Home Care That Protects Independence with Simona Gamarnik of Blue Palm Care — Full Episode Transcript

Welcome back to another episode of the Care Compass. I'm your host, Lindsay Friedman, and today we are here with Simona Gamarnik from Blue Palm Care, a home care company in Palm Beach County in South Florida. Welcome, Simona!

Thank you, great to be here. It's a nice Monday morning, at least here in Florida.

I'm in Ohio and it is a beautiful Monday morning here. It sort of looks like a Florida day here, so I'm thrilled. So I like to start off every episode because it's really important for people to know who you are. So tell me who you are, what you do — even though I kind of touched on that — and most importantly, why you do it.

Thank you for that. So I'm Simona Gamarnik, as you said. I'm the owner and CEO of Blue Palm Care. We are a home care agency — our office is in Boca Raton, Florida, in Palm Beach County. We are a care company and we really provide a high-tech, high-touch, and relationship-driven approach to care. We also developed what we call an independence model.

Basically the bottom line is we are not just task-oriented. When we look at the person, we look at the whole person. We don't say, okay, you're sick or you need this. We look at it a little bit differently: what can we help with for you to maintain your independence while living at home? So that's kind of how we look at things.

We provide companionship, we provide personal care, we will drive you to a doctor appointment, to the mall, whatever you really need. But it's really all about what that client needs. And we don't look at people as just patients. It's somebody's dad. It's somebody's mom. It's very personal to people, and we need to treat it as such. We cannot just come in and say, okay, you need this, this, and that. It's not like that, and it should not be like that.

In terms of why am I doing this, I had a very interesting experience with my grandfather. My grandfather died about eight years ago. He was ninety-eight years old. He lived by himself. He actually finished the last edition of his book about his life a couple of days before he died — we actually found it in his apartment. He cooked himself. He did have somebody cleaning up a little bit, but like literally an hour. He walked everywhere. He refused to take a car. He maintained his independence till the literal minute.

And to me, this is something that everybody should have. Maybe not everybody is as healthy as he was, but they should be able to do it. So if you want to make lunch but you can't get yourself to the supermarket, you can get somebody to drive you — but at least you're going to get it yourself, you're going to bring it home, you're going to make those choices yourself. Not somebody else making that for you, but it's yours.

So that's kind of why I do it. I really would like to get to the point where at least clients within Blue Palm Care — and hopefully everywhere else — have that level of independence. My grandfather definitely had a huge influence on how I'm looking at things right now.

I absolutely love that, because I think a lot of older people hear home care and then they're like, you're taking something from me, you're taking my independence. And so it isn't as welcoming. So I love this idea of home care encouraging independence and promoting it — and potentially making it so you could potentially do these things without home care. A very positive spin on it to the client who needs the care. How do you approach this, and do you ever get pushback from people who are like, well, you're here to do what I want and I don't want to be independent?

I've never heard that before, honestly. The first thing that I hear — from not everybody, but from a lot of clients and from their children — is that I want my mom to be independent. She's been independent her whole life. Up until a month ago she was able to do it herself, and now she can't. What can we do to support her? So that's usually the kind of questions we get.

We do have what we call an independence questionnaire, because independence looks very different to two different people. What is it that you are trying to get out of it? And talking to the children as well — what are your goals for your mom and dad? Do they want to maintain the lifestyle? And the answer is yeah, of course they do. So how can we support it? In some cases maybe it means getting a walker so they can get around the apartment, so they can actually go down to the pool area instead of just sitting in one place.

We ask those questions. We don't come in and say, okay, you need help with food preparation, we need to get you out of bed. That's very negative, and it's also very much task-oriented. We want to get away from that. We want to be lifestyle-oriented. What does your lifestyle look like and how do you want to continue?

In terms of pushback — I haven't heard that. The clientele we get is usually private duty, so it's a little bit of a different approach. These are people who really care about their lifestyle, that's kind of why they call us. Everybody likes the idea. They bring this up themselves, really. I don't even have to sell it.

I absolutely love this idea, and I love even more hearing that you have an independence questionnaire versus a what-kind-of-tasks-do-you-want-done questionnaire. Can you share a couple of those questions and what they're looking for? And especially, what should adult children be talking to their parents about when we talk about finding home care that increases independence?

Let me start with the adult children. I just want to acknowledge first, before we go any further, this is extremely difficult for them. These are people who have seen their mom and dad being independent, doing things for themselves their entire lives, and then all of a sudden they have to have that conversation. Sometimes they have to make decisions for them. A lot of times mom and dad don't want anybody — they're like, why do I need this person in my house? I'm by myself, I'm fine. So that conversation that the children need to have with their parents is very, very, very difficult.

In terms of the questionnaire and how we approach it, we look at six different pillars of independence. We talk about nutrition. I know it's very basic and everybody has lunch, but really based on where you are, what kind of nutrition do you really want? We want to make sure that we do something that you actually like — maybe somebody likes fruit, maybe somebody likes something else. We need to know what that is so we can actually help you with that.

Physical activity is another one. How active are you, or how active are mom and dad? Do they exercise? Do they like to just walk on the beach? Maybe they are not in the position to do that, but would they want to, even in the wheelchair? Would they want to do a chair exercise? Let's say the mom is in the wheelchair as of a month ago, but she was with a walker before — do you want to see if we can get her back to the walker? And that actually happens. I've actually seen that happen. When people think, okay, I'm stuck — but you're not. Let's work with you, let's encourage you.

Mental engagement is another one that we talk about in the questionnaire, and that's one of our pillars as well. Keeping the mind active, whether it's playing games or maybe going down to the recreation room, playing with other people, engaging with other people — not just keeping that person in the house. It's nice to come in and say, okay, I'm gonna do one, two, three for you, you sit here and watch TV. But that mental engagement and the social connections are one of the most important things, at least as far as I'm concerned, and that's one of the predictive factors on how long they're going to live as well.

Creative expression — things like listening to music, art. I actually push for something that people think I'm completely crazy about: I like gardening, even in the apartment. You can get a little plant, you can go to Trader Joe's and get herbs. Take that pot, put it somewhere, make sure you water it, and you see it grow. It really brings something out in people — not to mention the fact that the soil is really good for arthritis, but that's kind of a side effect.

And then really personalized independent planning that comes out of that questionnaire. I know everybody calls it a care plan. Our care plan is not just about the tasks. It's about how do we support that independence.

I love — I mean, I keep saying this, but I just love this approach so much, including the idea of creativity and gardening, because it's purpose. And I think a lot of home care companies go in and say, I'm gonna shower you, I'm gonna put you in bed, I'm gonna make sure you have lunch — I'm just gonna do all of these things for you to make sure the tasks are done. And we forget about the value of purpose. And it's beautiful that you are bringing that.

So with that — you're doing all these amazing things — but what are some of the other things that home care covers in the state of Florida? Because as you and I've talked, it's different across the country. So in Florida, what can somebody expect with home care?

On a very basic level, what we are allowed to do — not so much what we want to do, but what we're allowed to do. Companionship is number one: companionship and engagement. Personal care support — maybe somebody needs help washing their hair, taking a shower, brushing their teeth, depending on where they are. Assistance with anything — let's say you want to go somewhere, you want to go to a doctor, the aide will drive you to a doctor, they will go in with you. They're not allowed to talk to the doctor because we're not what's called skilled. We're not allowed to give medications, but what we're allowed to do is medication reminders. So we always have it on our schedule — let's say somebody takes medication twice a day, the aide will say, hey, it's time for you to take your medication, very gently, without pushing, without yelling. Because sometimes people with dementia get upset, they don't want to do it.

Meals — preparing meals. Housekeeping — light housekeeping, organization, maybe organize the closet, take away the trash, organize your newspapers. And of course a lot of our clients have memory issues, so memory cognitive support — could be games, could be puzzles. I've been reading up a lot about music therapy, which is amazing. I know you need a license for that, so I'm not gonna say we're doing it, but we can do elements of that.

This is kind of a sideline, but I really like to talk about it. I was reading about this choir, I think somewhere in the Midwest. The choir consisted of people with heavy Alzheimer's, like advanced Alzheimer's. And what happened was when they listened to the music from their youth, somehow they actually remembered that, and they started singing. And so they got the entire choir together singing — and these are the people that don't remember what happened yesterday, but they remember this music. So there's a very interesting connection between memory loss and music. We try to do elements of it. We're not building choirs, but we're doing elements.

Palm Beach County has a large Jewish population and religious communities as well. We're Jewish-owned, and we understand the laws of Shabbat and kashrut. We understand when people want to go to the temple on Saturday morning. Our caregivers are trained to respect that, and to prepare meals based on keeping milk and dairy separate — they understand how that works. So we're able to provide that extra level of support to the Jewish community as well.

I think that's fantastic, because I think a lot of people in the industry know it's very culturally based — how you behave in somebody's home, how you care for them. So it's wonderful that you're able to meet those needs and that you train your aides to meet the needs of your clients.

And I love the fact that you said it's very culturally based — it really is. And not only that, I think it's also personality-based. When we do a match, it's not just matched on, okay, this person needs that and you have it, or they need you to drive them and you have a car. This is all great, very basic. Are you a good match based on personality? Maybe the client is very quiet and doesn't like to talk, and the caregiver is yapping the whole day — you don't want that. Or maybe it's the other way around. You really want to make sure that there is a personality match.

I think it's just as important as everything else, because they're at home, and the aide is coming in as this person who they in general don't even want there. So they need to find a connection. And it's on the aide to find that connection, and it's on us to make sure that we do have the right aide for the right person.

And yes, there are some aides who walk in and everybody loves them. How do you ensure that there is a quality match? I'm assuming you know your aides pretty well — and then what do you do to understand the client to make sure you are making that great match? Because a great match is gonna have consistency and longevity and less turnover, which is always positive.

The first thing that I usually do is I actually visit the client. I have a conversation. We talked about the independence questionnaire, but we also have a conversation — you get a sense of who they are. You also talk to the children to get their view, because if the client's cognitive abilities are good, no problem — but sometimes that's not the case. So the extra layer is talking to the children: what type of person does your mom like? Who does she get along better with? We gather that information as well. It's not a formal document, it's more of a conversation — what type of personality.

And of course we do know our caregivers. I don't have hundreds of them. We are small, we're really more of a boutique type, but that allows me the personal connections on both sides. I can tell you about my aides — I can tell you what they like, where their children are, what they don't like. I also know their food preferences, because I like to bake, and a lot of times I will make a bread or cookies just to bring them.

I also visit clients at least once a week, just to get a sense of where they are, whether they're happy with their care, is there anything else that they need.

This is amazing. You are a huge asset and a very special lady in the home care community. So to adult children who are trying to make this transition — obviously if they're in Palm Beach County, they should call you, but most people aren't in Palm Beach County. So if they're gonna start interviewing for a home care company, what questions should an adult child ask?

I would say definitely find out about the background, find out about the size of the company. You have a lot of franchises, and I'm not saying it's good or bad — it just depends on what you want. If you want boutique type of a service, a franchise is probably not for you. So ask about the size. Ask if they know their caregivers. Find out about the background of the staff, what experience they have.

I would also go meet them. Seriously, I think that's probably even before you ask questions — just go meet the person. Go meet whoever runs it, whether it's a CEO or somebody else, and find out what their values are and whether or not you can connect with them on a personal level. That's more important than any questions, to me at least. Establish this relationship. If you don't feel the connection — and it could be on a very basic level, it's not something that person did or said — but you don't have that connection, then move on.

You need to be comfortable with the person you're entrusting the care of your parents to. So I would definitely start with that, and then you can ask questions. You might have special needs in terms of the language — as we all know, once people get to the advanced stages of dementia, if English was their second language, a lot of times they actually forget it. So now you need to find somebody who speaks their native language. Do they have caregivers who do that?

And if they have requests, do they just post really quickly and get somebody within half a day without meeting that person? If they do, walk away. But I would look for a personal connection. That would be definitely the first thing for me.

I think that's great advice. Now I wanna flip it a little, because I was a caregiver for a long time professionally, and I've also seen families that have taken advantage of caregivers, and I never wanna see that happen — because it's a hard job that takes passion and compassion, and you don't wanna burn these people out who want to do this job and are there because they want to take care of your mom or dad. So what is something you wish families knew, after they've hired this person — boundaries, expectations — what do you wish they all knew so that relationship is solid and sustainable?

Here's what I hear from a lot of caregivers — this is like the number one concern. They end up in situations, especially with patients with dementia, where the clients start yelling at them. They call their families and say this caregiver did not do the right thing, I'm not comfortable with them, they yelled at me, they hurt me — I have it happen literally all the time. A lot of people fire them right on the spot without doing investigation.

But families need to understand: if mom has dementia, she might not remember things the way they actually happened. It's possible she unwillingly made it up — not on purpose, but they need to understand that. And if they don't, then that caregiver is fired, then you go to another one, and the same thing is gonna happen, because that caregiver potentially didn't do anything wrong.

So just be careful, understand where your parents are, understand their behavior, and talk to them, talk to caregivers before firing them — find out exactly what happened. Talk to me, talk to the owner, talk to whoever is the supervisor, but find out.

I actually had a situation like that two weeks ago, where I was talking to the client and she said, this particular caregiver, I want her gone, she's horrible, she did not lift me the right way. And I started looking for someone new. And then I paused and I said, I have experience with this caregiver, she's never done this before — something is wrong here. So I called her daughter and we talked, and she's like, this is not what happened. Most of the time the children will have the same reaction — they'll say, okay, move on — and that's not good for anybody.

So definitely please communicate with the caregivers. Have that relationship. In my agency, all the caregivers, all the clients and the children have each other's numbers. They don't have to go through me — I need to be aware, but call them directly. Have those numbers, talk to the caregivers.

I think that's great, because communication is key across everything. So make sure you're communicating with your caregivers, and remembering this is a relationship — and relationships are not always easy, especially intimate relationships like caregiving.

Yeah, and it's very hard. As you know, a lot of people are not comfortable with somebody now cleaning them or changing their diaper. Can you imagine — for somebody who's been independent their whole life, now all of a sudden they need somebody to put a diaper on them. How does that feel? The caregivers, I think for the most part, are very conscientious about it — they understand what it means. But families need to understand that too. They need to understand that mom might be taking this out on the caregiver just because she's extremely uncomfortable with this whole thing, really.

And with caregivers, I think it's important for us as agency owners to understand the caregivers — understand their schedules, understand that they have kids, that their schedule evolves around the kids, and be flexible. To me, I have a client and I have a caregiver and they're literally on the same level. One is not more important than the other, because caregivers are human beings just like the client is a human being. They call me sometimes and say, listen, I have this event at school next Sunday — yeah, no problem, we'll figure this out, thank you for letting me know.

That's how you support caregivers and their lifestyle — that's how you get good care. It's a mutual relationship. It's not a one-way street, it's a two-way street. If I want their respect, I need to respect them.

It's so important, because people who listen or read what I'm about — I'm all about the caregivers, be they family caregivers or professional caregivers. We are all doing our best to tend to the needs of somebody else that we care about, and at times it can be challenging. This has been fantastic — I'm so glad you joined me this morning. Do you have any final words, and will you let everyone know where to reach you?

Thank you for having me. I think the final word is: if you are somebody whose mom and dad are getting to the point where they need help, don't wait until they're sick. It's not about that. Don't wait to the point where they get really bad. Support their independence — if they need little things, get that private duty. You don't need 24/7. Get them for four hours so that mom can make her own lunch, so she can go to the store with a caregiver and do it for herself. Support that.

That's gonna extend their lives. I don't have a scientific proof or anything, but I do believe that maintaining your independence, maintaining that social aspect, will extend somebody's life. This is just my core belief. So just think about that.

And where do people find you?

Our website is bluepalmcare.com — our phone number is on the website, we're very easy to find. And call me if you guys have any questions at all. You don't have to become a client, you don't even have to live in Palm Beach County. I do talk to a lot of people — a lot of people call for advice. We also have a huge network of people supporting senior communities, so if you need anything, I can probably get you a referral, somebody who can help you. We all help each other, really. We're really there to support the senior community, not just our business.

And I love that. I'll put your contact information below. Thank you again for joining us, and thank you everyone for listening.

Thank you, have a good one.