Falling Through the Cracks with Terrell & Ajala Clark — Full Episode Transcript

You are now starting to fall through the cracks because your insurance would only pay for so much care that you need. No one plans for a fall. No one plans for a decline in health. But these are the things we need to be planning for.

When caregiving feels overwhelming and the system feels impossible to navigate, this is your guide. Here, you'll learn ways to navigate long-term care planning, find real support for caregiving, and prepare you for the road ahead. I'm your host, Lindsay Friedman, and now you're not in this alone. Let's get started.

Hello, and welcome back to the Caregivers Compass. Today, we're here with Terrell and Ajala Clark, known as the Clarks. They are a dynamic and fantastic husband-and-wife team dedicated to helping families navigate the complex world of senior care with compassion, clarity, and confidence. With over 30 years of nursing experience, Ajala brings deep clinical expertise in adult and geriatric care, while Terrell brings a strong passion for advocacy, community, and connection. Together, they combine heart and knowledge to guide families through some of life's most emotional decisions. So welcome, Clarks.

Thank you. Hi, Lindsay. Thank you for that warm and fantastic introduction. We really appreciate it. Thank you so much.

Yeah, no, you're welcome. I'm so glad you're here because I've gotten to know you guys a little bit over these past few months. And the work you're doing and where you're coming from is so incredible and truly from a good place.

And we've talked a little bit about the challenges that you're seeing in the industry with families. You're seeing really these overlooked seniors, and you've told me about seniors falling through the cracks. So let's focus on that. Can you tell me what that means when we're actually saying that they're falling through the cracks? What are you seeing?

As far as falling through the cracks, it's actually heartbreaking. We're with CarePatrol, so from my years of nursing, I would see it from one avenue. The 30-plus years of nursing — CarePatrol is kind of showing me, because you're out in the community, you're in the hospitals with someone.

So say for instance you have a senior, and the hospital may call us and say, we have someone and it's time for them to be discharged, but they're not safe or able to go back home. So now we need a safe discharge plan. A lot of times that senior might have been at home and already was not safe. They might have been forgetting their medications, not able to get to a doctor's appointment. They may have a caregiver, a family member, but that family member is usually working, still busy, raising kids or grandkids, just extremely busy.

So a lot of times that slow burn is already happening, where that senior is starting to slowly fall through the cracks. So now here you have a hospital admission and they're not able to walk or function at the level that they could. And so now we're finding out, okay, they may have to go to some type of community because they need help. And the family's finding out, hey, things were already happening and going on. They're overwhelmed. The person we're helping, the senior, is overwhelmed because everyone wants to stay at home, right?

So now it's, who's going to connect the dots with the family, the senior, because they're finding out this information is this new information, and who's going to connect the dots with how much is it going to cost? A lot of times there's no one to help to navigate or to keep things consistent, that's going to meet the care needs and the financial budget of the senior. And a lot of times when we say seniors falling through the cracks, sometimes it has to do with their insurance and who's going to pay for their care.

The insurance might only be paying for a certain amount of days for them to stay in the hospital. They may need more days, but it's time for them to go and they have to be discharged. But they might not have a budget that would equal their care needs. So a lot of seniors in our area are Social Security. A lot of them don't have a very large pension, because a lot of the assisted living facilities, well, most assisted living facilities, are private pay. And a lot of them start at $3,000 to $3,500 per month.

So if you only get Social Security and a small pension that may equal up to $2,100 or $2,200, you are now starting to fall through the cracks because your insurance would only pay for so much care that you need. So it's a lot of social determinants of health that we come across for the seniors that need to be addressed — transportation, medication, not just housing, even food. So we're starting to see this as being a real crisis in our area. And I think it's actually a crisis nationwide.

Yes. And it is, it's very structural, right? When families get to the hospital and there is a discharge, they don't even realize that there's nothing in place.

So when you step in and you get called by a hospital and you step in to talk to a family and you start to say to them, listen, this is what's going to happen — what are the things that you try to address? And in some of these really hard situations, what kind of solutions are out there?

I think the main thing that we lead with is getting to know that particular senior, getting to know the family, what area you want to stay in. We even look at, what are your hobbies? What's your level of care? Do you need help with cooking and cleaning, or do you need help with getting up and walking, a wheelchair? So we're going to look at your level of care to make sure indeed that is safe. What's your budget? Some people have long-term care insurance in place, that's great, but then also finding a place that accepts the long-term care insurance.

We're also going to look at the affordability factor of being able to afford a place that's going to be equal to that level of care. So we really do a deep dive. If family's available to tour, we'll actually tour with the family. We will narrow down the list. We don't give you a huge list with 20-plus places. We're going to say, here's places that are going to meet that budget, and I'm going to be able to provide the care safely, give you a few options, and we're actually going to tour with you. So that helps to alleviate stress. If there's a caregiver that's involved and able to do that tour, we're more than happy to do that as well.

I think a lot of times when we meet with a family — and a lot of times we've come across, there is no family. It's just the senior. They've been by themselves. And it's very disheartening because a lot of times we see that they're by themselves and they've been struggling by themselves.

We've come across a lot of situations where a lot of the seniors have probably been homeless or living in their car, and they may be one check away from just their world totally falling apart. You're one accident away, one fall away from your world just falling apart. And your budget is already $1,500 a month and that's all you have to your name. You can't work. You already have a lot of ailments and sicknesses or diabetes or things of that nature. You already have a walker or a wheelchair or may have a limb missing.

We've come across a lot of these cases. So now we have to find someone that will match your care needs as well as your budget. And care in this country is expensive. It's very expensive. If they don't know how to navigate their insurances or pick the right insurance for your care, you're already starting ten steps behind. You might have a certain plan that fits your care needs while you're by yourself, but one accident away, that plan could be catastrophic to the care that you need.

You brought up something, and loneliness to me is the thing that eats at my heart more than anything. Most of these conversations that we have about care are really, how is the adult child, how is the adult spouse going to care for you? And you brought up these people who have nobody.

How do you address a situation with somebody who's elderly who has nobody, who may have some cognitive decline and is in need? How do you come up with that kind of solution? How do you address that with them when you know there's something that really has to be done?

I think that's where the cracks start to open up. That's where seniors really start to fall through the cracks, because in our job we try to assist the senior in finding a place that will take them as well as cover their care needs and take their budget. And a lot of times you just don't find that.

So that's where they fall through the cracks. They might have to file for a Medicaid waiver and then they have to be placed in a skilled nursing facility long-term. So that's where seniors start to fall through the cracks, and it's very disheartening when you see it over and over and over again.

So when these folks come to you, and because you mentioned a Medicaid waiver — there's a lot to get through to get that Medicaid waiver in place. Do you help with that, or what's that process look like? What is getting that look like in the state of Texas, for people who are aware that there is something they can do?

We definitely recommend that people speak with an elder law attorney because they're the experts in that. We do provide, say for instance in Texas, Texas 211 to initiate the application process. Some organizations may provide assistance with the application as well, different types of nonprofits, and we provide that contact information.

We found a lot of times those organizations want that person there to come to the office. We're already speaking of seniors whose mobility is limited, who may be actively in a skilled nursing or rehab. So they're not going to be able to go into the office. But we did find an actual phone number for Texas Health and Human Services, so they can speak to a human and start that process over the telephone.

If someone has a lot of assets, we're not attorneys, we're going to recommend getting an elder law attorney. But in fact, if someone does not have a lot of assets, then they can go ahead and start that process.

A lot of times people are thinking that their Medicare is going to pay for skilled nursing, long-term care, and they're looking at us or the hospital staff like it's information they've heard for the first time. So a lot of people don't even realize that Medicare does not pay for long-term, indefinite skilled nursing, or memory care, or assisted living. The list can go on and on. So we come in also to educate them on what services are out there and what's available.

You're right, so many families really are under that impression. I think it's like a smack in the face when they think, okay, Medicare, and they get the call. It's really hard to watch a family have that moment that this is going to be a struggle.

But you did mention about 211. So there are resources. What are some of the most overlooked resources you see in your community?

I think a lot of times a person may think, I'm on Medicaid, but they don't realize they're not on a Medicaid waiver. So let's not wait for the crisis to happen. Let's go ahead and apply.

If you have a lot of assets, people would think, well, I own this and that. Even my parents thought that, and I begged them for years — an elder law attorney, please, please, please. They had over the years attorneys and accountants for their multiple businesses. When dad fell and he started with one hospitalization, one stroke, it turned into many, and then we were involved in the crisis — elder law attorney and all of this business with my own parents.

And then people realize it's a five-year look-back. Plan early. Don't be afraid to go and just speak with an elder law attorney, find out that information, get some early planning and something in place to make sure that if a crisis happens, that you're ready and it's not a shock, and you're not spending money that you planned for retirement so your spouse can enjoy that. No one wants to think about having a type of crisis, but just in case, let's have some things in place. It's better to be prepared than not. We all are going to age, so be prepared so it doesn't become a crisis or a burden on your loved ones. Or if you don't have any loved ones, you'll fall through the cracks.

That's actually because you guys are some of our favorite trusted providers on LTCareNav. And that's one of the things we really talk about — the preparing. And as you talk about the financial piece, that's a big part of it. In our country, that tends to be the thing we only focus on, the people who are looking at the plan.

But there's so many moving pieces. What are some of the other things that families should think about in this plan? What else can they do to feel safe and supported beyond just the elder care attorney and talking through finances?

Long-term care insurance. That's huge. That's usually overlooked and undervalued until a person is once again in a situation and they're like, wait a minute, I remember someone speaking about that and I really didn't follow up on it. Even people that sell insurances are like, you know what, I saw it myself, but I really need to check into this. So long-term care insurance.

Also connecting with different resources such as ourselves. I really don't need the services now, but let's just talk about it, see what's out there, what options are out there, so I can plan ahead a little bit more. And we don't mind if someone calls and they just want information. We're here and we're more than happy to share that information.

And we try to stay up to date, or at least stay in touch, with people that do insurance — Medicare insurance agents, Medicaid insurance agents — because these are the ones that are going to know how to navigate your insurance. So at least be informed as much as you can about your insurance plan and what benefits it has, because if situation A happens, you need to know what happens. At least try to be prepared for situation A, B, and C.

A lot of times it comes down to finances when you're paying your premiums and things of that nature. But it's like, again, I can say it a thousand times — better to have it than to not have it, especially when you need it. Because no one plans for a fall. No one plans to decline in health. But these are the things we need to be planning for just in case.

Oh, absolutely. Because we're all going to get there, and that might be part of the problem. It's scary to think about that, right?

I do love that you threw out something about how you guys are available at any time. I try to tell people that you might not need any of these providers yet. But even if you don't now, have a conversation because the moment that you're going to need them is going to be an uncomfortable moment. So have the conversations beforehand, figure out who you're comfortable with. And the greatest thing about your service is you guys offer a free service, and you have the network. So for families listening, if you reach out to the Clarks, you can do it at any time, and then they're in your back pocket, and then they're going to help you. And if you have things that need to get started today, they're going to point you in the right direction.

Yes ma'am, absolutely.

So to leave families with a final word, one, tell them where to find you and anything else you want to say to them before we wrap up.

Sure, just once again, to give us a call. If that's not our area of expertise, we partner with many other organizations that can help regardless of your financial situation, and we're more than happy to help. We partner with organizations like ADRC, which is the Asian Disability and Resource Center, and 211. We've done venues and forums with them as well.

You can contact us at 469-721-1679. We are always here to help. Again, we are free. Our services are free to seniors. We are at no cost to you. And we want to see you thrive. We want to see you well. We want to see you healthy. And we want to help you navigate these situations in tumultuous times as easily as we can for you.

And you can find them at LTCareNav. So until next time, we hope everyone is well, and we will be back with you next week.

Thanks, Lindsay. It's a pleasure.

All right, that's wrap for today. Until next time, remember, you're not alone. Take things one step at a time, stay centered, and trust your compass. See you next time on the Caregiver's Compass.