Christina Drumm-Boyd and Amy LaGrant – Caring for a Loved One with Dementia

When facing Dementia, it's hard to know what to do.

If you have been touched by dementia, or are caring for someone with Alzheimer's disease or another form of dementia, our personal journey with our parents may give you some guidance.

This episode features Christina Drumm-Boyd, Owner and President of Care Connect of Hampton Roads, and Amy LaGrant, Gerontologist, Co-Founder BrandMETTLE, Ambassador Aging2.0, Walk2ENDALZ Committee Chair.

These two leaders are passionate and dedicated to advising caregivers and families going through dementia.

We cover topics like seeking services that can walk you through the difficult journey, dealing with grief, communication strategies as memory fails, legal issues that may arise such as guardianship and end-of-life decisions.

Bios:

Christina Drumm-Boyd
https://www.linkedin.com/in/christinadrummboyd/

Owner and President of Care Connect of Hampton Roads, Inc.

Specialties: Have over 20 years of Healthcare Sales, Marketing, and Geriatric Care Management experience focusing in the Senior housing industry, property census development, and turnaround strategies for focus properties.

Christina is also a licensed insurance agent in life, health and annuity products for the state of Virginia.

She holds designation as a Certified Senior Advisor and is an Accredited Agent with the U.S. Veterans Administration, licensed to represent claims before the Office of General Council.
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Amy LaGrant
https://www.linkedin.com/in/amylagrant/

Gerontologist, Co-Founder BrandMETTLE, Ambassador Aging2.0, Walk2ENDALZ Committee Chair

Amy is a leading gerontology professional with over 15 years of experience marketing to baby boomers, seniors, and family caregivers. Amy has held leadership roles in some of the industry's leading advertising agencies.

Most recently, Amy was SVP, Brand Strategy for Bluespire Senior Living formerly Martino & Binzer.
Prior to Bluespire, Amy led all marketing efforts for Virtual Health, a telehealth and family caregiver integration company. Before that Amy led strategy at multiple mature marketing and consulting agencies such as Continuum Crew, JWT Boom, and Age Wave.

Specialties: Client Management, Strategic Planning, Baby Boomer Marketplace, and high-regulated products

Transcript

Hanh: 0:00

Okay, great. You guys can hear me?

Amy: 0:02

Yes.

Hanh: 0:03

I've spoken to each one of you prior to this call, so I thought maybe the two of you can introduce yourself.

Christina: 0:09

Sure. Hi Amy. This is Christina Drumm-Boyd with Care Connect of Hampton Roads. I'm the owner of the firm. Very nice to meet you.

Amy: 0:17

Hi Christina. My name is Amy LaGrant and I'm a gerontologist and I actually just recently lost my father to dementia. Both my father and grandfather passed away from Lewy Bodies Dementia.

Christina: 0:31

My goodness. That's very hard. Sorry. Hard to hear. Oh my goodness. Grateful to have you here and certainly in the line of work that you do, that's wonderful.

Amy: 0:39

Yeah. Nice to meet you as well.

Hanh: 0:41

Thank you so much for both of you to be here. For those of you that are joining us, I'm recording this and it will also be published on my podcast. We're going through a fairly structured discussion today. The discussion, like I said, is recorded and we're all learning how to navigate clubhouse. So please advise if there's any room for improvement. The format is about the first 30 minutes. There is going to be some guided discussion Q and A, between Christina and I. And after that we'll open it up for any other questions, speakers that have any questions or wanna come up and join us in terms of housekeeping. If you want to come on stage, please raise your hand. And if you want to speak make sure that you unmute yourself. And when you're done speaking mute yourself while someone else is talking. And the topic today is "Caring for a Loved One with Dementia." My guest is Christina Drumm- Boyd, and also Amy LaGrand. A little introduction about myself. My name is Hanh Brown. I'm an engineer, real estate entrepreneur, and an investor, and I'm also a caregiver. My siblings and I have been a caregiver for my family, my mom and dad for the last 10 years. My dad had lymphoma and my mom had dementia. I'm also the creator of Boomer Living Senior Living Broadcast. And I have a mission to identify challenges and provide solutions in the senior living housing, operations, caregiving, dementia care, age, sensitive technology, and providers serving older adults. To say that the coronavirus outbreak is a challenging time for caregiving, families, would be an understatement, especially when you are already stressed. Fear and anxiety can cause strong and overwhelming emotions. While self isolation contributes to depression. So, it's no wonder that caregivers get overwhelmed by all the distress. And on top of this extra caregiving responsibilities with their families easily can lead to fatigue, anger, and resentment. So, my guest today is Christina Drumm-Boyd. She's the founder of Care Connect of Hampton Roads, where she's been addressing the growing and specialized needs of aging population since 2006. With a passion for senior advocacy and care management systems, Christina empathetically AIDS, families, struggling with challenges of longterm care. I'm also glad that there's people like Christina out there, to have the empathy to help families in these times. So, I'm excited to talk to her today on Boomer Living. So, welcome, Christina.

Christina: 3:58

Thanks so much, Hanh for having me. I really appreciate it.

Hanh: 4:00

So, christina, can you share with us how you got to your current role?

Christina: 4:04

Oddly enough when I originally went to school to teach grades four through eight English and social studies and in my last year of school on I came home and I remember telling my parents that I wasn't sure I was going to be able to make it as a teacher. Thankfully now the curriculum weeds out, people like myself, working with younger students to the extent that you do your kind of hands-on student teaching a little earlier on in the curriculum. My mom, obviously seeing that my mother was a caregiver for many years. I didn't think that was something that I was cut out for personally. And I applied for a job at this beautiful elder care community that was opening up actually right across the street from where I was living at the time and went through a very lengthy interviewing process. With the care home, I didn't anticipate it was going to lead me to where I am today. But I had an amazing executive director. It was one of the largest Alzheimer's and dementia centers still to this day that we have here in my state and locality in Virginia Beach, Virginia. And the amount of education that I was afforded there under this administrator, I, till this day credit a large portion to what we've created with care connect to Hampton roads the ability to work with the families from a consulting and counseling perspective with the 60 residents that were there in the dementia unit was incredible. Being able to counsel them, with regards to what their loved one needs, financially understanding what their needs would be on an ongoing basis, the families would be under the assumption that essentially the care home may accept Medicaid. And unfortunately it was one of the most expensive care homes that we had in the area, but the administrator was. Excellent. And that he did not want the families to leave without some information to assist them. So I ended up going back to school to get a degree in human services, counseling and working at the opposite end of the spectrum with seniors. And I've really never looked back. I think in essence, it found me and dropped into my lap and the capacity that I'm working in now. And the concept of what we learned or what I learned from working in that position there all those years ago helped me to build a fundamental building blocks for what we've built our practice on at care connect today.

Hanh: 6:23

Thank you. Thank you for your story. And I think we're very blessed to have you in this industry. I know that growing up, your grandfather moved in after being diagnosed with Alzheimer. So how young were you when this happened and what kind of impact did you think it had on you as a person?

Christina: 6:41

Hanh, that period of time I remember my mother was working outside of the home. My father was in the Navy. There were not a lot of resources. I want to say it was probably about seven or eight. And we had, we were living in new England at the time, and we had a large basement that essentially my family had to figure out very quickly, how to make that handicap accessible install, a type of call system, which again, there really wasn't the technology at that time to put into place so that he could call if he needed help, for us a floor above him. So they had to be very inventive. I just remember so much sort of chaos going on. My mother being very emotionally charged about it with bringing him in on top of his diagnosis of dementia and Alzheimer's type, he had suffered quite a few strokes prior. So there was some physical debilitation. He was confined to a wheelchair and his speech had been affected his memory, obviously. He didn't refer to my mother by name. He thought, actually my mother was his sister and all of this, to a seven, eight year old child at the time I had never been exposed to this. My sister was a few years older than me, and I think she handled that a little bit better with understanding, but I can remember. Having the family, all of us played a role in the day to day care. I was often encouraged to go down and spend time with him even just, playing on the floor with toys around him. And I appreciated the time that I had, but there was also periods of time where I was in fear because I didn't understand some of the things that he would say. I think that the period of time that I had and observing the role that my mother played as the caregiver as his. Child my role to the extent that I could have being a caregiver myself, because again, I think every person in the family had a hand in that taught me at a young age to be very empathetic and caring and understanding supportive of my mother emotionally as well. So I think that's when the spark kind of ignited. I saw my mother in a different light and I just thought that she was incredible.

Hanh: 8:55

Thank you. I share some of that journey, so I appreciate your Just being very genuine about that. So you've talked before about how your family at times struggled to adjust to your grandfather's changing needs due to the lack of specialized services and financial resources. So when you see families in this same situation and your day to day job, do you think this personal experience helps you better help them?

Christina: 9:22

I absolutely do. Over the years as we've added staff and we've interviewed people who come on and professional capacity to our firm, I think one of the things that has really stood out to me as a business owner, I'm an entrepreneur and the work that we do, I've had many people who've, I've had the fortune of working with who are extremely, well-educated have a slew of degrees. But those people that have always stood out to me Hanh have been the ones who've had, have been touched personally, who have had some level of personal experience with this. I think that part is something that just can't be taught. You have this sort of innate idea of how to communicate and translate. Effectively with the families when you've had some type of personal situation and experience with it.

Hanh: 10:16

Yeah, no, I agree. There's nothing that can, speaks for itself, although than going through the journey. Personally cause I don't know if I can relate or share my journey with someone that hasn't gone through it and you're right. It's the, how it is touch you. The disease and the decline, and especially your loved one who, you have high regard as your parent or grandparent. It's again I don't know if I'm able to share that with someone that hasn't gone through it, so that personal journey, I think it's really important. So, in your adult life, you serve as a support group facilitator for Alzheimer's association. So can you tell us a little bit about what this entail and what you got? What you got to do as a support group facilitator?

Christina: 11:07

The role actually, when I served with our local chapter of the Alzheimer's association here was. During my time when I worked in some of the communities that was, and I didn't realize when I accepted the position but went through the training to act as a facilitator. I didn't realize how much I would learn in that role. I knew that it would be good for the building and the position that I was in and being able to meet some of the families and the community. But your role is very neutral. You have sometimes spouses who are bringing their loved ones who are affected, and they may be very early onset with the disease process who would attend the meetings. You have different generations where you may have the daughter or son. You may have grandchildren who joined the meetings as well. So you're getting a wide review of how it's impacting within the generational family. The disease process, I think that it was also an extremely effective way for the people who were being affected by the disease to share in a neutral space. Different services that were available in the area that they may not have known about. As things have progressed, I'm seeing this now translate to the social media platforms that just, for what we're doing today, where I think that they're able to get together and be reached on a broader scale, which is amazing. But the face-to-face groups sometimes it just allows them to sit and weep and a space that they feel comfortable, in doing so where they can understand and feel like they're not alone on an Island, so to speak. And that there's husbands and wives, that are experiencing the same thing. Relationships and friendships develop as a result of that, but it was just a wonderful. Sense of family that I was able to witness, and help to bring together. So I miss that very much. I don't get to attend those types of things, the way that I used to I'm in my new role. But I think that it was something, again, invaluable from an education standpoint that I'm very grateful to have had the opportunity.

Hanh: 13:22

Thank you. Thank you. I got to tell you the reason why the three of us are a communication is at some point on social media, I just felt. Strongly that you both had a heart for caregiving in a heart for dementia. And I think that's what brought us here today. To have the opportunity like this I'm very blessed. So thank you for joining this conversation.

Amy: 13:44

Hanh, I would love to have the opportunity to reiterate some of the things that Christina has said. Especially around the personal connection. I've been a gerontologist at a very young age of 22 and worked in policy direct care in an Alzheimer's community. Very similar to Christina. And I will say that having this personal experience has changed my perspective on how I work with our clients to market and advertise to seniors and caregivers. I used to have a mug on my desk, in my twenties as a gerontologist that used to say, I'm not my target audience. And as I've walked through this experience and have met people who have gone through this experience, I'm involved in the Alzheimer's association as well. And I spent a good amount of time listening to the stories of people, and there's so many differences, but then there's so many commonalities. And I think that one of the saving graces in all of this, of being careful caring for a loved one with dementia is having that community and having people like Christina and having places like the Alzheimer's association to help support all of that. Because as a younger age, caregiver in my life I've had very interesting experiences of dealing with my parents. And I'm saying dealing, with air quotes. I guess helping would probably be a better word, but having that support and really dealing with having that personal story, I think helps you come to the table, just with some, a little bit more empathy and understanding of kind of what people are going through, because it is so different for everyone.

Hanh: 15:22

Thank you. Thank you, Amy. I echo that. I agree the the journey, it's different, it's unique for every family between yourself and your loved ones. And then not to mention the family dynamics. The more siblings you have, it can get really dynamic. I appreciate the support and I, I wish I had this conversation like eight years ago, it was a lonely journey. And, um, as I navigate through my own personal journey with my siblings, I guess that's what brought me here today. I can speak to it. It's still very emotional, but I can speak to it. I think prior to this, I wasn't able to, I wasn't ready. I didn't know where to speak, where to go to speak to people, So I'm thankful for this opportunity. Christina, so how has your company created a better way of addressing the needs of aging people?

Christina: 16:12

Oh, Hanh. I hope that we've and we're still evolving. I think that's one of the things that I pride myself on is that we're constantly learning new things to better, to be better equipped with working with our families. Because as Amy stated there really can't be any sort of cookie cutter approach. When working with families who are dealing with, various issues, with regards to caring for an elderly, loved one. The practice itself we've evolved to the point where we've really been effective in listening to what our clients have told us that perhaps, maybe we could do a little bit better or that they need a little bit more support in certain areas. We really strive to be the way that I describe it, the center spoke on a wheel and that. I couldn't do what I do without the wonderful people that I work with. Our partners in the community from, gerontologists that we have contact with from primary care physicians specialists, the properties that we work with at provide, amazing care the service organizations such as the Alzheimer's association. So it is a village, a community that we work with in order to make sure that we are making the best possible plan to care for each individual that comes through the door. The legal capacity. That was something that sort of, we found very early on, was going to be ingrained in that it was a fundamental building block for our clients and that we needed to make sure, certainly if they've had this type of diagnosis, that the appropriate legal documents were in place. And so that was an area that we evolved further. Their financial concerns, obviously with being faced with, these types of caregiving responsibilities and understanding how they were going to pay for it. We just found that they were in panic mode over it. It's 90% of the cases that we work with unfortunately are still crisis intervention types of cases. So we're striving to be that center spoke on the wheel that when they come in and we speak with them over the telephone. We're able to allay their fears identify any areas of exposure that they have and figure out how to best cover those areas for them, in a manner that addresses both the medical need the financial, as well as the emotional. And if, we're not able to do it directly for them, we have a partner in their area that, obviously provides excellent services that we can also refer them to.

Hanh: 18:37

Great. Great. Thank you, Amy, you know, along the way, please chime in. Share your thoughts. As we move forward.

Amy: 18:44

Definitely. Thanks, Hanh. I want to say for Christina, I think a lot of people they're very unaware about the services that companies like hers provide. I think there's a, not a great awareness. I actually was having a conversation. I get a lot of calls from people just because of my gerontology background on who I'm supposed to talk to. And a lot of, I provide a lot of geriatric care manager advice, not necessarily being certified in that, but I think there's not an opportunity. I was actually talking to a bunch of girlfriends and they were stating that they didn't feel like they even knew where to find those services. And I think that's an important element that we have to figure out is how do we get in front of all of these caregivers to show that there are resources, there are professionals that are providing some great information and very helpful advice during a really difficult time. So that's one thing that I know I have a great interest in is trying to figure out how we get the awareness of the services that are available to us.

Hanh: 19:50

Yeah, that's a good point. When I went through this journey eight years ago, it was very lonely. The no services like Christina didn't even know that it was a common dementia is common when it comes to aging. So I think you're absolutely right. I think we need to amplify more services like this so that people don't feel shameful that they have someone to reach out to. That's a great idea. Now, what are some of the ways you can help families through their long-term care struggles? What are some of the techniques that you guys use?

Christina: 20:24

Hanh, I think that from our perspective at our firm is, the first kind of touch point that we have with our families is usually by telephone. They've made an inquiry call and again, with 90% of the cases that we're working with being crisis intervention. We're unfortunately having to unravel and dispel some of the misinformation that unfortunately, a lot of people have received prior to getting to us much to what Amy commented on. And the fact that a lot of people don't know that geriatric case management services exist or in, in sort of the capacity. And I think that a large part of that is, is that it's somewhat unregulated and that there's not a sort of standard with what geriatric care managers do. Some of them, work in a capacity that they are with a certain care agency, for instance, perhaps it's a home care agency. And so their services in a consulting capacity may be somewhat limited in that they're not, exactly the same as what we do at care connect. So it varies. And I think that can be somewhat confusing to the families as they start this journey as well. But for us, it's just emotionally identify, what's happening with them. Understand who is the decision-making party within the family, when they contact us, so that we know that we can communicate effectively and developing the plan and getting that executed. But I think that the first thing that we're doing is dispelling some of the things that they may have been told or that they've read online, that's scary to them, most of which you know, has to do with a lot of legal or financial things. We get a lot of phone calls where they said, "Oh my goodness, we're going to have to pay for care, and Medicaid is going to take my parents' house." It's those kinds of things where, we're having to tell them, we need to take a breath and I'm going to give you some facts and some figures and we're going to figure it out. I think that's one of the big things that I really have prided ourselves on is being able to take them by the hand and let them know that yes, we're a source of information, but we're actually going to be able to get some positive things done.

Hanh: 22:37

That's great. That's great. How about you, Amy? What's your thoughts?

Amy: 22:41

I was, I was doing a little applauding over here as Christina was talking. And, I know we really haven't talked any at all about COVID and, unfortunately my dad had dementia for about 10 years, and then we had to go through the process from a personal perspective of, having home health in the home during COVID and then moving him into memory care during COVID as well. And I think this just adds another layer of complexity around what people are dealing with right now, and choices that people are having to make. And and also just not having necessarily the direction. So, I have a question for Christina, if you don't mind, I was wondering, how are you guys furthering and helping families with this dynamic of COVID? Because as a caregiver, during that time, even being somebody who's in aging services, I was struggling for so many different answers."Am I doing the right thing? What are the risk factors? What are the things I'm dealing with?" And I was just, I was always felt like I was just trying to make the best decision I could and just didn't feel like I necessarily had the resources at the information to make the most informed decision.

Christina: 23:48

Now, Amy and Hanh and I, that the first conversation that we had in preparation for this event to take place tonight, we touched on that a bit and how COVID has impacted us even for us, and those of us that work in this field. No one was prepared in any capacity for this pandemic and we weren't sure if the phone was going to ring at the families, we're going to be calling everything, just sat still for a moment. And then we had this Delage of phone calls that were coming into the office families, panic stricken saying, the facilities are shutting down. I'm not going to have access to my loved one. I'm not sure what we're supposed to do. And to be very honest with you, Amy, we weren't sure how we should advise them. And it really came from a point where I had to adjust myself professionally to say, it's not. So much of a professional answer that I need to give these clients it's not based on my education and clinical and that type. This really was an emotional search that we had to do with the families and understand where is your loved one at this point with their disease process"What kind of support do you all have at home?" Because we had to say, "Is this a time perhaps, maybe we should make adjustments and bring your loved one back to the home which we did for some of our clients." Then we had a certain number of our clients that we made some adjustments to have them transition into a smaller care environment where we have these smaller group homes that we're going to remain open. And they were able to do so with, wearing their PPE but could still allow the families to come in. Because they had families that were literally some of them in the position where they were beginning to transition to end of life. And they couldn't fathom the thought of not being at their bedside. And I just, was, I found myself being emotionally crushed by that for the first time ever in my career, this span of 20 years, I was facing something emotionally that I had never dealt with my families before.

Amy: 26:05

I think just having somebody, if you were to just were holding my hand during this whole process, just saying"Amy, you're making the best decision." I think that's even an even enough. So, appreciate all you're doing.

Hanh: 26:15

Thank you. Thank you for you both. Now, I wanted to inquire about the options that exists for funding long-term care for families who may not have the means to pay for care for a care solution, out-of-pocket. Christina, do you have any thoughts on that?

Christina: 26:30

Sure. Hanh. As I stated, that's one of the large concerns that the families have with regards to caring for their loved one is, How much is it going to cost now, and how long, will we have assets? How long will they last? And then what we need to transition to some other type of payer source. So, when we meet with the families where we are doing a financial resource evaluation to understand what income they have. What assets they have? Are there any federal or government benefits essentially that they may be eligible to qualify for either immediately or at a later date as assets are further depleted? So, part of it is that we, obviously are assessing if what they're individually income is, the assets that they have. Are, is there any long-term care insurance that perhaps we should take a look at? We're licensed in life health and annuities, and we don't sell any products. But in order to be compliant and effective in assessing or helping our clients with filing a claim through their long-term care insurance, which can be very complex. We are licensed to be able to do that. Some of our clients, we even find that now is not the time to file a claim with the policy that they have, because it could be somewhat limited. And perhaps we want to preserve that until the later date, when expenses have increased or their medical needs have increased. If we're having to assess for Medicaid within their state. We do have clients that we work with both in the state of Virginia, but we also have clients all across the United States that we assist with that process to help them understand Medicaid in their respective state. And then with VA pension, if there's been military affiliation, there may be certain benefits that they can qualify for that they had no idea probably even existed that we can help to obtain, to supplement. And then there's also certain things like bridge loans that individuals can qualify to receive to help bridge a gap or to help bridge a gap while they're waiting for other benefits to be made available. And then we also have certain families that we assist with evaluating whether or not a reverse mortgage may be appropriate for them. So there are a lot more options. Obviously it's not a one fits all type of scenario for them. It's just based on their individual needs.

Hanh: 28:57

Thank you. Thank you. Do you have any thoughts on that, Amy?

Amy: 29:00

I think it's just everything that Christina is saying. And all of the things, even when she mentioned this earlier, which is about a lot of misinformation out there. I think that is, just outlining all of those options that she shared with us. I think, how do we get people more aware of what is actually happening and how do they get to people like Christina, more and more? Because I think people make so many errors. And how do we bridge that between different organizations to get more Cristina types into people's homes when they're going through these challenges? So that would just be, my wish for us. Cause I think there's to Christina's point earlier, there's a lot of misinformation out there. Oh, Medicaid will pay for senior living or I have to deplete all of my assets or I need assisted living, when I, may my family member may just need independent living. There's just so many misinformation out there, the nomenclature, all of that. And when you're trying to navigate it, as you'd mentioned before, Christina, most of the people are coming to you, in a need driven or they've just dealt with a crisis in their family, and now they're coming to you and it's like, how do we get people to plan earlier? How do we get family members to plan? I will tell you the one saving grace in all of this with my family for the last year was we knew exactly what my dad's wishes were, how he wanted things, handled all the powers of attorney, healthcare powers of attorney, all of that stuff was taken care of. And so when we ended up in crisis, it didn't seem as much like a crisis because all of that had been handled. And I never had to question myself around, was I honoring my dad and his wishes? And I will tell you that was probably the only thing that was, gave me peace during this whole situation that I knew that I respected what my dad wanted.

Hanh: 31:00

I'll tell you that sounds like it's the exception because my family, for example, we've never talked about it and it, and I'm putting the word out there. It's never too early to start talking planning in just, recognizing that as your parents, as we are all are aging and is your parents' health may be declining financially how do we prepare for all this? And, you know, and as we speak, I'm thinking that all these moving components such as, your health, finances, your emotions. All of these are heavy components that affect your wellbeing. So the sooner that you talk, prepare the more options you have, but let's say if you don't and you face it in the thick of crisis, you have less options. And it may be the one that you don't want to go with. You follow what I'm saying?

Christina: 31:55

Hanh, I absolutely agree. And Amy with what you were commenting and saying that, the one bright spot was that your parents had developed a legal plan. You had those fundamental building blocks that I referred to earlier which does help to facilitate the process where you didn't do so much, second guessing you're dealing with so much emotionally and, and they call this disease the long goodbye for good reason to have all of this administrative sort of red tape to have to contend with at the same time, is it just elevates, the difficulty that much more. We really have tried to work with our local hospitals who obviously we, when you have that triggering event, a lot of our referrals come from the timeframe of the person's getting ready to be discharged. And perhaps they're going to a skilled rehab center. And they're just now starting this process because they've gotten the information that they're no longer as independent as, what they once were and they're not going to be able to return home and, they need additional assistance. So we're trying to educate my peers are our social workers are our caseworkers and our physicians to say to them, "We realize you have limited time." You have some restraints with regards to how much counseling and consulting you can provide to these families, but we can be that source for them allow us, to be able to make things a bit more streamlined in that consulting capacity to help get them from point a to point B with some leverage of, this information that we can provide to them. The legal documents, we're really trying to educate the general public on the fact that these documents, it's not just for our aging population. These documents such as powers of attorney documents are important, when you have an adult that reaches age 18. I had my son who is now 21 before he left, to go to college a few hours away. We had to have him sit down and sign a power of attorney, naming us as his parents as his agents, because even though we're paying for his schooling, we're paying the bill at his college university. We would not have the ability to even view his grades because he's 18 years of age. If something had happened to him and he doesn't have the capacity to give consent we wouldn't be able to pay his bills, from his bank account. Those types of things. So, these documents have become so much more important, not just the financial power of attorney, but the advanced medical directive as well. And making sure that these families understand how each of these tools work as well as their Last Will and Testament. It's very important so that we don't get to a point where we're having to stand before a judge to get, and a lot of cases, a stranger appointed, for an individual. That's a really hard thing to have to relay to a family.

Hanh: 34:55

That is great advice. I heard that prior to my kids going off to college, I just hope more and more, families are aware that when they turn 18, like you said, parents who are paying for their schooling you don't have access to all those files. And you got to take the right legal steps to ensure that you can help make those decisions if you need to. So thank you. Let's see. So, I know that you are also an accredited as a us veteran administration agent Christina. Now, can you tell us a bit about what that means and why did you chose to pursue this accreditation?

Christina: 35:38

Hanh, I think that I had mentioned my family was military. My father was in the Navy for 20 years. And what I found really intriguing about what I discovered through the department of veterans affairs is that in my adult life, the veteran's administration doesn't really take the responsibility to follow veterans retirees to the extent of letting them know later on in their they're retired part of their life about benefits that may be available to them or even to their dependent, widowed spouses. So I have, I had my doors open at my firm for, I want to say it was maybe 24 months and I had a woman come in who was in her eighties and she had lost her husband rather unexpectedly. He had gotten up to do a routine fix her up or item at the house and fell, and unfortunately passed away as a result of the injury and had been military. And she brought these papers into our office, I had never seen them before. And she said, "I tried to apply for this benefit, this supplemental benefit stack of papers." I want to say there was probably over 250 pages. And she said, "It's been 18 months. I haven't heard anything." That is actually how, one of the specific benefits that we have now been accredited to obtain for our clients. That's how I found out about it. The, authority that I have through my accreditation is I have legal authority to represent claims before the office of general counsel, which is the department of veterans affairs, private court. So it's a very separate process from when we apply, for instance, to receive Medicaid benefits through an individual state on their behalf, they're both federal benefits. A person can't receive VA pension in conjunction with receiving for instance, Medicaid in their state. The federal government considers that essentially to be somewhat double-dipping, but this benefit has become a huge supplemental source of income for so many of our clients, I never anticipated that. It would be such a big part of what we do at our firm. And as a result of that, we do screen every single person that we come in contact with to ask if there's any type of military affiliation, because what we've discovered is that a lot of families don't even realize that they may be meeting the criteria. That has been mind blowing to me. And that really hasn't diminished any. Myself, there's, other colleagues obviously that are working in this area for families, but there hasn't been any slowdown in the pace of clients that we've identified, who may have missed out on 10, 12 years of benefit, that they may have been able to receive.

Hanh: 38:31

Wow. Thank you. Thank you for sharing that. So, you see that, how much of your clients are from the the VA and, were you able to shorten the process and helping them, do you think?

Christina: 38:43

So the department of veterans affairs, when we first started practicing in this space. The average time for processing was just deplorable. You could submit an application Hanh and with receiving acknowledgement back that they were even working on the case could take six months. The government has stepped in and cleaned up the process a bit, the paperwork process. It's very rare for instance, that at a presidential level that our president gets involved with the VA. At that level, they tend to keep some degree of separation, but the paperwork was being so mishandled that the president stepped in, made some drastic changes across, administratively across the department of veterans affairs. And we have reached some significant improvements as a result of that. For us now, in office, we typically anticipate and tell our clients that we may have cases approved in as little as four weeks, but then we may have other cases that don't get approved from start to finish for four to maybe six months. We can never promise the timeline. But what we do tell them is that we are very proud of the fact that we have a hundred percent approval rate and that the benefit is retroactively paid from the first of the month, following the month, essentially that you submit the application for adjudication. So they are accruing that benefit while they're waiting for it.

Hanh: 40:11

So, here's another example, right? How do we amplify the service? Because if we're saying that there are families going through this alone and may not know services like Christina, I can imagine VA families may not even know of all services like yours. So, yeah, perhaps that's something that we should consider outside of this conversations, how to just amplify this and make it more known to families in need. What do you think Amy?

Amy: 40:40

I definitely think that's an additional area. My dad was a veteran as well. So having the ability. Now, one of the things, and around kind of people not knowing to gain access, or even look for services like this. Is I think a lot of people don't necessarily, we use the word caregiver. I don't think people necessarily say that they're just doing, I'm just being a daughter. I'm just being a son. I'm just supporting my family. And I think there's just a lot of people that say this is what we were just supposed to do. And they don't necessarily seek out resources. It's not "Oh, I'm going to go to a lawyer. I'm going to go to a financial planner, to help me figure out how to navigate with my parents." And I think it's also, I think there's generations right now that we're struggling with that don't necessarily want to get their kids necessarily involved. They don't want to be that burden. And so I think there's a lot of families are just challenged with the situation because they wait until it's too late to be overly proactive with it. So, I think there's that dynamic, like how do we make this more normalized and let seeking out help and trying to find resources is appropriate and that you're not failing your parents because you're trying to get some help?

Hanh: 41:51

Absolutely. You're not failing your parents. That's one, and there's nothing shameful as a family, as an individual as your parents, go through in this journey. I think that's huge. Too often we feel that we're alone and it's something to like, to be embarrassed about. Did you experience that and did you see that in your clients, both of you?

Christina: 42:13

Hanh. I, I definitely, I see it now. And one of the things that Amy was saying is that I think that helping or acting as a caregiver can look different. The hat that you put on can be in varying capacities. One of the services that we developed was this lifetime care plan or lifetime protection plan for our clients, because we did have parents come to us and say, I've gone through this with my mom and dad. I do not want my children to be in the same position. Christina, I don't want them sitting in this seat with you going through this same situation and all of the stressors and financial, grief that we've experienced with this process. So, I want to know how I can specifically avoid that. So, the plan that developed is that we essentially have a certain number of clients that come under our umbrella. They're still independent at that time, or they may be just now approaching a situation that they need some supportive services, but we come on board as an adopted extension of their family and that if anything changes with them medically, financially. We are there to address it at each stage of their life cycle. We have within our firm, obviously, succession planning that, if something should happen to us and we obviously have a certain, number of these clients that are under our umbrella, that we can continue to service them obviously through to end of life. And so I don't think that the caregiver role or that hat that you're wearing has to look a specific way. It doesn't mean that you have to be the one physically doing the bathing, the dressing the meal preparation, the supervision, those types. It can be as the organizer or the facilitator to identify those certain services that may be able to be plugged in and put into place to meet those needs. And to not have to feel that guilt associated with that. That's really what we want to be able to provide, to our clients. If we have clients that want to do those hands-on roles and those things, certainly we want to be able to make things easier so that they can do it. But if that's not their forte or not what their wishes are, or even what the parents' wishes are for their children, we want to be able to make sure that we can support them in that capacity as well. And to help them to understand it, doesn't have to look any specific way to act as a caregiver. You're still a caregiver, if you are the one facilitating and identifying other services that your loved one needs, you don't have to physically be the one performing them.

Hanh: 45:03

Thank you. Thank you. Do you have any thoughts on that, Amy?

Amy: 45:06

I completely agree, Christina, that I think there's a lot of misnomer about that, in order to be a caregiver, you have to be, managing those ADL's those activities of daily living. I think there's many different types of caregivers, financially supporting. I know big part of my role was really helping to get all the paperwork, everything taken care of, taking burden off of my mom, cause she was doing more of the day to day. And so I think, but some days I just thought I was a daughter. I didn't necessarily define myself as a caregiver. And so I think that's where I think a lot of people struggle as they don't necessarily,"I'm not doing that, so maybe I, maybe that's not going to help me.", or "I'm just paying a couple bills. ", or or " I'm just noticing some things with my mom. It's I'm not, we're not there yet." That's like the difference between like senior living, like "I'm not ready yet." And it's caregiver's thing is like, "Oh we're not there yet. We're not there yet." I feel like a lot of people say that. I think I even said that"We're not there yet. We're no, we don't. We don't need to talk about that. We're not there yet." So, I think there's, and then all of a sudden, their yet becomes tomorrow.

Hanh: 46:13

Yeah. Yeah. I got to tell you having gone through being a caregiver for my mom and dad, and then my daughter too. She cracked her skull in high school from a sporting event. But thank goodness, she's fine now. But I did not see myself as a caregiver to be honest I just felt that, I am the daughter, and that's part of my was part of my privilege is part of the role as a daughter and I wanted to do it. But never did I consider myself like, a title of a "Caregiver." I think it has a lot to do with what you don't know and when you're going through it alone, you think that's the role that you fulfill. It is rewarding because you get to be closest to your parents and it's also very, straining. But yeah, I got to tell you more and more folks are going to be on this journey. And I think I mentioned to maybe to you both offline is that, either we are a caregiver or a recipient of one. That's it that's something that's guaranteed.

Christina: 47:10

Oh, it's absolutely correct. And so for me, I feel fortunate enough that I've experienced things personally to help me better understand how to meet the needs, of our clients that are coming through the door in one capacity. And then also, dealing with it for my parents for a period of time. And I found that oddly enough, with the position of dealing my father was the last of our elders in our family who passed a year and a half ago, but his journey and struggle with the changes with his decline in his health. I had so many family members who were looking to me because of what I do in a professional capacity and saying to me, fix it, you can fix this. And, I had to play this role of yes, being professional, but also, as a family member, the emotional aspect of it. And that I had to allow him the privilege and honor and out of respect to make some of his own mistakes before I could step in to make things better in a professional capacity, as well as his daughter. That was something that was very new for me to walk through and to have to display that, to our other family members who were concerned, but didn't necessarily understand the process, in the way that I did because of what I do for a living. So that was a very big learning curve, I think for myself, even 20 years later in, in my career. So, when I say that I'm always learning new things, I'm very grateful, for that. And I still don't think, to this day for the fact that he has been gone, a year and a half, now that I've learned everything yet from his transition, to end of life.

Amy: 49:01

I was just going to your story there, Christina, just reminded me so much. It's like I was in the same situation as being a gerontologist. And I just remember just being like, I'm the daughter now I'm not a gerontologist at this point anymore because it's just, it's so different than being at work. And it being very, specific and "Oh, we have these steps.", and then you bring in the emotions of being the daughter. And I just was like, I took my gerontology hat and I just put it on the side at, during that time and just wanted to just be the daughter.

Hanh: 49:31

Yeah. I remember my sister telling me the day that she had to tell my dad that he had Lymphoma, she couldn't do it. She went in the car and cried and told another primary physician to tell him. But although later she, she took him home, but it's very difficult, to put on those multiple hats. Gosh, I appreciate both of your time. I've just, considering that we're talking about a subject that is very near and dear to our lives and in many lives. And I know we haven't met each other, but I feel like, when I just saw your either profile or content, I just knew that there was a connection. So, thank you so much for your time.

Christina: 50:19

Hanh, thank you so much, and Amy, both of you. I appreciate so much to know you, even in this capacity and that you're out there doing such wonderful work for people. It is needed. It's growing, in capacity. And certainly I look forward to staying in touch with all of you in the future.

Amy: 50:36

Yes, me as well. I felt like I've met some sisters that I just need to have in my life. I appreciate both of you for everything that you're doing. And as a fellow daughter and caregiver with dementia, with caring with somebody for dementia, I just respect you both so much.

Hanh: 50:52

I thank you both. And let's leave our communication open and let's come back. Let's continue this conversation.

Amy: 51:00

I'm in.

Christina: 51:01

That sounds great. Thank you all.

Hanh: 51:03

Thank you and have a great night.

Amy: 51:05

Good Night.

Hanh: 51:06

Bye-bye.