you can turn off a stove or a stove will Automatically switch off if it hasn't been used in a while. You can change the thermostat so you don't risk having a scalding hot water. you know, using, uh, voice activated you know, Alexa, Siri, Google... to do things like turning on lights so that people are not walking around in the dark. if you look at your, what your habits are in your house, you may find that you get up at night, you walk to the bathroom in the middle of the night in the dark, no lights on, and that's where the. when most falls happen at night. So having lights, motion sensor lights, timer lights, I'm just sort of laundry listing it right now. But, anybody that's, that offers a home safety evaluation would hopefully look at all of these issues and come up with a plan, an action plan where these changes can be made incrementally, again, some that cost nothing nominal amounts of money, a simple purchase on Amazon, you know, leading into more major fixes. Sure. And I imagine that one of the things that we didn't talk about yet is just as simple as saying. Okay. Yes, your master bedroom and master bathroom may be upstairs, but maybe it's time to shift around the less important stuff or the room that might be on the ground floor and move the stuff that was in there upstairs, move your, you know, your bed and toiletries and things like that down into the ground level. Exactly. and that's where again, you know, it doesn't cost anything to move furniture around. If you have to start making major changes. one of the terms people might be familiar with is universal design. it's been around for a long time in the building industry. If you see a sidewalk in the street that ends in a ramp, sidewalk ends in a ramp into the street. That's a universal design, meaning. Anybody can use that curb. They can be on a wheelchair, crutches, a baby carriage, You can go from sidewalk to street. That's a universal design principle. People of any age, any capacity, any abilities, Can function in an environment safely and easily. So we look at the age friendly home that way. And some of the principles for that are having, um, one-level living. So if you're in a two story house in the master bedrooms and all are upstairs, you wanna look at your space on how could I live on the main floor with a, a kitchen, a bath, bedroom. Now the full bath, we're talking often about a remodel where you need to take the existing shower or bathtub shower and make it into a, um, zero theshold shower. Where you can easily roll a chair in or use a walker again and with no step. So that's a renovation. Um, but it becomes accessible to anyone. Raising your toilet seats, having a toilet that's, a DA height, a higher toilet seat, um, having the grab bars, things like that. the bedroom could be a bedroom or it could be a quarter of the living room that's converted into a bedroom. So you can be very creative that way. Creativity definitely helps. Is it realistic to think that most people who work and are certified in, aging in place, whether it's a CAPS or just an aging advisory service person, if they're a specialist, will they be, helping or making recommendations as far as important paperwork and drawing up plans and, and things like that is, is that something that you do? I always start my work with clients with what I call general assessment, and we're looking at health needs and wellness all aspects of their life and in particular resources. what's so fundamental are your in order. And there's sort of three key things that are so important that we talk about. if folks need help preparing or updating their affairs, I can make recommendations to wealth managers, elder care law lawyers, wealth managers to help with that. But it starts with the Power of Attorney that people have appointed who is going to make decisions for me if I become And once you're 18 years old and you're an adult, you need a power of attorney. It's not often enough to say, I. My spouse or my parent now, you know, automatically has that power of attorney, but actually assigning them that power. While you have capacity, you're, you're making your own decisions, but it's [for] when you don't. there's also what they call an advanced health directive, right? Who is going to make those health decisions. So that has to be somebody should be, ideally somebody you trust, whether it's family, friend, or professional who knows your wishes and needs and can talk to the doctor and can talk in a situation to help make those decisions, and the other thing is kind of the, the cluster of having your will, trust. your in order. So often people have done one or some of those things, but it really is a package deal, as I say. And a story I'll share quickly is, um, a client of mine that I started working with a year ago, I'm on the West Coast in San Diego, his nephew in Boston called me and said, my uncle needs help. He's alone. He's in his eighties and his memory is terrible these days. He's not himself. Could you help? in our journey, what eventually happened is my client was diagnosed with disease. He was insisting on staying home. We were getting him all the help we could, but he fell and I found him after he was on the floor for He ended up in the hospital, he ended up in rehab and he's now in, a senior living home and it never to go back This story has a happy, very happy ending. And for two reasons. His nephew who loves him dearly the year before, convinced him to sign over power finish the trust, and appoint the advanced health directive. Had he not done that, when I there was nothing any of us could have done. Right. the hospital would be going to the courts and we'd be going to guardianship. So we were able to help. Um. Number one and number two is I was in his life and we brought in care companions. We brought in senior living specialists, and we were able to get this gentleman to a phenomenal senior living home, matched to his personality, his needs, what suits his life. And fast he's better than he was five years ago. He's thriving. It's an amazing story. It required a village. It required, things we haven't talked about before in this conversation of medication management, which is also such a key issue. You start becoming on more meds. Are you taking them consistently at the right time? Are they interacting properly? medication management. when we can't often do that for ourselves. You may not Or there's so many reasons. So getting this gentleman in a controlled care environment where his medications were being handled properly was a game changer. And you know, a big part of contributing to the environment, the support, the love, his affairs, in order to him saying, oh my gosh, I have a life. There's I'm so glad you brought up the importance of those three specific documents. yeah. So, um, so thank you for that. I don't want to take us too far off track, but I think the medication management thing is, is worth talking a little bit about. and specifically when somebody is at home and, and let's say they're a, they're a solo ager what sort of recommendations do you make for medication management at home? it's a specifically good question. the, the key is, is the person managing their medication? And again, that requires, it's kind of your cognitive ability or mental health ability to do that. If you're having memory it may not work right if you're having trouble. So you're gonna need help. So, kind of stepping back, if someone has very serious health issues, what I will do often is bring in what's called a care manager. There's a field, and I do wanna give a shout out to this field. There are life care managers or people might know them as geriatricians. these are licensed nurses, LVN certified CNAs social workers. So sometimes we have to bring in that licensed skilled help who are going to bring the medical expertise to this person and help get them set up where somebody is going home, and literally helping them manage how they're gonna manage their medication. I have a lot of adult kids who go to their parents' house once a week or once a month, fill all the boxes, make the lists and say, all right, you're gonna follow this 30 day... it works until the parents are confused and can't, aren't doing it right. Happens all the time. Or you drop the pills. There's so many reasons. in the fellow I just talked about, we brought in a care companion who was going in every day Or most days But if you don't have somebody, they're 24 7, it's hard Yeah. often it does require in professional home care aides, companions. in which case you're now starting to talk about added expenses to build I call an assisted living environment in your own home. So you're investing in this added of, of help it seems like that's one more reason why you want to start thinking about these eventualities early on, because. I don't know what the numbers are, but it sounds very expensive to me once you start having somebody come in on a daily basis to help you with these things. I can see the value of it for sure, but it's also something I think most people are going to want to have considered and factored in to their savings or, for the kids, for their expenditures on behalf of their folks to pre-plan for that before getting hit with a, you know, weekly or, or monthly cost that is substantial. Speak to that. there are things we look at to underwrite costs of care. Some people have long-term care insurance policies and often wait too long and often don't know what they actually provide. So if you have a long-term care insurance policy, you wanna be looking at how much can you spend out of pocket when to, because that amount versus what it really costs to have care can be very different. So, you know, having it, using it, but ahead of time, really understanding, which is something I do spend time with with my clients. If you're a veteran, VA benefits can be fantastic, but people often don't realize they qualify and they don't enough. cost of care, depending on where you live in the country, in San Diego, they're very high. We're looking at $40 an average. It, you can budget safely at $40 an hour average to have home care. It can Be a little less. Some places it's 28, let's say 28 to 38 to 40. if you need skilled home care, meaning licensed nursing, licensed care, you're into 70 to hundreds of dollars an hour. So one of the things we say is if you are needing more than six and a half hours of home care in San Diego... A week? I'm sorry... a day. Okay. so if you're in that six hour a day of home care that you have a companion, an aid, helping you get around, prepare meals, get to the bathroom, transition from a bed to a chair, to a walker, any of these, what we call activities of daily If you need home care aides for that support and you're hitting six hours the cost of that becomes more cost effective to live in a senior living environment where you would have more of that support longer. So cost of care at home versus senior living is something I spend a lot of time with my clients on. And what I'm finding is financial advisors, wealth managers are starting to either call on To help them, or they're even becoming, they're becoming educated themselves to say it's one thing to retirement financially, but are you getting into the details of what it costs to well and what it will really look like? If I need help with activities of daily living, or I have to bring in outside help and create this assisted living environment, have you really figured out the costs? And at that point, don't be scared, right? Because lots of solutions, for people depending on their abilities and their resources. But you've gotta, again, face it, and know it, and prepare Jacqueline, I'm not even sure how to ask this exactly, but you have talked about a ton of different resources that you can connect people with that are specialists in their particular fields that can help people. but there's so many of them, it's, it's almost, it's almost overwhelming to, um, to hear it and to think about it. And then you start thinking about the costs that must be associated with, some or all of these things. And I imagine that some people sort of shut down or, or get confused by it and don't move forward.. Absolutely. And that is the intention we wanna take what seems overwhelming, and take that away. I certainly wanna leave people with peace of mind and confidence that they're doing the right thing. So, yes, I think terms people can look for in terms of aging in place are navigators. We're helping navigate. you have certified senior advisors, you have life care managers. I kind of look at buckets financially, financial advisors, elder law professionals. I health. So are people going to need a home care agency where they have a care manager who's gonna help them get the right home? Whatever and you know, I look at the home itself. How are we gonna make physical. Changes to the environment and, outfit the home. when we're talking about moving and downsizing, there are senior real estate specialists, so people can look for SRES, senior Real Estate Specialists. They tend to be real estate brokers from, all your familiar brokerage agencies, but they've gotten their certification. Many, are CSAs, many are CAPS, and they are senior real estate. So they know the specific things that you're going through as the older adult. The emotional part of it, the overwhelmingness of having to change and downsize, all of that, and how to help you find the right home, or move to a senior living. Most importantly, I partner with placement specialists, which are senior living specialists. And what I will often do with my clients is say, while we talking, let's set you up with a meeting with a senior living specialist, and they're gonna talk about the vast options of where you can live other than the home you're in. There's so many different kinds of senior living communities, and ways to have graduated Care support and your senior Living placement specialists, placement referral specialists. um, NAPR, the National Association of Placement Referral Specialists is where you can find those professionals or through people like me that work with them, but, they're out there for you when it comes to it's time to leave home. We've sent all we can And, and learn those options. And they know how to work with financial resources, whether they're abundant or they're sparse, they know how to handle geography. we just moved somebody from San Diego to New Jersey to be closer to the parent, I mean the adult kids. And we explored places here in San Diego. We found them people to help explore on the East coast. And we help guide the Family through the decision of let's move east. We can take the overwhelm out and, there are some key professional services to look for. Okay. you know, a lot of people want to stay in their home as long as possible and, and come hell or high water and. it's a point of pride and, Autonomy that it, it just seems like that must be a very challenging thing, for you to help people plan for how can I stay here for as long as I can, and then how can I judge and transition when it's time to make a different decision. Yeah, the whole conversation people have with themselves and their family wanting to stay put versus moving. it's a really fraught, subject. the older adults want to maintain their independence and autonomy. And the adult children, friends, whoever is in your life, are worried about you. one of the things we say, there's a paradox. The more you ask for help, the more independent you will be. as you're getting older, and health is changing, it's harder to do these things for yourself. The things you used to do and handle you can't. So if you have built support systems and there are people that know your wishes, the whole goal is that they're going to be acting in a way. That's what I do as a professional. We're not doing what I wanna do. I'm helping you do what you wanna do, and I'm working with you and saying, you know, to get real So I could say to somebody, who are you gonna depend on if you fall and break your hip and you can't get up and leave the house for six months? My kids. Oh, really? Okay. Oh, they're three states away and they're gonna, so they're flying in and leaving their family and their job for you. So let's talk like. What are some things you want them to do for you as you get older? Your kids, the people you're depending on? What don't you want do? I was just talking about that with my dentist this morning. The things that he had to do for his parent with him. You know? And you start to say, okay, I, I would like my children, I would like my spouse to stay, my spouse, my husband, my wife, my partner. Rather than my nurse, my caregiver, I want my adult child, to be my child, not my caregiver, my nurse. We will look at the ADLs, the activities of daily living. When you can do everything independently, great!. When you start needing somebody else to make it Meaning preparing your, getting to the bathroom safely, and cleaning safely, getting dressed. up and down, transitioning, as we call it, grooming, taking showers, hygiene. When you start you can have that help at home with loved ones, with bringing in home care. When it starts to become it six hours a day, eight hours a day, 12 hours a day, when there's a risk, you're gonna roam in the middle of the night because there's cognitive decline. are all factors that you may be off moving. So if I walk into that situation where things are It's probably, we're either talking about that or there are enough resources to do to do 24 7 care, but much of it is and so much of it is relationship. for my sister with our 95-year-old dad, she's gonna probably go the full gamut. I'll be very, I will be very direct with our listeners if, and, you know, as a person becomes you know, for my sister, we're gonna bring in 24 7 care, versus moving him to someplace where you would have that care. So The options are there...... if the resources are? Resources, yeah. Yeah. And help, as the spouse, as the child, as the best friend, just not doing this alone. And when there's cognitive decline, I have so many clients that are calling when they have tried to care for their partner, who has Alzheimer's, has Parkinson's related dementia, and they are at their wits end. 70% of caregivers in extreme situations, die before the person So we're saying to that caregiver, it is time. We you know, pull you back and get them help, a professional environment, a memory care environment, where they're safe, where they can thrive. earlier we, I, we mentioned this idea of, you know, you're gonna have to take me outta the house feet first. That's not thriving. right? I, I'm, I'm seeing a new client tomorrow who goes from saying, I'll kill myself before I leave to, I can't stay So we wanna come in and make this easy for you. let's start this conversation so you get to a place of making a decision, and like my client who has a new lease on life, where you can thrive, a person living with who is just, know, potentially locked in a room at home because everybody's so scared they're gonna hurt themselves or roam It be free and with people that have to reach them and give them a quality of life to be at home. Jacqueline, there are so many nuggets of gold in in that last, whatever it was, five minute segment that, it's hard to unpack all of it, but I wanted to say that having those conversations may be best coming from someone like you, rather than a family member, because you are able to be direct and be pragmatic about it and sidestep the kind of shoulder shrugging that somebody might do with their, their kids or their loved ones to say, oh, I'll just, I'll deal with it later. we are the third party you bring in a placement specialist to talk about senior living. You bring in myself, really, I mean, any of the wonderful people I work with in, uh, in their specialty areas, we are neutral. We don't have the baggage, I will tell you that I cannot do this and my, you know, my mother is my doctoral degree in this. As I navigate her journey, which right now my sister and I have become her guardians, it's gone that far. am applying that to the people I work with. It's, uh, because as that professional neutral, we have different conversations and I'll often say to the families, I may say exactly what you're saying and they're gonna listen to me, or they're gonna respond. They're not gonna fight me. it strikes me that the other half of the having the support system allows you to, become more, independent is the fact that on the other side of that, if you don't do it and you get to a point where you've had a fall or you are compromised and it takes a lot longer to, heal from that, or, you know, God forbid you hit your head and there's something that, that occurs there then your desire for independence has actually probably put you in a, a worse position where you're going to need to ask for more help and more intense help than you would have had you been getting little bits and pieces and familiarizing, the people around you and your, your support network with that kind of relationship. Yes. It's a great point, and we're talking about adaptability. And we do adapt. As humans, we adapt and the more we're talking and the more help we're receiving gradually. So I, so again, proactively, if we're making changes, you don't make them all at once. We're not gonna walk away from, you know, when I meet with a client and give them a plan of here's some things we're gonna do. We have a very short term one. It's just a couple of steps. have longer term goals, term, this idea, of adaptability is also as people move into almost all time people might be like, ah, for the first month I wanna go home. I wanna go home. I miss my home. Within no time there's that a adapting of saying, wow, I'm so much better off. I have a new here. I feel so much better. I have new friends, whatever the situation You, you do see that often? Oh, almost almost always. Jacqueline, if somebody wants to start working with, an aging specialist, what do they need to look for to make a good choice? are there other things that people should be looking for besides just rapport? so I think when people are looking for a specialists, I think they're A number of things to consider. One is, I think any professional that you're calling really, offer you a, a free, a complimentary I know for me, I, you know, I start off that way and they generally, it's a half hour conversation to really find out what's happening, ask questions back and forth, and allow me in my case to talk about, here's some things that might help you and ways we might move forward. So I think anybody, whether you're calling a home care agency, a senior living placement specialist, a care manager, someone like me, aging in place. and then you have the opportunity to say, how How did I like that person? Did it connect and click? You know, and I'm always looking for that click with my clients. so I think that's one thing. And you know, I, I've, I'm a certified senior advisor. there are national placement referral agencies. again, I've talked about senior real estate specialists, aging life care managers, so people can Google. often talk to friends, people have, they loved their caregiver. It doesn't mean that caregiver's a good fit for you. So really relying on professionals who can come in and get to know you, we. so many more options than your friend. We know so many more Google. So start talking to somebody that's certified, coming through a good resource, certified senior advisor, certified aging in place specialist, start and we're, you know, once you talk to one person, we're gonna recommend that. And I think for me, when I, when I talk to people, the most important thing come across as is somebody So you want somebody that you feel is really listening and hearing you and not coming back response. So that might be a tip and you have to go with your own gut on Mm-hmm. my husband just went to the gym and tried out a new trainer and came back and said. Guy was on automatic response. He wasn't hearing, I was like, eh, find another trainer. Right. And again. The one size fits one, I have a lot of experience to bring to the party, but I have to that I am here for that person and that family, that situation, and really listen and hear and what matters most to them. What feels right. it's a conversation. It's a dialogue. And then for, I think people looking, it's go with your gut. You should feel oh, they took a load off my mind. You know, I'm feeling more at peace just by having that conversation or I, I am feeling hope or I feel like there's somebody out there and you just wanna, that's what you're looking for. Not a sales because there is no Right. I like to leave people with this you know, of looking at their is a mission. It's, something that you're going to work on every day a little bit. So creating this environment where you're gonna be safe and comfortable and live life on your own terms. All right, so... DNA. Aging's in our DNA and there's a DNA to practice: The D is essentially Do it. What does that mean? Sit down and let's start to talk. Let's normalize the conversation about our aging. Let's make a plan. Right? N - Not all at once. it's just overwhelming to think about this. You don't have to do it all at once. Just get it out and come up with one step at a time. And one step might be you're gonna reach out for help. Whatever it is. And the A is the most important thing of all. Ask for help. Overcome the reluctance to ask for help. So call an aging in place specialist and find somebody like me, [or] others, to come in and do a home safety evaluation for you. Basic. Ask your loved ones or whoever to sit down and have a conversation. Ask your financial advisor, your accountant, to talk to you about what's it really going to cost for me if this happens? If that... what if, what if...

So DNA: 54:35

you know, Do it, start planning. Not all at once. Ask for help. Great. I love that. What I've discovered there's a synergy between the Aging In Place professionals and the Senior Living Placement professionals. And one of the ways I experience this is sometimes people Google where does mom live? You know, where do I send mom? Where do I send dad? And they find a specialist. the placement specialist calls me and says, you know, I talked to these folks. They're really not ready to make the move. Maybe they should, but they're not ready. I've referred them to you. I could now meet them in the home, meet them where they are. Start my general assessment of putting a plan in place that may say we're gonna thrive at home longer. We're gonna mitigate but we're gonna also start touring. Right? In which case I bring them, I bring back in the placement specialist. there's a synergy and people don't have to figure this out by themselves. and the senior living specialists have no charge. They will work with you for free, and they have vast knowledge. and the way they charge, a senior living specialist, is if they work with you and they act, you actually move into a community. It's the community that takes care of their payments, so to speak. Kind of like real estate, a commission. in my case, there's a charge for my services, but again, I work with people on a consulting basis and I try to make everything I do accessible. and giving resources, one of the set of resources many of us have is to free services. There are extraordinary social services. There's an umbrella organization called area agencies on aging where people can call and then find resources, free resources, volunteer programs, anything from getting grab bars installed for free to, Home care to health, to moving. and I, I will talk to people often in my free consultations and make warm introductions for them to those resources. That's great to know that those exist for people who, who may not have the resources... let's hope that those things continue to exist going forward. I, think aging in place also starts with a mindset the idea that there's a zen Buddhist principle, right? That you have to accept. We accept that everything changes, time changes. nothing will stay the same. I've always done it this way. It doesn't mean you're always gonna be able that way. So that mindset, I often say aging doesn't rob you of your dignity. It's your reaction to it that does. So if you wanna maintain that grace, that dignity, living with independence and autonomy, it's how you act proactively. we wake up every morning aging in place, thank goodness, wherever we are, wherever we call home. So how we react proactively and how we take care of ourselves is important and who we ask for help. And that's where the professionals come in, the aging in place professionals and all of the resources that we can tap into in the professional world. Jacqueline, thank you so much for all of this wonderful information that you provided and for the service that you're providing for people. If people want to get in touch with you is the best place to do that through your website of agingadvisoryservices.com, It is the best place and I'll, I'll say people anywhere can call me. I can talk to anyone, offer a complimentary consultation and help find resources wherever you live. if I can be an ear and a help, I'm happy to be! That's wonderful. Thank you so much for offering that to, the listeners of the LightAtTheEnd.com Podcast.