Now or Never: Long-Term Care Strategy with Kosta Yepifantsev

Caring for the Caregiver with Elizabeth Miller

March 07, 2023 Kosta Yepifantsev Season 1 Episode 26
Caring for the Caregiver with Elizabeth Miller
Now or Never: Long-Term Care Strategy with Kosta Yepifantsev
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Now or Never: Long-Term Care Strategy with Kosta Yepifantsev
Caring for the Caregiver with Elizabeth Miller
Mar 07, 2023 Season 1 Episode 26
Kosta Yepifantsev

Join Kosta and his guest: Elizabeth Miller, Certified Care Consultant and Founder of The Happy Healthy Caregiver, a resource hub, podcast, and community of caregivers growing and sharing tips, resources, and support to create happier and healthier lives for caregivers.

Today we’re talking about how to care for the caregiver.

In this episode: As a caregiver, how do you manage caregiver stress and avoid burnout? What’s the greatest challenge facing caregiver’s today? What should we do when personally providing caregiving support for our loved-one is no longer an option? 

Find out more about Elizabeth Miller and The Happy Healthy Caregiver:
https://happyhealthycaregiver.com/

Find out more about Kosta Yepifantsev:
http://kostayepifantsev.com/

Show Notes Transcript

Join Kosta and his guest: Elizabeth Miller, Certified Care Consultant and Founder of The Happy Healthy Caregiver, a resource hub, podcast, and community of caregivers growing and sharing tips, resources, and support to create happier and healthier lives for caregivers.

Today we’re talking about how to care for the caregiver.

In this episode: As a caregiver, how do you manage caregiver stress and avoid burnout? What’s the greatest challenge facing caregiver’s today? What should we do when personally providing caregiving support for our loved-one is no longer an option? 

Find out more about Elizabeth Miller and The Happy Healthy Caregiver:
https://happyhealthycaregiver.com/

Find out more about Kosta Yepifantsev:
http://kostayepifantsev.com/

Elizabeth Miller:

So a lot of times stress can be related to some kind of worry well naming what the worry is and then trying to take a step or an action towards that worry. You know, if you're worried about the companionship if you're worried about safety, like what's one thing that you could do to try to mitigate that but then trying the different things on like, it's you know, I started saying the beginning about how it was like a game for me where I would just like pay attention to what people were talking about that was making them feel like that was a stress relief. And I thought, well, people talk about this all the time. Let me try this or let me try that.

Caroline Moore:

Welcome to Now or Never Long-Term Care Strategy with Kosta Yepifantsev a podcast for all those seeking answers and solutions in the long term care space. This podcast is designed to create resources, start conversations and bring awareness to the industry that will inevitably impact all Americans. Here's your host Kosta Yepifantsev.

Kosta Yepifantsev:

Hey, y'all, this is Kosta. And today, I'm here with my guest, Elizabeth Miller, certified Care Consultant and founder of The Happy Healthy caregiver, a resource hub, podcast and community of caregivers growing and sharing tips, resources and support to create happier and healthier lives for caregivers. Today, we're talking about how to care for the caregiver. To start, will you tell us about happy, healthy caregiver, how you became a family caregiving advocate and what attracted you to this industry?

Elizabeth Miller:

Well, it wasn't necessarily something I intentionally set out to do. It was a need that I saw through my own personal experiences of being a family caregiver. So I cared for my parents who had chronic comorbidities. And also I have an older brother that has a developmental and intellectual disability. So I've seen caregiving from many parts my entire life, but things really started spiraling from my husband and I in 2014, when we were working full time, and we were raising our own children, and caregiving for our family members started to really take a priority and we were losing our minds. And I kept kind of turning for places to go that could help me provide support and resources to help me through this really difficult season of my life. And I was coming up empty.

Kosta Yepifantsev:

It's astounding, because you would expect that, you know, something as important as providing like, care for a human being, you know, it's like doing your taxes. There's an h&r block on every single corner, right? But there's really nothing out there. So when you made that realization, like I'm on my own, like, what do you How did you climb out of that hole? Essentially? Yeah,

Elizabeth Miller:

I mean, my personality is definitely like a roll up your sleeves and figure it out. Yeah. So but I at first, I didn't go there first, I was just starting to kind of wither and lots of tears and frustration. And then I thought this is this is not how I want to live my life. And I'm also very, you know, it's apparent that little people are watching me on how I'm living my life and potentially modeling that. So I just started writing was basically what I was doing to, to help provide some emotional relief for me and kind of just process what was going on in my life, it was something I had studied way back in college, and then have always been trying to write and do something as a way to kind of heal and process things. So that was my first kind of endeavor in it. And then it became kind of a little bit of a game I was playing with myself, frankly, about like, Okay, if I want to I see these people that I'm caring for that have made different lifestyle choices that have put me in, in this situation. If I keep putting myself last on this list, I'm going to keep I'm going to essentially repeat the same cycle for my for my kids, and my husband and I had this intentional conversation and really decided that that wasn't something that we were willing to do. So we had to try on different things that were self care for us so that we could tell a different story.

Kosta Yepifantsev:

Yeah, I mean, was it a significant transition? Like, has your life changed? dramatically since this experience?

Elizabeth Miller:

Yes. It changed my career, frankly. Right. So I did it and strategy made a really nice living doing that. And I immediately thought when I started, became a primary caregiver for my mom, like, I've got to figure out how I can have full time flexibility. This is not this is not sustainable. For me. This is not viable. And that was where the business ideas started is like, Look, I'm not the only one in this situation at the time. I didn't know but there's you know, 53 million plus caregivers, just us alone family caregivers. So but at the time, I just knew that this was something that was going to come into people's lives. But now Now it's my full time job since 2021. And there's a growing need for it. You know,

Kosta Yepifantsev:

it's that's 15%. Right? Yeah, that's, that's 15% of the US population. Yeah, I

Elizabeth Miller:

think it's one in one in five. Wow. Yeah.

Kosta Yepifantsev:

Yeah. 20%, I guess, wow, a

Elizabeth Miller:

lot of people are, you know, 60% of caregivers are working. Yeah. And that's where, you know, being a caregiver and being a caregiver on top of that. So, you know, it was definitely like I had added another part time job on to my life. And that was even with my mom in an assisted living community. You know, that is a misnomer, that there's not a caregiving role for those people, there's still a significant caregiving role, and a massive expense, right. So the even more of the reason why I needed to keep working. And you know, I'm excited that employers are paying attention to really investing in their employees who are working family caregivers, trying to provide the support and resources to help them.

Kosta Yepifantsev:

Absolutely. And so you touched on a few things that you did like riding, having those intentional conversations with your family, to promote your own self care, what other things can you offer our listeners, so that caregivers can find balance and also emphasize self care for themselves?

Elizabeth Miller:

I think at first, you know, I thought a lot about physical self care, like eating right and exercise. But it's self care for caregivers goes way beyond that. It is about you know, asking for help creating your care team of people doing things that are going to help simplify your systems that you have how you care, and put those into place. That's so it's not just the physical self care, it's you know, emotional through meditation and yoga and writing, it's spiritual, it's social, through connecting with other caregivers practical through getting your care team set up, setting boundaries, all kinds of things. So you know, when when I say happy, healthy caregiver, like it's not necessarily about those weekends away and the the respite that we all are kind of craving for, but really the intentional things that we can do in our everyday life to kind of microdose self care so that this can be a sustainable journey.

Kosta Yepifantsev:

Can I ask you a question? That's kind of I don't want it to be complicated, but it may come out complicated. So I've never been a caregiver. But I do have kids, right. Yeah. Yeah, I mean, I have so obviously, in the in the business that my wife and I own, you know, I've worked on shift before, and I've provided the same tasks. But being a caregiver for a day is much different than being a caregiver for years and years and years, right. I have kids, four of them, that are eight and younger. So it's a lot of work. And I understand as you're, as you're explaining it, I'm thinking to myself, like, yeah, those are all things that I also have to do for myself, like, you have to find time to exercise you have to find time to be grateful and be happy and be in the right mental state. So this is why I feel like this question may be somewhat complicated. When you spend so much time taking care of your children, raising your kids just to arrive to the stage in your life where you were expecting some freedom, I guess. And you then end up having to take care of your parents, without many resources at all similar to I mean, is it fair to say that there's more resources for kids than there are for for the elderly, for the elderly, individual?

Elizabeth Miller:

I mean, I think for sure, because people people go into that role, first of all, like, usually not by accident. But there's so many books, and there's so many things and it's so a time of celebration, right? When you're when you're having a bringing a child into the world, and people are identifying role, right with the role of being a mom or being a dad, whereas being a family caregiver isn't something that necessarily people are owning that role. And then I think if they are kind of unwilling to accept that role, then it is more difficult to find the resources and support that are gonna help them and you know, I think to your point, yeah, is there resentment of course, and I think that there you know, one of the things we don't talk about sometimes is a lot of the negative emotions that go are with caregiving. And yet yes, and like there's a lot of joy that comes in that caregiving moments to like, I mean, I had the the gifts of spending a lot more time with my parents and And during their final act of life than I potentially would have they, you know, just something suddenly happened to them before they, they passed on. So it's, it's both I think, I think very, it's not often that there's like a, you know, really solid answer on some things, but it's really a cornucopia of different emotions, and they all happen within the same day, just as you know, I think in some ways similar to parenting, but I would say the one main difference is that, you know, eventually your kids are going to be more and more independent. And they're gonna go off into their own and, you know, unless there's some kind of as a special needs situation there. But with your older adults, and a lot of the folks that we're taking care of, it's usually the opposite, where, you know, it's kind of as good as it gets on day one. And then things can continue to decline, which is even more of a reason why we have to proactively have these conversations and set ourselves up for sustainable success. Because it's, it gets harder.

Kosta Yepifantsev:

Yeah. And you need to set those expectations. That was a fascinating explanation. I always love doing these shows, and like, I, you know, you, you do so many of them, and you think, Okay, well, I've figured it out. And then you hear something like that. And you're like, Wow, I never really thought about that. It's really interesting perspective. So I want to know, though, in your opinion, what do you think is the greatest challenge that's facing caregivers today?

Elizabeth Miller:

I think that we're being asked to do a lot, you know, we are, we can't wait kind of for the government to kind of figure out the answers, because it's a very slow process, and very few people qualify for Medicaid. And, you know, the, the, the number of faces I've seen of people where they first are finding out for the first time that Medicare does not pay for long term care, it is shocking to people Yeah, to say that, again, though, Medicare does not pay for long term care. Like, it surprised me, and it surprises people. And it's hard to get on Medicaid, like even my mother in law, she got denied so many times, and all she had was her social security check, which was like$800, and that my husband and I were scratching our head, and we're like, who gets approved for Medicaid if if she can't get approved. So it's so the struggle with caregivers that is that you know, more people are wanting to age in place at home, which I think you know, if you and I have the choice, when we get older, that would be our choice, right to be at home as long as possible. So that we cannot do that. And but who is bridging the gap then for to make that possible is this growing segment of people, family caregivers, who are also contributing to the workforce, who are also, you know, raising responsible independent kids someday. And so it's a lot of being asked, and it's a big strain. And so what I'm hoping will happen is that there will be more resources for caregivers where we can either get paid, you know, get paid for the care that we're providing at home, and have more respite opportunities, because we all are desperate for a break. It's really, really hard situation.

Kosta Yepifantsev:

And it's an what's what's interesting about that statement specifically is it's not that family caregivers are shocking the work of being a caregiver, they're not saying like, I'm the odd one do, I'm not going to do it, you pay for it. They're not saying that they're like, Okay, listen, I will do it. But I mean, you know, usually

Elizabeth Miller:

financial assistance. Yeah, somebody's family is usually stepping up. I'm one of six kids. And I will say we are not all on the same page. Oh, yeah. So there's always usually,

Kosta Yepifantsev:

within the family, yes, there's typically somebody. And so that means for every fit for every nucleus of a family or nuclei of a family, you're gonna have somebody that is going to be the primary caregiver. That person has, I mean, probably can't work full time. Sometimes, in instances of like individuals who have Alzheimer's or dementia, they may not even be able to work part time. And, you know, to hire a caregiver to hire another human being to care for another human being you gotta it's expensive, because you're paying a person, right? And you're not a business. You're just a family. Right? And so it's, it's astounding to me and it's similar to like, whenever during the pandemic when they started to pay for for, for daycare, you know, they made daycare free, or they provided some type of subsidy, like why not use that exact same method to be able to help family caregivers have the funds to be able to feed you know, their themselves and their families. And I mean, you could, you could reduce the amount of, of resources that taxes the industry, and you can create what I believe is really the only skill illusion technology, which is what about next is one serious one. But a real solution is more multi generational families. That is probably the key to solving this problem. But it's going to come from policy change. Yeah,

Elizabeth Miller:

I mean, that's how it used to be, right, we used to have these multi generational care. But the big difference there is that we didn't have people living as long, you know, we didn't have the, the cost of the way. Things are today with gas and food where most, most people have to have a dual income family in order to, to have that same lifestyle that we grew up having. And people are living longer, right, like medicines and think, you know, it's it's a yeah, we've got some advancements and health and things that are happening. But that's a long time that people can can try to fill the gap. And I do caution people from, you know, I speak for a lot of employers, and I think sometimes the first instinct can be like, Oh, I gotta quit my job, I gotta do this, and maybe, you know, try it, you know, slip into it, try FMLA and things like that if as you can, because otherwise, we're also creating this same systemic problem, right? Like, if I don't work, and I don't have the money, like, who's gonna pay for my care when I'm like, it just gets worse?

Kosta Yepifantsev:

That's right. Well, it is a it is a very complicated really diving. And

Elizabeth Miller:

there's an answer, though, I do think that that's a start. And there are some states that do pay their caregiver that you know, it's not it's a, it's there's a process in place. I know, Colorado is one of them. Georgia is not one of them, where you can, you know, pay an informal caregiver. But it's, it's, it's to everybody's benefit, right to keep these people out of the hospital systems out of it. So if we can kind of come together and figure out some kind of solution, I think, I think it's probably not like a one answer solution. It's a bunch of different things. And I'm encouraged that, you know, while the government is figuring out what they what they've got going on, there are a lot of companies and peep startup companies that are really trying to attack this problem. Sure,

Kosta Yepifantsev:

absolutely. And so on the on the note of startups, what role is technology currently playing and helping caregivers manage their responsibilities? And how do you see it being used in the future?

Elizabeth Miller:

I mean, I think there's a lot of ways I say that technology really is part of the care team, you know, so it's your family, friends, home care technology, like it can help you simplify things, you know, everything from, you know, meal delivery services, to, you know, ordering your groceries, having having different tasks done for you, there's a lot of apps that are out there that can help you communicate with your care team. And also, request help that way. So remote monitoring, I think is another way where caregivers are getting a peace of mind, particularly like, not everybody lives with their person, right? Like maybe they live close by or across the country, a long distance support caregiver. And so there's ways that you can kind of keep tabs on your loved one through technology and have that peace of mind without physically being there, which is nice.

Kosta Yepifantsev:

Yeah, there's a couple of companies in our, in our geographical area in the southeast of the US, that uses a combination of sensors, passive monitoring. And a lot of it is based around data collection. And so like, for example, as you're describing, like with, you know, somebody that's caring for their mom or dad, and they live in a different state, even, you know, you can use these data, these data centers, Chair alarms, you know, or bed sensors, Chair sensors. And if somebody's sitting in a recliner, the entire, you know, for like six hours straight, and you can read that data, you know, obviously something may be right, and you could, you know, maybe have a wellness check or something like that happen. But I believe in my opinion, that technology is a quintessential application to solving the lack of caregivers that are available to pay it because there's a lot of for that for the people who don't have family to care for them. Because what I've noticed, working in this industry, is there are many people that are on the Medicaid side of things, who are completely alone. And as a provider as a company, we step in, essentially to become their natural supports, and try to provide the best quality of life possible and yeah, there's not a lot of yeah, there's not a lot of people were stepping up and wanting to be caregivers nowadays.

Elizabeth Miller:

No, it's a tough, it's a tough position to be in. And you know, there's also this whole thing about socialized isolation. So particularly if people don't have somebody that is, you know, checking in with them frequently, there is some technology even that is trying to handle that we're like they can have a conversation beyond Alexa, but like learning people's behaviors and having conversations with, you know, some sort of a robot type of thing.

Kosta Yepifantsev:

Well, there are Yeah, it's like a Rosie or something or Rosa. So I was listening to NPR and one A, and they actually, were profiling a nursing home. That launch some type of like, robot that tell jokes. Yeah, you can ask tell jokes and delivers meals and stuff.

Elizabeth Miller:

Just, you know, hey, do you want to listen to some Frank Sinatra, like, they kind of learn your behaviors, the one I know of is called le que is the same type of thing, but lots of different things there. So I'm excited to see you know, particularly my IT background, like I love kind of when these two, the my worlds are colliding. And there is a lot of opportunity, and we're gonna need technology to help bridge that gap gap for sure.

Kosta Yepifantsev:

Yeah, well, we can have a whole show just on technology alone in this space. So but let's get we're gonna we're gonna side back to slide back to caregiving. As a caregiver, how do you manage stress and avoid burnout? And how did these feelings normally manifest?

Elizabeth Miller:

Well, it's a roller coaster, right? Like they, there's, I think most caregivers kind of like their first go to is to kind of like, well, I'm just going to do more, I'm going to do more, and then you kind of figure out that that's not sustainable, and all the systems start to break down. And I think there's a lot of different ways that you can kind of manage stress, but for me, and for other people listening, like self care looks differently for all of us, like, I know, for me, it's, it's about like, what's going to give me energy, what's going to provide peace of mind. And really like naming my worry. So a lot of times stress can be related to some kind of worry, well naming what the worry is, and then trying to take a step or an action towards that worry. You know, if you're worried about the companionship, if you're worried about safety, like what's one thing that you could do to try to mitigate that, but then trying the different things on like, it's, you know, I started saying the beginning about how it was like a game for me, where I would just like, pay attention to what was what people were talking about that was making them feel like that was a stress relief. And I thought, well, people talk about this all the time. Let me try this or let me try that. And you won't know until you try it on what works for you. But some things could be you know, think about your five senses, you know, aromatherapy, you know, getting outside in nature, listening to music could be writing could be journaling, and I think the point is, is like, it doesn't have to be you know, 15 minutes, 30 minutes, it's like little incremental things. I really challenge people when they say they don't have time for self care, because it's not an all or nothing thing. There's we all have to create the time. It doesn't just doesn't happen.

Kosta Yepifantsev:

Yeah, you know, you've really created an incredible resource for caregivers and prospective caregivers alike. You walk us walk us through happy healthy caregiver and its most commonly utilized resources.

Elizabeth Miller:

So it's evolved over the years right up front, a lot of spaghetti to see what sticks and best way to do and so you know, a bit I became a certified caregiving consultant because I wanted to help myself and coach others. So I do offer complimentary coaching for an initial session. The podcast is is full of resources. I mean, I believe that family caregivers are the experts in caregiving and family caregiving. So that's what you'll find on the happy healthy caregiver podcast is over 150 episodes sharing caregiving and self care tips. Speaking is something that is really a main way that I monetize my business. So speaking with groups of employee resource groups, affinity groups, different organizations that are celebrating what caregivers are doing. And then I love to collaborate with partners who are trying to put their brand out in front of the world you know, the technology companies and so forth. We talked about I want to be that that conduit to really fast track caregivers to the to the resources so that they're not fumbling and stumbling over Yeah, are there things that I can really kind of pull them up and be like, Okay, we've got this. So those are some of the things that I that I provide through happy healthy caregiver.

Kosta Yepifantsev:

I love that. Why do you think that more people don't embrace technology? Like just something as simple as the is having a conversation like electronically as opposed to face to face like a two way iPad, right like why I, a lot of times people like feel ashame to call somebody on an iPad as opposed to going in person. And if they, if they're out of state, especially like, that may be the only form of communication, except for maybe some unique periods when you know they're visiting. Right? Why do you think that caregivers are ashamed of taking care of the easier

Elizabeth Miller:

caregivers or the care recipients? I mean, I think it could be either, right? Like they gotta kind of in the middle, I would say that that's moving in the right direction that more people are open to it, I think they just don't have the time to research. So you know, somebody's listening to this, and they're more of a support caregiver for somebody who's a primary family caregiver, then that is something like at a distance as a support caregiver you can do for somebody is like, figure it all out, and then just show up with the system and be like, Hey, I found this thing. Like, let's, let's try it and see if this works. You know, I went, you know, I want to help you figure this out. But some of it, I think, is pride. And just, you know, people are stubborn, and trying new things can be a fearful thing. Maybe it's a fear of privacy for some things. Sure. So, I think it just depends.

Kosta Yepifantsev:

Yeah, what do you what do you typically tell people who are financially ill equipped to handle taking care of an aging parent or taking care of themselves? Who may be aging? And have no like, what do you tell them is like the first three steps, aside from obviously, what you would do internally for yourself as a caregiver, but how do they get through that?

Elizabeth Miller:

I mean, there's some things they can do that don't cost anything, right, like there's some things are connecting to support for themselves, is a way because nobody's going to understand your situation like another family caregiver, and you can do that virtually, or there might be an in person, group that because they're gonna help problem solve that for you. So that's free, frankly. And then, you know, gathering your care team, if you're thinking that this can be a solo caregiving job, it can't be. And so there are some resources that I provide for people to really divide and conquer their responsibilities. And, you know, maybe there's things that they could do to barter with people to, to trade for services, sometimes a reduced rate for respite care, like there's some day programs for folks with dementia that can be very affordable for an all day education. And then of course, you know, maybe they have somebody that has a veteran there, there could be some veteran benefits that they could get, or, of course, they can look into the the Medicaid route for things. Yeah, I know, for me, like, I'm looking ahead, like, I'm 51 years old. So like, I'm thinking about, like, how are my kids going to pay for my husband? You know, how are they going to handle this situation? If we don't have enough money to, frankly, pay for it? So one of the things that we did proactively is we got something on our life insurance called Living benefit, which I didn't, wasn't aware of. But that's something that you know, if certain things are true, that we could maybe we can draw upon this life insurance policy, because you know, long term care insurance is expensive, and it's not something that is extremely expensive, particularly when you're over 50. So it's, yeah, it's not, you know, it's not a sustainable, what would you add to that coast? I'm curious.

Kosta Yepifantsev:

Well. So what I typically tell people, and I am very, I'm very pragmatic, because obviously being in this industry for for a while, like, I know what works and what doesn't. And usually what happens is everybody wants Medicaid, because, well, I don't want to I don't want to put everybody in that in that bucket. But most people if they knew what Medicaid paid for Pate, what Medicaid would pay for and what it provided in terms of long term care services, they'd be like, Yeah, I want it. What do I need to do? You know, and Tennessee is a asset relinquishment state. I don't know if Georgia is but in Tennessee, if you want to apply for Medicaid and you have assets, they'll let you apply, but you have to sign all your assets over. Okay. Yeah, so like,

Elizabeth Miller:

I don't know exactly what we have left. Yeah. Which

Kosta Yepifantsev:

is why Medicaid is so complicated, because there's 50 different approaches to it, right? Which is another like that's, that's a third podcast that we can do so. So there's a huge bargain that you have to make if you want Medicaid, which is essentially you give up all your generational wealth, and you may end up giving it up anyway if you're paying for long term care out of pocket, but the long and short of what I'm trying to say is what I tell most people is if you actually have a loved one who is who has suffered a significant medical Levant. A lot of times if you can. If you get placed into a nursing facility, you can transition to Medicaid within that facility through their social work services. And it's, it's, you got to really have a stomach for it, though.

Elizabeth Miller:

Yeah, there's, it's a process, you know, yeah, no matter what you haven't been, it's a process,

Kosta Yepifantsev:

right? You have to be almost like, I can't take care of my mom or dad unless I have help. And and you can't literally you cannot deviate from that message. Because the only way that you're going to get Medicaid or get any kind of support, because you know, those social workers at the nursing homes know everything they know all the programs and how they operate, and they know how to access them, and they have all the contacts. But unless you're saying, like, they're gonna stay here, and you can't bill for those services, because their Medicare days have run out, and they're not on Medicaid, and we don't have anything to pay for them out of pocket. They won't do anything to find, you know, a solution to what becomes their problem. And that's what I do. I tell people, I tell people to leverage everything that they have to try to get Medicaid. It's a crazy, it is crazy advice. But if

Elizabeth Miller:

why not? The communities maybe that you were I might want to live in will accept Medicaid, either. So that's your doubts currently, you've got to kind of like lay out all the options. I think another underlying underutilized service that is available, if somebody is really, you know, in a chronic situation, maybe potentially has six months or less to live is hospice, I think a lot of people, and that is something that Medicare will typically pay for is hospice services. And I think that is an underutilized service.

Kosta Yepifantsev:

Yeah, and I think, correct me if I'm wrong, but also palliative care,

Elizabeth Miller:

palliative care, yes. Is, is treating the symptoms. And you can have that, at any, it doesn't have to have that six months or less. But I will say like, my mom lived for two years on hospice, she was reevaluated, you know, every 6090 days. Could she have castaways in the next six months? Yes, she could have you know, she was bedridden the last two years of her life? Oh, wow. So it's it? You don't know unless you ask the questions, right. And everybody's situation is different. But I think that there's not enough education around palliative care and hospice care. And again, that's where like, the free thing of support, like if you get plugged in, you will hear it all because you're learning a whole new vocabulary and a set of terms that have never, you know, it's not a book you've ever wanted to pick up before. Like it's,

Kosta Yepifantsev:

and I think the best thing, and you said it earlier in the show, the best thing that people need to know, at an early age is in this will keep them you know, at least abreast of the fact that they need to prepare in some capacities that Medicare doesn't pay for long term care.

Elizabeth Miller:

That's what's your, what's your plan here? Exactly what is your plan to have those courageous conversations now like to have them now. So that when you you can avoid the headaches as much as possible, later and allow people the privilege like I'm so grateful, right that my parents had, first of all the financial means to pay for their care, right? And secondly, the all of their paperwork in order it made us as their kids. We were allowed to just kind of be in that moment. Like it was still terrifically hard and emotionally draining. But thank goodness, we didn't have to make those types of decisions about Yeah, what what they want it like it was very clearly indicated, and we can simply follow directions and really focus on being present and handling the crisis of the day.

Kosta Yepifantsev:

Absolutely. There is one more thing before I wrap up there is a disability trust, I think it's called I had I had a friend of mine who's an attorney here in town and we talked a lot about disability trust. So it's a real technical episode if you want to check it out. But you can get a disability trust at an early a yes. And if there is a look back period for Medicaid in your state, which most states have five, three to five year look back period. The Disability trust kind of interjects and says Whoa, you don't need to look back period because all of this money is in a trust and so the state can't touch it and you still qualify for Medicaid and your your assets are protected. So that's that's another Yes

Elizabeth Miller:

party special needs. I know my brother has a special nice dress which is which I'm grateful that was, you know, again, smart dad that set that up for my brother, you know who's now approaching his 60th birthday and we have we're his caregivers, right the siblings now for him so he is he does have that I don't know the all the ins and outs of the of the special needs trust, but I do know that it's it's something that is really helpful in our situation for us care.

Kosta Yepifantsev:

I am curious about something though, like, what? What, um, it's a little bit taboo. But I think it's a really important conversation. What should we do when personally providing caregiving supports for our loved one is no longer an option?

Elizabeth Miller:

I think we all have to think that through right is like, what, what is our boundaries of what we're willing to take on and impact like, I know, for me, like even even my brother's situation, like it wasn't an option for him to come and live with with us because I had a young daughter and sometimes he could be inappropriate, it's so you have to kind of figure out your boundaries on that and, and know what you need to be true. Like, I knew I needed to keep working. So for mom to move, she needed to live in an assisted living and what my role was, was going to be like, but to have those conversations because it's, and we all have different strengths, right? Like I will say, honestly, like I'm, I'm a way better advocate for family caregivers, than I am a hands on family caregiver for my my family members. And that is because like, I'm kind of a tough love caregiver. Like I was that person with my mom, like, Come on, Mom, you can do that for yourself. Like, knowing that really, she's part of her, she was a part of her own care team. And that while it might be easier for me to do things, for her, it was part of her occupational therapy or physical therapy to do it herself. And so I would constantly say to her, you need to meet me halfway. I don't think that makes me a bad caregiver. It just like I might not have that altering gene as much like I'm like, let's figure this out. Let's do this together. Whereas like my older sister is the, you know, epitome of what anybody would want her to be their caregiver. She's amazing. She cooks amazing. I'm not a great cook, like all of that. So

Kosta Yepifantsev:

I love it. So we always like to end the show with a call to action. What's your advice for anyone that is struggling today as a caregiver and feels like they need help?

Elizabeth Miller:

I would we touched on these already, but like the first thing is to seek support. And you can set up a complimentary coaching call with me. We can talk through that you can google it in your area, the name of your town, caregiver support, see what comes up. In don't wait too long. I think people wait till there's a crisis. I'll do that when like no do it proactively do it when it's not a crisis so that you have all your options in place you have your people in place so that when the crisis happens, then it's just going to be something that's more easily resolved that way. And then as a as a follow up to that to like schedule your time for yourself like it's you're not going to find it you've got to create it and so just put it as a wellness appointment for yourself on your calendar of what that what that can look like and have it something so that you can look forward to having it

Caroline Moore:

Thank you for joining us on this episode of Now or Never Long-Term Care Strategy with Kosta Yepifantsev. If you enjoyed listening and you wanna hear more make sure you subscribe on Apple podcast Spotify or wherever you find your Podcasts, leave us a review or better yet share this episode with a friend. Now or Never Long-Term Care Strategy is a Kosta Yepifantsev production. Today’s episode was written and produced by Morgan Franklin. Want to find out more about Kosta? Visit us at kostayepifantsev.com

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