Researching and Choosing the Right Caregiver for Your Family

Are you struggling to navigate the complex world of caregiving? Boy you are in for a treat with our guest Nichole Claiborn as she shares her personal journey from studying psychology to working in the field of home care. Her motivation came from witnessing the challenges her family faced when her grandfather was diagnosed with cancer. This experience made her realize the importance of finding the right care at the right time.

Nicole emphasizes the crucial role of caregivers in providing assistance with daily tasks and non-medical needs. From helping with medication management to grocery shopping, caregivers play a vital role in ensuring the well-being of aging adults. However, she also highlights the difficulties families face in understanding the available services and making informed decisions.

Here are 2-3 tips from the episode:

1.      Research and choose a reputable agency: When selecting a caregiver, it's important to research and choose a licensed and bonded agency. Ask about their certifications, background checks, and liability insurance. Ensure that the agency has a nurse on staff and follows proper safety protocols.

2.      Communicate openly with the caregiver: Establish clear lines of communication with the caregiver and the agency. Discuss expectations, preferences, and any specific needs or concerns. Regular communication can help address any issues or changes in care.

3.      Be aware of financial aspects: Personal care services are not typically covered by insurance, so families often have to pay out-of-pocket. Research options such as long-term care insurance, VA benefits, or Medicaid coverage. Understand the financial requirements and minimum hours of service when hiring a caregiver.

Don't navigate the complex world of caregiving alone. Take action today and find a reputable agency that can provide the support and care you deserve. Ask the right questions, ensure proper qualifications, and prioritize safety protocols. Remember, you have the right to choose the best care for your family. Don't settle for anything less. Take control of your caregiving journey and empower yourself with the knowledge and resources to make informed decisions.

Transcript

John: 0:10

Hi. I'm John. Hi.

Erin: 0:11

And I'm Erin, you're listening to connect and power the podcast that proves age is no bearer to growth and enlightenment.

John: 0:17

to growth and enlightenment. Tune in each week as we break down complex subjects into bite sized, enjoyable episodes that will leave you feeling informed, entertained, and ready to conquer the world. Our guest today will serve as our guide through the world of caregiving, offering insights and wisdom on what it is, what to expect and how to navigate this process. She's also a lover of the outdoors, camping and hiking, and she loves to cook and coming up with new recipes. Maybe we can get her to share one of her favorites. She's also a huge animal lover. But for the past 15 years, she has been involved in the personal care side of home care. She originally was going to school to become a child psychologist, but fell in love with health care. When her grandfather was diagnosed with cancer, she witnessed firsthand how difficult the system can be to navigate for patients and their families. her passion is helping them find the right care at the right time. Let's warmly welcome Nicole Claiborne.

Erin: 1:20

welcome Nicole

Nichole: 1:22

guys. I'm excited to be here. I appreciate it.

Erin: 1:24

Playborn. Welcome Nicole. I'm excited to So we all have a story. And so we're curious about yours, how you did switch from the psychology world and then come into healthcare. What made

Nichole: 1:35

Really, it was just as John had mentioned. My grandfather was diagnosed with bone and lung cancer, and I had just started working Home care agency, and I quickly realized how difficult it was for families to figure out what services they needed when they needed them, how services are paid for, and the type of caregivers that they needed. unfortunately, at the time for my grandfather, he needed more hospice care and personal care services. Thankfully, my aunt was a nurse, and so we, we had that within our family to, to help and support our family, but without that. We would not have been able to have figured it out. I just started in health care. I was learning what hospice was, learning what personal care services were, and I wasn't able to help them through that, and that really disappointed me. And so that's why it's always been my passion to, to see how I can help families better navigate the system.

Erin: 2:25

I found that too, with a injury that, a family member, that gosh, it is hard to navigate. nobody tells you, here's the checklist of what you need to follow, and why, and, so Yeah.

John: 2:36

yeah, the questions to ask and, in that moment, that emotional moment too, our emotions are all over the place. and Memories are popping in and we want the best thing for this person that we love, but we don't know what that consists of and how to put that all

Erin: 2:53

you don't know what you don't know either, right

Nichole: 2:55

And there's so many agencies out there, and so you get what everyone tells you, and if you don't know what you're looking for, you don't know those right questions to ask, and so you just get stuck in that, this is the right one, and you don't realize that there's others, and that you can interview, and there's a process, and that you have a right to choose, and that's something that not a lot of people are aware of.

John: 3:12

I'm so happy that you said that. So what are the key reasons aging adults might consider hiring a caregiver and what services can caregivers provide?

Nichole: 3:23

Yeah, that's a great question. So personal care services, the way that I like to explain it best, and what you'll probably commonly hear is it's called assisting them with their activities of daily living. And so what we help ourselves with every day, getting our breakfast, lunch, and dinner together, bathing, toileting, taking our vitamins or taking any medications that we have. That's really what caregivers are there to do and to help their participants with. And so it's really just whatever they need when they need it. So if somebody is realizing that they're struggling with their medications, they're forgetting to take them timely, they're missing them, they're taking their morning, but they're not taking their afternoon and they're noticing that. They're seeing other declines because of that. That's something a caregiver can help with. They can come in and make sure that your medications are being taken timely. they can help you with grocery shopping if that's something you struggle with. And so if a participant is realizing that it's really taxing to get to the grocery store and they need someone to help them, whether it's going for them or helping them in the grocery store, that's what those caregivers can do as well. there's so many more things I could talk about. Everything that a caregiver can help with. We don't need to get into all of it. but really just the way to think about it is what you do for yourself on a daily basis is really what caregivers are intended to do and think of it as more non medical. And so some people, when they think of a caregiver, they think of a nurse and that's not what a typical caregiver is. A caregiver is non medical. They usually do not have a nursing license. And so their realm and really the scope of where they should stay is on that caregiving activity of daily living side where they're helping you do those daily tasks.

Erin: 4:55

How does a family go about researching when they pick out a caregiver? what are some of the questions and qualifications they should look

Nichole: 5:02

you look for? I think how they can go about researching is there's lists. You can go online and find a list of agencies. The Idaho Department of Health and Welfare has a list of home care agencies that are certified through the Department of Health and Welfare that you can get. And really, I would say, make a couple of phone calls. ask them what sets them apart. In Idaho, caregivers are not required to be licensed. And I think that's something that a lot of people look for your agency licensed. They're not licensed. So it's really important that you make sure that the agency is bonded, that they have liability insurance, that they're going to be covered. If anything does happen while that caregiver is at your home and. a few questions to ask would be, are your caregivers fingerprinted? in Idaho specifically, there's a lot of agencies that do not have contracts with the state of Idaho or for the Department of Health and Welfare, which would be Medicaid type of insurance. And because of that, there's not really any regulations on them. So an agency can open a home care agency, and they could literally work out of their car. Their trunk can be their office space and provide caregiving services to you. So it's important that Do they have liability insurance? if they are not through the Department of Health and Welfare or contracted through the Department of Health and Welfare, what kind of certifications do they have for their caregivers? Say the most important one is going to be fingerprints and background checks. even if you, Decide that you wanna hire a caregiver through an ad and you don't wanna go through an agency, make sure they're fingerprinted, make sure that you are seeing what's on their background. If they're gonna be driving you, do they have a driver's license? Do they have auto insurance? Does their insurance cover you? If the insurance doesn't cover you, do you have to drive your own vehicle or does the caregiver need to drive your vehicle? So those are just a few questions that I think are important to, to ask.

Erin: 6:44

So those are you nailed it because I opened up a caregiving company here. And when I found that out that there's no rules, I was like, what are you talking about? But it gave me an advantage when I met with families because I had a book that I met with them and go, here's my licensing that I'm a registered business. Here's my insurance. Here's everything. This is how we certify our caregivers in the training that they go through. It's just so important. Literally, you could pick somebody off the street and go, Hey, I got a job for you. Here you go. Good luck.

Nichole: 7:11

Oh, absolutely. Yeah. Yep. I definitely have called a few agencies before and kids have answered the phone and, it's a little weird trying to, can I talk to your mom? and so that, that's definitely something they need to look at. and really any agency, I would say, if they're a good agency, anyone should be able to call them and say, tell me about your services, what sets you apart, what makes you different. They should be willing to come out and meet with you for free. that should never be something that they're charging you to do. And I don't know if that's just me, but I also think that an agency should be willing to set you up with the care you need. So even if that's not with them, there's something specifically you're looking for in a caregiver, and they can't match that. Ask them, do you know of an agency that you like really well? Who do you work with? what agencies have good reviews that you've heard?

Erin: 7:58

another question I like to ask is, what are the hours your caregivers work? because if they can pull multiple shifts and they can work 80 hours a week, I want to know that I'm not going to be tired that they're getting that rest and recovery. that's So, important

Nichole: 8:11

Yeah. That's a really great question because there are agencies that there's really no standard time. they can work 24 hours a day if they want to. there are some agencies where they'll have caregivers work night shifts and then we'll go into the next morning and be working with a client. And so that's not something that's uncommon that you hear clients call and say caregiver fell asleep on my shift while I was showering. And it's really not necessarily the caregiver, right? Like they just pulled an overnight shift and they were awake the entire night and then they had to show up and work the next morning. So I do think it's important to ask. What kind of schedules do your caregivers work? What are the amount of hours that they work? And then also I think it's okay to ask the agency what hours your caregiver works. I don't think it needs to get into specifics of like personal, but my shift starts at 7 a. m. I want to make sure that they're not working an overnight shift and they're going to be well rested for my shift tomorrow. And they should be able to give you an honest, true answer.

Erin: 9:06

I agree.

John: 9:08

Wow. I'm just yeah, I'm really surprised that there aren't mandatory rules and regulations when it comes to opening up a business like that, because they're working with these very vulnerable people and people that maybe have some memory issues or, open wounds or whatever. And you have somebody that you're just pulling. Maybe off the street that's working out of their car and, a pretty bad situation. I would think

Erin: 9:35

of the other questions we always ask, too, is the caregiver a smoker or non smoker?

Nichole: 9:40

absolutely. That's a great question.

Erin: 9:42

That's a great question. Are they okay with pets? some house have certain religions where certain religions, if you have a male caregiver, can't be alone with a female and how do you go about dealing with a cultural difference or religious

Nichole: 9:53

preferences? yeah, yeah, no, that's a great point, is that's definitely something that's come up, and I want to touch really quickly on, you had mentioned wound care real quick, so I'll go back to that, but, On wound care, something that I forgot to mention that I also think is really important is whether it's an agency that's private pay or through the Department of Health and Welfare, that they have a nurse on staff. it's a requirement if they're through a Department of Health and Welfare, if they have a Medicaid agreement or contract. It's not required if it's private pay, and so when you're talking about those more complex cares, no, a caregiver can't necessarily change a wound dressing, but a caregiver can keep eyes on that wound and can notify the nurse from the office and say, Hey. Something's a little different. the family member reported that it's it's just looks nasty. It's been oozing out. Can somebody come in and take a look at this and the nurse will come out and do that. And so I think it's important that an agency has nursing services for those more skilled reasons. But going back to your question, I do think that's important to ask because that is something that's come up. there may be a caregiver who is not comfortable providing bathing assistance or is not comfortable helping a male in the restroom, but it's fine helping a female in the restroom. And that's really important for clients to ask, is the caregiver okay providing these services? Because I think some agencies get caught up in just hiring. there definitely is a lack of staff right now in the healthcare industry. And so if they hire someone, they want to get them to work and they'll just bring them in quickly. They don't necessarily realize. Providing bathing assistance to a male makes them uncomfortable, and you don't want to put your client or the caregiver in that situation. So if you're a family or a client looking for services, I think that's something to ask. I'm a female, I want to make sure that they're comfortable providing these services to me, and not being embarrassed to ask those questions.

Erin: 11:33

and it just off topic too, it's interesting, especially with marijuana being legalized. and especially with COVID. So those have definitely come up Hey, are you okay? Caregiving in a home where someone smokes whether medical or recreational and the same with COVID do you have your COVID shot? And so there's a lot of things that have been presented lately, which can make it hard.

Nichole: 11:55

It's made it more challenging.'cause there's staff or caregivers who did not want to be vaccinated and there were. clients that required them to be. And so it narrowed down what they were looking for. But again, I think that's why it's so important that if someone's looking for services, don't be ashamed or embarrassed of the questions you're asking at someone who's coming into your home, providing very personal care to you. So despite what your opinions may be on those things, you need to make sure that it's what you want. So if that person is vaccinated, then you need to let the agency know it's important that the person's vaccinated for me and my health, or it's important that they do not smoke. I don't have any, allergies or anything that would make it to where I can't be around smoke, but I don't want to be, and so I think that everyone's entitled to that.

John: 12:36

So going to the beginning of the process, how can aging adults and their families work together with a caregiver to develop personal? plan of care. How does that whole thing start?

Nichole: 12:48

So a good agency in the very beginning of services, they're going to come out, preferably with a nurse. They're going to talk about what your care plan looks like. Doesn't have to be a nurse, but a lot of agencies will offer that. So again, another question to ask. But It's important to talk about the things that they need on their worst day. And so when you're developing a care plan, asking the client or their family, what does a bad day look like for you? You know, a caregiver can skip something on a good day and they can mark that it was not applicable or not needed that day. But typically if it's not in a care plan, a caregiver is not going to know to provide it. And so to make sure that the client and the family stays happy, think of what you would need on your worst day and write very specific details into the care plan. Make sure that, if there's specific laundry detergent that's used that's mentioned in the care plan. If there are specific stores you want to go to for financial reasons, mention that in the care plan. And then also, most agencies should adjust that care plan every year. so again, if you're with an agency that's contracted through the Department of Health and Welfare or Medicaid, it's required that care plan is reviewed every year. If it's just a private pay agency. That care plan may stay there until somebody says it needs to be adjusted. And so I think that's important for families to know, is if at any time you feel like your care plan does not reflect the needs that your family member has, request them to come out and rewrite the care plan. Because again, that is something that's done in the very beginning of service, prior to the first day your care river comes out.

John: 14:19

and they can modify that too, right? if say, you know. the person, the client has an issue or something changes and, maybe they slip and they fall and they need a little bit more help. Say they didn't need bathing before, but now they do need bathing. So they can go in and reevaluate that, that care plan and say, okay, now we need to do this. And they may have to pay a little bit more money and the prices may change because now they're doing, more cares or a different type. Is that

Nichole: 14:48

Yeah, 100%. It can be modified at any time. Okay. Yeah.

Erin: 14:52

as far as communication, what does the family expect from the caregiver? Like how often should they be updated by the caregiver when there's changes, oh my gosh, today they fell, or they're not drinking as much as they used to, and what's the best way for them to communicate

Nichole: 15:06

So, that can be a little complicated because that's really going to depend on the agency. So there are some agencies that to protect their clients, communication with the caregiver is very limited. They prefer that it go through the agency. So the agency will make sure that they are reviewing the timesheets or the progress notes of the cares that are completed every day with that client. And then it's the agency's responsibility to report any concerns that they have back to the family. Now there are also other agencies that will allow the caregivers to communicate directly with the family and so I think that's maybe something that brings up another good point. Maybe a good question to ask the agency if it's important to them to communicate with that caregiver. What are their rules and regulations around that? there also are. new things now, which is really cool with technology and new systems is that they have the ability for what's called a family portal and a lot of, systems that agencies use. It's called an EMR, but it's just basically where all that stuff goes in a system that agencies can look at to manage your family members care. And so there's what's called a family portal on some of these. Systems now where a family can be given access to that portal to review some of those notes, and they can log in daily. They can log in weekly, and then they can see anything that's changed. So that's. I guess another important thing to ask things are going to keep coming up as we talk just because I keep forgetting about these things, but, It is something that, it's just gonna vary depending on agency, how often that communication is and how it's relayed, whether it's through the agency, through the system, or through the caregiver directly.

John: 16:39

I think that's an amazing. thing that they've created because I know for people like, for instance, me living out in a different state than my parents, if they do start utilizing caregivers, I'd love to be able to monitor it and see how things are going and see what's updated in the chart notes and so forth. It, I think it's just a brilliant thing

Erin: 17:01

But you should if you're noticing that, oh, they're not drinking as much or, oh, their food intake is less than what it used to be. That might. I want to go visit mom and dad and go, Hey, what's going on? How are you feeling? Have you been to the doctors? It opens up another questions. I really feel caregiving is the most important and healthcare.

Nichole: 17:19

I totally

Erin: 17:20

There are so many things, one person or a few people take care of a client that can go wrong. If it's not done the right way, things can be missed. So I'm glad we're talking about this today.

John: 17:31

I think it's amazing too, because unlike some of the other disciplines like home health or even hospice and some of those other things, caregivers with home care companies or personal care companies, they have more time, right? They have more time to slow the process down, to evaluate the needs. Of the client, they're more involved. They're deeper. they're having deeper conversations. They're, they're developing a relationship with a person where when it comes to home health and sometimes even hospice and some of these other services, it's so quick. It's, they're coming in for an hour here, 45 minutes there, and Caregiving. it's a different depth of information. That's why I always love the collaborative approach, So for instance, if somebody is on hospice, then, it pairs up so well with a home care company because you have another set of eyes in there to help support that hospice team or even that home health team to continue with those exercises and stuff.

Erin: 18:29

now that we have the caregiver in their house and we've picked out the company and the caregiver that's going to be the house, sometimes things don't always go the way you feel it did when you interviewed. So what are some red flags that maybe a family member can look for going, Hey, this caregiver is just not working out. It's not that they're not good. It's just not working out for my family member. What are things we can look out for?

Nichole: 18:50

Oh my goodness. I'll try not to get too crazy on this answer.

Erin: 18:54

No, get crazy! Yeah.

Nichole: 18:55

definitely. I feel like this goes without saying, but if. if you have a caregiver that's not consistent, they're constantly calling out, they don't show up, they're late consistently, those are things that you need to talk to the agency or that, that caregiver about and make sure that you find another caregiver that's more reliable. Like I said, I know that goes without saying, but a lot of people I've noticed, they try to give them the benefit of the doubt. they said they had to do this. They needed to drop their child off at daycare. This is what happened. Okay, then if that schedule doesn't work, then we need to find a caregiver that schedule works for because your mom has medications at 815 and the caregiver shows up at nine every day. So that's not going to work. that's one example. I would say another would be a red flag for me is agencies should be reviewing time sheets. And again, if families are looking at time sheets and cares that's provided, and it's the same thing every day for weeks. Chances are that's probably not really what's happening. We all know that things change every day, your schedule changes. I may not feel like getting up and getting dressed that day. I may not feel like doing this day. And so if you're seeing a time record or time sheet, I'm going to call it multiple things, but progress note, something that is documented that shows the care that's provided, and it's the same every single day, that to me is a red flag, that person may not be 100 percent invested. In your family members care or in your care, because it really needs to be tailored to you and it needs to be documented exactly what's happening, even if it's just doesn't have to be negative, but had a bad day. Didn't feel like getting up and showering today. Didn't feel like getting dressed today. So dressing is not something that was provided. Bathing wasn't provided, but we did do these things. And so those two should be missing off of that time sheet. So I don't know if that those are just a few examples, but

John: 20:37

perfect. No, yeah, that's great. So talking about red flags can you. talk about the importance of safety protocols and, going into a deeper discussion about what we just engaged what about the fear of retaliation, right? Some of these older people, maybe a guy is a caregiver and he seems a little bit high strung one day and intense, or maybe the, the female caregiver, Had a family issue and brings it to work with them and is now working with a client, but it's a little bit rough.

Erin: 21:08

Or the other way around, where a client might have a mild case of Alzheimer's dementia and they get a little touchy.

John: 21:14

so how are some of those things handled, both for the safety of the company, but also the safety of the client? because of course, you don't want, to put either one of those parties in a compromising position, so. how do we navigate that

Nichole: 21:28

there's a few different ways that agencies can go about handling that. I will say For me, that's why I think it's always best to go through an agency. I know it's cheaper sometimes to go through a direct caregiver, but if there is an issue and you're going through an agency, the agency is helping resolve that issue. And so it's taking out some of those safety concerns because they're giving a barrier of protection, that, necessarily there if you just hire someone outright, but for an agency, if there's a concern, the first thing that we talk about is we'll bring the caregiver in or we will go out to the client's house and talk about, okay, what happened, what's going on, do a mini investigation, talk about how both parties are feeling about the situation. and some situations we've also, If it's, they don't feel comfortable going back, they don't want the client to know or the client doesn't want the caregiver to know that they don't want them back out there. Again, that's something the agency kind of handles of, unfortunately we had a schedule change and that schedule change didn't meet with yours, so we decided that this wasn't the best fit. We can take that on. Or again, if we're conducting a mini investigation and we realize there's a true problem there, then the agency is gonna, going to handle that how they need to, especially John, if you were talking about the caregivers being a little rough. is it just because, what does rough mean that may be an agency needs to go a little bit further than a mini investigation? This may be that person shouldn't be a caregiver anymore period. So it just depends on the situation and then also really depends on how the client wants it handled. If they want to remain anonymous and the agency keeps it anonymous and we will find a way to an agency. to eliminate that caregiver in that situation. So again, I think that's why there's benefit to going with an agency is there's investigations that are completed. There's other caregivers that are available to you so they can remove that caregiver from your home and provide somebody else. If it's happening and you're a caregiver, we can find you another client. Or if you love that client and you just don't know how to navigate that type of emotion, Then we can provide the training and skills to help you understand. Okay, this is when it's going to happen. And this is how you need to handle it. Because sometimes it's just as easy as caregivers may not be trained on how to handle the behavior. And if they know how to handle it, then everyone's a lot more comfortable.

Erin: 23:30

you brought up another good point that we didn't talk about. There are agency and private pay, but there's also individuals you can hire as caregivers.

Nichole: 23:39

Yes.

Erin: 23:40

vetting them out, it's completely different. And there's different things you need to look for, Correct.

Nichole: 23:45

Correct. Yes. Can you

Erin: 23:47

share some of those?

Nichole: 23:48

Specifically, if it's your vetting the individual?

Erin: 23:51

Yes.

Nichole: 23:52

Definitely, I would ask, making sure you're asking for references, still make sure they're background checked. they can provide a background check to you. You can do your own background check, whether you're doing that through what's called an OIG check where you can put in their information, you can ask them for their name and their date of birth and you can pull federal, a federal exclusionary check. You're able to do that. you just want to make sure that you're. This person's going to be in your house, right? So you want to make sure that they're safe. That's just a few ways that you can do that

Erin: 24:18

Now, they don't carry their insurance always on their own. Is that something, as a client, I can request? hey, can you get insurance while you're here to cover us?

Nichole: 24:27

Are you talking about liability insurance? Yes. Yeah, I'm pretty sure you can request that. Now, I don't know any caregivers with what they're being paid that would necessarily do that if it's straight through private pay, or through private pay through that individual, I'm sorry, not through a private pay agency, but through that individual. You definitely can request it, but I don't think I've ever heard of someone doing that

Erin: 24:46

I think it's also important to let people know you don't have to stick with that agency. If you get a feeling or something comes up or they're not meeting the needs that you feel need to be met. It's okay to say, I'm sorry, this is no longer serving us and go to another service. Don't feel bad about it.

Nichole: 25:04

Yep, absolutely. And you're not, you should never be stuck to a contract with a personal care agency. If you're unhappy for whatever reason, you should always be able to leave. If there's an agency that wants to hold you to a contract, I probably would steer clear of that.

Erin: 25:18

Yeah, I agree When hiring a caregiver, we know it's not cheap, so what are some of the financial aspects? What are some things to really look into when hiring a caregiver, 24 hour care? Is there a minimum that we're going to have to pay for? is there a deposit? Some might take a deposit. What are some things families should consider?

Nichole: 25:37

This is probably the most frustrating conversation when it comes to the financial aspect of personal care services. So I'll try not to go off on a tangent too much, but unfortunately, personal care services are not covered through insurance. So that's a question that a lot of people ask is, why is it not covered under insurance? Home health is, hospice is covered. Why isn't personal care services? I don't know. And it should be. I think that's something that we all need to really push and advocate for is personal care services should be covered. I think it would make things a lot cheaper if people were taking care of the way they needed to be taken care of in the beginning. It's going to keep them from that fall. That's going to put them in the emergency room. That's then going to put them in rehab. So personal care services are really important. It saves the state a lot of money. It saves insurance a lot of money. If only they realize that and paid for it, but they don't. So yeah, One of the ways to pay for it is private pay. So out of pocket agencies very largely on what that looks like. The last I was quoted probably a month ago here in Idaho is you can find anywhere. as 28 an hour to 45 an hour. It just depends on the agency. some agencies that do private pay services only, they do charge a little bit more because they pay their caregivers a lot more agencies that are contracted through health and welfare or Medicaid. They pay a little bit less because they're confined to what Medicaid reimburses. So their pay for staff is a little less. But again, they have normally, not all the time, but they have higher regulations that they have to follow because they're under contract with the state. The VA will pay for some services. so if the person is a veteran, there are services that can be covered. It's not a lot, but there are some. And then also there's long term care insurance policies, some that will cover personal care services. There's some restrictions to long term care insurance policies, which get a little tricky when you're choosing an agency. And you have a long term care insurance policy, you want to make sure that agency has a nurse. That's usually a requirement. The nurse has to complete the care plan Some people have fallen in love with agencies that don't. They get started, they're providing care, and then the agency realizes, I can't get billed for service, so I'm going to charge the client and their family. The client and family doesn't want to pay for it because they thought it was under their insurance. So just something to think about is make sure that the agency that you choose, if it's under a long term care insurance policy, meets all of those standards. And then also there usually is an elimination period. So they'll say you as the patient need to pay an out of pocket before your agency payments kick in. So VA Medicaid, so state Medicaid will pay for services if you meet certain criteria the VA long term care insurance, and then private pay.

Erin: 28:18

other resources out there that people can search for that might help cover some of the caregiving services that aren't any of those?

John: 28:26

of Aging. area of aging. yeah.

Nichole: 28:28

and they can provide some services as well to more of the rural community. But I. I cannot think of any that I've been able to find. Now, Erin, you may know more than I do,

Erin: 28:39

I don't, I know there's some like certain places, it's like grants, where you can go and apply for grants and different hospitals might offer it or different charity services and maybe churches and stuff offer it, but I didn't know for sure if there's an actual nationwide.

Nichole: 28:54

Not that I've ever come across. now I do know there's certain, depending on the diagnosis, there's certain things like if you have MS, there's an MS navigation team and there's funding that they have available. that funding will pay for some services, whether that's building you a ramp or providing you with medical equipment, and it may cover some temporary personal care services. So there's probably things like that's tied more to diagnosis.

Erin: 29:15

There's something here because we came to off topic. there is a caregiving conference. I came here when I actually from California here. I thought it was for actual caregiving, but it was families caregiving for their own family members. And that's where they were providing the free services. like you get. So I didn't know just in general here if there was something.

John: 29:39

and I, think Nicole can touch base on that a little bit too. I think there is like Medicaid will pay a family member, right? they'll pay a family member to help provide certain cares for their loved one, which is great because one who's going to be best to take care of their mom or their dad or sister, brother. Whoever would be, maybe a family member, but they can't afford to just stay home and take care of mom and dad for free, but if there's some sort of compensation. So do you know how that works and if, if somebody was interested in doing that, how does, how do they get that ball going? Yeah,

Nichole: 30:17

So, first and foremost, that client needs to be on Medicaid services through the state of Idaho. So the agency can help you with that and IT, or the Department of Health and Welfare can help you with that. But they have to conduct an assessment out in your home to make sure that you meet all the criteria once financially. So there's a financial application that you have to meet it, and then also the medical side of it. Do you meet that to need personal care services? Once that's identified and you are covered and eligible for those services, then the family member who's interested in providing the care. Together, you just need to pick an agency that fits you both best. And that caregiver, your family member, can then get hired on with that agency to be your

Erin: 30:58

Can you explain that a little bit more because some people are like, what agency do I join and what are you talking about? What do you, what, is there a program? Is there, what is it? So

Nichole: 31:06

So when I say agency, I mean specific personal care service agencies that are out there. So the companies themselves, the businesses themselves. that's what I mean when I'm referencing that. I did want to highlight that going back to what you were saying, John, with family members. Right now, it's very temporary. for example, if you have a child and you're a mother, that's a temporary service and the state's working right now on making that long term and trying to figure out how they can do that. COVID really brought a lot of awareness around that, that there's not enough caregivers, there's not enough healthcare personnel, and there were a lot of moms and dads who are having to quit their jobs and stay home to take care of their sick kids because there were no caregivers to help them. And so that was a temporary. Kind of approval that came through that the state had given, and that's gonna go away soon. And so there's a lot of families and personal care service businesses who are fighting to make sure that, that stays permanent. so right now when we say family, it's basically if you have an adult parent that you're wanting to care for or you have an adult child or a sister, a brother-in-Law, those types of things are already covered and they will remain to be covered. But if it's a.

Erin: 32:16

caregiver burnout. I know a lot of family members want to take care of their mom or take care of their dad or whoever their family member is. But I feel don't feel guilty even if you hire a company for a couple hours a day, right? That's super important.

Nichole: 32:33

important. Yeah.

John: 32:35

That's all I'm going to give my dad, but he needs something. And I need all of his meals cooked in that one hour. I need you to cook five or six, some unrealistic expectation, but they're finding financially they can't afford a lot. So is there a minimum when it comes to providing

Nichole: 32:50

Yeah, so I'm glad you looped back around on that because Aaron asked earlier, and I skipped right over it, but. Every agency is different, and usually, yes, there's a minimum. And most often, agencies are about two hours per shift. Some will have a weekly minimum, where you have to be at least four hours a week. And that most often needs to be in one shift. You couldn't do four hours and have four days a week. There's not many agencies that will do that. But yes, that is an important question to ask. Whatever agency you decide to go with is, do you have a minimum? Because a lot of them do

John: 33:23

Okay, great. And then another thing I was, I've heard stories of where a long term caregiver will be taking care of a person. They've developed this amazing bond, this amazing relationship. And then the, The person they're caring for, maybe it's a woman that has a little bit of money or a man that has a little bit of money. And so the caregiver throws out little comments like, Oh yeah, my car can hardly run. I'm having all these issues with my car. Oh gosh, I have no idea how I'm going to pay for my child's college education. the client feels almost obligated because the caregiver is providing so many amazing cares to help them with their daily activities. And they almost feel Oh, I should help with the car or I should help with this college education. So how do people face that? Because I'm sure, there's a little bit of preying on the vulnerable people out there that, that do have money. And they have this long term care. So how is that dealt with

Nichole: 34:23

Oh my goodness. So again, I think that goes back to this is why I'm a huge proponent of pick a caregiver that is with an agency, because again, the agency can help through that. Don't do it. I know that's very easy to say, but yes, because they do. They feel like family. It feels this is, this is my other, the daughter I never had, or the son I never had. And I want to be able to help them out. Don't go there. The agency's paying them to do that job. They're paying them for a reason. Some agencies pay them mileage. There's more shifts that they can pick up. There's more work that they can do so that they can get paid the right way. It never works out for the client or for the family when money is given to the caregivers. And most often, I guess what I would say is if you really love that caregiver. Don't do it because you're going to get them fired

John: 35:10

Yeah.

Nichole: 35:10

because truly that's what's going to happen. for someone who works at an agency for a really long time, if I had, if I have heard that's happened, which I have, the first thing we do when we know that it's legitimate and that a caregiver did accept money from a client, they're terminated. And so it ends up to where they no longer have a job and. It's for what's best for the client, because I do, I think that's a really slippery slope. One thing turns into another thing turns into another thing.

Erin: 35:38

But with the holidays, and I don't know for you, but with the holidays, if they want to gift them with something, it is very wise to go through the agency, through who they're hired and say, Hey, we appreciate the caregiver and the time we would like to gift them. So the agency is aware and can either be like, I'm sorry, we can't because of

John: 35:57

Or a limit.

Erin: 35:57

or yes.

John: 35:59

Yeah, because I know again, going back to whether it's somebody wealthy or somebody that, is on a fixed income, somebody wealthy could say, it's Christmas time. She's had car problems. We love her service. So we're, we're going to buy her a car and that's just not appropriate. if I'm the caregiver, I'm like, I hate to say it, but I would be tempted to say, it was worth losing my job because, I got a car out of it, and, there's other jobs out there,

Erin: 36:24

but we just want to protect everybody. Really? Just make sure everyone's

John: 36:29

Yeah.

Nichole: 36:30

I think in going back to what you were saying with the holidays, absolutely talk to the agency about it. there's a lot of situations that I can think of where you've had a husband and wife couple and the spouse gave money away or gave a gift away for Christmas. That person passed away six months later. said spouse found out that these things were given and they want to come after the caregivers because it's these caregivers took this money from my spouse. And as an agency, you're able to step in and protect your caregivers and say, I have this on file that stated that your spouse wanted to give this gift. They contact the agency. This was the amount. Is that the amount that was given? Okay. we have that. And it's. just protects things and makes it less messy. And so absolutely go through the agency, make sure they're aware. They'll talk to you about what's appropriate, what would be acceptable. And usually they're able to document that and get it in writing that it's something that was agreed upon.

John: 37:22

Yeah, I'm sure it's not a huge percentage, but more and more, I do agree with something you said earlier about caregivers as being one of the most important roles in all of healthcare. Even though it's maybe not classified as a clinical role, it's still an essential part of all of us as we age and get older, we're gonna need some extra care. And so I love that, that you brought that up

Erin: 37:47

what do you think about it? You're getting some PT from somebody. Your caregiver can assist in that, right? They can train right there when the PT comes to the home and they're helping the family, they're helping the client, like they're a vital role in this person's life, cooking their meals, making sure they're bathed, making sure their laundry's done. If they have an animal, maybe making sure that animal is walked or taken care of or gone to the bed or keeping track of their bills. where's your finance? Making sure your electricity stays on so

John: 38:17

And I know Nicole, you and I have had discussions about this, even when it comes to other services such as home health and hospice, maybe that caregiver has been with that client for a bit of time. They're going to know everything about that client, so when that home health team does come in to develop their plan of care or the hospice team comes in, they're going to have a lot more success if they respect that caregiver by sitting down with them for a little bit and just saying, Tell me about this person, what do they love? Are they a morning person? Afternoon person? What are their favorite topics to discuss? Because yeah, it, it creates this collaborative, approach, and there's a lot more success when we all come together and communicate

Erin: 39:01

and it's okay for the caregiver to go with them to their doctor appointment because there's some things the families can't answer and they're more comfortable or have become more comfortable with their caregiver because they are there every day going, Hey, this is their routine. Oh, I can answer that question. And we always encourage our caregiver if the family is okay, if the client is okay, that you're there in case the doctor has questions or needs more information and clarity on something.

John: 39:27

Yeah. did you have any more questions to ask? Okay. Okay. and I do too now because there's a few, going back to our intro of this whole discussion. Yeah. I'm changing things up. She's not used to this. yeah, so I, I want to share because it's so important that people don't just connect people with their education on. Service, right? And so I want people to know who you are, and I want you to share a little bit about some of the stuff we said in the beginning. if that's okay, like, your love for animals, you know, because I know. That, you're very involved in helping pets get adopted and stuff like that. So if you could touch base a little bit on, what that brings to your life and your love for that and yeah, maybe share a recipe. That would be cool. If something that you love to do, that would be cool if you have a sec.

Nichole: 40:17

yeah, I've just always been an animal person. I love them. My husband probably does not love that about me right now, So we had four animals total, two cats, two dogs. We lost our two Pomeranians within a year of each other. That was really hard for me and my husband. And I had thought, okay, I'm gonna. I need to find another animal. I've always been involved in trying to find animals homes. And I remember I was looking at dogs when I was working at Terrace and Corey came over and she's are you kidding me? You're not going to rescue an animal. like, gosh, Corey, you're right. What am I thinking? So started looking at the rescues that I've always helped find animals for and, fostered a dog and fell in love with her. She was amazing and perfect. And so I was a foster fail. We kept her. And my husband said, that's it. We've had two small Pomeranians. Now we have a giant dog. We're not having another dog. So we were on our drive back from Moab. And I saw these dogs need to be rescued. They're going to be euthanized if they don't find a home. So I told my husband, I'm just going to foster it. It's fine. I did fell in love with him, but unfortunately he got adopted out from under us, which was great for him. bad for us, but then it allowed us to foster another one that we are in the process of adopting. So my husband doesn't love it. Long story short, my husband doesn't love that. I'm an animal lover, but

Erin: 41:36

have just asked us. We have two.

Nichole: 41:38

always been, do you want to give up some of your animals? It's hard

John: 41:42

No, but I love that side of you because not only are you incredibly educated and very talented at running companies and helping serve people and finding everything that they need to really. Yeah. Do well as they age, but you have such an amazing heart too. And it just shows through some of this, of the stuff like rescuing pets and animals. And I know that's so dear to people. So I want to just quickly touch base on that. And, so what's your favorite thing to cook?

Erin: 42:08

You mean, what is she making us for dinner

Nichole: 42:10

know, right?

Erin: 42:11

love

Nichole: 42:12

Honestly, I love cooking in general. I cannot bake. I cannot. My sister is the baker. I'm an awful baker, but I can, I do enjoy cooking. I would say my favorite thing to cook that my husband loves the most is probably I make a fried chicken and jalapeno waffle and then Pour, like a hot sauce, maple syrup over the top of it. So that's probably my favorite and most requested meal of what's asked of me to

Erin: 42:39

You'll have to share that with us if you don't mind us sharing it with everybody else later. Yeah.

John: 42:43

If you share it, we'll have to attach it to your little blog post, and you'll become famous for this amazing, recipe. so I think we have one more question because Aaron asks this to everybody. So I apologize for throwing you a little bit off by my two. questions that were off topic, but, Erin asks this to everybody, so she loves it.

Erin: 43:04

know, and I need to find a new way to ask this, but there's just no other way to ask it really is. Do you have an adventure list or is there someplace you've been or you want to go.

Nichole: 43:17

I am probably the most boring person to talk to about that, especially for you two, because you're such adventure driven people. I have a very old soul. I'm paranoid about everything as well. And so I really don't. It gives me anxiety to think about going somewhere because one, I'd have to fly there and I hate flying and there's probably water and I hate large bodies of water. So you have to take all of that away. And I had zero fears in the world. I've always wanted to go to Africa. I love animals. I would love to just see some of the, some of those animals up close, probably very dangerous to see a lion up close, but that would be, that'd be really amazing. I'll just never get there because you can't drive there.

Erin: 44:03

We can always annex

John: 44:04

Yeah, there's plenty of, there's plenty of medications you can take and cocktails you can have while on the plane that would knock you out and you'd sleep the whole way. So

Nichole: 44:13

I know. I did get married in St. Lucia and that was amazing and wonderful. But it just. Thinking of places like that just stresses me out. The anxiety is just too much

John: 44:23

for each their own though, right? I think about your heart and your love for animals and what you're doing with, and it brings you so much happiness, so much joy. And I know you have two beautiful children that, that you absolutely adore in your amazing mom. So I know you invest a ton of time and energy into those two. I think Erin and I are on the flip side of it, you know, our kids are off and gone. And and so now we're ready to explore and experience different things. So yeah.

Erin: 44:48

I'm just not ready to die doing anything yet because I do want to see my grandbabies.

John: 44:52

Yeah.

Nichole: 44:53

See, and that's what scares me though. Every time I go somewhere, it's this is going to be the time I die on this plane. It's that Alanis Morissette song. This will be the day. So, but yes. Yes.

Erin: 45:04

higher probability

Nichole: 45:05

that all the time. It's just, no, there's more control. in my vehicle, I

Erin: 45:08

true.

John: 45:09

thank you so much for being here with us and sharing your knowledge of, home care, personal care. you're so articulate and there's so much great little nuggets of information. And I know that our listeners, some of them, they haven't ever experienced personal care services. And so we're really excited to, broadcast this out on our channels and let people know, gosh, this is what it is. These are some of the questions you should ask. and this is how you can protect yourself. So thank you for all that

Nichole: 45:37

Yeah, absolutely. Yep. Pleasure. Thanks for having me. And I will just add that if there's ever any questions that someone asks and I know you guys are amazing, come to you too and ask those questions, but I'm happy to answer them as well

John: 45:49

thank you. Thank you for tuning in to another episode of Connect Empower. We want to express our gratitude to you for being part of our community, and we hope today's episode has provided you with valuable insights and inspiration to enhance your life and that of a loved one.

Erin: 46:06

We are more than just a podcast. We are a community dedicated to enhancing the lives of our aging adults and their support system. We encourage you to visit our website now at www. connect empower. com. Explore more information about our guests from today's episode and to access our free resources.

John: 46:27

resources. Our mission doesn't end at the conclusion of this episode. We invite you to take action now by sharing the knowledge you've gained today with someone who may benefit from it. Whether it's a family member, friend, or colleague, your influence can spark positive change.

Erin: 46:42

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John: 47:03

I'm John.

Erin: 47:03

I'm Erin. Until next Wednesday.