Empowering Choices: Eldercare on the Air

Navigating the complexities of eldercare and special needs can feel overwhelming, but you're not alone. Join Michael Amaruso, an elder law and special needs attorney with Amaruso & Amaruso, as he hosts Eldercare on the Air. Each week, we bring you valuable insights from experts in eldercare, financial planning, independent living, and healthcare.

In this episode, we tackle the post-pandemic healthcare worker shortage and explore alternative care solutions with guest Brenda Moynihan, Director of Marketing and Outreach at The Kensington in White Plains, NY. Discover how enhanced assisted living models like The Kensington can bridge the gap between home care and nursing homes while ensuring dignity, security, and peace of mind for you and your loved ones.

Listen in, gain the tools you need, and empower yourself to make sound choices when it matters most. Don’t forget to visit amorusolaw.com to download past episodes and suggest future topics. Together, we can make aging in place a reality.

Transcript

SPEAKER_04 0:00

You've lived well, you've worked hard to make your place in this world. Your dignity and security are earned and well deserved. Or maybe you have a loved one who needs you more than ever. Well, we can help you help them plan life better. Amaruso and Amaruso.

SPEAKER_02 0:27

Welcome to Eldercare on the Air, a weekly radio show with guests in the fields of eldercare, special needs, financial services, independent living, and yes, people just like you. Where we will empower you to make sound choices when you're faced with an eldercare or special needs crisis. My name is Michael Amoruso, an elder law and special needs attorney with Amoruso& Amoruso in Rybrook, New York, which services clients in New York, Connecticut, and Massachusetts. You're at our new home, 107.1 The Peak. But I do encourage you to go onto our website, eldercareontheair.com. That's eldercareontheair.com. Click on the radio show tab you see. and just simply download the episode you'd like to listen to. You see, this show is designed to arm you with the knowledge and tools that you need to make sound choices to help you or a loved one age in place. If you have any questions or would like to hear topics on future episodes of Eldercare on the Air, please send us an email at info at eldercareontheair.com. That's info at eldercareontheair.com. We have an informative episode in store for you this week. So today we're going to cover something a bit different. We haven't covered this yet. And, you know, during the pandemic, there was a lot of chaos going on and how care can be delivered. And you may have even experienced it where you couldn't go see a loved one in a hospital or a nursing home and you're afraid to bring someone into your home. Well, now that we've gotten pretty much through the pandemic, we're dealing with some of the after effects of it now. We have a different crisis that's started to hit us and that's a shortage of home care workers and really healthcare workers in general, even in the nursing home environment. So today I'm thrilled to have Brenda Moynihan with me. She's the Director of Marketing and Outreach for the Kensington in White Plains, New York. And one of the reasons why I wanted to have Brenda here is to discuss another option with you and how the Kensington is dealing with this sort of change of the workforce and how care is delivered here. So Brenda, welcome to our show.

SPEAKER_01 3:02

Thank you, thank you for having me.

SPEAKER_02 3:04

It's great to have you here. So I sort of set the stage up with this healthcare shortage. Why don't you just tell the audience from your perspective what you have noticed in terms of the healthcare workers?

SPEAKER_01 3:14

Sure. So I think if you have a loved one, a mom or a dad, aunt or uncle that you're taking care of, there are several options. One includes keeping them at home with home care, and the second is moving to a senior living. Michael and I were talking before about home with home care. Unfortunately, there is no ideal situation. So if you've got a loved one at home, even with 24-7 care at home, there are still things that you need to do. You need to, first of all, vet the organization. Make sure that the caregiver is bonded. But even the best organization, you still want to do things like make unannounced visits. You have to have oversight. And that could include cameras all over. As I said, you know, I don't want to scare anyone, but you want to do the best thing for your loved one. And that includes that major oversight, visiting on off times, making sure, talking to the aides. What did they do today? What did mom do today? And again, I think it's important to have cameras throughout the house so that you can review what is going on.

SPEAKER_02 4:20

And that's a great point. And, you know, folks, there's a reason for this as well. You know, the agencies out there, while they may be bonded, they're starving for employees to help service their clients. Sometimes when that occurs, there can be a little bit of a lapse in terms of the type of person you're hiring just because you need the body there to service your client.

UNKNOWN 4:44

Right.

SPEAKER_02 4:44

So, Brenda, where does the Kensington fit? Because you're not a home care agency. You're not a nursing home. You're not a hospital. Where do you guys fit in this whole equation?

SPEAKER_01 4:55

You know, that's a really good question. I think when it gets to the point where, even with 24-7 care at home, it's not cutting it. So that's where the Kensington would fit in. We're actually an enhanced assisted living. We are a medical model. And we take care of a very frail population. So I'll give you an example. If you've got a loved one, mom or dad, and at this point they may have dementia, and they have multiple comorbidities, including CHF, they have an IV, they may have a wound, they take many medications, they're wandering, their behaviors, that's when you want to think of something like the Kensington, the next step after that 24-7 home care. So

SPEAKER_02 5:38

you mentioned that phrase, medical model. So in the assisted living environment, typically there's what? There's the medical model and social model and maybe a combination of the two?

SPEAKER_01 5:51

Sort of, yes. Okay.

SPEAKER_02 5:53

So explain to the audience what those differences are.

SPEAKER_01 5:56

Okay. So there's independent living, assisted living, and enhanced assisted living. Okay. Years ago, when senior living came into fruition in the 80s, people were in their 70s. They didn't want the upkeep of the home. They moved into independent living. And it was wonderful. Social model, think of it as you're moving. You're almost going to college, right? You do a lot of activities. Someone's making your meals, doing your housework, and stuff like that. Lots of fun. As those people aged... Independent living really didn't cut it anymore, and assisted living was born. And assisted living is exactly what it says. It's to provide assistance for people that need it, some minor assistance, some bathing, some dressing. Maybe you need some assistance putting on your socks in the morning and things like that. Again, think of the person that's aging. Well, what happens if it gets to the point where they're now wheelchair-bound? They have a catheter. They need their food pureed or chopped. At that point, they need to go into enhanced assisted living. Again, exactly what it says. It's for people that need much more care. Now, within that senior living, assisted living world, there's a medical model and there is a social model. So a social model really provides wonderful activities. And it's, again, for the person that can't really handle the upkeep of the home. the gardening, the painting, and things like that, and somebody who wants to be around other people and do a lot of wonderful activities. But they don't have high care needs. The medical model, though, like the Kensington, provides the activities, but the focus is more on the care. So it's really for people that have multiple, again, those comorbidities, and they need that enhanced assistance.

SPEAKER_02 7:48

So it sounds to me, as we sort of bring this full circle back to the health care worker shortage, if you have somebody that really has significant care needs at home and you can't find that steady aid system, You can afford to pay privately, but you can't find that steady aid. Right. Or they're shifting. Every couple of days, just somebody new, and your loved one's getting confused, and you're getting confused as the sandwich generation trying to care for them and keep track of who's in and what time and what are they doing with your loved one. That seems to be where the Kensington could step in and help.

SPEAKER_01 8:24

Absolutely. I mean, you know, we talked about this before. There's pluses and minuses with both home care at home and senior living like the Kensington. But you've got to think about all of that oversight. You know, you've got the 24-7 care at home, but all of the oversight. And what happens when the aide goes on vacation for a month, which does absolutely happen, or they're out ill? Is there someone else to supplement that? to provide that assistance. But at the Kensington, we've got all the aides. You know, what happens, and we've had nice weather so far. What happens when you have a snowstorm and the aide can't get to the home? At the Kensington, our aides are sleeping over. So there's always that influx of caregivers. So that's a big difference. Again, pluses and minuses of both. But that's a major consideration when you're thinking about providing that or getting that care at home versus the Kensington.

SPEAKER_02 9:18

And it sounds like it also gives peace of mind to the rest of the family that's caring for them because they know they're safe and secure at the Kensington. And it's not a nursing home. That's the thing I guess we need to communicate is there's a difference between enhanced assisted living In nursing home care, can you describe that a bit for

SPEAKER_01 9:38

them? You know, it is a gray area, the difference between senior living and especially the Kensington and nursing homes. Most, not all, most nursing homes are more sterile, a sterile environment, whereas the Kensington is more like a home-like environment. And if you think about all of the things that we did, you know, I mentioned it earlier, all of the care that we can provide, which is extensive, Similar to a nursing home, but in a different environment. And usually, and this is for the Kensington, the activities, we have a much more robust activity program versus a skilled nursing home. It's very, it's different in the sense that the feeder for nursing homes is usually the short-term. That's where they're getting their money, right? A lot of people that live in the nursing home long-term care-wise are paying through Medicaid. Whereas most, 99% of the senior livings in the area, it's private pay. And with that money that's coming in, we could have the wonderful activities and the higher number of care staff. So that, I think, is a big difference. In the

SPEAKER_02 10:43

non-sterile environment.

SPEAKER_01 10:44

Exactly, exactly, yeah.

SPEAKER_02 10:46

Good. So, you know, Brenda, obviously a place like the Kansas City is not for everybody. Right. So who is it not for?

SPEAKER_01 10:55

Oh, what a good question. Well, number one, you know, if you can't afford it. Most senior livings are anywhere from$5,000 to$15,000 a month in this area and more. So that's number one, of course, financially. Who is it not for? Someone who wants to stay in their room and not come out. When I say that, that's a lot of what you're paying for, that socialization, those wonderful activities. So if you have a loved one that's a loner, you know, my uncle never left his room, never made friends. Maybe senior living is not the best option. However, if his care needs are very high, that's a different story. So that is something I would think about, someone who really doesn't want all that socialization. Other than that, I've got residents in their 50s, and my oldest is 103, and we have everything in between. So I don't want our listeners to think, well, you have to be old. That's not necessarily true because if you have a movement disorder like Parkinson's, for example, and you may be 58 years old, you're wheelchair-bound, you need a lot of assistance, that's where the Kensington comes into play.

SPEAKER_02 12:09

And how about that potential resident who doesn't have enhanced medical needs and is really looking just for the social interaction?

SPEAKER_01 12:20

Right. Right.

SPEAKER_02 12:21

That's probably not the right fit either, right?

SPEAKER_01 12:23

Right, right. You know, when I think of the Kensington, if you are, I'll just give you the example, you're 80 years old, you drive, maybe you walk with a cane, you have friends, you have family. You know, perhaps the Kensington is not the best location for you because, again, we're a medical model. We have a frail population. There are so many other senior livings. I think there are over 40 in Westchester alone. So something that's more of a social model. would probably be more beneficial for that 80-year-old, for that particular person. So my suggestion is you look around. You visit, have dinner. You want to talk to people. Really look at the residents that are there and what would be the best option for your loved one and what would they feel most comfortable

SPEAKER_02 13:07

at. Excellent. Brenda, we're going to take a quick commercial break. Okay. And, folks, if you missed any part of this presentation, episode just please feel free to log on to our website at eldercareontheair.com that's eldercareontheair.com and I really encourage you to to re-listen or listen for the first time what Brenda was talking about and where the different levels of care and where you can receive that care really fit into the horizon for you or your loved one we will be back in a few moments

SPEAKER_00 13:37

Amoruso and Amoruso LLP advises clients on how to obtain public benefits, including Medicaid, and more importantly, how to protect and preserve their assets, whether they be modest or significant. Find Amoruso and Amoruso online at eldercareontheair.com. Amoruso and Amoruso, a 107.1 The Peak Ask the Expert partner.

SPEAKER_04 13:57

Amoruso and Amoruso Empowering you to care for the ones you love.

SPEAKER_02 14:06

Welcome back to Eldercare on the Air. I'm Michael Amoruso. And again, I'm thrilled to be here with Brenda Moynihan, who is the Director of Marketing and Outreach for the Kensington and White Plains. And I want to encourage all of you, if you've missed any part of this episode, to log on to our website after this broadcast at eldercareontheair.com. That's eldercareontheair.com. And listen to Brenda's show because she has given an incredible diagram of where we stand post-COVID in the healthcare delivery for home care, assisted living, enhanced assisted living, and nursing home, and maybe where you or your loved one will fit into that equation. So Brenda, again, thank you for being here.

SPEAKER_01 14:45

Thank you.

SPEAKER_02 14:46

It's great to have you. So let's move on now to the Kensington.

SPEAKER_01 14:51

Okay.

SPEAKER_02 14:51

Let's really give the audience a sense of a day in the life, where it's located, everything that they can expect if they happen to walk through your doors?

SPEAKER_01 15:01

Sure. So we are located in the heart of White Plains. We're across from White Plains Hospital, a hospital with a great reputation. And we're on the medium side in reference to, if I compare us to other senior livings, how many beds that we have. Our community is very warm, meaning the colors, the feel. When you walk in the door, every single person will say hello to you. We know each other very well. Almost all of the directors have been there since day one, which I can tell you, no other senior living can say that. So we've been there for over 12 years, most of us. And for the residents, I think that the care that is provided is excellent. So they get up in the morning, and we know our residents very well. For example, we know some people who, they want to get up at 10. If that's what they've done their whole life, guess what? They're going to get up at 10, you know, working around the meds that they require. Getting up, do they require assistance bathing? Most of my residents do, absolutely. Medication is given to them. Very different from skilled nursing where they're lining up in the hallways, right?

SPEAKER_02 16:12

Yeah.

SPEAKER_01 16:13

So we look at what do they want to do for the day. We've got an activities, a robust activities calendar. And because the caregivers, they're dedicated to that resident. So you may have a care manager, a care partner who says, That's who's your care partner Monday through Friday from 7 to 3. That is your person. They get to know you very well. And the care manager gets to know you very well. And you get to know the care manager. Well, we know your likes and dislikes. You don't want to go to Tai Chi. You'd rather go to the book reading. And the care manager is going to take you to that. Having breakfast. Even the dining staff, I have to tell you, they're wonderful. They know what my residents, I mean, they see them every day. So they'll say, oh, yeah, I know what you want today. You want a hard-boiled egg. I know you don't want the pancakes. They know, but we also recognize that there's choice. So for my residents, for example, that have diabetes, in the senior living world, there is choice, but my dining staff are well-versed, and they'll say, hey, Mrs. Smith, you know, you really shouldn't have that syrup, that full-sugar syrup. How about this? Why don't we try this? After breakfast, there's wonderful activities. There may be music. There may be more exercise, physical fitness classes. There may be some rehab. We have rehab in the building. Then they go to lunch. Again, it is a full-service dining room. There's dining staff. Again, I think it's so important that the staff, they know my residents so well. They have choices, options of their meals. Family members come and visit. So they may come and say, hey, you know what? We're going to have dinner in Mom's room. We're going to bring dinner in. We're going to have a party. We celebrate all kinds of anniversaries, birthdays.

SPEAKER_02 17:58

You really make it feel like their home.

SPEAKER_01 18:00

Oh, it is their home. It absolutely is their home. They may take a trip. We have a van. We have a town car. They may take a trip out to lunch or some other activity that's been set up. We have so many wonderful vendors that come in with activities. After dinner, we have happy, or excuse me, let me take a step back. We have happy hour every single day. I mean, think about it this way. If you were used to having a glass of wine, again, as long as the doctor says it's okay, why shouldn't you have it at the Kensington?

SPEAKER_02 18:31

Good.

SPEAKER_01 18:32

Right? Happy hour, music, then dinner, and then after that we have more activities. But again, tailored to the specific resident, if you want to take a nap in the day, you take a nap. We're not forcing you to do these wonderful activities, but we want you to participate. After dinner, there may be a movie, there may be another activity, and then the care managers get you ready for bed. And that varies depending on the person. There could be bathing going on, dressing, undressing, medications. But then there's also that oversight overnight, really important. There's care staff in the building 24-7. I've got nurses in the building 24-7. Very important. I know that a lot of other senior livings don't have the nurse in the building 24-7.

SPEAKER_02 19:22

Explain some of the benefits of that for the audience and maybe even give a typical example of something that may happen at night and what that triggers

SPEAKER_01 19:33

for you. Good question. So think of you have a loved one with Parkinson's. They're wheelchair-bound. They need assistance eating, bathing, most of their activities of daily living. At night, their stomach is upset. Because I have care managers in the building and nurses in the building, they're calling the front desk. The front desk calls the nurse. Hey, let's check on Mrs. Smith. She's not feeling well. And the nurse assesses, well, maybe it's indigestion or maybe it's something more serious, and then takes the next step. So I think it's important, folks, when you think of senior living, you want somewhere that has the proper amount of care staff, but 24-7. You don't want to get the call from your loved one in the middle of the night, you know, my arm hurts. You want the staff that work there to be able to assess and then take the next step. Is it that you just fell asleep on your arm and everything is fine? Or is it something more serious that we have to arrange transportation gets you over to the hospital.

SPEAKER_02 20:34

And I guess the call that they would rather get is a call from your administration that says, hey, the arm was hurting. We checked it out. This is what we found, and this is the action we've taken. Right. So it puts you at ease. Right. versus anxiety.

SPEAKER_01 20:48

And you know what? It's good that you brought up that point. That's one of the many things that we do that's so important, the communication with families. It's constant. Exactly what you said is what we do. Hey, wanted to let you know, mom woke up in the middle of the night. She wasn't feeling well. We addressed it. Everything is fine. Changing of medications, going to physicians. Because think about it. If we have such a frail population, they're seeing a lot of different physicians, different modalities. We are letting the families know, hey, mom saw the cardiologist today, changed her meds. Decreased, increased, constant communication. It has to be. And as you said, I think that alleviates the fear, the anxiety of, wow, did mom go to the doctor today? What happened? We're going to tell you before you ask.

SPEAKER_02 21:38

Fantastic. So now let's move into the actual room environment because I'm sure some of the audience, they're hearing us say it's not sterile, but visually they're thinking a hospital room, they're thinking a nursing home room. What is it like in one of these? And maybe I shouldn't call them rooms. These are apartments, right?

SPEAKER_01 21:56

They're suites. We call them suites. At the Kensington, you can have a shared suite or your own private suite. Shared makes it more affordable, you know, if you think about it that way. Private is a little bit more pricey, right? It's a suite. So within each suite, you've got bathroom. So you would have either your own private bathroom or your sharing. We've got a kitchenette. So there's a sink. There are cabinets. So at the Kensington, and this is most senior livings, we're providing all three meals and snacks online. But there are family members and residents who want to keep the orange juice. They want to keep some snacks. They want to keep the ice cream in the little freezer that's in the room, crackers and things like that. The bed, there are beds in the room. We take care of that. It's carpeted beautifully. I can think of a resident who wanted her room to be blue, sky blue. Guess what? We painted it blue for her. That's what she wanted. That's what she got. That's what she felt most comfortable with. It's not the typical, but... You said it before, Michael, it's your home. It is your home. You want to bring the things that you love to your home. Photos, tchotchkes, things like that. But by no means is the apartment just the only part of where you're living at the end of it. Because the entire building is your home. We've got little alcoves. We've got a library. We've got a cafe. And I see the residents during the day. They're reading the newspaper in the cafe. It's an extension of their suite. And that's exactly what we want.

SPEAKER_02 23:31

You know, it sounds like I want to go back to college.

SPEAKER_01 23:33

Yeah. And that's what it is. It's really, I like the fact that many of my residents leave the door open, just like college. I really like that. Yeah.

SPEAKER_02 23:41

That's wonderful. So how does somebody start the process of getting admission into the Kansas

SPEAKER_01 23:46

City? Good question. I think it's important that people call us, right? We want to talk to you over the phone. We want to get to know what are your needs. That's so important. What are your needs? What does mom need? What are you looking for? And then making the appointment to come for a visit. So, so important. You're looking around. You're seeing the residents. You're seeing the interaction. Talking to other family members. Because Or having a meal at the Kensington. You want to taste the food. Very, very important. Most of the time for my residents at the Kensington, it's the adult caregiver making the decision to move their loved one. It's not the resident. So that adult caregiver really has to think about all the things that we provide and is it the best fit for mom or dad? And it's really that feel. Do you like that feel? And I think that's true with any senior living. We actually encourage people to look at other places because we are so different and so unique in what we do in reference to the care that we provide. We want them to look at other places. We want them to ask questions. I think several of the most important questions to ask is, at what point will my mom have to leave? It's very telling because at many senior livings, because of the license or their model, You know, mom will have to leave maybe when she's wheelchair-bound or when mom needs an IV. So that's a very telling question. You want to ask questions. Absolutely.

SPEAKER_02 25:16

How about at the Kensington? What's that point? Because you're enhanced.

SPEAKER_01 25:21

Almost never. I would say if you needed a ventilator, a vent, which no senior living in New York is able to accept someone on a ventilator. Most of the skilled nursings do not accept people on a ventilator. So other than that, and this is all the senior livings, if you're a danger to yourself or others. Right? Other than that, really, you can age in place. It's one of the best things at the Kensington. You can age in place. So again, going back to the example of someone with a movement disorder, you may have MS and it's in remission. And you may be wheelchair bound, but you don't really have care needs. High care needs. But unfortunately, as the disease progresses, those needs will increase. You could still stay at the Kensington. Dementia. Unfortunately, dementia doesn't get better, right? It progresses. As your dementia progresses, maybe you get to the point where you're wheelchair bound. You are no longer verbal. Or I should say your loved one is no longer verbal. Needs extensive care. Bathing, dressing, IVs, catheters, wounds. your loved one can still stay at the Kensington. Very important question to ask. At what point would my loved one have to

SPEAKER_02 26:39

leave? And you know, what this is bringing to my mind, Brenda, is there may be points in time where a family has got to make a choice. They've got to make a choice after the realization that it's time to move their loved one into a 24-hour care facility. The only option is not nursing home. This enhanced assisted living,

SPEAKER_01 27:03

as

SPEAKER_02 27:04

long as they can afford to pay for it for the balance of that person's life, could be a better option in many cases because it's not that sterile environment. There's still social interaction going on. There's peace of mind for the individual. You're not necessarily subject to the aid-patient ratio that may be very high in certain facilities. That's right. It's, as we said earlier, it's more like a home.

SPEAKER_01 27:33

Right. I mean, at the Kensington, so we have the assisted living portion of the building, which is for people that don't have dementia. And then two dementia, we call them neighborhoods. One is called Connections. One is called Haven. Haven is really for people that have moderate to end stage Alzheimer's and other dementias. That care ratio is one to four. one caregiver for every four residents, no one can touch

SPEAKER_02 27:57

them. Yeah, that's fantastic.

SPEAKER_01 27:58

I mean, if you think of the best skilled nursing facility, and again, I'm not knocking them, it's just the way that they are, their model, right? There's no way it's a one-to-four care ratio. So, you know, we were talking earlier, you get what you pay for. Is the Kensington inexpensive? No, but you get what you pay for. If you have those high care needs, and I know there's a lot of guilt, there's a lot of fear, I absolutely know that. But if you think about what we can do at the Kensington versus any skilled nursing facility, and as I said, there's nothing wrong with them. It's just a different feel. It's very different.

SPEAKER_02 28:37

So how can they get in touch with you or the appropriate member of your staff?

SPEAKER_01 28:40

Sure. Just give us a call, 914-390-0080, or please go to our website at www.kensington.com. the kensingtonwhiteplains.com. And folks, I do encourage you to go to the website. We have events, several events every month. We're a resource. We want to be able to assist you. So even if you're not at the stage where you want to visit, please go to our website and attend a virtual event.

SPEAKER_02 29:08

Fantastic. Brenda, thank you for being on our show.

SPEAKER_01 29:10

Thank you.

SPEAKER_02 29:11

And again, for those of you out there, I do encourage you after this broadcast to go onto our website at eldercareontheair.com. That's eldercareontheair.com. And if you've missed the contact information for Brenda and her facility there, no worries. Listen to the episode again. It's all there for you. I truly hope you learned something today. This is a new area that we brought in, the enhanced assisted living, to our palette of shows out there. So hopefully this will serve you well and give you another option. I'll talk to you all again next week. Take care.

SPEAKER_04 29:48

Amoruso

SPEAKER_00 29:54

and Amoruso LLP and Rye assists clients with comprehensive estate planning and vital asset preservation tools that reduce financial risks of long-term care. Amoruso and Amoruso, a 107.1 The Peak Ask the Expert partner. Visit eldercareontheair.com for more details.

SPEAKER_04 30:16

Amoruso and Amoruso empowering

SPEAKER_03 30:18

you to care for the ones you love