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Dustin:             Good afternoon, Sacramento. My name is Dustin MacFarlane and I'm here on Talk 650 KStE. This is going to be a great day. I'm happy to be here. I'm going to be in the studio today with Carol Kinsel from Senior Care Solutions.

                        Before I get started with Carol, I just want to tell you a little bit about who I am and what I do. I am an Elder Law and an Estate Planning ... Let me just try that again. I am an Elder Law and Estate Planning Attorney. Tongue-Twister there. That means that I help people with their Estate Plan, their Will, their Trust, Powers-of-Attorney, that sort of thing.

                        I focus my practice on helping families who are caring for seniors. When mom and dad start to get sick, it's not really about ... I don't care so much as who gets stuff when they pass away. That's really easy. My focus is always keeping mom and dad warm and safe. If you're a care giver, if your family member, whether it's a spouse, or a parent, or a grandparent, if you're taking care of somebody, there's somebody in your family who's getting older and needs a little more help, then give me a call. I want to make sure that you can always take care of them; that you can access more, that you can make healthcare or financial decisions on their behalf, you can sign agreements. Anything dealing with the care of a senior, that's what I focus on.

                        My phone number is 855-588-5887. Let me run that by you one more time: 855-588-5887. I know, a lot of repetition in there. Hopefully, you'll get that and I'll give it out several more times.

                        Today, I have Carol Kinsel with me. Carol is the owner or co-owner of Senior Care Solutions in Fair Oaks. Carol, good afternoon. How are you today?

Carol:              I'm fine, Dustin. Thanks for having me back.

Dustin:             Oh, I am so glad you're here. Today, let's talk ... First of all, tell me, or tell everyone what you do?

Carol:              Dustin, we do a lot of things. We are a resource center for seniors and their families in the Sacramento region serving five counties. Our job is to meet with families, talk with families and help them decide what they need in their journey. If your mom is in a situation where she's in the hospital and can't go home or needs to go home with care, what does that look like? How do they do it? We give them the tools to be a smart consumer.

Dustin:             What I have found is that when people come into see me, this is the first time that they've dealt with caring for a senior. How long have you been doing this?

Carol:              Dustin, in January we celebrated our 18th Anniversary.

Dustin:             Okay. You started by actually taking care of your parents.

Carol:              Exactly. My dad had Alzheimer's. He lived with us while we were raising three young kids. It was pretty much a disaster. I won't sugar coat it. It was the most difficult period of my life, but it gave me the passion I needed to do the work I do today.

Dustin:             I think that is fantastic. That's what I think is really great too is that it's nice to have a place to go and get some advice with experience behind it. Not only do you have the personal experience, but doing this now for 18 years, this is not your first rodeo. You have seen everything. Well, we like to think that although, I think through the front door new stuff pops up every day. You've seen a lot and you're able to say, "These are your options as far as taking care of that parent."

Carol:              Yeah and I appreciate the fact that everybody that walks through our doors is different. Their family unit is different. They process things differently. Their story teaches us new things every day. We take that into account when were helping other families. We don't have a cookie cutter process. We work with families individually.

Dustin:             I think you're right. There is no cookie cutter process, but at least you've dealt with the emotion of it before and you've dealt with the various options. Carol is a fantastic ... I think you're a great resource and I've sent many clients over to you. All of them rave about being able to get the answers they need on how to take care of their loved ones.

Carol:              The majority of the answers to ... And just so the listeners understand, is we primarily keep our doors open by folks that are making moves into assisted living communities. It's important to us that we support people at home, also. We're going to be the first one to tell you, "You haven't tried in-home care? Why aren't you trying that first?" We're that neutral party that wants you to make the best decision. It's not just about making a move, but when people do have to make a move, we have interviewed and toured all of the communities in the region. We are not going to review you to that community if we haven't.

Dustin:             That's fantastic. Today, what I wanted to do is maybe a little different. I want you and I to have a conversation as if I'm going to be taking care of one of my parents. I'm not to far off. I'm one bad fall away from actually doing this, I think. My parents are both under 70, but I have a grandmother who I dearly love who lives right here in town. She just ... How old is she now? Born in 28. So what's that put her? 87 or something like that. 86 or 87.

                        This is a conversation that I can really be having with you. I wanted to sit down and go over this. If we were to talk about, if my grandmother, who lives here ... She lives alone. She is 87. She's probably 100 pounds soaking wet. Just a cute little old lady. Very independent. Does not want to be a burden on anyone. Would rather sit on a pile of rocks or broken glass as opposed to inconvenience anybody. She just is giving and giving and giving and giving. She's spent a life helping and caring for family members and now it's our turn to turn around and take care of her. If she were to ... In wanting to be independent, she lives alone in a great little mobile home park, a senior mobile home park. She has a little friends and she has a social network.

                        If she were to fall today, and break a hip, and not be able to live alone. If I came to you with those basic fact pattern that little old lady is in the hospital and the doctors are telling me what? She can't go home alone. She's got to go somewhere. I work full-time. What are some of the options that I have?

Carol:              First thing I would do is I would ask you Dustin, I'd go, "Okay, tell me a little bit about your grandma." I need to know what her personality is like. I need to know who are the members of the family that are helping on this journey.

Dustin:             She is the matriarch of the family. She's the glue that holds it together. She has five children. They're spread across the country. She has two daughters here in town. One, my mother lives just a couple miles away and probably could take care of her. The other daughter, my aunt, is in town also but has some medical problems herself and is probably not physically able to take on being a caregiver when she is taking care of her own personal medical problems.

                        I'd also say, my mother ... I'm the oldest of five children so my mother gets around to all the kids and grandkids pretty frequently too. Making her a caregiver is an option, but it would really limit the time that she can spend with her children and grandchildren which she does on a very regular basis. In fact, yesterday, she drove five grandchildren across the country to go have a happy, fun time with cousins.

Carol:              That's how I want to age. Way to go grandma.

Dustin:             It is a good way to be.

Carol:              Oh my gosh.

Dustin:             It is a great way to be, but if she had to be the primary care giver, that life would come to screeching halt.

Carol:              Absolutely. I think to know what grandma wants and have that conversation before this hip fracture ...

Dustin:             I wasn't watching the clock. We're going to take a quick commercial break. We're going to be right back. My name is Dustin MacFarlane with Carol Kinsel on Talk 650 KSTE. Stick around.

                        We're back. I'm Dustin MacFarlane here on Talk 650 KSTE with Carol Kinsel. Let me give you a phone number here in case you want to get a hold of me or Carol. The phone number is 855-588-5887. That's a toll free number. Again, and a little slower 855-588-5887.

                        All right, Carol. We've laid the ground work. My grandmother ... Those of you who are listening. This is just a vignette, so if you know my grandmother, she really didn't fall and break a hip. Don't worry about it. My grandmother has fallen. She broke a hip. She's in the hospital. I went through some of her background. What other questions would you might have for me? Where should ... Anyway, you take ...

Carol:              Dustin, this is probably one of the most common calls we get. I am lost, I'm a deer lost when the headlights. I don't know what to do. My mom's in the hospital. They're telling me she's going to be discharged. The first thing I want to talk to families about is, if it's a crisis and if you have limited time, we really need to kick into high gear to understand, did she have surgery? Likely she did, unless they chose not to for whatever reason. Two, she'll be going to a rehab center, a skilled nursing facility under Medicare most likely. What are your options?

                        Where do you live, Dustin?

Dustin:             I live in Fair Oaks and she lives in Folsom.

Carol:              Somewhere that's reasonable for family to visit. Who are your support members of the team that circles around grandma. You're going to have a handful available. The Discharge Planner in the hospital is going to come to you and say, "Dustin" or your mother, whoever is the key person, " You need to be prepared because we're going to discharge her soon."

                        Be ahead of the game. I'll give you some information on which skilled nursing facilities surround you. Also, medicare.gov to look for their website ... At the website to see how they're doing on their surveys and ask the right questions when you're there. Also, the Discharge Planner will let you know who has beds available.

                        The first step to getting grandma our of the hospital is, you have to pick a place for rehab. A lot of times, that's a daunting task in itself, because your dealing with the emotions of seeing grandma decline all of the sudden.

Dustin:             And to have to go to a senior care facility. Let me just ask this, why can't she come home with me? If me and my wife want to just take care of grandma, is that a good idea? She's just fallen, she just had hip surgery. Can I just bring her home because I can't bear to ... I promised her I would never put her in quote, "one of those places." Can I do that?

Carol:              You absolutely can.

Dustin:             What's the down side?

Carol:              The down side is, you're going to need 24 hour supervision, most likely initially. Most folks are not equipped for night care, day care, the round-the-clock care with somebody that's medically compromised.

Dustin:             When you say 24 hour supervision, you mean I have to ... Because I have to help her toilet and bathe and dress, because she's non-ambulatory, non-weight bearing.

Carol:              She's non-weight bearing for several weeks, because of the hip fracture. You need to ask yourself, do you have the tools? Is your house set up for this type of care? You will likely have ... Home health will follow you with physical therapy, but she's got limited therapies available to her until she is weight-bearing.

Dustin:             Unless she got into a rehab center?

Carol:              Exactly.

Dustin:             Then, it's okay. We're touring rehab centers.

Carol:              You're touring rehab centers. We get you some options and you decide, "I want facility x because it's right next to mom and she can advocate and I can stop by on the way from work, on the way home, and be a part of the process. Grandma's going to go to rehab. The admission process, the first few days, you're figuring out what it feels like. When the staff changes, how much care she needs. You're grandma's alert and oriented, so that's a good thing. She can advocate for herself. She can push that button.

Dustin:             That, she will.

Carol:              Good.

Dustin:             She's a tough woman. She refuses Novocaine when she gets fillings in her teeth because she doesn't like taking medicine. Maybe you can get her to take a half of a baby aspirin.

Carol:              She's not going to like the pain meds they give her for her hip fracture either. I guarantee it. She will be able to push a button for help. Where we get into problems with folks is when there's dementia diagnosed and they can't advocate for themselves. They can't ask for help. Sometimes, that ... But you don't have the issue. Grandma's alert and oriented. She will most likely be in the skilled nursing facility an average of three weeks. You're going to come to me and say, "Grandma's not ready to go home. Why are they discharging her?"

Dustin:             She's had her therapy, but she really can't walk across the room yet.

Carol:              [crosstalk 15:45] What are we going to do now?

Dustin:             What's going to happen now?

Carol:              No, what happens is, Medicare will keep her so long and then they can't continue rehab for her until she is ... The doctor has deemed her to be weight bearing a certain percentage weight bearing. There's this gap of services. Then, you have to figure out when they discharge, where she's going to go. Dustin, does your grandma have the finances for 24 hour care to go back to her mobile home?

Dustin:             She does not. She does not.

Carol:              Mobile homes pose a different problem and that's with steps. Usually it's a little ... The spacing is in the halls and the bathroom is a little tight.

Dustin:             Everything's small.

Carol:              Everything's small. Because of that, some of the homes can't be retrofitted for care appropriately.

Dustin:             I don't know that a walker would easily fit through the doorways.

Carol:              Some of the newer ones are really nice and more spacious. If an older one, and I assume she's been there for a number of years?

Dustin:             Yeah, it's an older mobile home.

Carol:              That's something to take into account. She is going to want to go home. There's no ... Everybody does, but it is realistic and is it going to be the best choice for her?

Dustin:             Is it safe?

Carol:              Is it safe? Oftentimes, when the patient is discharged after a hip fracture, we do what we call an interim step. If they are going to go home, maybe they're not ready to go home yet. We would try to find an assisted living facility for respite stay, which is a short stay that's billed day-to-day until the patient is ready to go back home. That's something you and family members, of course with grandma at the hub, would sit down and decide.

Dustin:             Could she go, instead of an assisted living, if she didn't have the finances, could she go to a family members home at that point?

Carol:              Absolutely.

Dustin:             She's maybe 50% weight bearing, she could use a walker, she can dress and bathe if she can sit on the chair, a shower chair.

Carol:              Absolutely, I had my own mom in my home after a massive stroke and we cared for her until we got her stable enough. She didn't want to live with family. She wanted to be social, so we moved her to assisted living after we felt she was stable enough to leave the home.

Dustin:             You're asking me the questions, but how did that conversation go with your mom. She didn't want to live with you anymore than ... Not to say you didn't want her there, but she wanted to be independent.

Carol:              She did. She was much like you're grandma. She made it very clear early on that she didn't want to be a burden on any of her kids. We did move her in, and we have every time she's had a hospitalization, she's did a short stay with us at home until we got her stabilized which you might consider for you grandma. Maybe your mom is comfortable taking her in. Or you are until we get her back on her feet again and see what her new baseline's going to be.

Dustin:             That's interesting because we think that we've just go this care and everything will just magically resolve itself. I don't think anyone really has this plan in mind.

Carol:              People, they might turn the show on today and go, "Oh, you know, We're good. I don't need to listen to that." Guess what? This time next week, you might find yourself in a totally different situation. Understand you have options. Let's say, your mom goes to the skilled nursing facility and grandma discharges home with mom.

                        I advise strongly that mom hire a caregiver to help her, because she is going to be one busy ... Because the caregiver themselves, burns out. Your mom is the caregiver of your grandma. She's is going to be a prisoner in her home, taking care of mom. Mom likely, shouldn't be left alone for safety reasons until she gets stronger and up on her feet again. What I see is families don't get the support they need when they go back home. Medicare will cover home-health to follow her, but that's only very minimal.

Dustin:             That's really not help. It's just checking on her medical ...

Carol:              It's nursing oversight and then you have your physical therapy, occupational therapy, and speech if it were be needed. Sounds like your grandma's got the speech dialed in.

Dustin:             Yes she does. At this point, yes. She goes home. Family should really consider caregivers then. The way I look at it, my mom is, let's just say not as young as she used to be. How does Dr. Laura say it, "Her twentieth anniversary of her fiftieth birthday party?" No, not quite there but that's a lot of work to take care of somebody. I give her my 7 year old daughter for the day and she's exhausted.

Carol:              I've done it multiple times so I can tell you what it did to me physically and emotionally without support. I'm the first one to tell people, "You need to get help if you're going to do this." Let's say you do, you hire a part time caregiver ...

Dustin:             Let me stop you right there, you hire a part time caregiver.

Carol:              A part time care-giver. If the finances allow, we always suggest going through an agency because they're insured, bonded and you're protected.

Dustin:             The people are trained.

Carol:              You're not the employer. There's a certain amount of training that is offered to the care staff when they're hired. You don't have to hire and fire. The company you employ does. '

Dustin:             Let me stop you right there. We're going to take a commercial break. I'm Dustin MacFarlane here with Carol Kinsel. My number 855-588-5887, give us a call if you want to talk to Carol or Dustin. We'll be right back here on Talk 650 KSTE. Stick around.

                        We're back, I'm Dustin MacFarlane here on Talk 650 KSTE. My phone number, or if you want to get a hold of me or if you want to get a hold of Carol, the number is 855-588-5887. I'm here. I'm an Elder Law and Estate Planning Attorney. I focus on taking care of seniors and really making sure that they're family can take care of them, make all their legal and financial, and health care decisions.

                        I'm here with Carol today and we're talking about my grandma. This hypothetical situation. Carol, before we go on, tell everyone again, just a little bit about your company and what you do. For those who just maybe tuned in.

Carol:              Okay, Senior Care Solutions has been around for 18 years in Fair Oaks. We are a resource center specializing, excuse me, in care options for families for geriatric care managers who walk through the journey with families and help them with the tools to make wise decisions.

Dustin:             That's what I love because you've done this enough times that you know what questions to ask. That to me is the hardest thing. Walking in, if I'm buying something for the first time, whether it's a service or ... If I've never experienced that before, I don't even know what to ask. You don't know what you don't know. That's why I think everyone should work with you. If anyone's taking care of a family member, they've got to give you a call. If you want to reach Carol, again, call 855-588-5887.

                        We're talking about my grandmother. If she were to have a stroke ... Or I mean, break a hip, she goes to the hospital, she gets discharged, goes to a rehab center and then comes home from there not quite ready to live alone again, so she goes to live with my mother who is in her mid-sixties, who's retired. Again, now start from there. What does mom need to look for or what does my mother need to really focus on?

Carol:              Your mom needs to take care of herself as a caregiver also. As I stated before we went on break, you need to hire help in the home. Typically, families start out gung-ho and everything's going to be great and then all of the sudden, the care giver or care givers start to get tired. Supporting yourself and realizing where your line in the sand is as far as, how far can you take this. I've had families take care of loved ones for 10, 12 years and their home. My hat is off to them. That's amazing, but the majority of the people don't last that long. It's hard. Depending on the acuity involved as far as the care level goes ...

Dustin:             So, how much care they have to provide.

Carol:              Let's say grandma is at home with your mom and they're trying to decide what to do at this point. Grandma wants to go back to her home. The doctor's telling her they're not advising that for safety reason. The reality is, she probably doesn't have the finances to support 24 hour care in the home which can run you anywhere from $400 to $500 a day in today's world.

Dustin:             Which is a lot. Most people just don't have that laying around the house.

Carol:              Yeah, it's very expensive and recent legislation has driven the cost up for the consumers. She has a home that isn't able to be retrofitted for care. She doesn't have the finances to support care. We need to look at the best option for her for quality of life and to offer her socialization, because she's a social, active, engaged woman.

Dustin:             Absolutely, even to this day you can't get an appointment with her. As a grandson, I can't get in.

Carol:              Yeah, so that's what we would look for. She obviously wouldn't do good in a small setting because she needs more activity and more people around her. At that point, I would come into your home and I would meet with grandma and I'd say, "Grandma," of course, I don't know her first name and I wouldn't call her "Grandma," but, "What do you want?" And grandma would probably say, "I want to go home." I said, "Yeah, that's what we all want." Maybe it's not going to work. If it doesn't work at this point. "Tell me about yourself. What kind of lady have you been? Are you a wash and wear kind of lady? Are you glass and brass?" Some people have a beer budget, but they have a champagne appetite. That's where we run into a little bit of problem.

                        Bottom line, we would look at options and not give long list of options, but things that would be appropriate for your grandma and help you and your family strategize to make this move successfully. It isn't have to be a final move so if it doesn't work, we tell grandma, "Grandma, let's just try this. If it doesn't work, we'll make other arrangements." It isn't set in stone. We don't have to sell your mobile home right away. Let's just try this until you get stronger. A lot of time, we see people, very surprised at how well it does go. The anticipation of making a change is the most different thing for families. They're afraid she'll never adjust, she'll never do this. Guess what? Most people do.

                        My dad never adjusted because he was just that kind of guy. He was going to make sure everybody was miserable along with him. He's been gone for many years. God bless him. My mom adjusts over night. It's just the personality. You do your best as a family. It's going to be hard on your mom because your mom is taking care of her in her own home. She's going to feel like she's throwing in the towel.

Dustin:             That is, I think a big concern of mine is not that my mom doesn't want to take care of her but maybe it's just can no longer do it. Just physically exhausted, just ... It's not about mental toughness, it's just about, is it going to be detrimental to my mom? Where I think if she got help, or if grandma went to live somewhere else that could do all the heavy lifting, then my mom could just be there every day for the fun.

Carol:              For the fun and be the daughter.

Dustin:             Exactly.

Carol:              One thing we didn't mention is you have several siblings involved here, are circling around the wagons around grandma. Even though some are out of state. That can pose a significant issue because everybody sees things through different eyes. Early on in this conversation, I think it's important that everybody hears what grandma wants. Also, meet as a family to, Who's going to do what? To identify on the team. Give everybody a little job if possible. Those that aren't going to be a part of the team, put their little comments in a little box on the side because you're going to get comments from folks that aren't involved.

Dustin:             Why aren't you doing this?

Carol:              Why aren't you doing this? Or, why did you do it that way? Just know that you're doing your best. Everyone once in a while, I work with families and everybody's on the same page. It's the most wonderful, wonderful situation and I just applaud them that it's rare, to [crosstalk 30:37].

Dustin:             I think you're right. I think that is rare.

Carol:              Well, you see it in your legal practice.

Dustin:             Last week, I sat down with a gentleman who was taking care of ... It was his turn. Three kids. Daughter had dad. He has full dementia. He's been dementia for over ten years. Daughter had dad for five years. Went to another daughter in a different state who took care of dad in her home for five more years. She is spent and now she called her brother and said, "It's your turn."

                        Which dad came down to visit to be with brother and he said, "There's no way. I'm putting him in a care facility. This is just above my pay grade." That's just the stage he's at. Father was over 90 and he's a tough old codger, but he was really hard to care for and that's every one in the family was on board with the care which made it much, much easier.

Carol:              I have great respect for the senior client that I'm helping. It's all about listening to them and treating them with dignity, but also looking at the family, the caregiver and understanding their role. Having been a caregiver myself, off and on for the last 20 years. It's daunting and you get warn out.

Dustin:             You do. We're going ... We have one more break, or one more segment after this. We're going to go to a commercial break. I'm Dustin MacFarlane and I'm here with Carol Kinsel. Carol's with Senior Care Solutions in Fair Oaks. If you want to talk to Carol about your family or your care for your loved one, give her a call 855-588-5887. Again 855-588-5887. My name is Dustin MacFarlane. We're here on Talk 650 KSTE. Stick around. We'll be right back.

                        We're back. My name is Dustin MacFarlane. I'm an Elder Law and Estate Planning Attorney. I'm an accredited attorney with the V.A., which means I can help seniors get some benefits that help subsidize assisted living or home care. I'm here with Carol Kinsel. Carol's with Senior Care Solutions and Geriatric Care Management, helping people navigate senior care, really right?

Carol:              It's a maze. It's a maze and most people don't until their entrenched in it, realize how difficult it can be to figure out.

Dustin:             I always just get a kick out of ... Even just trying to talk to people about Medicare or about where they should live. There couldn't be anything more complex than senior care, how to pay for it, what facility to go to, what questions to ask. I think you are a godsend and you just answer ... You help families take care of their loved ones and it's what you do.

Carol:              Thanks, Dustin. It's important to me because I was that lost person in the maze with my parents and there was nobody to help me back in the 90s. It was like, I was lost. I remember that feeling. Bottom line is, you do have options out there. If you turn to somebody that knows what they are and can at least minimize your stress and your search and educate. You're going to make wise decision or do the best you can anyway.

Dustin:             What I have noticed is that when I drive around town ... We've been talking about this vignette about taking care of my grandmother who hasn't fallen but if she had fallen and broken a hip, just the different care options. When we broke off, we said she'd been living, hypothetically who'd been providing care, but my mom was just exhausted and could no longer provide that care. Then, really the option is, she goes to another family member or she, and this may work really in a lot of cases, goes to a senior care facility. I've driven around town and so have you. There are just, I won't say hundreds.

Carol:              There are.

Dustin:             There's hundreds of options. First or all, just kind of go through quickly and the various levels of care that I'm going to be addressing. I think more importantly, once we identify the level of care, whether it's independent, or assisted, or memory care, or skilled whatever we're dealing with, what questions do I ask when I walk in the front door. If I just say, "Do you take care of old people and can you take my grandmother?" Of course, as long as I have a check book, they're going to say yes.

Carol:              Most of the facilities I really believe in my heart that they're going to accept residents that are appropriate for their building but I get what you're saying. They don't know what they're ... You don't want to be touring a memory care facility for grandma ...

Dustin:             If she doesn't have ...

Carol:              If she doesn't have ...

Dustin:             Well, she did forget my birthday last year.

Carol:              Yeah, well, that doesn't count. Anyway, you're options are ... We have hundreds of assisted living options and [boarding 38:37] care facilities, and those are all termed residential care facilities for the elderly or CFEs. You're going to see that term thrown out. It is also known as assisted living, [boarding 47:30], care, elderly care facility, congregate living, retirement community. All these things can mean the same thing. It's likely that your grandma is not going to be appropriate for independent living any longer, most likely.

Dustin:             There's no care in independent living. I mean , there's no ...

Carol:              You can live independently. Typically, if she were to go to an independent setting, we'd want her to have meal prep, a meal plan and housekeeping. Then, she could hire a caregiver to help her part-time.

Dustin:             The facility is really just a nice apartment complex that has housekeeping and makes meals.

Carol:              And activities and some transportation. If she's not recovering as well as hoped with her hip fracture and it looks like she's going to need some assistance with dressing and ambulating and she's a fall risk continuing. We're going to look at assisted living. She's a social lady. We're going to look at options that offer her socialization with activities.

                        For instance, my mom is in a setting and her activity is meal time. She's at lunch for an hour and a half and dinner for an hour and a half every day. That's three hours a day that she's socializing and interacting with other people.

Dustin:             And happy and enjoying life.

Carol:              I want her to be more active than that but that's her choice. The dining experience is a social setting, is the social setting for the individuals plus they have full activity calendars. You can be as private as you want in these settings or you can be as social as you want. Some people attend everything. They're out of the room all day long and some, like my mom, just go to the meals and the music. It's very individual and to understand what grandma wants and what she likes, she wants bible study, maybe she'll start a bible study group on site.

Dustin:             She may, knowing her.

Carol:              They're looking for people like her to be engaged in assisted living. It's also important to choose a facility that you can grow with care needs. Hopefully, you don't have to be relocating again. Sometimes finances dictate that. Choose wisely initially. Pick something that you can afford for the long run. Also location where family can be popping in and be in a part of her life. This is her home. She can come and go as she pleases as long as she checks out, she's not in jail. It's a social [model of 41:22] care versus a medical model and skilled nursing.

Dustin:             If I walk in into one of the larger, the big building type of assisted living facilities, what am I going to ask them?

Carol:              You'd have a tour set up. You call ahead, you set up a tour. We can schedule that for you or take you there. It depends on the individual. They would start by asking you questions. You're just taking it all in. I tell folks, a good time to visit is around meal time, noontime, because you sell all the residents out of their rooms. Otherwise, some will be in their apartments so you might not get a good sketch of the residents that live there.

Dustin:             Who's there.

Carol:              Yeah, so you're going to be asked a lot of questions. Typically, you'll sit down at a table with their marketing director who will give you a tour. They're going to start by asking questions and then you'll go on a walking tour of the community.

Dustin:             We just have about four or five minutes left. In the last few minutes, what are some kind of tips that you can give on planning for care for a loved one. We've been talking about my family. There hasn't been a crisis yet, and if there is a crisis just like everyone else, if we don't have a plan everything's going to be done in an emergency setting. We've got to make decision now because something's going to happen and we don't ... How to plan for this, some tips for families.

Carol:              People know when things are starting to change, people know but they tend to be in denial or they don't want to talk about it. It's a difficult conversation to have. Sit down with your family and talk about what you would want if something happened. Grandma hopefully would sit down at the next Easter holiday or a holiday where everybody's together and say, "You know, this is what I want if I can't stay in my home." Plan. That way, your children will know what you want. My mom told me you're going to take me out by my feet so I'm not going to be looking at anything.

Dustin:             That's right, out feet first. That's right.

Carol:              Yeah. We pretty much had to and that was very difficult on us because she wouldn't give us any input. We did the best we could.

Dustin:             I think we think everyone's like us when ... I don't know. For my family, what's difficult is that everyone says, "Oh, I'll take care of you, Mom." I, in fact, opened this conversation with my family about two weeks ago. "Grandma, what do you want when things go south?" Everyone first jumped to death. I said, "You know, stop for a second. The problems is, we don't just die. Some people are that lucky that they're just going along in life and they have something happen at the end of their life and it's just kinda lights out. I think, I count that as the lucky ones, but most of us are going to be sick for a number of years and we'll just be kinda dead. We're going to need help." So I said, "What is your plan," which my mother jumped in and said, "Oh, don't worry Mom, I'll take care of you."

Carol:              You've got to be careful about those words because you should include that to say, as long as I can.

Dustin:             Or, I'll make sure I'll do ... I'll visit you every day, or I will make sure that you're in the softest level of care or in the place that feels most like home.

Carol:              I think people, they need to realize that when they do have a loved one move into a senior community, their job isn't done. It's a lot of work advocating and overseeing care. I just got back from the emergency room late last night with my mom. It's ongoing. You're still a caregiver. At least you go home and you sleep at night. You have your space which I cherish that now as a working person and I don't have twenty-four hours a day to commit.

Dustin:             I think what people really need to do is give you a call and go over that family plan.

Carol:              Yeah, what is your plan?

Dustin:             Everybody needs it. Even for my family, my little family, my little kids, we do a fire escape plan and we ... I set off the smoke alarms and we have a place we're supposed to meet. The kids know how to open a window, they know how to kick off the screen, and they know how to run to meet at a set location so I don't have to frantically run for them if there's a fire. I pray there's never a fire, but we go through the drill once or twice a year and we do that because if there's a crisis, all the kids know what's going to happen and what ... I know what to expect from them, as well.

Carol:              Well, Dustin, we plan for everything in our lives. Vacations [crosstalk 46:19]

Dustin:             This is not planned for.

Carol:              People don't plan for their care. I think that I'm seeing a change, I'm seeing more people with long-term care insurance and think people are changing. Reality is, don't put it off. Sit down and talk with us and you'll walk out so much more empowered than when you walked in the office.

Dustin:             Everyone, I'm just going to give out the number again. My name is Dustin MacFarlane. I'm here with Carol Kinsel. Carol owns and runs Senior Care Solutions in Fair Oaks. The number you can reach either me or Carol is 855-588-5887. Again 855-588-5887. We're at the end of our hour. Thanks, Carol.

Carol:              Thank you, Dustin. I look forward to coming back.

Dustin:             We'll see you next time on Talk 650 KSTE. Have a good weekend.