Melanie Gleode: Caring for Aging Parents From Another State — Full Episode Transcript

They tend to not want to burden us. They see that we have children, especially if we're in that sandwich generation. We have kids that we're taking to practice, to school, and we're navigating our home life. So they don't want to burden us with what's happening in their home life. And so it does take sometimes going home for a visit. You might go on vacation. It could be over the holidays that you go and you start to notice.

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Hello, and welcome back to another episode of the Care Compass. I'm your host, Lindsay Friedman, and today we're here with Melanie Gleode from CarePatrol of Northwest DFW and Fort Worth. And I've been looking forward to this conversation because Melanie and I had this conversation talking about what it's like to move your family from different locations and all the complexities. And she and I were talking about that. And I was like, this is a beautiful show. We have to do this. So Melanie, I am so glad you're here today.

Thanks for having me.

No, thank you. So to kick off, because I always start with the same questions: who are you? What do you do? And why do you do it?

Absolutely. So I'm Melanie Gleode. I am the owner of CarePatrol. I have two territories. I'm all over a portion of the Dallas-Fort Worth area. I am a Certified Senior Advisor. And in my background, I was a speech-language pathologist, director of rehab. I've worked in acute care settings, rehab, home health. I did a lot of patient care and then I stayed home with my kids for a while and tried to find something to bridge what I loved and who I was at the moment. And I didn't really want to go back to patient care.

So this has given me the ability to help navigate just seniors and all the complexities that come along with them, just like I did in rehab, but so many extra steps past that. It took me out of just the gym and just the office that I worked in and has gotten me to join them in their homes and their new environments and everything like that.

I love that. And you were talking about some of the things that you have to navigate. And you and I are going to dive into one of the — I think it's one of the hardest things to navigate. We as adult children are moving all over the country, super far from our parents. And that adds such difficulty as they start to age. So let's start at the beginning of that journey. If you are an adult child living very far from your mom and dad, what are the first things? How do you start to notice changes? What does that look like for that family?

As a child who lives in Texas with parents in Kentucky, I can tell you just firsthand, it can be difficult because the things that we don't see are the day-to-day. So we might have phone calls with them and they can mask things that are happening, especially if it's a cognitive decline. They can sometimes just answer basic questions if you don't dig in, and you're not seeing what's happening inside of their home.

The other side of it is, I think our parents — it could just be mine, but I've talked to a lot of friends and I've dealt with a lot of people — they tend to not want to burden us. They see that we have children, especially if we're in that sandwich generation. We have kids that we're taking to practice, to school, and we're navigating our home life. So they don't want to burden us with what's happening in their home life.

And so it does take sometimes going home for a visit. You might go on vacation. It could be over the holidays that you go and you start to notice, wow, the house is not kept like it used to be kept. Mom is not getting around like she used to. Recently, you know, I've heard that maybe she's going to the doctor more, she's falling more.

It's those little things that, as a family member who lives away from our loved ones, we don't see as often. So sometimes it does take a bit of a catastrophic event as well — a hospitalization, somebody's going to rehab — and then you're starting to navigate it from outside of the state, not really knowing what's available locally.

What would you tell a family who has suspicions from over the phone that things are changing and they can't get there? What are some things that they can either ask or do or find in their community to kind of get some of these answers?

Absolutely. So neighbors are really helpful. I'm working with somebody right now and he lives out of state and his dad has a really strong network of neighbors. Church groups are really big too. You know, if there's a trusted person who lives in the area, just having that conversation back and forth — especially as your parents age, making sure you know who their trusted people are in the area that they live in, outside of just our little family bubble.

And those people tend to sometimes want to help them, guide a little bit without giving us too much information. But then when something happens, they are the trusted person that you know could quickly go and see what's happening.

And then the other side of it is, I think, starting to figure out: what things do you have in place? Because I don't think we all know what our parents have in place, nor do we know what they need to have in place so that if something did happen, you could step in as their child, as their power of attorney, to help make decisions and things like that.

What are the questions that an adult child should ask of this neighbor, this person who's stepping in? What are the good, solid questions that should be answered to make the good decisions?

Yeah, so I think it's important to see: have you noticed a change in my loved one? Are they not coming out as much? Do you feel like they're not eating as well? Have you noticed a change in their weight? That's huge, because I think a lot of seniors get to the point where, if you don't have great mobility, if you cannot get to the doctor's office, to the grocery store, to just your basic things, they might not be eating well. They might not be taking care of themselves.

So if they start to see that, it's important, I think, for you to ask them: do you notice that decline? Do you notice any changes? Now there are people who start to also isolate a little bit. So have they quit coming around to you guys as much as well? Because if so, there might be a reason why. They might have embarrassment because, you know, they're having incontinence issues and they're using Depends, or maybe they haven't even decided they need to do that and they're always taking care of that.

People who have cognitive declines, it's interesting because they start to pull back because they start to notice those gaps. And that's something that, if you can gauge from a neighbor how much they see them and what they notice about them — that's a big thing. And church groups, like I said, are also really big, especially if that's something they're involved in. Senior centers are other ones. There are a lot of our seniors who have consistently gone to senior centers. And those people are often the first ones to let somebody know when there's a decline, because they are very independent people. And if they lose that independence, they want somebody to help them.

Yeah, no, that's fantastic. So now say family members are listening and they're like, okay, now I know there's a problem. And I either need home care or I need to move mom out. What are the first steps? How do they navigate that? How do they do this in the way of, one, I live in Texas and my mom's in Kentucky? What does that look like if mom and dad are going to stay in Kentucky?

Yeah, so I think the biggest part is to have a conversation with your loved ones. Not everybody wants to be totally forthcoming about how much they make financially. That sometimes is something, especially in previous generations, they didn't discuss very much. But it is important to know things. Are they a veteran? Do they have benefits through the VA? Can they get pensions? Do they have a long-term care policy? How much are you making in Social Security? You know, especially with the homes — is it something that you would be willing to sell? These are things that I think it's important to talk with your family members about, because people really want to honor their wishes.

So if somebody's wish is to stay in their home as long as possible, we tell people: have that in your mind as the goal. But also, you have to have hard conversations sometimes. So it is that — how do you find somebody who's trusted? As a Certified Senior Advisor working with CarePatrol, we help people because we don't mind having that conversation that maybe a family member doesn't want to have, or being that mediator in between a family and their parent.

And we can also bring in resources. So sometimes that is a quick stay at a rehab hospital just to see if you can get stronger. And then you have the support from the therapists who are there, the case managers, the physician, telling your loved one: these are the things that make us a little nervous about you going home.

To start with, in-home care is always a wonderful option if somebody is able to do that, but it's also reminding them those people aren't always totally consistent. So can your loved one go if somebody misses their shift? If they don't show up, are they still able to be independent for that little amount of time while they are covering their shift? Because those people don't live in your home. It is the nature of somebody coming in and being your one-on-one caregiver.

And then the other side of it is, financially, having somebody that can say these are the options and these are kind of your price points for each — it often helps navigate whether somebody can truly stay in their home or if they need to go to a facility that would offer them a lot of socialization and a lot of support and a lot of care.

Yeah, and the one thing that you mentioned in there was about CarePatrols, which you have yours, but I think what's really amazing is they're all over the country. And so I think with a family, if you are navigating outside of your territory, finding a CarePatrol in that area is a great first step. So can you tell people a little bit about what you would do if you were coming in for a family in this situation?

Absolutely. So I've worked with CarePatrols across the nation, which is the amazing thing. So we have had people who have contacted us and we're local because we live in the neighborhood that they live in and they saw something about us, but then they call us about their loved one who lives in Washington. Well, the nice thing is, with CarePatrol, we take the information and then we very much just connect them with the right person. We know who covers the territory and the area that they're looking in.

There's also sometimes where families are like, I don't know if I want to keep my mom here or if I want to move my mom to another state with a different sibling — because that is the other dynamic, siblings across the country and maybe a family member who needs help but they're just solo right now. So which family member is it? And we have done the comparison where they have looked at communities in Texas and they've looked at communities in a different state, and they've determined, based on pricing and what they feel like they can get in each one, where they want to take their loved one, who they want them to be with. And then we help navigate all of that — the movers, just anything that's needed, reminding them of all the little steps, which there are so many things moving from state to state that a person has to keep in mind, because it's not the same in Texas as it is in Kentucky or it is on the West Coast. It's just totally different from state to state.

What should some families be aware of that are completely different that might help them make their decision if they're going to go to Washington or Texas?

Yes. So cost of living is definitely something. Different states just have lower price points. They might have just a longer ability to make their money last. So if somebody's working on a budget, they know they have a certain amount of money that's going to last for the next five years, but after that, they wouldn't have private pay funds — then it is kind of thinking, well, if you can get it for a lower cost in one state versus another, then that sometimes is what helps them make that decision.

The other side of it is, you know, your insurance — you have to make sure that that's covering. If somebody does eventually have to go onto Medicaid, that is a state-run service. So it is not a blanket across the nation. Each state has different intricacies with that. With Texas, we don't have as many care homes that cover Medicaid or take Medicaid. But I was helping a family who wanted to move to a different state — I think it was Washington — and they have a ton that do. So that's something that I didn't even know as a person from Texas. But it was so easy for me to hop on the phone with my CarePatrol in that area and say, tell me a little bit more.

The biggest part is, it does take getting on to that state and starting to get that process and making sure that it aligns with that. So it's not always that you move from Texas and then you move straight into a new state and then you're qualified. You still have to get everything in line with that. And that's where the CarePatrol in that area can help with what that looks like.

And so great, because it gives a lot of options. Yes — now I think the next thing that people forget about is, okay, we have all of our documents in place. This is great because mom lives in Washington. Now mom's going to move to Texas. What does that look like? And what considerations have to be made across the board, even legally and financially?

Yeah. So I've noticed that we had a power of attorney that was appropriate in one state, but then when they moved to another state, they needed to have everything redone. And so we ended up having — we have mobile notaries that can come in, or we connect them with the people who need that.

The other side of it is their medical insurance, and making sure that the insurance is appropriate for the state that they're in. And so we have different insurance providers who can help, and they can help make sure that they're on the right one, so that if they did have to go to the hospital, if they did need to go to rehab, whatever they needed, that they're covered for that.

I also have had a case where somebody had guardianship and they got it in place in one state and it was approved. But then in order to come to Texas, they now have to have that guardianship shifted down here. So they have to work with somebody in Texas in order to have that same guardianship so that they can help their mom, who is a little bit resistant to going to a community because she's still — she's not cognitively able to make her own choices, but she's still very determined that she wants to. And so they have to have that in place. Otherwise she would get here and that community could potentially let her walk out the door without having somebody showing that she does have that cognitive decline and somebody is her guardian.

So with all of that, now say they finally get all your documents, all of that in place, and somebody goes, well, how am I going to actually get my mom there? Travel becomes difficult. So what does that look like? And how would you help somebody navigate that actual physical part of moving?

Yes. So I'm going to give an example, because I did this last year with a family. I had a sister that reached out. She was talking about her brother in their support group. And their support group leader reached out to me and said, I don't know if you can help for the state that he's in, just making sure that he's well taken care of. There were some things that came along with it — maybe there were people who weren't in the best interest of him, and no family was over there. So she didn't know what that would look like.

And we quickly — I think it's best to start to say what needs to happen first and then go down the order, because people become very overwhelmed with what does a move look like. And some people who suggest places for people to live will say, well, all I really care about is I'm going to get them moved in here once you get them here. But CarePatrol is very different. We love a problem to solve, and that's something we enjoy doing.

So it went from this gentleman — we had to get in touch with his current rehab. So getting doctor's notes, getting an understanding of what his needs are. We needed to have conversations with him. He had an apartment to clean out. So the biggest thing is, where did we start? We had to start with: let's figure out how we get everything in place so his sister can have control over his finances. So while he was there — he was in the state, I think he was in North Carolina — she went and got a power of attorney for his finances, medical, everything that she needed so that she could easily act on his behalf. She cleaned out his apartment with our assistance and finding somebody who does that.

And then we had to start to navigate: what does it look like when he gets here? We could say we're going to move him straight from there here, but he couldn't sit in a car for the entire trip here. So then there's the type of transportation. Some people can ride in your car. But if your loved one has incontinence issues or cannot sit for 12 hours straight, what are you going to do? So there are medical transports that are in vans and they do a great job. Some have nurses that can stay with somebody if they're more medically complex. And then there's the same option with a plane. So we found for him a private jet that was able to support him just with caregivers. He didn't need all of the nursing support. But if he did, we could have found that. There's also companions for airplane travel, but somebody has to be able to stand up and pivot into a chair if they're going to go onto a traditional airplane.

But then the other side of that is, what does it look like when he gets here? He would have no doctors, he would have no oversight for his medical needs. And he did truly have some medical needs that he needed to have looked at once he took such a long trip. So we had a rehab stay lined up for him. So he immediately went into rehab, where we knew he would have eyes on him, we knew that he would start to get some doctors' orders, and we knew that he would have physical therapy, occupational therapy, everything he needed. And we already did have a home lined up for him to move to — it was a care home setting, like an assisted living, and we had that ready.

So then the other side of that is, once she got him here, we started to say, okay, he's here, he's safe. Now let's start moving his things into this new room that he has. And then once he discharged from there, he moved over and everything was a smooth transition. So it is always thinking a few steps ahead, but helping that family to know you can do this, but we need to go one step at a time.

And that is amazing. And I think families are hearing that there are just so many things. You are looking at financial and legal and physical and the complexities of moving that are escalated in these situations. And I think what's so amazing is that all these wonderful people at CarePatrol are here to hold your hand and help you even understand the things you don't even know you need to know.

Absolutely. I think that you can forget some little details along the way, and that is where it's helpful to have somebody that can guide you. You know, we're never going to tell you this is exactly the path you have to take, but we will guide and make sure that you know that you're supported along the way.

It is. It's so beautiful and it completely changes outcomes and trajectory and peace of mind. So for families listening who now are thinking, man, I'm doing this every day, I'm really lost — obviously you can reach out to CarePatrols across the country. But if they are in the Texas area, how do they find you?

So my number, you can always call, it's 817-223-6563. If you go on to carepatrol.com and you put 'find my closest' and you put in your zip code, it'll bring you to the right CarePatrol. And that's the easiest way to do it. And then like I said, we always partner together — even the person in North Carolina was a support for me because he had resources, and that's a huge thing that we provide. We provide resources. So even if it's not quite time to make a move, or it's not quite time that they need help, it is always good to have things in order.

Like you said, the paperwork, the knowledge of what your family wants — have those hard conversations now while there's not a fire to put out, because it is a lot harder when somebody falls and breaks their hip and they're in the hospital and then you're scrambling and you did not know anything about what their wishes were. You can ask your family members to have a binder of their information put together and share that with you, because that's important. Those people who have their things in order make life easier for their family members, by far.

Absolutely. And that really is, you know, my whole thing. Like, have a plan and find that person who's going to help make sure that your plan is smart and able to be changed and you're able to execute on it. So Melanie, thank you so much. I've been looking so forward to having you.

Thank you.

As fantastic as I knew it was going to be, so thank you so much. I appreciate it.

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