You Don't Get to Decide When Care Happens with Colleen Cruz — Full Episode Transcript

The biggest cost that I find that really affects and makes the most impact negatively is the effect that it has on the families. Once you're in a long-term care situation, unfortunately, it is too late.

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 another episode of LTCareNav's Caregivers Compass. I'm so pleased to have Colleen Cruz of Rey and Colleen. Colleen brings over two decades of experience in residential living, along with a background in real estate. She focuses on long-term care planning and guides families through the difficult financial considerations of future care needs, offering clarity, compassion, and holistic approaches. Welcome, Colleen.

Thank you, Lindsay.

So to start, can you tell us a little bit about yourself, what you do, and what brought you to it?

Well, I appreciate the kind introduction. So my husband and I, we have been in the long-term care industry for almost two decades now. We got into this because after college, we were just kind of trying to find ourselves. My in-laws actually had a small personal care home, and they were in the industry, and they thought of expanding, but they wanted my husband to. And so naturally him and I decided to go for it. And from there, what we thought we were only going to do for a few years ended up being almost two decades. And we have never looked back since. All those years that we spent taking care of others, we've learned a lot of things along the way.

That's kind of a great segue. So you worked in the personal care space, which I think brings such a level of expertise into any kind of long-term care planning, really having a good idea of what that truly means. So how did you transition from the care space to long-term care planning, and what drove you to that transition?

We actually are still in the care space right now. And what we saw was that a lot of families were just coming unprepared, coming looking for help — they were just defeated. They're in a crisis situation. Their loved one either had some type of critical illness happen or something terminal that they found, and they just themselves could not take care of them at home by themselves. Taking care of an aging parent or someone in a situation like that demands a lot of not just resources but also time. And nowadays when people are juggling work, family, all of that, it's just — people are not able to add something else on top of that.

So you deal in the care part of it, and you've gotten to see that in real time. But because of that, you've really seen that there is such a financial implication that comes with care. So what is the real cost financially, but also emotionally, if people don't start to think about what that plan is going to look like?

Well, financial costs vary from wherever you're at. However, in what you were saying, there are different types of costs. And the biggest cost that I find that really affects and makes the most impact negatively is the effect that it has on the families.

Like you said, emotionally, even physically, if someone decides to take on caregiving on their own, they compromise their health and their wellbeing to a point where they themselves no longer can care for their loved one. It even trickles down from not just the children, but even to the grandchildren, because when the mom's stretched too thin or the dad's not able to be there and show for the games, it does put a strain on the family, and also the patient themselves. They don't want to feel like a burden to anyone. And so it really affects families on multiple different levels.

Seeing that — as professionals we see all of these things that happen to families, and it almost is often because they didn't start planning. What do you think holds people back from creating that plan?

This is something that I deal with all the time. Unfortunately, people don't think that it's going to ever happen to them. I think back then, a lot of people were always understanding that when I get old, I'm just going to go into a nursing home, or my kids are going to take care of me, or I'm going to just be healthy forever and I'm never going to need help. But that's not the case.

That's what we're seeing a lot of times when we're talking to families — to try to educate them ahead of time, when they are younger, when they are healthier, when they have more time to plan — that this is something that a lot of financial plans, or even your portfolios, your investments, are missing, that really wipe things out so quickly when you don't have certain solutions in place.

You talked about things in place, and I think that's going to be the key into how we do that. What are some of the things that you can help easily put into place, and what does that look like in somebody's financial situation versus their long-term outcome if they do need care?

There are a lot of modern solutions with living benefits nowadays that people aren't aware of, unlike traditional policies that are just used for death benefits. There are plans out there that allow clients to access portions of their coverage during their lifetime. They don't have to die to access it while you're alive. For certain qualifying situations like critical illness, long-term care, critical injury, if you have Alzheimer's or dementia, or even terminal illness or more.

There are life insurance policies as well with built-in riders. There are also long-term care standalone policies. Even retirement strategies — I can't go into too much detail at this time on a public forum — but even annuity solutions. That's why it's so important to sit down with a financial advisor to look at your complete picture, so that way you're allocating costs in ways that make sense for you at the time, but also still planning for the future the best you can.

When you have a family that comes to you, my guess is most of them are coming when it's like, I need care. Is that correct?

Unfortunately, yes.

So for those listening, or even when you have the families and you have the adult children there — when is the ideal time to plan, and how do you start looking at it when you're 45 and you feel great and you feel like you could jump off buildings? How do you plan and how do you have that conversation?

In terms of how to plan, I think the best thing to do is really, like I said, start with someone that's in an industry that understands your financial situations — that's obviously licensed appropriately as well — that can look at your financial picture and say, hey, look, this is where you're at, but is there a gap for this? Are you covered in terms of long-term care?

People think that they're going to have robots take care of them. I've heard so many crazy things. And I think the craziest that I hear is, well, I'm just going to die. Given my experience in long-term care, especially in the hospice realm, you don't get to decide that. When your time comes, it comes. If it doesn't come prematurely and you live a long life and you didn't plan for it financially, your situation could be very detrimental, not just to yourself, but to whoever is involved in your life and your care.

You mentioned that people are like, robots are going to take care of me. Being in the care space, I find that really creepy. And I believe that robots are going to be able to stick their little metal arms under someone and turn them, right? Do you think there is going to be something completely missing from that experience of having a person there who says, hi, Mrs. Smith, I'm here to turn you. How are you feeling today? Because a robot's not going to do that human touch. Do you ever see robots taking the place of a home health aide or a nursing assistant in a facility?

I don't have a crystal ball, and you see lots of movies and you see things pop up on Facebook that perhaps AI and robots aren't going to be there. I've learned to not disregard things. However, there is a human element in caregiving, in being compassionate, in being able to adjust your tone to that person. Even any second, someone can feel a little bit different, especially when they have a mental illness or dementia, when they're already confused in themselves.

So I don't know if they're going to be able to replicate being a human, but it is scary. It would be scary for, I would imagine, people like us that aren't used to having robots around.

Yeah, I think it'll be an interesting transition. And with transition, we'll come back to kind of what you really deal with. One of the things I want to ask, because there used to be really great policies of yesteryear — of long-term care insurance. My grandma had this policy where she paid for it, it wasn't too expensive, and it was unlimited. Whatever you want, wherever you want to be. Do those kinds of policies still exist? And when people are negative about long-term care insurance, where's it going? What's your advice about that?

There are policies out there that are indemnity style that allow you to even have in-home caregivers, and they would reimburse you. Talk to your financial professional about that, of course.

I think a lot of times people have gotten a negative rap about long-term care policies because it's hard to also get the provider to fill out the paperwork, to do the monthly, to submit all the monthly paperwork to the insurance carrier. Personally, operating our own small residential assisted living, I always work hard to make sure people have access to that money. There's also another scenario where the family didn't file the paperwork in time. So that's not necessarily the carrier's fault — it's because the family procrastinated to try to collect the money after the patient passed away.

Even then, that scenario was quite interesting, but we were successful in submitting a lot of the paperwork. I worked with her to ensure — not as the agent, but as the provider — to make sure that she was granted some of the funds that her mom had paid into all those years. So I think a lot of times people have a negative mindset about it because they don't understand there are some complexities to it, in terms of how to qualify for it and all the paperwork that's involved.

In most of these policies, people have to look at them pretty young, correct? It's not like you can be like, I need long-term care next week. I'll buy this insurance policy.

Absolutely. You're 100% right. Once you're in a long-term care situation, unfortunately, it is too late for you to be eligible for a long-term care policy.

What options are available when you're already in a long-term care situation and you're there and there's your moment of, I didn't plan? What is available?

There's not really much available at that point. And that's the reason why my husband and I decided to branch out and help educate people on the importance of what we're seeing time throughout the years. And it's only getting worse. More and more people are needing care. They don't have the resources to get the care that they need, let alone what they want.

People want either private rooms with everything furnished to the nines. However, that's not what they're able to afford, and they're having to settle, go against their parents' wishes. It just becomes a really hard situation for them when things aren't planned, or when you don't have the resources like a policy. It's not even just long-term care policies — there's also, like I was saying, some new disease options if everything's structured right as well. I think that's a big part of it — structuring it.

You've mentioned about always talking to your financial planner, the insurance agent kind of thing. So when you work with a family, do you sort of bring in a team to make sure it's a complete package and get them set?

Absolutely. I really believe in a holistic approach. My husband and I don't want to sell you a policy just to sell you a policy. There's that school of thought, well, something's better than nothing. However, that's not a one-size-fits-all for everyone. There are sometimes situations where they may not need a long-term care policy and they're self-insured. That's not the case for most people, but we bring in a team of financial professionals, financial advisors to look at your scenario and walk you through the journey.

And we don't just stop when you're set up. We understand that your life is going to change. And so that's why it's so important to have semi-annual reviews to see if anything has changed in your life. Anyone getting sick? Did you have a baby? Did you lose your job? Are we able to adjust certain things in your policy to fit your needs right now for a certain type of window till you get back on your feet? So yes, we look at everything from a whole picture and where you're at in your life right now.

One thing you said in there that's super interesting and I think will make people feel better is, some folks who are like, I'm in a good position right now. I could buy this financial tool, but what happens if I'm not? So are you able to adjust if there are moments — are you locked in forever and stuck, or is it able to adjust what you're doing day by day given we're in a kind of tumultuous time?

It really depends on how things are set up. And so that's why it's very important to work with someone that understands how to structure the policies properly and is looking for what's in your best interests. So that way, if you do foresee that you might need some type of flexibility to adjust the payments or even pause sometimes, that's an option for you in those different seasons in your lives.

When you say financial experts, I sometimes find that even the best financial advisors sometimes underestimate the long-term care piece of it.

Yes, they definitely do. And I see that a lot. And it's really hard though, right? You don't really know exactly what you're going to need. But what we do know is that care costs are rising, and they have — since we opened many years ago, the costs of things have changed so much. You can only plan so well. And that's another thing too, because it depends on your lifestyle, it depends on what you want. And so they're going to try to give you something that might not cover your entire stay, but at least supplement a large part of it.

Do you find that the financial advisors are sitting down and saying, hey, Mrs. Smith, what kind of care do you want? Because do you want to age in place? Because that's going to be a different cost than an assisted living, because at some point that definitely trumps the cost of assisted living. Or is that something — do you have these conversations with these financial advisors? Are you available to do that for families?

Absolutely. Actually, that's what I focus on the most when we sit down with families, which is why I've partnered up with really big-hearted financial advisors that allow me to take the time to do that. And I advocate for them, because you can easily just say, they're going to need X amount of money for this X amount of years. And I said, well, how do you know that? How do you know what their preferences are?

If we can look at everything and have a wish list first and see how much that costs and then work backwards and say, hey, this is going to probably be the best-case scenario with you. You might have some concessions. However, we did take into account the fact that you weren't so against having a shared room, but it was important that you were in a residential facility versus a larger one, things of that nature.

I think those are so important, and I hope for everybody listening, really figuring out what you want is the first step, don't you think?

Definitely. People don't want to see themselves in this situation. They don't want to envision themselves getting older, or I think not even getting older, just needing help. Especially nowadays when everything has changed, you can do so many things with health technology. But when you get into a situation like that, and to qualify for most long-term care policies, you just have to not be able to do two out of the six daily living activities. And you don't think that's a lot, but that ends up being a lot on a person and a lot on the family day to day, even multiple times a day.

What I really am hoping to see change, because there's so many family caregivers, right? There's so many people who are going through this and struggling. I'm hoping that these family caregivers say, that was really hard. I'm not going to do this to my children. Are you starting to see that pattern? Do they sit with you and say, I need this for mom and dad, but I should start thinking about it for myself? Or do you have to guide them there?

No, by the time they come to us, at least in our assisted living space, they already know that they need something for themselves. The sad part is though, if the parent didn't plan properly, what we're seeing is that the family member has to start tapping into their resources, their retirement. So even if they want to put aside something for long-term care, some people can, and a lot of people can't anymore because all their resources are going to make sure that their parent is taken care of.

That's really hard. And talking about that — that's like the cycle. It's like the first domino — our parents who didn't plan are going to kind of click back, back, and back. So finding some way of doing it right.

Yeah, and that's why we advocate for this so hard, because we want to break these generational curses, where back then, at least for our families, I grew up in a household where we took care of my grandmother for many years and that was the expectation. But through that you see a lot of challenges affect the family. And like I was mentioning earlier, on all different levels — it goes from the grandparent needing help, the strain on the marriage, then it trickles down to the kids and what's happening in the household. It's really hard.

But we're seeing a lot more movement. I think I see that more culturally. We're seeing a lot more things evolving and changing because people are more aware now of taking care of themselves, and just from a health-wise perspective, not even just financially. So that's what we're seeing.

No, and that's really good. And I guess that's all we can hope for. You and I who advocate for these things — that's the end goal. So if families want to find you, where do they do that?

Definitely. You can visit us at www.reyandcolleen.com, or you can find us on Facebook or Instagram at reyn.colleen.cruz.

And we'll put them below. So thank you so much for being with us today, Colleen, and thank you for the work you're doing to help families through this hard time.

Thank you for having me, Lindsay, and I appreciate your time as well.

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 compass. See you next time on LTCareNav's Caregiver's Compass.