Welcome to another episode of Modern Financial Wellness! I’m your host, Jim Grace. In this episode, we tackle an essential but often overlooked part of financial wellness—how we support our loved ones (and ourselves) as we age. Whether you’re part of the sandwich generation juggling kids and aging parents, or you’re planning ahead for your own well-being, today’s conversation is for you.

To guide us through the complexities of aging and care planning, I’m joined by Jennifer Mahoney, head of Live Well Care Management (formerly AZA Care Management). With over three decades of experience in Greater Boston, Jennifer and her team of healthcare professionals help families navigate the maze of senior care, advocate for loved ones, and coordinate personalized plans for happier, more connected aging.

Key Takeaways:

1. Start the Conversation Before a Crisis: Most families reach out to care managers after a fall, hospitalization, or urgent diagnosis. But proactive planning, like Jennifer’s “Peace of Mind Program,” establishes a relationship and understanding long before emergencies arise—saving stress and improving outcomes.
2. Care Managers Aren’t Just for Healthcare: Live Well’s team handles everything from medical advocacy and managing appointments to arranging social outings and digital connections. Quality of life for seniors goes beyond medicine—it’s about relationships and daily joy.
3. Delegating Care Coordination is an Investment in Relationships: Caring for a parent or spouse often brings stress, time pressures, and even guilt. Hiring a care manager doesn’t mean you’re neglecting your responsibility—it frees you up to be more present as a spouse, son, or daughter and creates a healthier dynamic for everyone involved.
4. There’s Help (and Funding) Beyond Private Pay: Jennifer highlights lesser-known Medicare Advantage benefits, VA programs, and local resources like senior centers and councils on aging. A seasoned care manager navigates these options, ensuring families don’t miss out on valuable support.
5. Handle Resistance with Empathy and Communication: If a loved one is reluctant to accept help, frame the conversation around your need for support—“I need someone local to help me help you.” And remember, care managers can advocate for the senior’s true needs, even when family expectations don’t align.

If you’re preparing for aging—your own or a loved one’s—the key is to plan ahead. Have the conversations early, reach out to care management, and don’t go it alone. Everyone will be better off for it.

Be sure to subscribe to Modern Financial Wellness for more conversations that help you and your family thrive—financially, emotionally, and beyond!

Welcome to Modern Financial Wellness, everyone. My name is Jim Grace and I'm your host. The podcast was created to help people have a healthier relationship with their finances and beyond. And today we're very grateful to have Jennifer Mahoney here from Live well Care Management to talk to us about everything. Aging, seniors, longevity, planning for care, this whole, you know, space of getting older and how to go about it efficiently and effectively for our loved ones. So, Jennifer, thank you so much for joining us today. Appreciate it.

Yes, Jim, thank you for having me. I appreciate it. I'm excited.

So I mentioned a little bit, what we'll talk about today is this idea of aging, which is this big, big broad term probably, but I think we all have people in our lives who are getting older. We have parents or loved ones, friends and neighbors who are getting older and aging. And everybody at some point needs a little bit of help and care. And that's what Live well Care Management provides, is a resource, it sounds like. Correct. So could you tell us just high level what you do and a little bit about Live well as we kind of kick things off today?

Yeah, of course. So Live well Care Management, and that's actually our new name, we rebranded on April 1st of this year. So prior to that we were AZA Care Management. And we've been around in the Boston area for over 30 years. We now have a team of, there's 10 of us total that are healthcare professionals that work as care managers. And basically, you know, we're individuals, mostly nurses and social workers, but we have a nurse practitioner, we have a nursing home administrator. Administrator. And by virtue of our careers, we've been doing this for at least a couple of decades.

We get hired now by clients and families to help them navigate the senior care landscape, the healthcare landscape in general. So that could mean advocating for a client at the hospital, that could mean bringing a client back and forth to doctor's appointments and reporting back to family that doesn't live nearby. Locating the best senior living community for someone, someone wants to age at home. And we're the ones who provide them the different resources and what's available and what will be covered by insurance and who the best home care agencies are to go to. And so that's kind of in a nutshell, care management.

Yeah. And you mentioned so many different aspects of aging. Right. And so many, whether it's the healthcare or appointments. I mean, there's just so many things that go into caring for a loved that's getting older. I work with a lot of clients that I would describe being in the sandwich generation. So they're mid career professionals, they have young children and they have aging parents. Right.

So they've got a lot going on like most of us. Most of us do. And then when a, when a parent becomes ill or just generally needs some help, I think it becomes a really daunting task to try to sort out how do I provide the support and care for, for my mom or dad or loved one that they really need. So it's great to have resources like yours and your company out there that can help. I guess one of the questions that I have is what are some of the first signs that people might need some help or some care? Right. So I know that people are probably familiar with an Alzheimer's diagnosis or somebody falls and breaks a hip, right. And gets injured and it becomes very obvious that they're going to need care in the future. But are there any other signs of aging that might be signals for us to pay attention to? If our parents or loved ones are starting to exhibit these signs that we might say, hey, maybe this is an opportunity for us to think about what the next steps are moving forward?

Yeah, absolutely. And we have a lot of families that hire us that don't live nearby and we kind of become their local boots on the ground. And for those individuals, it can be even harder to make that assessment because they're only talking to mom or dad or whoever it might be over the phone. And it's not as easy to get an idea of, you know, is the person taking the correct medications and how are they doing and, and all of that. So, you know, I would say there's certainly no wrong time to involve care management. We do end up getting a lot of new clients when there's a hospitalization, there's a hip fracture, a short term rehab, you know, there's some episode going on essentially. We also have individuals that are noticing and decline, whether it's a new diagnosis or just new symptoms. A lot of dementia, of course, and they know that their loved one wants to remain at home.

And now it's getting to the point where they're trying to figure out, are they still safe at home, what do we need to bring in, who do we bring in, how does this all work? And, you know, that's when they turn to us. You know, I would say that in terms of, you know, we. One thing that's nice about our program is that we have active care management where, you know, you call us and you're in the hospital and we need to act Right away. And, you know, we're happy to do that. But we also have what we call our peace of mind program. And that's basically for the proactive, independent person that wants to make sure that they're a little more prepared with their care manager by the time that they need the help. And so, you know, the nice thing about if people called early, I would be able to talk to them and assess kind of where they're at and what the help is because, you know, they might be better suited for a peace of mind program to start.

Right.

Basically what that means is they just pay an annual rate and they have. They're connected with the care manager, and the care manager visits them quarterly. And so those visits are just to slowly get to know the person, see the home, to know, okay, if they go to the hospital, can they go back in a wheelchair or is it not wheelchair accessible? And, you know, kind of all those ins and outs and, you know, the goal is to basically have a better understanding of the person so that we can act. If we suddenly get the call from the daughter saying, oh, my mom's in the ambulance on her way to Mass General, you know, then we, we already know her, we can say, okay, we're on our way. We'll have them call you. You're the health care proxy, you know, and we can help advocate for the client. You know, depending on what the circumstances are, they'd probably want some advocacy. So, you know, that's the nice thing that, you know, when people do call too early, which is rare, you know, we're able to talk to them about our peace of mind program, you know, if they don't yet need us, but they want to start thinking about, you know, the time that they will need us.

Yeah, and I'm glad we were able to touch on that because I think that's where my question was coming from. As a financial planner, I think far too often when it comes to aging estate planning, long term care planning, these aren't conversations that people necessarily, A, want to have and B, they tend to get prompted by a crisis. Right. So something happened, and now we need to figure out how to help mom or dad or whoever. So in hearing that you have this kind of first step program to get to know the clients you potentially be caring for in the future. I just. It sounds like such a great idea. As people are getting older, if you're doing some planning, if you're doing the estate planning, you're talking about all these other things that might go into aging, why not make A call to a care management company like yours, just part of that process, right, to check in and see what the resources are and what the next steps might be in the future to have a plan.

As a financial planner, I love calling too soon, right? Better. Better to call too soon than. Than too late. So take us through what the process looks like when somebody reaches out. I understand that there's an initial assessment. What are you looking for? And what can people expect when they reach out and connect with you guys?

So each call that comes in is, you know, there's no two calls that are exactly the same, just like with any client family. And so I could tell you kind of the. The normal process, but it always, you know, veers from that. So typically, you know, we'll get the call from, you know, another professional or something saying that, you know, they want to refer someone and then they'll have the information and okay for me to either call them or they just give me a heads up that they're going to be calling me and then that person will. Typically, you know, oftentimes people don't know what care management exactly is. And so, you know, I tell them, okay, I can explain what we do and, you know, our company and how it works, or do you want to first explain kind of where you're at and what's going on? And then I can tell you how we can help. And they are usually looking for information and desperate for resources. And so they quickly want to launch into their story, which is great because then I can quick, I can get an idea of, okay, this is what the care manager would be able to do for you and your family and how we'd be able to help.

And, you know, kind of outline, like, let's say, you know, the person's at home with dementia and they have a private caregiver in there. But, you know, they're not sure how many hours it should be. They're not sure what should go on. And, you know, they want someone to oversee all of the care. And then I could talk about how we, you know, will oversee the caregivers. We can make recommendations for additional caregivers if we need to add more individuals. We can talk about, you know, ordering the groceries to alleviate that from the daughter. We can talk about how to manage medical appointments, whether they want us to be involved or if they want recommendations from us.

So it kind of opens the window and I start, you know, kind of giving them ideas of where we come into play. And then depending on that conversation, a lot of times people are interested in getting the agreement from there. And so we email the agreement via DocuSign system once they sign it and we get the notification that it was signed, Then I work to introduce them to the care manager right away, either that same day or the next morning, so that they can get started and build the relationship. And I try to step out of it at that point because it's really important for the care manager and the family to build the relationship. As much as, you know, I like talking to these families and everything, the sooner I step out and the care manager can kind of help them, the sooner they're really on their way. However, a lot of people also, you know, need time to digest it and talk to other families and figure out if this is what they want to do. And so a lot of people will say that, you know, they'll talk to family members and call me back the following week. There are certainly times where there was actually a client this morning I went out to go see and I brought the contract because the attorney that had referred this client, she doesn't have any family locally.

I didn't know if she was savvy on the computer to be able to sign an agreement on the computer. And I figured this was the sort of setting that I got the sense that it would be better to do an in person visit. And so I did that. I brought the agreement. I told her there was no expectation to sign it, but I was just bringing it. And now I'll be following up with her son from there and figure out kind of next steps. So there's no direct way or right way? I guess so it just kind of depends on what's best for that client and family.

Yeah, but it sounds like you take the time up front to understand what it is that they need and then design a plan and scope of services that are going to meet those needs. And then the care coordinator, this is their point of contact, they begin to kind of quarterback or concierge all the different services that the client might need moving forward. I'd imagine that that person becomes pretty tight with the families that they're working with that they come to kind of play an important, special role in, in the lives of the people they work with.

Yes, some of our care managers have been working with the same client for over 10 years. And you know, it's very clear based on the conversations that they feel like a family member. You know, it's kind of like they, they join the family after that much time. But yeah, we're happy to take on you know, as much or as little as that client and family need. So, you know, there are some clients that, you know, over time have wanted, you know, us to take them to a restaurant and to eat or to, you know, arrange social activities for them and a friend. And, you know, that's certainly not within the healthcare scope, but we can certainly do that, you know, in a range for rides and, you know, get them out for socialization or whatever it might be.

Well, I'd imagine those things are really truly important in addition to the health care side. So I think our minds, when you think about care coordination, always goes to the health care side. Are they staying at home? Do they have the right people coming in for appointments? Are they getting the health care that they need? That's, that makes a lot of sense. But I'd imagine as we age, being disconnected from your community and your friends or not being able to get to your favorite restaurant, that starts to kind of diminish the individual a little bit and, and kind of take some of the normal day to day connection and community that they have. It kind of takes away from ideal health outcomes. Do you see a lot of success in those little things that you wouldn't think of that aren't part of the healthcare, part of the plan, really improving the lives of the clients that you're working with?

Yeah, yeah, those, you know, we call them little things, but you're right, they really are big things. You know, having, you know, being able to keep those friendships and relationships in place and those are vitally important. You know, they're, they're arguably as important as making sure that you're taking the right medication and going to the doctors because, you know, you want to still maintain that quality of life. And granted, quality of life can change over time and what that looks like, but to still, you know, be able to visit with friends or even, you know, the population we work with isn't always the most technologically savvy. So, you know, there have been times where we've set them up with Zoom and a Zoom account so that they can call friends and that they can speak to them virtually or see or see their grandkids.

Right, yeah.

Because there's no one locally that would be able to help them with that. And you know, that's just something so small that you just do once and it makes a huge difference for that one client and family. So we're always looking for, you know, little opportunities like that to really bring out, you know, who the person is and what matters to them.

Yeah, yeah. That's. That's amazing. I'm thinking about the comment you made about boots on the ground where people don't live locally or in close proximity to their family anymore. That's the case for me. So my parents are in Connecticut. I live in New Hampshire, my sister is local in Connecticut. So that makes me feel a lot better.

But I'd imagine is. Is more and more. Are you seeing more and more clients whose family members are not local to the ones that need the care? Is that a trend that you're seeing as well?

Yes, definitely. We've seen a lot that have, you know, oftentimes it's the daughter in California, the son in Florida. Those seem to be the two states where people are residing, or even if they're, you know, Mass or New Hampshire, and they're a little bit further away, you know, still within New England. It's not like you can just run to the doctor's appointment. They have that next day or something like that. And so we help with a lot of those families and really providing that peace of mind so that they know that, you know, okay, mom went to the appointment and, you know, we asked all the questions we needed to, and we're able to send a report to the family to let them know, you know, this is the med change that happened and this is why, and this is what they talked about during the visit and, you know, to kind of give them a window to make them feel as if they were there. And, you know, the way I describe what we do as care managers, a lot of times, the easiest way to describe to someone who's not a care manager is to say that we basically act as the adult child. And that's really what it looks like.

And I think it helps people wrap their mind around, you know, what this looks like. It's essentially like hiring a professional that's been in healthcare and, you know, that that is able to. Able to assist you with those different things that normally maybe a child, if they were nearby, would be the one that would typically try to assist with those things.

Yeah, that's an interesting description, that you actually use that term of becoming the adult child. But I'd imagine when I talk to people and this comes up all the time with the clients that I work with that have aging parents who find themselves in the role of care coordinator. I haven't talked to many people that enjoy it. I don't know of any adult child that loved the experience of being the care coordinator. And deep down, if I were to ask them, I think all they want to do is go see their mom or dad. Right. And spend time with them and talk about memories or show pictures of the grandkids or whatever it is. They just want to spend time, time and be with their kids.

So even if you are the adult child in close proximity to a loved one, to me it almost makes sense that this is an investment to delegate that responsibility to a professional. Not that you couldn't handle it, but again, it's not an experience that most people that I've met who go through it report back that it was enjoyable. And isn't it an investment to kind of free up your own time to have more meaningful experiences with your loved ones? Do you see that as well? Do clients talk about that at all with you?

Absolutely. Yeah. There are definitely. You know, normally the family doesn't come outright and say that they don't like it. They just talk about how stressful it is and how much more work it is than they realize.

Right. That's a good distinction. So no one's actually come out and said, like, man, this really sucks. But they are talking about how stressed they are or how overwhelmed with everything else they have going on that, God, this was really a nightmare to try to coordinate.

Yeah, yeah. And I think, and I tell people all the time that I think a lot of people think that you just set up 24 hour care for mom at home and then everything's managed. But, you know, those caregivers need to be able to follow up with someone if something's going on or if someone's late or someone gets a flat tire, you know, so all those little things the family ends up taking on, not even realizing that they're taking that on. And so there is certainly a lot that goes into that. And I talk to families a lot when they're, you know, thinking about care management and they're weighing the costs and, you know, kind of what does that look like? And does our family need it? And I tell them, you know, that you would be just as involved as you want to in, you know, mom or dad's life. Visit just as frequently. You know, you'll get updates all the time, but you can be the daughter visiting and not the caregiver that has to run over with toilet paper because the aide forgot to tell you they were running out of toilet paper and you had to. And all of those sorts of stories have happened before, and I've heard those from family members and, you know, they just appreciate being able to have things handled.

And then they always get notified of it. But it's usually, you know, after the fact of being able to say, okay, you know, this morning the caregiver that was incoming ended up with a flat tire. So I ran over to the house and stayed with her until the, the new car or the new tire was on. And that was a couple of hours. And mom was great and she's having a good day. Just wanted to let you know. Whereas that would have been something that the family had to really handle and figure out who was going to follow up and how and who was going to be with mom and everything like that. So, yeah, it certainly helps to delegate.

And I think people don't realize how stressful it can become and how much it can impact their own relationship with their loved ones. And you know, I think sometimes people feel guilty that, you know, I am the adult child so I should be able to do this. And you know, but, but like you said, I've talked to people many times about how it's an investment and you know, we're happy to work with whatever they can provide. So we have some clients that, you know, want us to take on. Anything that comes up, we're, we're taking on. And then we have others where there's, you know, the daughter in New York, the mom on the Cape, and you know, the daughter says, well, you know, I can get back there. You know, I handle most of it, but I really need help with the long term care insurance and following up on an appeal and submitting the invoices. And so, you know, her and the care manager talk regularly and the care manager only helps in that way.

And I'm sure they've gone over other things, but right now, you know, that's how she helps. And then, you know, as needs change, they'll already have a relationship and the care manager will be able to, you know, do more physically if needed.

So even if it's just the pain of the administration of a long term care insurance policy, which for people who aren't familiar or haven't experienced that, that's something that comes up all the time. I hear those complaints we have long term care, but we can't get them to cover this because we didn't submit the form correctly, those are the types of things that can be offloaded through a care coordinator like LiveWell or. Which is fantastic. Yeah, yeah. It makes me think of, you know, as you were describing that you mentioned earlier that you have healthcare professionals, social workers, nursing home administrators. That is what makes up your team at Live well is those types of folks. You're professionals in the space. Right.

And you had described where as we get a little bit older and our parents get older, I feel like there's this obligation, this is my responsibility and I should be able to handle this or can handle this on behalf of my, my parents who have provided a lot for me as I grew up. Right. And we want to kind of give back and these are our folks and it, and it's meaningful. But you know, it kind of strikes me, and maybe this is a bad analogy, but I can do my own taxes, but I don't, I delegate that to a cpa. I could change the oil in my car, but I don't, I don't want to do that. And I just want to take it to a professional and pay the fee. That's worth it for my time. And I kind of think about this similarly.

If there are pros out there in a business that was designed specifically to take care of all these things, does it make sense to investigate that and to look at delegating some of that responsibility so I could just get back to being, you know, my parents, son or daughter, whomever, and spend that time with them. So I can't stress enough. If you're doing that planning, if you're in the estate planning process, you're thinking about long term care insurance, you're thinking about aging and longevity. Care coordination, you know, should definitely be a part of that conversation. One of the things that I noticed recently, I have a client with an aging parent and he was in that role of care coordinator for many years. He has some physical, some back issues. He's got some things on the healthcare side himself. He's just got a million other things going on.

And the care coordination was really starting to get to him. So she ended up in a nursing home. So they didn't go the care coordination route. But one of the things that I was struck with in talking with him recently was how significantly improved she seemed to be once she got into the nursing home. So she was given the appropriate care. She was part of a community and her vibrancy, I don't know how you want to describe it, I forget the word he used, but there was a noticeable improvement in getting the care that his, that his mother needed. Do you see a lot of improved outcomes that people, once they start to get coordinated care, they get the right resources. The things are happening when they should be that the parents or the loved ones that are aging are starting to feel better, move around a little bit easier, just generally have a Better experience with life.

Yes, absolutely. You know, it makes things a lot more effective when going to different doctor's visits, making sure that, you know, the caregivers that are in the home are following up with any recommendations that the doctor's office has and, you know, just kind of overseeing the bigger picture. Because I think a lot of us, you know, outside of the healthcare world think that, you know, of course this doctor talks to that doctor and, you know, if they do get to talk or they review each other's notes, they could still miss something. But when you have one person who's going to all the appointments and following up with all the individuals involved, you're, you know, just really making sure that things run smoothly and that every. Everyone is updated on what's going on. And it's made a huge difference for a lot of our clients, I would say, you know, in. In different ways. We have one client that I visited back probably about six months ago at home, and the client was still able to move around independently and do things independently, but he was cognitively starting to decline.

And it was a lot for his wife to manage who he lived with. And so, you know, most of the visit was spent with the wife and she was just very visibly just couldn't relax. She was hanging on to my every word, was just desperate for resources, reassurance, assistance in any way. And, you know, and I assured her we can help and this, and we talked about different plans and what we would do and in what order we do them and all of that. And then about three weeks later, I went back for the second visit and she looked like a different person, the wife. She was relaxed. I walked in and she was just eating when, you know, that might not seem like a big deal, but, you know, she's just casually walking around when before, you know, she was just, you know, you could tell, was just holding so much tension in her body and she was just, you know, practically like had her feet up is how I would describe her. And, you know, you could tell it was such a difference.

And, you know, it wasn't even a case where we were doing tons of care at that time, but just knowing that she had someone to call when or if something happened or if they needed an additional resource, she had someone, you know, kind of in her Rolodex to call upon. And that made such a difference. And I've never seen such a visible, obvious outcome as that one.

Yeah, and I think you describe it really well as people hold a lot of that stress and anxiety and overwhelm in their body and it's not good for them physically. Right. If there's a spouse or partner in a home, especially trying to give care to a loved one, that can take a toll. I know in my own family, my grandfather had Alzheimer's and died with it in his 90s. My grandmother, who everybody thought was fine, passed a lot earlier, and I can't help but feel like maybe that was partly due. Her health declined because of just the stress of, you know, trying to manage that on her own for. For many, many years. So there's benefits for everybody involved here to invest in something like.

Like care coordination.

Yeah. Oh, sorry, Jim. I know that you touched on, you know, kind of the obligation that. That children can feel to their parents and caring for them, but then there's also, you know, kind of like what you mentioned, that spousal obligation. And, you know, I talk to spouses all the time and, you know, they're like, I think I can still manage it. But, you know, they sound and appear pretty frail themselves. So you're wondering how they're also caring for someone else. And, you know, so I really try to, obviously they.

They should. They need to make the best decision for themselves, but I really encourage them. I said, even if it's starting out with something small, you know, a few hours a week to give you a break, like, let's start somewhere, at some point you're going to have to introduce someone new to the home to be able to help you, and we really can't have any happen to you. We need you to be in good health. We need you to be okay. And you're still going to be there. You're still going to be involved. You can just maybe here and there, a caregiver can take over with certain tasks, and they can do, you know, the more physically taxing things.

So we're talking to families about that a lot because we unfortunately do see the healthier spouse, you know, sometimes end up, you know, with their own health issue or end up, you know, passing before the one that they're caring for. That can be really, you know, troubling and concerning for everyone involved.

Yeah, yeah, yeah. You mentioned before the financial aspect of this. This is a financial commitment, high level. What are the service levels? What does care coordination cost? If you're open to talking to that in kind of general terms, like what kind of investment would a family need to make into something like this?

Right. So I'll say first, our Peace of Mind program. That's an annual fee. It's about $2,500 around that for the four visits with the care manager and that's the annual price. As far as active care management, we do request a thousand dollar retainer to get started and the hourly bill rate is around $200 an hour. And we do bills similar to, you know, essentially consultants or attorneys in terms of billing for everything related to. And so, you know, it's always hard to give people an idea of how many hours it'll be because it just, there's so many different factors involved in that. But in an effort to, you know, really just be transparent and try to help as much as we can, I'll tell you know, any call that we get, I'll say, you know, if you want me to email you every Monday with how many billable hours we're at, or if you want to cap the number of hours at, you know, a certain number per month so that you have it budgeted, you know, or you only want us to take on certain things, you know, all of those things, we're happy to try to, you know, come up with whatever we can so that they, you know, can receive the benefit from our services, but also, you know, not be concerned about the financial impact of it.

Of course we don't want any surprise bills or we don't want them to, you know, go into debt, you know, trying to get some help for their loved one. So I try to be creative in how we can help them and I've done all of those things before. Whether it's emailing the family weekly or they give us a total number of hours to start or a total number of hours per month. We try to be very flexible in that way.

That brings up another question. I just wanted to clarify. You have an hourly rate for the care coordination and you could do a lot or a little depending on what the client needs when it comes to the resources that are also provided. So anything health care related is going to get picked up by Medicare or private pay insurance. Medicare doesn't pay for long term care services. So in home care or stays at nursing homes, things like that, Medicare is not, not going to cover. But is there so anything else? The services and the actual resources that are provided, is that an hourly basis as well or is it kind of combination? And is that your job to figure out what, what's available to them through the insurances that they have or other resources, VA benefits, things like that, do you kind of help sort out how to pay for the actual care itself as well?

Yeah. So what we typically do is we Find out, you know, from the first visit with the care manager, you know, they work to figure out do they have Medicare or Medicare Advantage and what's the plan? Because, you know, Medicare Advantage has plenty of, you know, small, insign, feel insignificant benefits. But when a client needs it and, you know they're already paid for it, then, you know, we can set that up. Like, I had one client recently that after a short term rehab stay, her Medicare Advantage plan was sending her 14 meals. And meals weren't even anything that she wanted. But I told her, I said, well, it's free. We're going into the winter. You're, you know, you're able to cook, but what if, you know, the groceries can't be delivered a certain day and you just want to heat something up and have a nutritious meal? And you know, so she ended up getting them and loved the meals.

And so that worked out. But then we've had other clients where, you know, they want to keep the individual at home and they're trying to figure out how they're going to pay for that. And so with one of those recent clients, I ended up having them apply to the VA because he was a veteran but hadn't yet been connected with the va. And so I connected him with the VA and told him exactly the program that he would apply for and how they help with home health aid hours. So we're aware of all those different resources that people might be available for. And we always try to go that route because if there's something that their current insurance, whether it's Medicare or private insurance, will cover, then we want to go that route first.

Right.

You know, to try to get that help. There is also elder services in Massachusetts for that covers every town in Mass. And elder services will cover a portion of some services. Like they might cover, you know, a few hours of homemaking a week or personal care or something like that. And you know, I always tell clients about that, about elder services. So they're aware of. But there's not always depending on how much care you need. We might have clients that are beyond the point of needing the help from elder services because there might be a wait list.

They might not be able to get the services right away. And the clients might prefer, and the families might prefer to, okay, let's just go the private pay route. We can control what hours they are. We could control, you know, who comes in. You know, you just have a little bit more control that way. But that's certainly something that we do talk about, you know, because Elder services is certainly a benefit for people.

Yeah, yeah. It brings me back to what we were talking about before is the sooner you can have this conversation and assess the situation and understand the benefits you will have, the easier life becomes when you need it. My uncle, unfortunately was diagnosed with Alzheimer's recently, so I mentioned my grandfather had it, and they're, they're getting connected to the va, but it's going to take a couple months before that really kicks in. And my aunt, from what I understand it, is in desperate need of a break. Right. So had we planned a little bit differently or they had and maybe been aware of some of these things, maybe we could get resources that are at their fingertips a little bit sooner that can benefit everybody. So again, if I sound like I'm beating the drum here to plan and plan ahead of time and understand the resources and make the call to Jen, I encourage people to do that. So we could probably go down a lot of different rabbit holes in terms of the work that you provide.

Are there any other resources, ideas, tips? Is there anything else that you want to share with folks before we let you go?

I would say that, you know, oftentimes the first place I tell people to start when they're starting to think about, do we need something, what do we need is to reach out to the primary care physician's office. A lot of times they'll have a nurse or a social worker that can provide resources or, you know, they can set up visiting nurses or whatever it might be, or make other recommendations. And also the senior centers or Council on Aging in town, they have tons of activities. Many of them offer home delivered meals to the area. Many of them will set up transportation with a buddy system. So another senior in town might be able to drive you to a doctor's appointment so that you can get there. They just have so much to offer that I'm continually impressed by the senior centers. I mean, all of them have, have so many resources.

So even, if, you know, you're not sure if your loved one is really going to engage with that, you know, you could still call the resource person there, the outreach coordinator, and, you know, explain the situation and see what they have in terms of resources, it doesn't mean that you have to go to, you know, the classes that they offer there or anything like that, but it's certainly a great resource in the town.

To look into, just get connected and see what's out there. One thing you just said made me think of one last question, which is whether or not they're going to engage. Do you deal with any reluctance from people who need care, where the family is adamant and mom and dad need help, and mom and dad are saying, I'm good, you're shaking your head. For those that are listening and not watching the video every day. Yeah. So I think I'd be remiss without exploring that a little bit. So what do you see? And any advice for families who are trying to get care for reluctant individuals?

Yeah, so our typical case is the adult child calling us and wanting to utilize us. They're often out of state, and they say, mom or dad is not open to it at all, but we want to bring you on board. Or what do we do? Can we bring you on board? How does this happen? Do they need to know what it costs? Do I need to tell them anything? And, you know, there's a lot of nuances to all of that as far as, you know, what. How independent the person is, whether there's a cognitive decline, if there's, you know, a healthcare proxy in place and the family member is the healthcare proxy, you know, so we always try to make sure that, you know, obviously it's all above board, but, you know, we certainly have clients that, you know, don't need to be aware of, you know, the cost of the services. And either the family is paying for it or a trust is paying for it or whatever it might be. And, you know, it works better that way because then the family gets the help that they need. We've also had family members where, you know, the family will pay for it, not even tell their loved ones how much it costs. And they'll say, you know, this isn't because you need anything.

Mom and Dad, I know you're independent, but I'm out of state and I need the help and I need the support. And so trying to phrase it in that way as it's helping them more than it's helping, you know, the couple or the client themselves, you know, that can be beneficial, too. But, you know, unfortunately, people also, you know, have the right to. Or fortunately, people have the right to make their own decisions. And, you know, sometimes they're not on board for. For what they really need. And, you know, we do try to gently talk to them about that and help them understand that, you know, we are part of the team that could keep them at home because that's usually what most people want, and that we'd be able to be proactive and be involved to do things now to try to prevent that fall in the future or try to prevent that infection that leads to a hospitalization and, you know, kind of, you know, doing those sorts of things. And, you know, sometimes people come around to it, other times there ends up being an event which leads to a hospitalization, and that's when they engage us.

So it just kind of depends. But there's definitely a lot of resistance from the older generation, you know, not believing that. That they need the help that, you know, maybe their family members believe that they do.

Yeah. Yeah. I love the way that you describe that. And that's a great suggestion to mom and Dad. I know you feel like you don't need this, but I need some help in supporting you. That's a great, great tip. What about. There was a section on the website that talked about patient advocacy.

So do you find yourself advocating for the patients kind of in response to what a son or daughter might feel like mom or dad need and have to really educate the son or daughter or the loved one that's. That's trying to help out their loved one, but. But maybe not have the right frame of mind or perspective and maybe doing more harm than good with what they're suggesting.

Yeah, it can be tough because sometimes, you know, the person who brought us on board, the family member, you know, we end up coming back to them with different recommendations than what they were telling us or thinking originally. They thought that, you know, mom isn't home, isn't safe at home anymore, and she needs to be moved immediately. And our care manager has gone in before, and, you know, then we had a conversation, and she said, you know, I think she is safe at home. You know, she lives with her son and he's doing X, Y and Z. I saw her safely ambulate. The house is clean. There's food in the fridge. You know, they kind of went through the whole checklist and, you know, it doesn't happen that often, but that's when we have to go back to, you know, the other family member and give them our professional opinion of, you know, this is what we saw.

We think that, you know, it's okay for now. Well, we try to, you know, make plans for the future of, you know, if you want us to stay engaged and we can visit maybe every few months to kind of check in and see how things are so that we can catch something when we need to maybe provide more care in there. And it's always up to the family as far as how involved they want us to stay. And fortunately, it doesn't happen that often because it can be kind of an awkward because you feel like you're working against the person that brought you into the picture. But ultimately the client and the individual that needs the care is the person that we're thinking about first and foremost. And that's always the focus. And so we always want to do what works best for that person. You know, there are also times where you have the individual that wants to age in place at home and has dementia.

And we have a client like that right now and you know, they came on board with us a few years ago. They now have 24 hour care in place and they have three children that live locally and visit regularly and everything. And you know, at some point, probably fairly soon, the client might not get as much of a benefit living at home as she would maybe in a memory care facility where there's going to be a lot of staff around, a lot of other residents, a lot of activities. Right now she has all the care she needs and she's at home. But unfortunately with dementia comes a time where your world becomes smaller and smaller and she might actually get more benefit from going to a memory care facility where there are more people around and more socialization and activities. And that'll ultimately be up to the family. But that's also something that we kind of lay the groundwork for, of just making sure that they're aware that, you know, this is what could be happening and this is what you might want to be thinking about, you know, just to lay out the options for them.

Yeah, it's. There's so much involved and I'm sitting here throughout this conversation and just thinking to myself about conversations I may have with my sister in the future. How do we prepare for this? How do we get a care coordinator involved with my parents early, ahead of when they might need it? Because it just seems like such a gift to everybody to get professionals who are aware of this situation and know the ins and outs involved from both sides. Everybody, the outcome for everybody is, is going to be much improved to get support and the resources. So, Jen, thank you so much for joining us today. Where should people go to check out Live well or any other resources that you might want to mention?

Yeah, so our website is Live well. Our office number is 617-254-9800. And we're always taking new clients. We're happy to. I'm always happy to have conversations with family members, whether they're thinking about care management now or they just have more questions and they're thinking about it for the future. You know, all of those conversations are helpful to have and I'm happy to have those with with anyone that calls. So I encourage people to call.

Yeah, that's great. I do as well. I encourage people to go to the website. Looks like you have a blog there with multiple posts and articles just talking about different aspects of this topic. So a lot of great resources at the website, so I encourage people to check that out. If you're in this situation. I can't stress enough. Plan early, make the phone calls, ask the questions, go to the senior center.

All those other tips that that Jennifer recommended, just prepare yourself and think about incorporating care management into your financial plans. Everybody involved is going to be much better off for it. So again, Jennifer Mahoney, thanks so much for your time and we'll look forward to talking to you again soon.

Okay, thanks a lot, Jim. I appreciate it.

All right, everybody, go over to modernfinancialwellness.com, you can check out this conversation and much more and more. And don't forget to like and subscribe. Thanks for listening, everybody. We'll talk to you next time. Thanks again for listening to this episode. A quick note, although I do hope that the information that we talked about was helpful, in no way is anything discussed on the podcast to be taken as specific financial advice. Please consult your own advisors and do your own research when you're making important financial decisions.