Achieving Independence through Comprehensive Brain Care

How can we better support individuals with brain-related conditions across all age groups? 

Join us as we welcome Nate Gardin, Chief Operating Officer of Life Skills Village, to explore the transformative world of neurorehabilitation and mental health services. Nate offers a detailed look at Life Skills Village’s unique, team-based approach that includes neuropsychiatrists, neuropsychologists, social workers, and therapists, all striving towards one goal: community reintegration and independence for their patients. From children with brain injuries to elderly patients grappling with dementia, discover how this multidisciplinary team is making a difference.

The conversation dives into the specific therapies Life Skills Village offers for children, teens, and adults facing neurological challenges. Nate shares eye-opening insights into how modern technology and social media are intensifying traditional teenage struggles and the innovative ways their therapists are stepping in to help. For adults, we discuss the comprehensive rehabilitation programs tailored for developmental disorders like autism and neurodegenerative diseases like dementia, including critical aspects like career transitioning and vocational training. Learn why obtaining precise diagnoses through neuropsychological evaluations is essential for planning legal, financial, and care needs.

Finally, Bob and Nate highlight the importance of early intervention and timely access to mental health services. Nate elaborates on Life Skills Village’s efficient intake process that connects individuals with the right resources quickly, including the significant advantage of self-referral. We also challenge misconceptions about modern therapies, explaining how they can enhance independence and dignity for patients with dementia, rather than prolonging suffering. Please tune in to hear how Life Skills Village is dedicated to improving the quality of life for patients and reducing the emotional and financial burdens on their families.

Host: Attorney Bob Mannor
Guest: Nate Gardin, Life Skills Village
Executive Producer: Savannah Meksto

Transcript

Speaker 1: 0:00

You're listening to Advice from your Advocates, a show where we provide elder law advice to professionals who work with the elderly and their families. Welcome back to Advice from your Advocates. I'm Bob Manor. I'm a certified elder law attorney in Michigan and we have an excellent guest today. It's Nate Garden from LifeSkills Village. Nate, can you introduce yourself and tell us a little bit about LifeSkills Village?

Speaker 2: 0:24

Nate, can you introduce yourself and tell us a little bit about LifeSkills Village? Sure, Thanks a lot, Bob. My name is Nate Garden. I'm the Chief Operating Officer of LifeSkills Village. I was also on the initial founding team. Lifeskills Village is primarily a neurorehabilitation facility. We treat from pediatrics so kids, all the way through older adults, and we're largely the brain experts here. So whether it's injury, illness, whether it's a congenital disorder or a neurodegenerative disorder, if it's focused on the brain, then we have the disciplines and the modalities of treatment here to help people recover, help people adapt and help people live with their diagnosis.

Speaker 1: 1:04

So I want to ask you a little bit more about that and just get a little bit less technical, because sometimes when we talk about those more medical terms, I'm not entirely sure what you're saying. So I understand Explain the degenerative nerve, degenerative disease.

Speaker 2: 1:21

So neurodegenerative today is most commonly associated with dementia. So it's a disorder of the brain where it stops operating the way it had been operating and you see a reduction in function and cognition. So how you think, your memory, how you process through life. I think a term people would find most familiar would be Alzheimer's, not as the diagnosis, but just an example of a neurodegenerative disorder and it's dementia and you're seeing them more frequently in the population today.

Speaker 1: 2:00

Yes, absolutely. We're dealing with that quite a bit. So what about things that people have heard about for mental health, things like bipolar? Would that be included in the people that you serve?

Speaker 2: 2:27

deal with mental health issues. So there's a lot more awareness today. I think if you look at some of the positives of just the past few years and dealing with the COVID crisis, I think you see a lot more awareness into mental health. So you have mental health issues that are congenital. You're born with them. Their mental health, your brain works a little differently. You have chemical imbalances that people have and it's always existed out there and I think today you see a lot more understanding of the disorders, a lot more tolerance and a stronger approach to actually getting treatments and working with people and trying to improve their lives. As opposed to working with people and trying to improve their lives, as opposed to back in pre-80s just locking people away.

Speaker 2: 3:08

So yep, that would be bipolar, it would be schizophrenia, schizoaffective disorders. So these are things commonly that we've all seen over the years, no matter what age people out on the streets, wandering, people that seem a little different than us, that never really connected, that aren't stable on their own, back years and years ago, where we were a more institutionalized country with institutions meant to house and care for these individuals. Today those don't exist. So we see an increase, but I think there's a lot more awareness, specifically over the past handful of years, and, hey, this is an issue we can address this issue. It's 2024. There's a lot that can be done to assist people in getting the help and services they need.

Speaker 1: 4:00

Now I think I understand that Life Skills Village has kind of evolved over time as to who you mostly serve. Is that accurate? Has there been sort of an evolution from head injuries and things like that to what you've been talking?

Speaker 2: 4:14

about now was from Dr Brian Weinstein, who's a neuropsychiatrist, and he had a practice that really started evolving into treating head injury and he was running into some of the same issues and concerns. He'd see patients and they'd tell him they were depressed and they'd be seeking medication.

Speaker 2: 4:48

And when he got down to the root cause of it, he said that they're depressed not having anything to do with an injury or illness, but because their life sucked fart in the branch and he looked out there and he was disappointed in a lot of what he saw as far as availability on rehabilitation, a promotion of getting people to the highest levels of independence and really a community reintegration, functional approach to treating head injury.

Speaker 2: 5:12

And so he pulled together a team, of which I was one member, and we developed out really the initial concept for Life Skills Village, which at its origin was primarily traumatic and acquired brain injury. So yeah, traumatic brain injury would be physically your brain has been impacted, whether you fall off a ladder, whether you get hit by a car or you get injured at work and your brain swells and you have a physical injury to the brain. Acquired brain injury would be something that would come from a stroke or an aneurysm or a cardiac event where you lose oxygen and your brain's now starved. That would be an acquired brain injury. So I just really want to make that distinction for the listeners.

Speaker 1: 5:58

And how long has Life Skills Village been around for?

Speaker 2: 6:01

So we started working on the programming at the beginning in February of 2010, and we started seeing our first patients in July of 2011.

Speaker 1: 6:10

So we're in our 14th year now therapists occupational therapists that listen to this podcast. So what types of professionals are you working with, or that are your participants working with, at Life Skills Village?

Speaker 2: 6:32

So they really include all of your listeners. So we start we're a medical director and the founder is a neuropsychiatrist, a physician. But here, in practice, every day, we have behavioral health, made up of neuropsychology and traditional clinical psychology. We use social workers and counselors as well, and then, on the rehabilitation side, we have occupational therapy, physical therapy, speech and language pathology, and we do vocational rehabilitation and also recreational rehabilitation.

Speaker 1: 7:05

I know this is a little bit of an aside, but for your neuropsychiatrist, did they see patients through LifeSkills Village, or did they also see patients through their own office or a hospital?

Speaker 2: 7:20

So LifeSkills Village is a division of Mind Health Group. So Mind Health Group is the general psychiatry practice and we're nestled under the psychiatry practice Traditionally speaking, although in mental health and rehab it's a little different. But traditionally speaking people go to a physician and then the physician either treats within the practice or refers out, so we're the actual treatment side for the psychiatry. So you see the doctor, he is making a diagnosis, he or she is making a diagnosis and then making recommendations for treatment. And then this is just one avenue of treatment, especially when it comes to the brain and the mental health realm.

Speaker 1: 8:06

Now you have a physical location. Where is that, and do you incorporate any telehealth services?

Speaker 2: 8:12

Sure, absolutely so. Our primary physical location is in Oak Park, michigan. So we're in southeast Michigan in the metro Detroit area. We're well-situated, we're a fairly high population density and fairly easy access. We serve patients from the east side, the west side, downriver, the Pontiac area. We had a physical location in the Flint area up until the COVID crisis.

Speaker 2: 8:41

And we still do treat people, but we still see many patients a week from the Flint area. And yes, telehealth is an adaption that we made fairly early on. It lends itself to the discipline of mental health and psychiatry, as we joke here frequently, out of all of the physician services that exist, if your psychiatrist is touching you it's probably a bad thing.

Speaker 1: 9:07

so it really lends itself to mental health.

Speaker 2: 9:10

I think almost every other discipline of medicine there's more of a physical component but psychiatry and psychology is working in the in the head anyway, which there's no way to touch. And in fact telehealth, if you speak on the psychiatry side, has really improved the capacity for the physicians and the PAs on the psychiatry side to really see the environment people are living in, because environment plays a huge role in mental health and prior to people get dressed up they come to the office. You're seeing people in an office, they're already out. It's a more normative setting, it's not a natural setting. The telehealth has really opened up the ability for them to make observations on the environment and other people in the environment which can have a profound effect on really people's status, whether it's depression, whether it's anxiety, whether it's just any type of life disorder or concern. Getting into people's homes and seeing the environment that they're in has really widened the information they have to make appropriate diagnosis and get patients treatment, and from the behavioral health side as well. So we have a fairly large team of behavioral health specialists doing counseling and therapy. I'd say our team is probably on behavioral health side about 50-50 in person and telehealth. There are many patients that opt into today, coming in maybe for one session and then doing three for telehealth.

Speaker 2: 10:42

Obviously, we work on a lot of different diagnosis. If your issues are depression and isolation and we're just doing telehealth, it's not necessarily helping. But telehealth has also expanded that as well in having a counselor that can work with someone there. Everyone carries a cell phone today and if there's a patient that's struggling with isolation or struggling with social issues and getting out there in front of the public, they can actually carry their therapist on them with a phone and actually do some fairly immersive therapies right there, Whereas traditionally if you're seeing someone in an office, you're waiting in the lobby, you're going to their office.

Speaker 2: 11:20

So it's really widened what we can do, especially on the mental health side in treatment, and we utilize it. We were utilizing it before COVID. I think one of the brighter sides of COVID was just this huge leap in technology and even awareness and education for people that hey, you can do this. There's no reason you always have to show up in person. Access is a huge issue for some people, especially those struggling with a disease or an illness, and it's really widened it. So, yeah, telehealth is mighty. We treat patients all throughout Michigan via telehealth on the behavioral health and the psychiatry side.

Speaker 1: 12:00

So I know I'm being a bit repetitive, but just from the standpoint of you know I hear this all the time where folks will say well, we don't have very good mental health services in our area, your main office, but a lot of the services can be done remotely and they can be anywhere even in a rural area that doesn't have very good mental health options?

Speaker 2: 12:33

Sure, absolutely, and I don't want to be repetitive either.

Speaker 2: 12:35

Covid, I think, opened up the eyes of government.

Speaker 2: 12:39

So CMS, in really restructuring and reformatting what would be allowable from the backend payment standard of treating mental health. When we first started doing telehealth, we physically so we had a telehealth location for psychiatry in Flint. There's a lack of psychiatry services in the Flint area, so we physically, in our Flint facility, set up an office with cameras and the software and equipment and the patient would have an appointment. That was a virtual appointment only because the psychiatrist was sitting in Metro Detroit. The patient themselves still needed to come in.

Speaker 2: 13:21

When it comes to paneling and being approved by the insurance companies whether it's Medicare and Medicaid or some of the more traditional commercial health you had to at one point meet certs for being a rural area and being a lack of services in order to do it. Since COVID it's been wide open and the access is resolved, at least in the state of Michigan. If you're in Michigan but you're finding it difficult to access for many other reasons, so you don't have transportation, you're caregiving for someone else it's someone that's bed-bound you can get those services via telehealth today and it's pretty standard.

Speaker 1: 14:04

Yeah, that's a. You know it's funny. We look at COVID and think about all the terrible things that happened, but there's definitely been some advances that we made as a society as a result of that, and I think medicine is one of those, especially to be able to be able to get access to people that sometimes we had trouble getting access to because of geography, because of transportation, all those types of things, and I think it's been a, you know, a net plus, as it was in that particular area For mental health 100%.

Speaker 1: 14:36

It's a game changer. So you know you've mentioned that you work with all ages and so I want you to talk a little bit about that. From working with, you know, maybe a teenager that's struggling or someone who is, you know, sort of midlife, and then I specifically want you to talk about, you know, working with anybody that might be later in life or might be experiencing some form of dementia later in life or might be experiencing some form of dementia. So if you can kind of give us a little bit more about because those are very different things from a teenager to an 80-year-old with Lewy body, dementia or something like that, so tell us a little bit more about that Sure absolutely.

Speaker 2: 15:17

So, starting from pediatrics because we really do age two and up, so we work with younger children that have developmental delays, that have congenital disorders, so that's something like Down syndrome or CP or autism, something they're born with and just the way their brain is wired. So we have in our rehab facility here we have a pediatric space. So it's really I wish I could show you a picture of it or give you a video, but it's a space designed for kids. It was designed by OT, speech and Language Pathology and Behavioral Health to be a space where kids can be kids but they can have the therapeutic functions within the space. So we work on helping kids develop and catch up their development. We work on kids that have congenital disorders, on coping strategies as you get kind of older in age. We also work on some of that delayed development, so those delayed development skills, specifically after COVID and with the digitalization of just socialization for kids.

Speaker 2: 16:31

Today we do a lot with kids and social programs. So that's through our speech department. We have a variety of different programs, so our social butterflies, our curious cattle, caterpillars we have a number of programs designed to help kids really catch up in their development, to catch up in their socialization. We have a number of therapists here that specialize in teens that are struggling with things I think historically teens have struggled with but are now magnified. You and I when we were kids, if you were having an issue at school, when you left school, the issues stopped. We may dwell on it, but today's kids don't have that break. Due to technology and social media. It's ever present In the summer, when I was a kid, I never saw anyone.

Speaker 2: 17:22

I didn't want to see because I just didn't hang out with them. I didn't see them Today with social media. So we do have a number of treaters that do specialize in working with kids on that. It is a real issue. It creates some real stressors and mental health issues for teens and then, as we get to adults, we have a fairly intensive rehab facility built around assisting adults whether they're injured, whether they have an illness, and so we are the brain experts here and we do focus a lot on what's on the head. But we also have a fairly diverse physical therapy, occupational therapy team here. So we work on orthopedic injury as well.

Speaker 2: 18:06

We don't really work on the specialties of fine motor, on the hands, but we do a lot for adults' career transitioning. So you have someone with an injury or an illness or just a disability they're born with. So kids with developmental disorders or congenital impairment like autism, become adults at some point and I think sometimes the programs out there give up on just how independent people can be and we've really pushed forward and we have a number of programs really designed to work with people with mid-level or moderate autism and other impairment to really function out in the community and integrate it to the community, out in the community and integrate it to the community and to really try and get people jobs. So we have a very significant vocational rehabilitation program here. So we do career exploration, career reorienting and then we do work hardening to train people.

Speaker 2: 19:04

We have both in-house, we have enclaves, we have a workshop in-house and we have hundreds of partners out in the community that will help take our patients in and whether they're trying out a skill to see if it's a skill they like, whether it's something that they're trying to build. We have many patients that go out in the community and hundreds of success stories where patients were then actually hired by our community partners to work competitively in full-time and then we work a lot. We have our own neuropsychological division here. So we have five treaters performing neuropsychological evaluations and I think just the evolution of society today and the fact that people tend to stay healthier through the advances in medication and preventative medication longer and we really see an uptick in neurodegenerative disease, which used to be or no psychological evaluations, which used to be 80% injury, are now probably 60 to 70% neurodegenerative disorder.

Speaker 2: 20:14

So that's really opened up the doors for our older populations.

Speaker 1: 20:19

I have a question about that, one of the things that's really important, that I recommend to my clients because we have what we call a dementia-focused practice. I recommend to my clients because we have what we call a dementia-focused practice, and what I mean by that is. A few years ago we realized, you know, we've been helping people with long-term care issues and how to find and advocate for good care and help get benefits to pay for that care. And as we started looking at our clientele, we noticed 70 plus percent of the folks that we helped had some form of dementia. And so when we realized that, we said, hey, we should probably start saying that out loud, because that's not something that most folks would realize that there would be a lawyer that's focused on helping families that have someone with dementia. And so one of the things that we're often advising our clients to do is, when they go seek medical diagnosis, to try to get a more specific diagnosis.

Speaker 1: 21:13

Many, many times in fact I'm going to say the vast majority of time the diagnosis we get is dementia, and, as you know, dementia is more of a category of diseases. It could be any number of things, from Alzheimer's, which is the most common, to Lewy body or vascular, or frontal, temporal. I mean. There's multiple different types, and that's something that, from a planning perspective, from our perspective, when we're trying to help the family plan legally, financially and carewise for the future, knowing which type of dementia can really help, because we have a better idea of what the trajectory forward is. Now I fully understand at least I think I understand that you can't give a 100% guaranteed diagnosis of what it is, but is that something that your group tries to do? Is to provide a little bit more detail of what the diagnosis is, other than that sort of category of this is dementia?

Speaker 2: 22:10

Absolutely. You're speaking to one of my passions and where I spend a lot of effort today, and that's working on neurodegenerative disorders like dementia. So today there is no cure today. I'm confident that at some point the folks in the pharmaceutical industries are going to find things that delay and extend things from a chemistry level and from a pharmaceutical level. But my passion is what you're discussing today.

Speaker 2: 22:46

So, yes, the answer is our neuropsychological team. So when an individual starts struggling with cognition so how the brain works and how the thought process works, and memory, which is usually a fairly big red flag for individuals to start questioning things, whether it's themselves or their loved one that goes to a physician, whether it's a terminal medicine or family medicine, whether it's a geriatrically oriented doctor, whether it's neurology Frequently that's where we get our referrals from for a neuropsychological evaluation. So a neuropsychological evaluation to try and put it as a very complicated evaluation, as simple as possible and concise is evaluating how your brain is thinking and functioning with memory against how it should be, and the broad spectrum of diagnosis we treat is. Our neuropsychologists have a vast variety of assessments to use in testing batteries and we do try very hard to pinpoint as best as medically possible today exactly what's happening so things. We all use the term Alzheimer's, but from my understanding, alzheimer's is not even something you can verify until someone has passed on in life. It's not so. It's a rule of disorder. It's this. We all say dementia, alzheimer's and we cross it over. It's like Kleenex and tissues right, kleenex is a brand and tissues are what we're using. I think it's more frequently used. The importance of a neuropsychological evaluation is it tells you where you should be. It tells you how things are progressing and moving and really gives a lot of direction into what the next stages in treatment are. And my passion understanding there's no cure today and, as an estate planner, this should resonate with you.

Speaker 2: 24:52

The treatment for dementia today is about buying time. You're not going to heal. It's about buying time, and one of our biggest frustrations here is we have a vast rehabilitation complex here of services that we can offer and nine out of 10 times when a patient comes to us, they have a neuropsychological evaluation because there are some concerns and they're given the bad news that they do have a degenerative disorder. And nine out of 10 times they go home and we never hear from them again. Our neuropsychologists are making recommendations. Their doctors are making recommendations and people go home not being aware that there are things and therapies they can do that will buy time by extending independence, by preserving dignity, by preserving memories, in your practice of dealing elderly law, by preserving assets. The longer someone could be independent, the better the quality of care they can have with the assets that are available to them. And we see all too often people go home and die not realizing that it's 2024.

Speaker 2: 26:14

We're blessed with technology today to allow people to be independent. My kids and I have family members that do have degenerative disorders. They have watches today that they can lock on to deal with tracking you have when it comes to cooking right. There's always a concern when it comes to memory and condition issues with cooking, that someone's not safe in their home. There's all sorts of devices proximity devices today where if you walk away from the oven it will turn off. If you walk away from the stovetop it will turn off. We walk around with our cell phones on us. That's a memory machine. If we know how to use it right, it will prompt us for our medication. It will prompt us for our appointments. We work with companies that are med boxes now that can be controlled via an app and have family members have an app just to make sure a loved one is taking the medication as they're supposed to.

Speaker 2: 27:14

There are so many things today that buy time on care and they buy time before. Someone needs a person with them a larger extent of time, which, as you know, is money. They buy time that people can be independent and not be worried and not be anxious and they buy those memories with their family and it is a huge passion of mine to try and let people know getting the diagnosis isn't the end of the day. There are treatments you can get. Meet with occupational therapy. They're going to give you tens of different ways to improve independence and improve safety in the home and reduce the need for care until later on. Physical therapy right. Everyone knows that walking and movement. It's going to increase your independence. It's going to increase your health. It's going to increase speech and language pathology and communication right, memory issues.

Speaker 2: 28:06

There are tens of different things that can be done and implemented in the life for a patient, for their loved ones, for their caregivers, to help extend independence. And nine out of 10 times we never see the patients again and we speak to the doctors about it and I hate to be as brutal as I am now, but it seems like nine out of 10 times people get the bad news and it's horrible news, and then they go home and they go home to die, and they do it slowly and slowly it's, it's, it's a stress on the family. Has anyone of you or anyone that you know, been to a funeral of someone that was dealing with a family, a funeral of someone who had a family member or a friend that passed and they did have dementia and a degenerative disorder? And do you know how frequently I think to myself and I've heard expressed that it's a level of relief. It's a level of relief, right.

Speaker 1: 29:07

Someone's passing is not just sad, it's a level of relief it's a level of relief, right.

Speaker 2: 29:08

Someone's passing is not just sad, it's a level of relief, and I think that that's something that we all have right. I don't want my family to be relieved by my passing. I want them to be mortified and sad and be mourning. I don't want them to feel bad about it and I think today, through the use of technology, through understanding that there are therapies Medicare and Medicaid pay for these therapies that will extend dignity, they'll extend quality of life, they're going to extend independence and they're going to extend assets right, they'll allow your assets the later you push off needing the care the longer your assets are going to be around to help take care of you and they're going to reduce the chances that, after your funeral, people are relieved for your family members.

Speaker 2: 29:58

I think this is so important.

Speaker 1: 30:01

No, this is great, this is so important. This is all the types of things that I want people to hear, because I think you're absolutely right and I'm always curious about that when I say, okay, what specialists have you gone to? And they say that, well, they went to a specialist, often a neurologist instead of a jury psychiatrist. But I often do encourage them to not just stick with the neurologist. But the problem that I often see is they go once, they get a fairly generic diagnosis and then never return for any therapies or any you know additions, and I think what I'm hearing you say you mentioned buying time and I know my families that I work with and some of them are thinking exactly what you thought or you said, which is, boy, my dad is suffering so much, my mom is suffering so much. I don't want to necessarily extend their suffering, extend their life, but what you're saying is the opposite. You're saying extending their independence.

Speaker 1: 31:01

And it's not just a drug. I think so many people go to the neurologist. They get the prescription. They say, okay, I got the prescription, hopefully it works, and a lot of times it doesn't. And so they say, okay, it's the drug and that's what it is, and that's kind of what we're taught is there has to be a drug that fixes it. But as powerful, and probably much more powerful, would be the follow-up, the therapies, the how to adapt to the things that are happening in your life, because that's probably going to be much more effective at least from what I've observed than taking a pill that might slow down the progression and might not and might have side effects Together is exactly right.

Speaker 1: 31:39

I'm not saying don't take the pill, but I'm saying do both. Frankly, for some folks the pill doesn't, you know, doesn't change the trajectory. It does for some, but obviously not everybody. And I'm not talking about any particular medication here, I'm just saying in general. You know, the therapies are going to be important to adapt to the changes in your life, and that's really important and something that I really would wish more people would pursue.

Speaker 2: 32:06

Sure, if I could follow up on two points, because, as I said, nine out of 10 of them and I'm probably being polite, it's probably 95 out of 100 people we never see or hear from again, and when we follow up with the physicians, neither do they there are two objections.

Speaker 2: 32:22

So we work on this coin a bit because we're trying to figure out is it education, is it awareness? How do you promote this? So the two strongest objections that we have are number one we don't have a lot of time left, so we don't want to go to therapies. I'm telling you this today you have a lot more quality time left if you go and see OT or speech and language therapy once a week. Use those resources because those are going to educate you. They're going to make life easier for you. They're going to introduce you to tools that you can use in the home and make life so much easier.

Speaker 2: 33:01

So when you say it's not worth the time to go for an hour appointment once a week or twice a week because I can't stop it and we don't have a lot of time left, I'm guaranteeing you today it's buying you a lot of time. It's going to buy peace of mind for both the individual struggling with the illness. It's going to buy peace of mind for the caregivers. So you may not know, there are devices that can help a person remember to close the fridge and open the fridge and find a bathroom, and devices that can track an individual. I keep pointing to my watch because I track my kids that way. But there's a lot of devices that's the number one objection of which the handler is I guarantee you could point them to Nate Garden and say Nate Garden guarantees that if you go to some therapy you're actually buying a lot more time on the back end and the second objection, which is a little more challenging, is access right.

Speaker 2: 33:58

So you have an individual now. A little more challenging is access right. So you have an individual. Now they already started showing deficits that led to going to the doctor, and some of those deficits may now limit driving. So you have people that may have been driving on their own and they're now reliant on others. So access becomes a huge concern. And we get that a lot right. So-and-so doesn't have access, I can't get them out. So that's a huge concern, and we get that a lot right. So-and-so doesn't have access, I can't get them out. So that's a two part. So number one is any family member should bring them out. At the beginning, it's critically important to understand what you're working with and understand the options. And then we talk about you and I are today meeting over a video stream, right? So telehealth is certainly a solution and, being very frank, as people progress in a degenerative disorder, the treatment sometimes is not treatment for the patient, but it's treatment to enhance the care for the patient.

Speaker 2: 34:53

It's really assistance for the caregivers and that's massively important. We talk very frequently about so the OT and the speech and the PT that makes sense for the patient. The behavioral health side, the therapies and the group therapies At some point they stop being. They just create more anxieties for the patient.

Speaker 2: 35:14

But it's the families that need them and I understand that one of the challenges today, of which I believe they're correcting to some extent, is so if I have the diagnosis and you're my caregiver and now therapy, so meeting with a psychologist no longer makes sense, but you desperately need it. You're caring for me. You need to understand. You're frustrated, you're depressed. I'm in a degenerative disease. I may not be aware, but you're dealing with it. But if I have Medicare and you're depressed, I'm in a degenerative disease. I may not be aware, but you're dealing with it. But if I have Medicare and you're younger and you don't have insurance, how do you get treatment? So you can care for me? Because my insurance is for me, and so I think there is some awareness and there's some great groups out there that are promoting the advocacy to try and get some benefits. So for me, as the patient, and my insurance will cover you actually getting some things that help improve my care and treatment.

Speaker 2: 36:09

And so those are two strong points.

Speaker 1: 36:12

So and I know you've said this a few times, I just want to highlight it A lot of your services are going to then be covered by insurance or Medicare, or sometimes even Medicaid, correct?

Speaker 2: 36:23

Correct when you talk about kids, for certain adults most of the time and older adults 99% of the time. They have coverage for these services CMS, medicare and Medicaid. They want people who have a degenerative dementia disorder to go and get therapy, because it's proven to reduce the long-term cost of care and the more people can be in their homes, the better it is for everyone.

Speaker 1: 36:54

This is a great conversation and I know that with the information I've got from you today, I know we're going to be sending you more of our clients and I'm going to ask my team. I have what I call planning services team. Those are the folks in my office that work with you know we do estate planning, we do estate administration. Planning services is the group that includes social workers and paralegals and Medicaid specialists and veteran specialists. I'm going to have them all watch this or listen to this podcast, because I think it includes quite a good amount of detail in what can be done and what can be covered under insurance. And that leads me to my next question is when we have somebody, or when one of the listeners have somebody that they think could benefit from this, what's the best way to refer? What's the best way to become a participant in the Life Skills Village process and the bigger analysis and all of that.

Speaker 2: 37:55

Sure, absolutely so. Although many of our services require a script, we're big on patient access, so if you have a question.

Speaker 2: 38:04

if you want to know more, please call us at 248-788-4300. That's our main number. We have a great intake team. They can really listen to what you have to say. They can point you in the right direction. Very frequently our clinicians themselves may get on the phone and discuss more treatment and be able to provide advice to individuals as far as how to follow up with their physicians and their primary care providers and get services. So we answer a lot of questions. We can't do therapy over the phone to people we don't know.

Speaker 2: 38:39

A lot of people try, they call and they have a lot of questions, but we can certainly point you in the right directions and get you the access Our website, wwwlifeskillsvillagecom, so that's L-I-F-E-S-K-I-L-L-S-B-I-L-L-A-G-Ecom, or info at lifeskillsvillagecom. So we have contact forms on our website. Everything is as confidential as things could be on the internet today. So don't reveal too much you don't want to see. Reveal, but give us a call or send out a contact form. We'll have someone give you a call and if you have questions, you're not sure what you need, you're not sure what's going on, we can certainly point you in the right direction.

Speaker 2: 39:31

If you have questions and you need things to be sent to a physician that you're treating with, if you're worried that maybe you have a disorder and you want to get some additional testing done and you don't know how you can reach out to us, we'll be happy to get your primary care information and get them information and get you really the best care that you need. So we have a great team here. We understand almost anything having to do with the brain itself and rehabilitation, and so, whether it's dealing with a small child, whether it's dealing with an adult that's struggling or injured, whether it's dealing with an older adult that is struggling with dementia or some type of degenerative disorder. Reach out, give us a call. We'll be happy to point you in the right direction and if we can help you, I'm fairly confident we know someone that can.

Speaker 1: 40:20

And you mentioned that they might need a script. Wouldn't you agree that most doctors, if the patient requested information from you in Life Skills Village or had requested to work with a group like yours, most doctors are going to be amenable to that? If the patient requests it and says you know, can I get a script to go and get the services here versus here, a lot of doctors are going to be open to that.

Speaker 2: 40:50

Sure, absolutely, absolutely. And I know you have some fairly large health systems here in Michigan and, without dropping names, we have many referral sources that refer to us. Just due to the wait time To get a neuropsychological evaluation, today can be, in many in the hospital systems, a six to nine month process, if you go to larger systems and I think people want answers sooner.

Speaker 2: 41:18

We can get you in. We can get you scheduled for your initial assessments and your testing, usually within even when we have a heavy referral stream going between, you know four to five or six weeks at the latest. So it's a lot quicker, but you're on time and we have many doctors that refer to us.

Speaker 2: 41:36

I have not met a doctor that refused giving a patient a script for a service or an evaluation and then I think it's important to note as well that congressionally they made some changes a number of years ago, probably 15 years ago already, when it comes to mental health services.

Speaker 2: 41:54

So not necessarily a neuropsych evaluation or rehabilitation. When it comes to mental health services, if you're concerned, you have access your insurance, whether it be a commercial health policy, whether it be Medicare or Medicaid they cannot deny you can self-refer for mental health services If you're feeling you need to speak to someone, whether it's about a disease, whether it's depression, whether it's anything that's concerning you. I would strongly encourage you. You do not need to go to your doctor and get a script for it. You can go seek out a mental health professional and you can self-refer yourself and you can get treatment. They can't limit the amount of treatment you get. If you need treatment once a week for 50 weeks, it is covered under every carrier today. They cannot limit the number of treatments for mental health. So I think people are confused on that topic and I find myself frequently telling people they do not need a script for psychological services.

Speaker 2: 42:53

So I wouldn't if your viewers know anyone it's just great to know you can go and self-refer. You do not need to wait to see your physician to get a note to go see a psychologist. Go see a psychologist if you're struggling, why push it off?

Speaker 1: 43:07

Yeah, that's great to know. So I want to repeat your contact information. Phone number at LifeSkillsVillage is 248-788-430. And you can be found on the internet at lifeskillsvillagecom. Thank you so much, Nate Garden. This has been a really great topic and really great information and, like I say, I think we'll be sending you a lot of referrals from our office. If you enjoyed this podcast, don't forget to subscribe. We're adviceice From your Advocates and you can find it on YouTube or on our website at mannerlawgroupcom, or you can go to anywhere and subscribe, anywhere that you listen to podcasts. Thanks again, Nate. Thank you Bob.

Speaker 2: 43:52

I've enjoyed myself. Hopefully we can teach people.

Speaker 1: 43:57

Great Thanks for your information. Thanks for listening.

Speaker 2: 44:06

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