Blog

SPEAKER_01:
0:10

Welcome to Patty's Place, a place where we'll talk about grief, dementia, and caregiving. I dedicate this podcast to my mom who passed away about two years ago from dementia. So pull up a get get your cup of tea, your cup of coffee, or like I said, if you have having a really bad day, a glass of wine. And today I thought we would talk about long-term care and financial investments because it's something that you don't think about until you need it. So today's guest is Raymond Levine. He is the principal at Levine LTC Benefits, which offers long-term care insurance benefits to individuals, families, and businesses. He has been associated with life insurance companies, uh, Mo Moni and New England companies offering insurance benefits again to individuals and companies. He was a president of a mortgage banking company and associated with prominent banks such as City National. Uh he's become he became knowledgeable about the long-term care benefits because his father, who was a judge in Los Angeles, needed care several times in his career. And his mother, an estate planning attorney, lived to be 103. So he recognized the need to own an LTC plan and she used the benefits for 18 years. He has also been recognized on TV on Moving America Forward with Doug Lewin and William Shatner. And he's also appeared on numerous podcasts discussing the long-term care insurance and other financial topics. So thank you, Raymond, for joining us here on Patty's Place.

SPEAKER_00:
1:38

Lisa, it's a pleasure that uh you've invited me to be a guest on your podcast. I'm honored.

SPEAKER_01:
1:44

Uh well, I'm glad you're here because this is actually a very good topic. So can you tell us what exactly is long-term care insurance?

SPEAKER_00:
1:54

I've asked myself that question many times. What is long-term care insurance? Let me start off with a couple of uh uh things. Caregiving in America is in a crisis, and you don't want to be poor or not have uh available assets and need caregiving. Now, why am I saying that? It sounds like you know, I'm just trying to be uh doom and gloom. What I really want to get people to uh uh is to be motivated to say, I've got to do something long before I need uh caregiving. So what is long-term care insurance? Long-term care insurance is part of financial planning and something that you know uh uh some uh uh wealth advisors and financial planners advocate, some don't, or um, but it isn't as advocated as much as it should be. But why? Well, the reason is is because um it's you know, they always talk, you know, have the thing about death and taxes. One of the other things that's almost guaranteed is you're probably going to need caregiving. What's caregiving? Think of yourself when you were when you were little, your parents uh took care of you. They to uh and uh and as you grew up, then you became more independent. And then as you uh age, uh other things happen. Uh sometimes you uh have an illness, sometimes you have an accident, or you could have early stage cognitive. So caregiving benefits, long-term care insurance benefits, is a form of health insurance, it but it doesn't pay for uh your doctor, uh doctor visits or uh um uh uh diagnostics or hospital care. It pays for caregiving services. And what that means is it's caregiving services because it's not that you have some medical issue, it's what has the medical issue done to you that you need caregiving. And the typical definitions are eating, bathing, uh, uh dressing, transferring, um, or you have cognitive issues. In other words, it's what has it done to you. For example, supposing uh uh you hurt yourself, okay, you hurt yourself, but uh um and you're in pain or or you have uh uh bandages or you need uh crutches, but supposing it's um a situation where you can't uh you need somebody to help you uh get up in the morning or bathe or dress or uh uh or to drive you someplace, that's where the this type of insurance pays either a family member or a friend, if it depending on the policy, or for professional licensed caregiving services. Um, and depending on the situation, you know, if you need to be in a care uh center and there is a nursing home, uh assisted living, cognitive living. Um, and you know, I'm going on and on, but what I want to uh emphasize is most people want to be at home. They don't want to be in a care center for a variety of reasons, not the least of which is you're with other people. The best care is uh uh where you live if you're set uh if you um are at home and you have people that can take care of you because you know your surroundings. And the other reason is there's an obvious thing. The ratio of caregiving if you're at home is one to one or one to two, one to three, uh, if you have enough people that like you. Um if you are in a care center, you know, it might be uh uh one to 10, one to 20, you know, who knows what the ratio is. And most Americans are impatient, they don't want to wait around for someone to do something. Um, and so this is where um Americans or people, people like choice. And one of the things that people don't want to do is uh uh if if they don't have to, is they don't want to rely solely on their own assets. And they don't want certainly don't uh feel that they want to rely on social services for all the reasons, you know, of uh, you know, they may feel it's bureaucracy or it's tell somebody saying uh, you know, it's like in the thing, you know, uh uh uh my social services, my rules. And so these are things that people uh, you know, if you have a plan and you and you can fund it, and it's and it's probably going to happen, then you have uh you're gonna you're gonna emotionally your family is emotionally and physically and financially gonna feel better. And so is uh the uh the person that needs caregiving. And there's something else that sometimes I don't bring up as much as I should is that when you're not feeling well or you have you know a severe you know uh uh issue, uh you you feel vulnerable. And I've had you know uh some uh a couple times some severe uh medical issues. I had a couple of heart attacks, I had a severe hernia uh uh situation, and you know, my parents' uh uh lives, they had some uh very stressful um uh um uh a car accident, heart attack, long long term, and it makes you feel vulnerable. And that's a bad place to be, you know, when you're feeling vulnerable and you have all the other worries and the people around you uh uh are are worrying. So what I do is I'm not gonna make you better, and I'm not gonna maybe I may not even make you happier. But what I but what but I can promise, what I can promise, uh, and I'm not even running for office, is I I will promise you that you'll have, you know, if you have the appropriate plan, it will provide sufficient money so that you can make those caregiving choices.

SPEAKER_01:
7:45

So uh what is the difference then between uh your regular health insurance and say Medicare with long-term care insurance? Because people might be like, okay, but why do I need this in addition to that?

SPEAKER_00:
8:00

That's a great question. Health insurance pays for health insurance. Medicare is is A and B or the supplementaries pay for the same thing that uh your company health care plans or your private health care plans. Uh they all do they all they all do the same thing. Um the but here's the difference. Neither health plan, whether it's a private health plan or Medicare uh plan, even even if you have a Medicare Advantage or supplementary plan, it will pay for some care services for short term. For example, uh supposing you have an accident or you have a heart attack or stroke, um, and uh uh uh you're in the hospital, and maybe you even spend some time in a uh care for uh uh facility to be rehabilitated. It will pay uh the first 10 days full amount, anyway, uh up to uh up to up to 100 days. After that, you're up and out. Um and uh uh uh but some of that you might have to uh uh do a copay. Whether you're at home or you're in a care service uh facility, Medicare doesn't pay for that, not for the long term. That's why they call it long term. It will pay for short term. Let's say you have a medical procedure, uh, Medicare, um, not your health insurance, but Medicare uh uh will pay for short term period of time um um uh you know for recovery. Let me say it that way. It'll pay for recovery. Long-term care insurance, you might recover. You might. Right. And and that's fine, you know. Uh, but if you don't, the long-term care plan will will carry on. Medicare won't.

SPEAKER_01:
9:44

Okay. So here's a question, because my dad and I ran into this with my mom. So when, you know, she when she got diagnosed, they the doctors and everything told us right away she was unfortunately she didn't get diagnosed until she was in till she was moderate to severe dementia. And the doctors and the nurses all told us there was no way we were gonna be able to take care of her uh at home by ourselves, you know. So we were gonna have to put her in medical care. Because because she was so mobile and she was already so severe, there was no way just he and I could take care of her, you know. So we had to put her where she was safe because she got out a couple times out of my house with it. She escaped, huh? Yeah, yeah, she did. And she she was very she was very mobile considering um even the hospice nurse had said she was highly unusual for the severity of her dementia that she could still walk without a walker or any assistant devices to the very end. So my dad and I didn't even realize about long-term care insurance until we had to start looking for a place, a memory care facility. And at that point, there was no way he could get the long-term care insurance. So what when is a good time to get it? And like I mean, it's kind of like what are the odds that somebody might need might need it? And when should you get it? Because you can't if you when you need it, it's way too expensive and you can't use it. So you have to get it ahead of time, right?

SPEAKER_00:
11:15

That's right. Um a plug for me is that um if you go to my website www.levineltcinsk.com and you look in the upper left, uh, you could there is a it's it's an uh um artificial intelligence uh um uh thing. You can put in your information about your lifestyle, and then it will tell you your likelihood of you know how long you live, and then it will get into a number of other things of how you know what the cost of long-term care insurance would be in 2026 or 2046 or 2056 to sort of give you an idea of you know what you think your might uh your longevity um might be based on your lifestyle. Um, so that'll sort of give you an, you know, g uh give you an idea of uh, you know, uh uh when the likelihood is of you needing caregiving. Now, uh uh the simple answer to say when you should get it, it's the same, it is almost uh the same thing as you know, when should you start retirement? Today, yes, yeah. That's true. You know, what uh uh uh when should you have uh good eating habits today? You know, uh uh you know, give up the potato chips, uh, have them every once in a while. Look, I love potato chips, right? Um, but I and I'm a recovering blubber person. Uh if you want I've got I've got uh last uh a year and a half ago I was 245, I'm now 170. Oh, well good for you.

SPEAKER_01:
12:37

Yeah.

SPEAKER_00:
12:38

Yeah. So talk so you know, so when should you begin uh to think about it today? Uh why? Because uh uh there there are three factors that I believe are important, or I mean, some of it uh is part of the um uh getting your long-term care benefits. One is your health. It's all done by health assessment. Uh and so the better health you are, you don't need to be perfect. You don't need to be perfect. Uh, but if you have, you know, uh if you do have some chronic, if you have a neurological disease, you've been diagnosed, or you have, you know, severe heart or diabetes, there's some things that, you know, are more complicated. However, uh, there are still plans, depending on the state you live, that you can still get a plan. We can have that conversation, you know, and or if you have assets not needed for retirement, there are plans where you can just transfer the assets and leverage it. What do I mean by leverage? Leverage means uh you put uh something in and you get something and that you have uh uh it multiplies. So for example, you could uh if you have a um annuity or you have uh a cash value life insurance, or you have you know some other uh asset that you can convert to cash, let's say you put in 100,000, you would then have three, two, three hundred thousand in benefits, and you don't need to even have any health just uh uh because you're transferring it to a long-term care annuity. So there are there are ways if you that uh that can be done. Um, but um uh the set the second part is uh that I uh is it's your health and your age. Why? There it's the same with uh uh retirement planning or any kind of planning is that um the uh the sooner you do it, the younger you are. Uh usually you'll have a cost of living uh writer as part of your plan where the plan grows and there's a monthly benefit. Let's say you start off with 4,000, that you know, by the time you need it might be eight or nine thousand. So you uh you you're giving it time and the premiums are there uh uh the uh the premiums are a lot less. You know, it's sort of like buying a car. When do you buy a car at the end of the month or at the end of the year? Right. Uh that you'll save some money. So uh, or you know, you go to Costco, when do you get the best deals or you know, when's the most available early in the morning? So and the third and the third third thing that I also say, you know, ask people is what do you want your plan to do? Because that's also important too, because people say, well, I don't want to spend a lot on it, I don't want the uh the question last is, what do you want your plan to do? Um, you know, if and if and whatever it is you decide to do, whatever it is you tell me to do, even if I might say, look, you know, let me make some suggestions, that, you know, uh, those are decisions you have to live with. If you say, you know, I want the minimum, you know, and that's always the thing, you know, I I always say with car insurance, uh uh when you buy car insurance or home insurance, you want uh you want a high deductible. But then when you need it, then you want that, you know, then you want then you want a low deductible. So you don't, I don't want to give people, you know, uh buyers remorse or to say I should have. It's you know, uh when you have a conversation with uh Raymond, it's we'll have a conversation, and whatever it is you decide to do, then I'll I'll do in a summary to say, you know, we talked about this, you said this, so that you know, uh it doesn't come back to me, say, well, why didn't you do this or why is it this? Um, you know, some people make decisions, and he here's the yeah, it's not a downside, but it is a buying a long-term care plan is not there's nothing fun about it. No, not at all. You you go and you buy a car, you go to have a nice dinner, you go on vacation. That's fun. Uh, but doing this, uh, if you do it right, it may be a uh uh uh uh once or twice, meaning you buy it, maybe you need you know uh uh um something extra, you know, uh uh something extra. But once it's done, it's done. It's like doing your you know estate plan. You do whatever you do you do it every once in a while. Uh you check on your retirement plan every once in a while. And it's the long term. You know, I'm hoping the people that you know are clients of mine that are maybe in the 30s, 40s, 50s, I hope they don't need it for 30 years. And that's a lot, you know, that's a long time.

SPEAKER_01:
16:57

Yes.

SPEAKER_00:
16:58

Um, and and so as I say, you know, you uh you're buying the future, and you know, and a lot of people don't want to buy the future. They want to buy right now, or they want, you know, they want the fun or the the benefit um right now. But some things it's better better to plan so that you get something in the future. Look, uh we all spent uh uh more or less uh uh 12 years uh uh uh um uh in graduating from high school, then you know, depending what you did, whether you went to technical school or college or something, that you know, sometimes you know, the the big payoff, you know, might not come for 15 or 20 years, but you got to do all the other things in advance before you get, you know, the benefits.

SPEAKER_01:
17:38

Right. And I don't think a lot of people realize how much it costs to take care of somebody. Example, with my mom, my dad spent um like seven thousand dollars a month for her to be in memory care, and she was in it for three and a half years. You know, people don't realize how much that costs. Now there are, you know, Medicaid homes and things like that. He we were able to, she was able to be in a private home like that, but it it was it was crazy the prices of what it costs for that. I mean, and that was out without any insurance. So if we would have had long-term care insurance, it might have helped him a little bit financially.

SPEAKER_00:
18:19

Well, it would have helped it it would it would have helped immeasurably if not the least of which, depending on where you got the 7,000. If it was from income, you know, retirement income, uh uh you paid taxes on it. If you want a long-term care plan, here it here uh uh uh here's here's the thing is uh makes it fun to own if you want to have an immediate thing benefit. If you want a long-term care plan, it's not taxable. If you get$7,000 a month, it's not taxable. You don't have to listen in your tax on your tax return uh as as income. So that's$7,000 that you were you were uh uh paying, you could either re have reinvested, you could do you you could uh you could have done something else uh to have it to have it grow. But if you so it's a good if we're not it it's a good tax planning advice uh uh um um uh uh device. Also, if you own a business, you can deduct uh a good portion of the premiums. And also let me bring up for is that you know you say about when to buy, one of the other things that you know uh um uh is to encourage people if they're in a company is to is uh to ask them if they have a company plan. And if they don't, say, you know, uh uh uh why don't you talk to Raymond or or you know somebody um uh or some some brokers know about it or they'll say uh well, you know, it's awful. But when when uh uh ask within the company, you know, look, are have people left because they have to take care of people? Or uh uh or the owners or the managers, you know, they've been in caregiving situations where their assignments and somebody says, you know, where's this? Oh, they're they're they're uh their way taking care of a parent, and here they have, you know, um job assignments. So it and here, but here's the benefit if uh a company has a plan is especially for the younger people, they might own a plan and let's say they have a 5% cost of living writer. And if they don't need it for 50 years, even if the even if it's 2,000 a month, do you realize you know what uh a$2,000 uh uh dollar a month benefit with 5%, you know, in f in 50 years what it would be, they might never have to have a plan. The other benefit is uh some of the uh some of these uh plans uh even if you have lousy health even if you have no health you'll still uh you'll still um uh if it's uh uh a a plan that doesn't ask for any health assessment you'll get you you you will get covered oh so what would be some of the main factors that might affect a policy premium for a person well one is age okay that's you know that's the uh that's the obvious it's again it's like retirement uh you don't you don't want to you don't want to start retire uh uh uh uh saving for retirement at 64. Exactly right um unless you know unless you're expecting a big inheritance or something well yeah that'd be nice yeah yeah but you gotta you got you got you gotta get you gotta give it you gotta give it time right but the best you know but the early you know the the younger you are uh the premiums are a lot less they're a lot less and it gives you time to build you know to uh to build up your plan on the on the reverse the older you are you know the older you know the the closer you are that you might need uh you might need caregiving and you have to buy uh a bigger plan because you need you want uh more in monthly benefits you haven't given it time so those two factors alone uh uh will make the premium more expensive and hopefully you're in uh uh reasonably good health at least you can get standard now if you're really good health you you can get even uh pre uh um when I say substandard I'm what I what I really mean is that you the uh that you uh um that you you can get a pr uh premium that's less because you're in in uh in better health and so actually uh actually it's not actually it's really morbidity you're more likely uh uh uh you're more likely uh to to not need caregiving sooner and you're probably gonna live longer so they'll give you a discount.

SPEAKER_01:
22:15

Oh okay so what are some alternatives if someone can't afford or doesn't qualify for the traditional long-term care insurance what can they do?

SPEAKER_00:
22:24

Interesting you have okay if you have this also something I've heard if you have family and they like you know you can ask people you can say look you know uh I'm on a fixed income you know could you help contribute? So uh and from the family point of view it's a good if that's a good investment where you know if if the family you know contributes to the premium you know then then uh uh mom and dad or the step people whatever uh uh that they have a plan so that they can continue on with their uh uh lives and careers and you know save for retirement and do all the other things they want to do so families can can contribute. Now if if if if your family doesn't like you, you don't have any family, you don't want to ask them, you feel embarrassed, depending on the state, there uh uh there are more and more there's Aetna, there's uh uh uh Wellaby and uh uh um um um can't think of the other one as a very very uh omniflex there they these are short-term plans uh they can be one or two years but depending on how you do it you can even extend it out and the premiums are really reasonable I mean you can get uh just a phenomenal plan for like$125 a month and it it it can be as good or better than a regular long-term care plan. Um and or another one you can uh get is called true freedom it's$95 a month it's it it has uh uh four levels it's like Costco you know you have the basic and then you you have the different levels but what you it's a subscription plan actually something else you don't need any help so long as you don't need immediate caregiving you're gonna want a true freedom plan and it's and it pays for home care. It'll either pay uh uh uh reimbursement for a uh licensed care center or if it's off hours uh it will reimburse family or friends um to pa uh to help you with your care you know after five o'clock um and you what you're doing is you're buying hours it's like it the example would be Costco or Walmart you know uh a uh some subscription plan it's a subscription plan it's really not a health plan it's a subscription plan okay and it will it will it will pay only for home care uh benefits but it will do you know most of the things that a regular long-term care plan will uh uh provide okay well those are all good alternatives so if somebody is interested in this what would be the best thing for them to do I mean obviously because you said it varies a little bit by state so where would be the best place for someone to start well you start in the state that you uh uh you are and if you want to contact me uh it's Raymond Wine 253 432 uh 9491 or 253 2756091 I sound like an Earl Scheibe uh commercial yeah um the um uh depending on the state you know you can call me and if I'm not licensed I'm licensed in most western states but if if I'm not licensed um uh there then uh you know you can call me and I'll uh uh refer uh somebody that's really good in uh this uh they may either be in uh uh uh what are you know your state or um um or or or they have like me a lot of non-resident licenses um uh to practice in uh various states. So you know if you want to call me and just and uh you know tell me the situation I'll say look you know I think this person would be um good for you. Now if it if it's for a company then I can deal I can deal in any state. But if it's as if it's an individual or family they can uh they can call me and I can uh you know depending on the state I'll I know I know somebody or I can find somebody that's very good uh to consult with them.

SPEAKER_01:
26:08

Okay. So and you also have uh a website too right it's Raymond Levine Levineofficial dot com and it has a lot of that information on there as well too is that correct that's right and my website is www dot L A V I-N-E L T C I N S dot combine ltcin s dot com. Okay so yeah so that way people can check that out in that because long-term care insurance is something that you don't think about till you need it but then it's too late so it's always something to think ahead of time because you you never know when you're gonna have to you'll be in that caregiving situation whether you're the caregiver or somebody's taking care of you.

SPEAKER_00:
26:49

So it's definitely something to think about I I you would agree I'm sure I'm an advocate of it because uh just like you you've been personally involved you know what the costs are so if you know what the costs are uh then you say if it happened uh to my parent or to my mother or will happen to my father it's gonna it may happen to me so what am I gonna do about it? And the way to do about it is that uh um you know the the the the ultimate thing is that you have a long-term care plan but if you if you if you feel that you have enough money or enough family and you really don't want to do it there's nothing I can say that will say you know say you know buy a plan. Right but alternative it it it is a it is a great investment. And you may say well it's insurance it's an investment. When you buy life insurance you know do you know I mean if you buy uh um whole life insurance it uh it's insurance I'm not gonna do but it's the it's an asset if you uh uh when you when you're listing your assets and you own um uh cash value uh life it's an asset um if you own a hybrid plan long-term care plan it's you you can let you can list it as an asset it's so it's an asset so you could and also if you have uh uh some side business you know you make uh pottery or you make whatever it is you do uh and you have an LLC you can deduct some of the premiums you can deduct a premium and when you get as I said pre earlier if when you need the plan if there there are no taxes. Okay well this this has been very informative very very informative so thank you for joining us here today uh Raymond uh I really appreciate it I think you gave our listeners a lot of good information well thank you for having me Lisa it's been fun yes definitely uh I I've learned a lot myself today so so you explained it because sometimes I get a little overwhelmed with all the insurance so it made more sense to me now so well if if you talk to me or you talk the the the thing that uh I wish people would say is um you know I don't want to be overwhelmed and I understand that because I don't like to be overwhelmed the way I do it is you know I I will have the conversation I I I will explain um I you know they they often say you know I'm gonna educate and I think we sort of overdo that you know we'll have we'll we we will share information so you know by the time you know you either decide you know uh that you're gonna do something that you will feel comfortable about the process and you'll feel comfortable to say uh if I did it I did the right thing and I and I and I don't and I and I don't have I do not have any remorse.

SPEAKER_01:
29:24

Yes exactly so well thank you again for joining us so hopefully um you've uh our audience has learned some good information about long-term care insurance so hopefully they've enjoyed their cup of tea or their cup of coffee or their glass of wine and hopefully you all juice yes or juice yes for it and I'll have all the information on uh how they can get hold of you as well on the website so uh hopefully everyone will join us again for another edition of Patty's Place

SPEAKER_01:
0:09

Welcome to Patty's Place, a place where we talk about grief, dementia, and caregiving. I named this podcast for my mom who suffered from dementia. Uh, she passed away about exactly two years ago. And so I thought we would f have a place where we could talk about all these things and just know that you're not alone with going through all of these things. So pull up a cup of tea, pour yourself a cup of tea, a cup of coffee, or if you're having a really bad day, a glass of wine, and let's get started talking. Today we have a special guest. Her name is Erica Sell. She's the founder and CEO of Harmony Home Medical in San Diego. It's the leading home medical equipment and accessibility solution provider. Erica grew up in Northern California in a medical equipment family, and she saw firsthand how the most durable medical equipment dealers operated out of bare warehouses and how little choice end users were given. So after she attended Pepperdine University and graduating from University of California in San Diego, she turned her passion for helping people live with dignity and independence into a business in 2008. From a startup booth at the Del Mar Fair to a full showroom in a second location and multiple expansions, Erica transformed the industry by treating shopping for mobility and home access solutions like with real product demos, selection, education, and service built around the person, not the insurance company. Erica holds certification as a certified assistant technology professional and certified aging in place specialist and is known for pushing innovation in home accessibility and mobility equipment. Well, welcome Erica. Thank you for joining us. Yeah, thank you, Lisa. Thanks for having me. So this is very interesting. Uh it's a it's a very interesting industry for it. So you got started with all this, you know, because you said you came from a medical equipment family and that. So what do you think people need to know about like assisted devices and that?

SPEAKER_00:
2:07

There's there's so much. Um so yeah, I came from uh um growing up working in my mom's store that was an insurance-facing store. So they they almost exclusively worked with third-party payers. Um, and I I actually went away to college to not work in that industry and I came back for a family emergency. And during that time, I saw how there were specialty products, things that most people don't know exist. And we can go into some of those today, um, called shower buddies and ceiling lifts and um vertical platform lifts, all these different things um that most people didn't know about because insurance doesn't cover them. My mom's company was doing them for an agency called Regional Center, which services developmentally disabled clients, usually, you know, kiddo populations. And I was like, why don't you show this to our seniors? Why don't you show this to your all your clients in general? And she said, Well, because Medicare doesn't pay for it. I said, That doesn't mean people shouldn't know about it and see it because I just don't think that people will pay for it. And I said, I think I think it might be off. Let's try this in the city because we lived in a small town. Okay, you know, and that's kind of where the idea was born to come down and try it in San Diego, the big city, and and see if people would be interested in learning about these more um specialty. Now they're not so obscure, but at the time they were obscure things. Rolling showers weren't ever talked about then. Um so I developed a tiny little showroom. After the Del Marfare was a success, um, I developed a tiny little showroom just cramming every single piece of nicer equipment and helpful equipment I thought people would want to learn about. Like I had a ceiling of this a thousand square feet this place, and I had a ceiling left in there, a roll-in shower, a walk-in tub, the tiniest of power chairs, the most nimble of scooters, the things that weren't really covered, uh, along with the more covered items too, where I could fit them, but really seeking products that delivered value over just economy. Um, and and we're most of the time not all the way covered by insurance. And so um, so our store, and still to this day, is kind of like uh the Toys R Us for the aging adult and an educational hub where you can come in and kind of explore what's available um beyond what you might hear or get referred by your physician.

SPEAKER_01:
4:40

Well, and that's really a good point because as you go through caregiving for you know with your parent, there are things that you come across and you're like, okay, how do I how do I take care of this? Like with dementia, they don't they they just don't like taking showers for it. So it's it's quite a challenge with it. So how let's start with dementia. So how do we make caring for a loved one with dementia easier? What are some products that we could try?

SPEAKER_00:
5:11

Yeah, so it's just so there's it's such a spectrum with dementia and how people um default to either like a happier version or maybe more combative version. Um, but starting with the the shower and the the um the bathing, there's of course the full gamut, which is that roll-in shower and you roll them right in in a chair, and there's not a lot of need for transfer participation from the the client. That's the ideal outcome, but it's also the most expensive outcome. Okay. You know, it's like a bathroom remodel or rolling piece of equipment. Um, those are great. Sometimes, if someone is combative even to that level with water, there's a couple things that we can roll back to. Um, before I get to those, in between there, we have products like the shower buddy or new product system. And these are really cool. A lot of people don't know these exist. These are little tracks that you set in your shower or your tub that a rolling bath chair comes and connects to. So then you connect to that track and you slide it across, and it creates the same outcome for the patient as a rolling shower, meaning there's no transfers, everything is wheeled safely from the bedroom to the bathroom. You can also do toileting from that chair. And so everyone's safe in the bathroom and they don't have to participate a lot to get that shower done. It's it's getting the construction outcome without the cost of construction, the caregiver just needs to do a couple extra steps with clicking the track in.

SPEAKER_01:
6:46

Okay.

SPEAKER_00:
6:47

Um those products are really cool. And those products are three to five thousand, where a full bathroom model is, you know, up in the teens of thousands or higher. Um, but then if someone really doesn't like the water aspect, if that's the piece, um, you know, then the bed baths and the special items for bed bathing are out there. There's the inflatable little um tubs, either just for doing hair a couple times a week, or a full-body sponge bath that you actually do right in the bed. And then the latest product I saw, which has we still have, but it hasn't taken off. But it's a really neat idea. And I'm sure people do this at home in their own way, but it's the bed spa, and it is a warming bottle of water. It sprays really fine mist, and you use that with the no-rinse shampoos. You put the no-rinse shampoos and body washes on, um, and then you wipe them off with this warm kind of spa-feeling mist of water with a hand towel. Um, it's about as elegant as a bed bath can get. And that's that's some way that people can get a little bit more clean and a touch of moisture and water on their skin to remove the buildup that can happen. Because when we're not caring for our skin and not getting um not getting the layers and the buildups off, that's when problems like skin breakdown to cubitus ashes show up, which can be a lot worse than sometimes the um stress of the behaviors coming out in the shower. So it's different for everybody, but it's kind of a spectrum of best to minimalists, you know, that we could do with the shower. And that would be consulting with a company like Harmony about the behaviors and budget that people are working with and mobility level, of course.

SPEAKER_01:
8:43

Oh, definitely, because it is it's a struggle. Uh I don't I don't know if it's the way that the water hits the person with dementia, their skin or or something, but that tends to be such a struggle, even for caregivers, because my mom was in a memory care unit and she it the caregiver struggled with that to take care of her. Like I I would be happy if they were able to get it every couple weeks. They they got her.

SPEAKER_00:
9:09

Yeah. Um change. Yeah. Change, I think, is hard to even just the change in their current state um can be upsetting. And so, yeah, so I have to get creative. I have a caregiving company that uses like music and aromatherapy to try to calm the setting before doing the bath. Um, so yes, yeah, I know that it can be tough, but those are the mobility tools that might help to get it done.

SPEAKER_01:
9:37

Yeah, exactly. And when hospice came in, that's what they started with. They started with the music, and and while she was still somewhat mobile, they were able to get her in the shower and then it they ended up doing the bed bath and things like that. But I could see where like that warming might help too with it.

SPEAKER_00:
9:53

Yeah, it's really gentle. Like you could do your own version with warm water in a spray bottle, but the way it missed is super gentle, so it doesn't feel shocking whatsoever.

SPEAKER_01:
10:05

Yeah, I could see where that would be really helpful uh for them. So what do you what do you suggest? Like what are some of the best products to help families with caregiving in general?

SPEAKER_00:
10:16

Well, some of the things that people don't think about that are this, these, this one is uh again a little bit on the higher end of things, um, but the bed setting, the bed that people use is it's this is our um best category. Um, our most popular category is beds and bed surfaces. And what we find with so many of our clients is they need, you know, positioning always beyond a semi-electric. So insurance covers a semi-electric hospital bed. That's a bed that you have to crank up and down, but the head and foot oscillate. So that's what's covered on insurance. At the minimal, people need the high, low powered feature so they can change quickly for transfers and for care. But for caregiving, and a lot with dementia and um just the psychology of coming home to home and not home to hospital, our high-low adjustable bedline has been extremely successful. And that's beds that do the extra high so the caregiver doesn't need to bend over and hurt their back, and the extra low so they don't uh risk injuring themselves if they roll or fall out of bed. And all of that is in a package that looks just like a traditional bed. You have no metal framing, it's padded, there's color selection, and that sets the patient at ease that they're coming home or they're living in a non-medical space, a home environment, which tends to have better outcomes when they come home versus when they're in a um hospital. So if they're gonna be able to be discharged home, um, they tend to do better. And if we can make that home feel even more home like with products that integrate into the setting, then uh everyone is just happier that way. So those beds can be a huge success or a huge help when someone's coming home to help them feel happy about using this equipment and being open to it. And then for the caregiver, that high-low feature, which is available in also the hospital bed style beds, that saves backs. If we're doing dressing changes, um, you know, rolling the client in bed and not um transferring out, um, even getting a sling on for using a patient lift, all of those things to do it at waist height versus down closer to like thigh or knee height is huge for the caregiver.

SPEAKER_01:
12:48

Oh, for sure. Uh I know um uh I know sometimes the patient prefers like a recliner as opposed to the hospital bed and makes me wonder like if it like you were describing it, like it looks like a traditional bed, if that would be better for them than the actual, you know, hospital bed, even though it's absolutely it's great you brought that up because that was the most aesthetic solution um about three years ago, two, two, three years ago.

SPEAKER_00:
13:17

I mean, they had adjustable high lows, but they didn't have all the framework covered like they do now. Um, and a lot of people opted for that lift chair. It's still pretty, it has a lot of uh infinite positioning options. It just doesn't assist the caregiver like a like the high-low bed working space does.

SPEAKER_01:
13:39

For sure. Uh with my mom, you know, once she was no longer mobile, that's when hospice brought in the power chair and and then the hospital bed and that. And uh yeah, she was she liked the recliner, uh, the bed she slept in. At that point, I don't think she really knew the difference. But I could see for other patients, it could be a mental thing where they would just prefer to be in the chair as opposed to that hospital bed with it.

SPEAKER_00:
14:06

Absolutely. It is, it is sometimes there's some resistance to all of it. Um, and so when we can make it look a little more like home with both the lift chair recliner, that um that style adjustable high-low bed, um, and then trying to conceal or just integrate some of the transfer devices. So that's the other category where there's some products that people don't often know about that can be really helpful for transfers because transfers is a tough topic too. Nobody likes to hurt their back, and nobody likes to bring in the traditional manual manual uh hoyer lift or patient lift. Okay.

SPEAKER_01:
14:46

Yeah, for it is, you know, you you because you don't want to hurt hurt your loved one, but then you don't want to get hurt and you don't realize how many times that you do end up transferring when they aren't mobile anymore or they're very shaky, you know, or they're prone to falls. So what are some things in the transferring area that people can do?

SPEAKER_00:
15:06

Yeah, there's kind of like a pyramid, right? From the from the bottom up as far as mobility need goes. Um, and so first it's just learning the body mechanics of transferring. We teach that in the in the store. Um, but you know, the knees bent, the the hips over knees and shoulders over hips, um, to try to not put too much strain on our back when we're bent over to do transfers correctly. And in that stage, using a gait belt um can be helpful around the client's waist. And then using the lift chair to help do the lifting and using grab bars or floor to ceiling poles. Floor to ceiling poles are awesome. Sometimes people aren't aware of them. They're like floating grab bars, they're tension mounted, and they're very strong. So the client can yank on those versus yank on you, and you can help them up. So you're not this the transfer bar. There is a transfer bar, and you can put those anywhere. They're not just needing to be on a you know a wall or in a bathroom, so they can be next to your favorite recliner, next to the bed anywhere. So that's kind of like phase one. Um, and then phase two comes into using a transfer device, and there's some transfer devices that are easy to use, they don't require the sling that are kind of in between. And the most known brand, and that's called a Sarah Steady, and that's because they use it in the hospital. Uh, but there's other brands. We carry one from Best Care, the Best Care SA450. And these are um manual devices, they don't have slings, so you don't have to put anything on the client, but they have kind of like a handlebar that the client pulls up on. And as soon as they get some space below themselves in the their bottom in the chair, you can flip a paddle down underneath their bottom. So then it holds them in a seated position as you move them over to their chair or their bed. So they need to have a little bit of ability, but it's real easy for everyone if they do, and then and it's real quick. So no slang, a little stand-up, and then a paddle support underneath them. And that gets the job done for a lot of patients. There's a big spectrum that can use that, but often don't know about it and they get sent straight to the Hoyer lift. Okay, because that's again what insurance covers.

SPEAKER_01:
17:31

Okay.

SPEAKER_00:
17:32

Excuse me. But when you go to the Hoyer lift, um, you have to put on that sling, and it gets a little scary for the patient. So if they have the ability to bear weight in their legs and they have this that manual option, and then after the manual option, there is a powered sit-to-stand where they're using a sling, but it's basically just a piece of fabric thrown behind their back in their armpits, and it lifts them up instead of their legs having to do the lifting. So the frame of the unit is very much similar to the Sarah Steady or the manual one, but now it's powered and they have a sling and they get into a seated position with that sling's help, and then they get set down in a seated position. So they're not flying in the air ever at any time. Their feet stay on the platform of the lift and they can transfer in that 90 degree seated posture. So it's easy to land in the right position into your wheelchair or into your lift chair. So that's that is the kind of third phase where they have still the ability to bear weight through their legs and moderately participate in the process, but they really don't need a lot of strength. I even have uh paraplegic clients that can do this. They just have good bone density still and flat feet, or they can still use this lift. Um, and then the last stage is that full assist with a Hoyer, a powered Hoyer, or a ceiling lift. Any of those require the full body sling or divided leg sling, but it covers you know most of your body and it lifts you up in a hammocked position.

SPEAKER_01:
19:09

Okay.

SPEAKER_00:
19:09

And that's the last phase of transfers. A lot of people are go ahead.

SPEAKER_01:
19:14

I was gonna say it makes me think of when my mom um ended up having to be in the wheelchair and transfer. She did not like being in the wheelchair, so she would shuffle her feet, and when they would try to transfer her, she would like grab onto the TV and all kinds of stuff because like she just didn't like that. Like it was like her way of holding on to her last minute of independence. She she hated all that.

SPEAKER_00:
19:39

Yeah, she hated all the equipment. Yeah. Right. She wanted yes. Yeah, there's such a psychological barrier to equipment for the end user until they see that it delivers them this newfound independence and ability. With your mom's case with dementia, that that bridge is sometimes harder to cross and harder to find. But uh for a lot of people who are aided by it and then able to could do other things as a result, it does change, but there's always that first, you know, barrier to entry with their with their beliefs around it.

SPEAKER_01:
20:13

So how do you go about that? Um because obviously I mean I know with with my dad sometimes I kind of fight with him at times like, you know, do you have your cane? Do you not, you know, are there different things to help? Because it is, like you said, that psychological you want you're independent. You you want to be able to do this, but you also want to keep your loved ones safe and knowing something assistive might help them. What are things that you can do?

SPEAKER_00:
20:40

A couple things. So in the very beginning stages when someone needs it in their wall walking, we call it like they're holding on to the items, furniture and you know they need a walker. We've had families get the walker and leave it with them in the room without anyone seeing them so they can experiment with it and use it without feeling embarrassed that they're using it without anyone watching. We've had that work and that's with the you know cognitively inclined person who's stubborn um and that we've had that have some success. Then also kind of rewards or those outcome rewards so if we can get mom or dad into the transport chair, they get to go to B's recital um you know or they get to go down to the midway ship here. That's that was one for one of our families who used to volunteer and loved the midway and like if he could use the equipment then they could get him to be able to go volunteers agreed are still out there. So there was a reward afterwards for the an outcome that they were seeking. I think that's really powerful. And then lastly is peer group I do see adaption of equipment use go a little easier in communities like assisted living communities because there's so much widespread use of wheelchairs and walkers and other adaptive aids that it's almost cool. You know they I I have clients they they dress them up they want the latest and greatest they show their friends. So a peer group that is uh already acclimated to devices and think that they're valuable that helps a lot too oh yeah I could I could definitely see that what are some of the mobile mobility devices that you think could be game changers that no one really knows about yeah so um a few one the uh for Parkinson's specific is the U-step the U-step is a walker it's kind of conky it's kind of a bigger walker but it's the only one that has reverse braking in a in a functional way for Parkinson's so that means that instead of squeezing the brakes to stop you squeeze the brakes to go. And that's really important because they get freezes and so on a traditional rollator they might get a freeze and that rollator keeps rolling. They can't squeeze the brakes to stop because they have a freeze. So being able to squeeze the brakes to go and then when you get a freeze you're unable to squeeze anymore so the walker automatically stops. Oh and that's cool it's a sturdier walker so it it gives balance okay so yeah that's a pretty neat one that people um don't know is out there don't see it too often um and then adjacent to that for people without Parkinson's but similar are the upright walkers. Those are the ones that have platforms up above you walk inside of the unit versus behind it. And this has delivered people the ability to take larger strides upright versus kind of just holding on for balance a little bent over at the back of a regular rollator the ones with the seat and the handbrakes um this brings them inside of the frame of the walker and it gives them a platform for each elbow so they can hold themselves a little more upright and take sturdier straighter taller steps that's new not that new anymore new about eight years ago now I think um but still sometimes people may not have seen it um and then a lot of families this is a really simple one but they don't know the difference between wheelchair and transport chair. They might just get prescribed a wheelchair from the physician and so they get their you know 40 pound big wheeled wheelchair from Medicare and they're doing all their visits and their outings with this chair and then they discover they come in for like a repair or something they discover that there's these tiny little 19 to 25 pound chairs. We have them in all different styles now like ergonomic and uh Hemi, which means lower to the ground like different ways to meet the person's physical needs. But these chairs are like strollers for adults that you're really lightweight and fold easily to go in and out of the car. And while it's super simple a lot of people know about it there's still people who don't and they're lifting their full blown like 40 45 pound Medicare issued wheelchair in and out of the car. So that one can be a game changer for the caregiver. And then in the powered world there's a few things that are pretty neat people don't know about um the the the one most do now is the carbon fiber and ultra lightweight aluminum folding power chairs. So now power chairs which which can return independence where they don't need to be pushed you know they can choose where they go are down to 26 pounds. 26 to 36 pounds are the range for these chairs now which is just incredible. It is that is a 60 pound improvement from what we had three years ago. So it makes it very feasible for people to take their loved one out and lift this in the car and even for the end user to take it out themselves and still do their outings. Yeah that's pretty cool.

SPEAKER_01:
26:14

You don't I don't I don't even think about uh how heavy those chairs are and what that is like you know so you mentioned yeah and and for people who are right on that line where they're just doing their own care still and they want to be able to do it it can be the difference maker between going out on their own and not.

SPEAKER_00:
26:30

So some people can still do it. But then for our clients you know 30 pounds is still really heavy. So it's a push but it can make it possible and then it for sure possible with a caregiver. And the last powered thing I wanted to mention that people may not know about power assist devices for your manual chairs. So you can add either like a front scooter wheel to a wheelchair or a rear powered motor wheel to a wheelchair. And these devices they are a little bit pricey um they can range from about 2,000 to 7000 depending on the brand and the style but what they do is they turn a manual chair which a lot of times is best for indoor someone can still push themselves around they're mobile in it it's easy to get and out of the car but it can turn that manual chair into a power chair when they're in the world. So they want to go further they want to go faster they don't want to tire out they can add one of these power aids onto their manual chair and they're both very light. So they're still getting lightweight things in and out of the car and being able to have those dual devices you know manual chair inside and add this power device when you're in the field. So and these become a little less popular as of late because of the super lightweight power chairs available now. But it's pretty relevant for people who like to stay as active as possible. So they want to be doing the chair pushing as much as they can when it when it's feasible but they need that little extra assistance up a ramp um out in the world so they can do that adaptive power to their manual chair and it's like a fusion of their effort and the power to effort.

SPEAKER_01:
28:20

So let me ask you I I know a lot of people they might be listening and being like okay this is sounds really great and that and some things the insurance will cover some things don't how do they go about if the insurance or Medicare won't pay for it but they know this will help their loved ones are there financing available or yeah.

SPEAKER_00:
28:40

Yeah there's financing there's new and used we do both new and used um there's 0% financing uh we use a company that does 0% financing for uh I think it's 16 months or eight 18 months and then there's charged financing after um there's also like a reimbursement form so if one of the items say like a nice wheelchair the basic wheelchair code is covered they can submit the invoice with the reimbursement from a Medicare and get reimbursed what Medicare pays which can often be way, you know, only a fourth or a fifth of what the product costs, but it's something they may be able to get reimbursed. And then the the other things that exist sometimes are grants depending on a diagnosis uh or your area there can be grants in place that can help fund for some of this stuff. But a lot of times people are paying out of pocket and so how we help with that is we do financing um new and used rent to own those are kind of programs that we try to make it a little easier.

SPEAKER_01:
29:49

Okay. Now where so where should somebody start? I mean obviously if they're in California they can go to Harmony Home Home Medical where would be somebody like I don't even know where to begin to start. How do they even look up a place to get home?

SPEAKER_00:
30:04

Yeah I would do a Google search so medical supply near me and see if there are any medical supplies that show their their retail store. You can kind of tell online if it's um a warehouse you know insurance one you can call them too and see if there's somewhere you can walk into a lot of my industry is small mom and pops there's a lot of great small mom and pop dealers around the US like Harmony but a lot of areas especially more rural areas don't have it. They don't have that option um but I would start there and see who's local who can help you um and then next would be to go on to YouTube and check out some of our YouTube videos and get answer ask some of the questions you're wondering about in in YouTube um and then pick up the phone and call us if there's questions you know that we can answer. We sell and drop ship nationwide okay but a lot of a lot of these things you know you want someone to be hands-on with so when it's appropriate I I have turned down plenty of business and Googled for people to say you know how I see um I remember the client up in the Bay Area and I I see I forget it was called something about Palo Alto medical supply is is there let me call them call them up and see what they offer and they did have an ATP on staff which is uh someone who designs custom wheelchairs that's my credential and um and help them get a smart drive up there one of those power assists for their chairs because some of these things really take someone measuring you and understanding you and getting you the right product ordered. It's not real easy online. But if you don't have that then calling someone like Harmony and we can do remote virtual assessments we can get height weight and I've walked people through measuring in Mexico I've done quite a few chairs where I just have the family member on FaceTime and I get all their measurements that way. So there's ways to go about it but I definitely think a little bit of your own research online and then working with an industry expert in your area or remote if you don't have one would be the best place to start. And whether you purchase or not with that company at least it helps weed out some of the mistakes you might make. I I see that a lot I have a lot of people call us and say will you buy this or will you buy that? I bought this on Amazon I bought this on Spin Life it doesn't work for my mom or dad and we don't buy back product lines that we don't sell. And so you know they're stuck buying multiple times products when they could have bought it once with a little bit of help.

SPEAKER_01:
32:45

Yeah I mean Amazon is nice but when it comes to caregiving and that you really do have to match it to the individual.

SPEAKER_00:
32:52

Yeah and when you're getting a bigger item like a bed or a wheelchair power chair um you want a place that you can get it serviced at so again why a local dealer is great um and in the first choice. And then if you work with someone if you don't have local deal and you work with someone like Harmony to do it nationwide or remotely need to make sure that the white glove or the tech support services are in your area or find that out beforehand. We have a um for different product lines they're called different things but like for our lifts it's called lift squad and it's a network of installers and technicians throughout the country so people who can help you fix things because it is equipment it is mechanical there will be times when you need to have a repair or a battery swap or something you know so it's good to make sure you have some support.

SPEAKER_01:
33:44

And then lastly what are the most commonly used pieces of equipment for say dementia or ALS or just aging in general um bath equipment it always it usually starts at a bath equipment inquiry you know and grab bars are the new safety belts.

SPEAKER_00:
34:01

Everybody should have them I have them everybody should have them they're beautiful there's nice ones um so outfitting your bathroom is number one it's the place where 80% of the falls that happen at home happen. And then the um the looking at transfers and and home access I guess would probably be next so you know if you're using the wheel device our threshold ramps and our in and out of our house safely um is really important and then going up to the bed the bed you know it's kind of like the the progression of getting less and less mobile eventually that bed becomes a really important piece of the care. So making sure that if you're getting a bed on insurance or hospice pay the difference to have them make it a a um a full electric, a high level full electric they can do that. You just need to push them a little bit they can do it. Okay. So so that could be you know majority covered when someone qualifies um and they just pay the difference on it. But looking at that and deciding what kind of bed you want for care when you're getting a little later down the line when you have a lot of caregiving going on becomes real important too.

SPEAKER_01:
35:18

Oh definitely I mean it's it's so overwhelming being a caregiver. It really is.

SPEAKER_00:
35:22

Yes yes and then you know the the pinnacle rule for all caregivers is care or like the or the airplane too like put your oxygen mask on first. You know take time to take care of yourself to learn the safe transferring techniques to make sure you don't hurt yourself because if you're hurt you can't care for your loved one and look for resources in your area. What are there respite care programs here in San Diego the Alzheimer's Association the local one has a respite volunteer program. It can take time to get paired with but after you are you can get I believe it's five hours a week of a volunteer to come over and give you a break to go get your hair done go to the doctor go, you know what you need to to do. And so making sure you've got you breaks is a is really important.

SPEAKER_01:
36:10

Yes yes it really is so uh you mentioned your YouTube channel so I'll go ahead and wanted to tell people again how they can look up your YouTube channel or your website as well.

SPEAKER_00:
36:20

Yeah it's harmonyhomedical dot com and on YouTube it's the same you type in harmony home medical we're the only one on there we'll come up and um there's if you type in questions or products on there it should come to the video or you can scroll them we have a lot of different videos and we're going to continue to add them. And so on our website we have a product education tab where you can go in and learn about the differences between manual chairs, the differences between power chairs, the differences between beds and lifts and that's a helpful place to do some learning around what might best suit you or your loved ones' needs. So and then we're always a phone call away have a great helpful staff we don't mind answering questions no matter where you are and um always happy to help people get started in the right direction.

SPEAKER_01:
37:09

Well thank you Erica so much for joining us today. This was very very informative.

SPEAKER_00:
37:14

Thank you thanks for having me is my pleasure thanks for doing this.

SPEAKER_01:
37:18

Oh thank you so I hope today's been helpful for our caregivers and assistive technology. So hopefully you enjoyed your cup of tea or your cup of coffee or if it was really bad day a glass of wine and hopefully you know you're not alone here and join us again for another edition of Patty's Place