Sherri Coates and Sara Hoover: The Long-Term Care Myths That Keep Families Waiting Until Crisis | Full Episode Transcript

This conversation could be very different than what a lot of people perceive another myth, that everything's like the nursing home of old that they saw their parents taking their grandparents to. And we still have so much of that. 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. So, welcome back to another episode of LTCareNav's Care Compass. I'm your host, Lindsay Friedman. And today we are here with Sherri Coates and Sara Hoover of CarePatrol of Middle Tennessee. Welcome, ladies. Thank you. Thank you so much for being here today. And I think this is gonna be a great show because

There are so many myths that come with long term care and options. I think it's gonna be really great to like dive into them and really give some clarification of what this really looks like. But before we do that, let's start with the questions that I always ask. Who are you? What do you do? And why do you do it? Do you wanna kick us off, Sherri? Sure.

I'm Sherri Coates and I co own CarePatrol Middle, Tennessee with Sara. And what we do is we're a senior advisory service company. So we are complementary to families and we help guide them through the process of care. So care from in home care or placement in independent living, should they still be independent, or assisted living if they need more care, or memory care if it's an Alzheimer's dementia diagnosis that we're working.

So really just helping families navigate through that process, which can be very complex and very confusing. So that's what we do on a short basis. Why do you do it? Well, for me it's very personal. My mom was at home for eight years with heart failure, congestive heart failure. So at that time, there really weren't assisted living communities. There were more like residential care homes. So my family really felt

strongly to keep her at home as long as we're able to, we were able to, with a lot of help, you know, from home care companies and PT and OT companies. So that was my first journey with it. And then repeat several years later when my father got remarried and my stepmom went through almost the exact same thing. And now helping care give for my husband's family who are in Florida. So caregiving from a distance and my in laws are in assistant living in Florida.

Very expensive one, I might add. And there's still, you know, some issues most of the time. I'll I'll just leave it at that for now. Yeah, so three sets of parents, I guess, at this point. So I have some experience. So definitely went into this work personally. More so. My background was in business and finance. So I did not do this type of work before. Yeah, no, it sounds very personal and you know, it's such a beautiful motivator on that. Now, Sara, it's your turn.

Well, I'm Sara Hoover and as Sherri said, I co own CarePatrol of Middle Tennessee. I got into this work partially personally. My father was ill and there was the journey of getting him cared for until he passed, and then helping my mom from afar for a long time as she downsized, had various health issues. I was constantly going out to California. And then a couple of years ago she moved in with me, so I'm currently

living the caregiver journey. Fortunately she's in pretty good health, so it's it's not a huge burden. But it it has shown me that it's very difficult to be a prophet in your own land because she's not gonna ever go to assisted. Right. But anyways, unless it's memory care and she doesn't know what's going on. And but the other part is I sort of enjoy this kind of work. I've always been done a lot of nonprofit work. I like working with people who are vulnerable and I love project management and that's kind of what we do.

As Sherri said, it's project managing care for people in a certain circumstance. Yeah. And and I think these personal reasons mean so much and it actually gives you such a great perspective of understanding how much complexity there is. And even as a professional to switch over to a family caregiver, like the whole dynamic changes. It does. Yeah. Yeah. We do the work during the day and then we sort of are, you know, do it after hours or our own.

And I think that's actually let let's start with that myth. So many people who have never been a caregiver don't realize what this actually looks like. So what's the biggest myth that people who have are haven't been a caregiver yet, but most likely will be? What do you think the biggest myth they're gonna face is? I can start. I think it's first they think they can do it, you know? And I think as women, you know, we tend to be multinet.

Taskers by nature and we're handling a lot of family connections anyway, you know, and I've seen this more so even in spouses, you know, this obligation obviously honoring your loved one. It's most difficult sometimes to work with spouses because they definitely have an extra sort of, you know, obligation to honor you know, in sickness and in health, right? But the myth that it's doable long term.

You know, I think that's important to add is definitely a myth. You know, you can't do it alone. You know, you're definitely gonna need a team, you're gonna need some people to help you along the way, and that help will change and look differently over time. so I think I just had that reality because, you know, I went through it pretty early in my life, so I knew what it took to care for my mom and help me.

But I think a lot of people go in thinking, no, I can do this, you know, or some people are like, I'll just quit working or I'll have a family member move in and help. You know, I think those are all part of this that it's doable and especially for our type of work at home. I don't find that to be the case at all. And the you know, the white flag goes up pretty quickly. I would just echo what Sherri said, that the thought that you can do it by yourself is

impossible. And it's it's gonna take a team and it's more than you think it is because it's constant. It's somebody else's needs all the time. Even if they don't have that many needs, they have needs. And it it's just constant. And it's gonna take more skills than you have. It's gonna go on longer than you think it will. There's no breaks. It just takes a team. So it's a myth that you can do it alone.

And I would just say to spouses, yes, you promised to love and care and sickness and in health, but it didn't mean you had to do it with your own two hands, all of it. And it doesn't mean that you have to sacrifice yourself. Yeah. And and sometimes I always tell families, sometimes when you are placing an assisted living or memory care, it is the most loving thing you can do because you aren't capable of giving the care that they deserve. Not that you don't want to. Yeah.

Plus when it you know, there's a line that it crosses too when it comes to medical care. You know, whoever you are, you actually can't, you know, draw blood from someone. I mean, you know, I'm using that as an example, but that's, you know, doing labs. I mean, you know, no regular person is a nurse per se to be able to do that. So, you know, some of those things we can bring in the home, but in a community it can be done there, you know, just readily.

Yeah, and there's a team there. And it comes back to what you said, Sherri, about having a team in place and having a whole a whole slew of people who are really there to just service the person you love. And then you get to be the husband or the wife or the daughter again. That's right. That's right. And and that is such a big myth. But there are are so others that are really that even start the whole journey and I think that keep people from even talking about it and creating a plan.

And that is the Medicare or insurance will pay for it met. Right. At least half of our calls. So let's let's talk about that because I think this is the biggest thing that keeps people from planning ahead because they're like, I've got Medicare, it'll be fine. So how do you address that? And what does that really look like? So Medicare was designed to take care of medical needs. And what assisted living does is help you with

Things like bathing, dressing, eating, toileting, transferring. They call them the activities of daily living. Medicare does not cover those at all. It's all medical. So you're trying to get better. You're not managing your daily life. You're trying to get better. Medicaid is the same thing. It's meant to be medical. Most states have a waiver program where a little bit of money can go towards assisted living or memory care.

So that you don't have to go into skilled nursing Medicaid figured out that that's more expensive. But at least in Tennessee, it's not very much money and there aren't very many communities that take it. So it's private pay or you have long term care insurance and there's a little bit of help if you were a veteran during a w if you were in the service during a war. Otherwise that's it. Yeah. And it's we Sara and I, you know, we have marketed to doctors' offices, healthcare providers overall.

And this is really the myth that they don't understand themselves, healthcare providers. You know, they'll refer a client to us, their nurses, referring nurses will refer clients to us. We'll talk to them and we have to make it clear that this is self-pay, other than if they had long-term care or BA assistance. And they're completely shocked. You know, so that referring nurse or doctor did not know that home care is or assisted living, memory care.

is not paid for by Medicare or Medicaid to a large degree. So then we have to have those difficult calls with the families. Or if it's an older person that we're talking with, the older adult themselves, that's really difficult. You know, especially with cognitive decline. You know, so there's this myth around around the country that Medicare, Medicaid pay for this. And it is, I think this myth is a big thing that

causes families to wait till crisis because if they didn't have this idea that this was going to be taken care of, they would be reacting sooner in the process. At least I believe that. What about you? Hundred percent part of it. But it's also the not wanting to have that conversation. So you wait till the very, very last second. And then with that, you know, there's this myth that that if you wait, that you might just not need care.

These all these misconceptions that come, like there's a myth that like I I see people go, Well, I'm just not gonna talk about it, then it won't happen. Right. And then they get there. How do you talk to families who are coming earlier in the process of when you have a plan and you don't have to execute on it? How do you walk them through all of the options that may change? I had a client recently who's in her early seventies, doesn't really need assisted living yet, but she's been falling, so she wanted to make a plan. So we

We started out talking about her money and how long it would likely last depending on when she went in and where she went. So then we picked took up talked about the options that would wouldn't kick you out when you ran out of money. Then we sort of talked about what she liked to do, how she wanted to live, what kind of what mattered to her. And then we went and saw three very, very, very different communities. And we could tell from there which one she responded to and which one

you know, felt good to her. And so I think she feels like she has if something happened tomorrow, people would know where she wanted to be if that was a possibility and how she would pay for it and what we do with her house and all those kinds of things. So that was kind of a satisfying interaction. Never happens. That might be my first one. Well I I'm I'm trying to personally train my friends because I'm definitely of the age group that's the sandwich generation.

And so it it's interesting because sometimes I have placed a friend's father or mother, but the other one is still very independent. I'm going through that now. So really walking them through, you know, preparation, because right now I was able to get him to assisted living because he doesn't have behavioral issues or elopement risk, even with full, you know, full blown dementia diagnosis. So he's still able to be an assisted. Well, she's very independent.

So she does not want to move into assisted living at all with him. So now, much to Sara's client, we're looking at independent living, you know, from actual like senior living apartment. I'm showing her one of those options, and then an age in place option. And I think that's the difference. Like a big part of our work is just educating people on the options, right? Because if they really believe they're truly independent.

We can show them really independent places. And this conversation could be very different than what a lot of people perceive another myth that everything's like the nursing home of old that they saw their parents taking their grandparents to. And we still have so much of that. You know, like, no, not going there because that's what it looked like, smelled like, felt like, looked like. We're like, no, some of our communities are like cruise ships on land, you need to come with us.

And we need to show you, you know, how active and how enriched they are versus what the myth was of the old folks' home, the old nursing homes. You know, but that's still very much out there. So really if I could, you know, we could show them options that are so much brighter and livelier and sense of community and all the things that some of these communities do offer, then that conversation could be very different. Yeah.

And I'm one who like I've already picked out my assisted living because I love this community and I loved the ladies that were there. I wish I was like already there with them, like some of these ladies. It is. It's like it's it's invigorating and it gives you a sense of purpose and your b ability to interact. It was really they're they're really beautiful places and I think there's so many myths around what the that experience is like that just need to be disproven. So as we ate

I offer all the time. I said, just come with me to one place, just one. You know, I'll show you. And it because it's very much a feel thing too, right? We can talk about it, but we actually if a person just actually sees for themselves that there are, you know, it's like they're people, right? 'Cause that's really a hard thing to try to convince people about until they actually see it. Now of course we have seniors who think forever more that they're twenty, thirty years younger anyway.

We can't change that. A couple of times. I've had clients say, Well, could there be no walkers in wheelchairs? I'm like, Okay, that's kinda impossible. That's like an impossible task. That's like a myth, you know, that like walkers and wheelchairs are not no truly independent living like a C C R C you know, like that is truly independent. Yes, they can ask for that to be, you know, less in the background or not in the background, but

Not a regular assisted living or memory care community. That is like a super hard ask and almost impossible. Well, and it's not really that kind either, right? That too. Yeah. There's definitely, you know, independent living communities. C CRCs can be very, you know, kind of clickish in that way. They don't want to see walkers and wheelchairs. But you know. But it's also a buy in community versus like the traditional

month to month communities that we're talking more about. Yeah. And and I think that brings us to another myth where f families who really are saying, I want to age in place, I want to be at home and it'll be less expensive to have home care than assisted living. And people are really like, I'm not going to be able to afford assisted living but this. What is the truth about that? And why do people have this misconception that staying at home is going to be less expensive? I don't know. Because

In Middle Tennessee it's approximately thirty-five dollars an hour. So if you're twenty seven did I say twenty five? Thirty-five dollars an hour. And if there's if you need twenty four seven care, you're moving in on three hundred thousand dollars a year. We can do assisted living for seventy-five, you know, going up. So it's quite a lot more expensive. Plus you still haven't the the main reason

One of the big problems of staying at home is there's no socialization and you haven't solved that problem. Just having one other person there who you might or might not like is not going to solve your s your socialization issue. Whereas if you're in a community, you can have lunch with friends, you can get to pick your friends because there's bunches of people, you can have dinner with friends, do activities with friends. It's a completely different experience. I was just I just had a meeting with a home care partner.

Who said to me, once this lady gets her bill, her mom's bill today, she will be calling you guys. And I think that was really realistic statement because she's 24-7 at home, you know, for the past several weeks. And she's not, she's gonna see last month's bill, right? Because we're the first of the month right now, and she's gonna be shocked and she's gonna call us. And so there's that comparison to Sara's point, it could go up to three hundred thousand a year, or

Even long term care here. Like we are a medical centric town. Like we have hospital groups below here. And if you go into a long term care here, it it you're talking fifteen thousand dollars a month. So assisted living, even with care levels, is half that. You know, our memory care here, we have some, you know, near eight thousand dollars to about twelve, still less. You know, plus you have twenty four seven care.

You know, versus just being in a long term care, which is really a hospital setting, where the person is just basically in bed and propped up for meals. There's no so s socialization under the otherwise the like they put them in the wheelchair and put them in front of the T V room. That's socialization in a long term care setting. So that's also, you know, families don't understand the difference, you know, where they can actually end up if they wait too late. And that's what we're trying to tell them. Don't do that.

that your only option is either a behavioral health hospital or long term care. Right. But waiting too long is one of the biggest problems. The really the only major, major requirement to get into assisted living is that you can put some weight on your feet and pivot so you could get from a a bed to a chair with only one person helping. And once you wait past that, you're stuck

Now in what Sherri just described, the hospital setting, fifteen thousand dollars a month, you're probably moving into Medicaid and then that limits your options even further. It's so much more pleasant if you can get yourself to move while you're still conform relationships, while you can still have fun and you're physically well enough to get into these communities. I try to take them if we are touring, try to take them during happy hour or a so or a social hour.

So they can see, you know, no one's just talking about this stuff. It's like, or they're getting in the bus because they're going out for lunches and activities. It's like you're not relegated to being in the community either once you're in there. It's like once you're in there, you create connections and have fun, you know, and have this whole enrichment, talking about enrichment and programming. That's something that a lot of family members don't realize is actually, you know, the positive, just even some of the positives in community.

Yeah, there's a myth that you go there and that's it. Like you just stay there and don't do anything, you know, like you're stuck there. Families can, you know, you could go in and out. Some of our residents are still driving who are in assisted living. Some in memory care too. Although they should be. But that's a neurologist not wanting to write that order, right? But yeah, we still have a lot of drivers out there. So well, there's so much life in the community. That's definitely a myth.

Like people don't know how much engagement and enrichment there is there. One community actually took its assisted living to Florida for a week. Wow. Wow. In a like multi million dollar home. And I said, Do you need some chaperones? Right on the beach. Right. I was actually touring. They have villas that are independent. We're talking about the same one, I think, right, Sara? I think so.

You need some chep rooms? And they're like, this is a wild bunch. Uh-huh. We're taking several of our staff to watch over them. That's where I want to go. I just changed from my assisted living that's down the street from me to this assisted living that's gonna take me on vacation. We just stopped it. I mean it's it's actually the first I heard of because it's a week and it's a beachfront, you know, house that they're renting. There was enough sign ups for them to do it.

I love that. I love that for them. Yes. But you know they get the ballet, the theater. I mean, it's not just like grocery runs or shopping runs. I mean, they really go out to the community, you know, are really good communities and do that for their residents. We always know like the best activity directors and, you know, the best, you know, just people in the community who really I mean, they go out and they ask people, what do you want to do? What are your interests? And they try to create those.

I mean, we've got some serious like bridge clubs, you know, bridge players, master gardeners, master librarians, you know, all these wonderful backgrounds that people have coming into a community and the good communities really look at that and try to build, you know, engagement and community around those skills. But you know, these people were full blown, you know, community people, right? And you know, they had interesting backgrounds and careers.

And part part of it probably is 'cause we're in Nashville, but there's so many musicians in these communities. Some like one has a Juilliard trained violinist, there's pianists, there's guitar players, and they take advantage of that and those people provide entertainment during the course of the week. It's great. Well we have a group called music for seniors and it's all like volunteer based musicians and there is no shortage here.

No, which is great because some of our communities have music like three times a week. That's a lot. You know, but they love it. Yeah. I don't when people push back at this, I'm so confused on it because I'm like ready to sign up now and I'd like my parents are one. They're like, I don't know about this. Like obviously I've walked them through a lot of this in a more meaningful way, but most people are like, I'm just never doing that. And I'm like, I can't wait to do this

Just the laundry and housekeeping alone. Sara and I are constantly like, sign us up. Like this is a no brainer. Three mails a day, happy hour every day. Yeah. And some of the communities let you do your own laundry and are constantly like, Why? Yeah, let's let's get it all done. You've worked really hard to get here. Like enjoy these years of having the ability, as you said, to live on a cruise ship on land in some of these places. Yes. So

Last words for a family that are just not sure of what to do or if their timings right, what would be your last words to them of what they should do next? First I would say call us. We're not gonna whisk you away in the middle of the night and put you into assisted living. So we can start to talk through some of these issues. And then let us take you to a couple of places so that you can imagine what it would look like in your life. I don't know, Sherri, what would you add?

Yeah, I think that's really, you know, the main thing is we just try to meet with them, right? Like coffee, we're constantly at Panera's or, you know, wherever else. But, you know, just meeting the p family, so having a connection with them, you know, as early on as possible. I mean, Claire and I have people that have been talking to us a couple of years, you know, and they're still not ready. So it's you know, but you have to start somewhere. You have to have at least a conversation in the connection so that you know what your options are.

So we just try to do that. We try to be very friendly, you know, around any any referrals that we receive because we know it's hard. We we are in it ourselves and just try to assure them like listen, this is not like it doesn't have to be an immediate thing, but let's have a plan in place. That's the most important thing. Absolutely. And how do people reach out? Well, they can call us as Sara said, or you know, our website and you know, a lot of our families just

A lot of the families just have our cell phones. So they're you know, they don't even call our main line anymore, which I think is great. You know, a lot of our families refer to us, which is the most, you know, I mean it means a lot when our own Okay. So now that sound is back. It's like a driving sound now. Do you wanna mute yours for a second, Sherri? Okay. Okay, unmute yours. Sara, you wanna mute yours? Sure. Okay.

So Sherri, unmute yours. Okay. Okay. So Sara, it's on yours. So what is good about that is that all the times you were talking, it was pretty clear, Sara. And so that means Sherri's because it records on hers, we should be just fine. Okay, great. Yeah. Okay. So if you wanna I yeah, so I'll have you mute, so and I'll just like say goodbye, but then it should be they should be able to pull it out, so that'll be great.

Did you I'm sorry, when you asked that last question, did you want me to give our phone number and our website? I'm gonna give you the websites below, but as soon as you said cell phone, I must say, Don't do that, don't give that out. I wasn't sure. I was like sorry, I wasn't sure on that one. No, yeah. Okay, so I'll just kind of finish it up from where you were and then we can we'll wrap it up. So thank you so much and we will put all of your contact information in the notes below as well as contact information.

For the other for care patrol, because there's also other care patrols all across the country. So even if you aren't listening from Tennessee, they are able to help you and help you along this journey. So thank you, ladies, so much for joining me today. It was a pleasure. Nancy, thank you for having us. Thank you. 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 LT Care Nav's Care Compass.