Eldercare on the Air: Navigating the Path to Dignity and Independence

Welcome to Eldercare on the Air, your trusted weekly podcast for navigating the challenges of eldercare, special needs, and independent living. Hosted by Michael Amaruso, a seasoned elder law and special needs attorney, we bring you insights from experts in eldercare, financial planning, rehabilitation services, and more.

Discover tools and knowledge to empower yourself or a loved one to age with dignity and maintain independence. From cutting-edge rehab technologies like exorobotic systems to navigating Medicare and Medicaid, we provide actionable solutions for life’s most challenging transitions.

Listen now on 107.1 The Peak or visit our website at amorusolaw.com to download episodes and explore how you can make informed, confident decisions during times of need. 

Tune in this week to hear inspiring recovery stories and practical advice on how technology and compassionate care are reshaping eldercare. Together, let’s 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_05 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 Well, this is gonna be a show that would be quite interesting for all of you. I'm thrilled to have with us today, Laura Fallon, who's the Director of Community Relations for Briarcliff Manor Center for Rehabilitation and Nursing Care. Laura, welcome to our show.

SPEAKER_02 2:38

Thank you so much.

SPEAKER_05 2:40

And in particular, Laura's gonna give you a little background of what her facility offers and what the company offers. But as we get into this show, we're going to bring on a second guest. And his name is Sergio Antonio Gonzalez. And he's the director of rehab services. And in particular, he's going to be talking about the exorobotic system at Briarcliff Manor Center for Rehab that actually can help the body regain its strength and mobility. So maybe, just maybe, that loved one could walk out of the rehab facility and get back into the community. So Laura, why don't you tell us a bit more about Briarcliff Manor Center for Rehabilitation and Nursing Care and the parent company?

SPEAKER_02 3:26

Oh, thank you so much. I'm happy to. So Briarcliff Manor Center for Rehab is one of 28 nursing homes that is owned by Excelsior Care Group. And Excelsior Care Group is a rapidly expanding premier healthcare management firm that strategically provides management consulting services to subacute rehabilitation and nursing centers. We are proud to introduce our proactive, sophisticated vision to the healthcare industry. Excelsior is committed to the individuals and family in our growing network. We have 28 nursing homes. We're in all five boroughs, including Westchester, with the exception of Manhattan. We have six in New Jersey and six now just currently in Florida. We try to identify specific needs for the rehab services. With award-winning initiatives, heart health, orthopedic, neurological rehab, pulmonary and wound care services. We're trying to raise the bar in our customer service, bringing hospitality to the forefront in healthcare to marry those two. Gratitude campaigns, Excelsior Care Academy dedicated to training our teams with top-notch customer service, incentivizing our teams and creating positive work environments. Excelsior was rated top workplaces in 2022 in the AM Metro New York area. We have certain exclusive programs for our employees. Excelsior Clean is a program where we assure that the highest level of cleanliness, especially during the pandemic and COVID, with superior infection control. We have the XONR, which Antonio will be talking about further. We have that in Briarcliff Manor. We also have it in our Brooklyn community. And we also have it in Anchor Care in Hazleton, New Jersey. We have concierge services, like no other in the industry, solely dedicated to the patient and family experience. Because when a loved one comes in, there can be some They can be frightened. They don't know what's going to happen next. They've had a catastrophic event sometimes. They were home cooking one day, and the next day they're in the ER. And so it's a very frightening thing for a lot of families.

SPEAKER_05 5:49

And how would you define concierge services for the audience?

SPEAKER_02 5:52

So we have a person that greets the loved one when they come in. We try to have something specific for them when they come in that we know that they like. We try to drill down with families, but they make sure that the experience as well, whether the call bell's not working, the tea's not hot enough, whether they had a bad experience at night because staff was loud in the hallway, whatever it might be, that role for that person, that's their entire job is to make sure that the experience that the person is having while they're with us is a positive experience. Oh, that's wonderful. Yeah. So we really, we also provide respite services for people that maybe need a break from caregiving or maybe they have a wedding in another state and they can't take their loved one with them so they can come bring them and they can stay with us and we take care of them during a respite stay. We also specialize in workman's comp. And another thing that's different that we do weekend admissions. We're 24-7 operation and that's across the board for all of our communities. But one thing that's different in Briarcliff that I really am proud to say is the company is invested. They just put multimillion-dollar renovation into the building. It's beautiful. State-of-the-art rehabilitation, luxury. I mean, it's absolutely beautiful. And I hope that you can come by and maybe take a walk through with us and see the level. We have a new team, new administration. It's a physician-led organization. clinical team. We have a wound care company that comes in. We do all different levels of care. It's, you know, premier quality health care. It's really where we want to be. And, you know, with that, we talk about state-of-the-art rehab, rehabilitation gym. We do have the XONR, which is a robotic system that is really exciting, and we are exclusive to that in Westchester County. There are some of the hospitals that do utilize them for inpatient or acute level of care. Acute level is three hours plus. Some people who have had a really tough time of it, whether it was an illness or a stroke, a head injury, or just declining due to MS. This is very exciting for them because it's something that can take them to the next level without having to have four therapists to be able to help somebody stand up. So it's really exciting that we are the only subacute nursing home that has that capability for rehab because Some people don't qualify for that high level of three hours plus therapy. They have to start slow. They're 84. They were completely independent, driving, cooking, and then the worst happened. And they want to get back to that. They want to get back home. They want to get back to some semblance of what's normal for them. So it's our mission and our dedication to try to get people to the highest level of functioning that we can. And this company is very dedicated to doing that with new technology. And we're constantly looking to how we can be better for those that are suffering.

SPEAKER_05 9:28

Well, that's fantastic. And Laura, is there another application for this? Because you just mentioned that perhaps a patient can't endure the three hours plus of intense therapy. Could this be a first step as well? Yes. Or a prerequisite to maybe an additional surgery that that person may need?

SPEAKER_02 9:47

It can be. Right now, because of the pandemic, there's something called... What happened during the pandemic was... Correct, yes. Correct. to come into our community for rehab. So that is going to be ending, I believe it's in June. So it's complicated because people can't come from home to rehab after that date. They typically have to have a three-day hospitalization to qualify to come in for rehab. But sometimes somebody who might be, let's say they're bone-on-bone, knee-to-knee replacement, double knee replacement, whatever it might be, or one or the other, The doctor may have them hospitalized, do some acute rehab in the hospital, and then send them out to get a higher level, just continue strengthening for the procedure. We've had two residents come in that did that. They came in and had their pre-surgical rehab for knee replacement. One just graduated and went home walking with a quad cane and doing very, very well. And the next one has her surgery next week. And we'll be happy to have them come back and finish up their rehab. But the recovery is much, much quicker when they've had the pre...

SPEAKER_05 11:28

Sure.

SPEAKER_02 11:28

I'm losing my word here. Pre-rehab for surgery. But there's all different kinds of conditions where it's certainly... Doctors will recommend that they... They come in and get some strengthening before going to surgery.

SPEAKER_05 11:43

Now, Sergio or Antonio will be coming on the second half of our show to really get in-depth with this wonderful robotic system. But can you give the audience just sort of a brief overview of what this is and how it assists with their rehab?

SPEAKER_02 11:59

So the exoNRs is an exoskeleton that– Somebody who, let's say, has Parkinson's, as they lose their ability to kind of be mobile or be able to be in a standing position, which is really important for the human to be able to stand for breathing issues, for all different kinds of mobility. So this robotic system has sensors on it that helps us guide the computer system to be able to say, this person's very weak on the left thigh, it needs more pressure, needs more assistance. And then as they get stronger and stronger and stronger, they need less and less and less of the robotics. But it's a game changer. On the website, we have a couple testimonials, but also on the XONR website, There was a gentleman who was home for 12 years post-stroke, and it took four therapists to get him up out of a chair to even walk with a walker. It was an assistive three. And after two uses of the robotics, and he was able to do it with one therapist.

SPEAKER_05 13:14

Wow.

SPEAKER_02 13:14

And then after three months of therapy, he walked out with a cane, and he had been home forever. unable to ambulate for 12 years. Oh

SPEAKER_05 13:23

my goodness.

SPEAKER_02 13:24

So it is a game changer in the industry. It really is, especially for those people that have suffered from where maybe their left side or their right side is paralyzed. But it is really exciting. And we're just so proud to be the first in the county to be able to provide those services for people who need it.

SPEAKER_05 13:46

So Laura, if folks want to find out more about this service that you offer, how do they... get in touch with you or someone on your staff?

SPEAKER_02 13:54

Absolutely. They can go to our website, and that's bmcrehab.com. Certainly, give me a call. All information would be on the website and phone numbers. Again, I'm happy to go and meet with families, and I go to the hospitals and I meet with families. I tour families. I have them come in and see the community. If they're not able to do that, maybe the daughters in Pennsylvania or Florida, I will do a FaceTime tour with them, walk through and show them the rooms and show them the luxury and the whole new rehab gym. So I'm happy to work with any families that have any questions. And going forward, you know, happy to tour anybody who'd like to come see our beautiful community.

SPEAKER_05 14:44

And let me ask you this question. What if you have somebody that has maxed out their Medicare skilled nursing rehab services, but the family wants to help them improve? They feel like maybe a facility gave up too early on them. Can they self-pay for this level of rehab or not?

SPEAKER_02 15:05

Yes, they can. But that's where you come in, Michael. That's where I come in. There you go. That's where we say call Michael Amoruso for the next level. Sometimes people can come in and we actually, I have one woman who came in about two weeks ago who unfortunately didn't have Medicare. And the family really wanted her to be able to be as high functioning as she can. So she came in and is being paid privately for the therapy. And doing very, very well. And we'll be going home next week. So the family's thrilled about that. And they thought that this was the end of the line. So yes, absolutely. We work with families. And if it's a situation where they could get on Medicaid, which is where you come in, then we would work with them. Because if they come in under Medicaid and stay for a short time, we don't want to say it's going to be forever. But if they come in and they stay after the Medicare days, then we can bill Medicare B for continued therapy.

SPEAKER_05 16:07

Oh, that's fantastic.

SPEAKER_02 16:08

So it's just a short time, but it's giving them a little bit extra time instead of having to go home if they're not quite ready.

SPEAKER_05 16:16

Yeah, and you know what? That may be the difference between someone spending the rest of their days in a facility or getting the therapy they need so they can go back home. Correct. Excellent. So, Laura, we need to take a quick commercial break. However, is there anything else you want to say before we leave?

SPEAKER_02 16:34

I just would like to say I'm very invested in helping this population and I try to be out there doing educational programs. A lot of people unfortunately don't know until they need to know, but it's really important for loved ones to be out there and see what else is out there in the industry. Like we talked about another place, it's Ever-changing. So I would love to have anybody who'd like to come see our luxury, beautiful, brand-new, state-of-the-art community. I'm happy to meet with them.

SPEAKER_05 17:08

Excellent, Laura. Well, thank you for being on the show. If you've missed any part of this broadcast, then no worries. Just log on to our website at eldercareintheair.com after this live broadcast, and you'll be able to hear Laura talk about this exciting new rehab program service that they offer at the Briarcliff Manor Center for Rehabilitation and Nursing Care. We are going to take a quick commercial break, but be sure to come back because when Sergio Antonio Gonzalez gets here, he is going to really talk to you all in depth about this exciting extra robotic system that they have. We'll be back in a few moments.

SPEAKER_00 17:48

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 18:08

Amoruso and Amoruso, empowering you to care for the ones you love.

SPEAKER_05 18:18

Welcome back to Eldercare on the Air. I'm Michael Amoruso, and I'm very happy to be here for the second half of our show with Sergio Antonio Gonzalez. He's actually the Director of Rehabilitation Services for the Briarcliff Manor Center for Rehabilitation and Nursing Care. If you missed any part of this episode, just log on to our website after the live broadcast at eldercareontheair.com. That's eldercareontheair.com. And you don't want to miss what Laura Fallon was talking about in the first half. And you definitely don't want to miss what Sergio Antonio is going to talk about now because we're about to dive deep into that exorobotic system that Briarcliff Manor Center for Rehab has and how it can actually help you or your loved one. So Sergio, Antonio, it's a pleasure to have you here. Thanks for joining us. Thank you, Michael. It's a pleasure to be here as well. So one thing Laura was talking about is how this robotic system you have can be so beneficial for somebody that either had a stroke, a traumatic brain injury, ALS, MS, Parkinson's, or even is just someone who's looking to get pre-surgical strength in their legs or some part of their body that Apparently this could help. So why don't you tell, you know, give first a broad overview of what this robotic system is and how you start to implement it in your

SPEAKER_01 19:44

practice area. Well, the XONR is sort of a dynamic frame where we place our patients. We adjust all the systems and all the areas or this frame. And it assists the patients from standing up and just walking. hold a good posture while they're standing, to shift weight, to keep their balance, and also to ambulate, to walk. And they also help to improve the quality of that walk. So that's basically the premise of the device. It's, in a way, an intelligent device because it assists the patient throughout this whole process, and it's able to measure the level of effort that is coming out of the patient and to compensate. So whatever else is needed in order to complete the task, we can also program it to provide resistance if this patient is more high functioning and we're just working to increase quality of ambulation and things like that, or strengthening. We can just increase the resistance of the device and it's gonna help with that as well. So it's very versatile in that sense.

SPEAKER_05 21:03

You must enjoy seeing the surprise and shock on some of these patients as this device is assisting them doing something they possibly couldn't do on their own. The joy that must come out of

SPEAKER_01 21:15

their face. The whole process of rehabilitation is a process of joy. You really have to love this if you want to get involved in this type of treatment and services, right? With the robotics, of course, being... cutting-edge technology. It's always incredible just the look of the patients when they see the frame itself, when they see the robot. And everybody's curious about it as well. So once they're in and the robot assists to bring the patient up, it's just an incredible experience for them and for us. It's something that we just share. It's an incredible moment, especially when it we're talking about patients that haven't been able to stand up for a long period of time. So it is an incredible experience, it is.

SPEAKER_05 22:05

So let's put this into context for the audience now. Give an example of, in your mind, a successful case, how this robot actually assisted somebody.

SPEAKER_01 22:18

So just to give a couple of examples, one of the most successful stories that we had since we had the EXO in our facility is one patient that just had an overdose of medications, of heart medications, statins, and his body completely shut down to the point that he was completely paralyzed. He was not able to bring his hands off the bed. He was not able to touch his face or his body, scratch his hand, nothing like that. We took him on board and we worked on sitting balance because you need to have some sort of ability to hold yourself at least in sitting position to be able to be in the robot. And once he got to that level, we got him into EXO. And that was from day one, an incredible, incredible experience to have him standing up just holding himself in that position, seeing himself in that position, developing the tolerance to the standing position because it was to that level of severity where he was, and then moving into shifting his weight to increase his balance, and then coming into a walking training, just moving his leg forward, one step, two steps, then decreasing the level of assistance eventually of the robot to the point that he was able to propel the leg forward, and so on and so on, to the point that he just left the facility with a walker. This is something that was not even expected by the doctors that were treating him in hospital. They told him and his family that he would not be able to walk again in his life.

SPEAKER_05 24:00

So he went from

SPEAKER_01 24:01

paralysis... Complete paralysis.

SPEAKER_05 24:03

...to walking out with

SPEAKER_01 24:04

a walker. To walking out

SPEAKER_05 24:04

of

SPEAKER_01 24:05

the facility.

SPEAKER_05 24:06

Wow. And all it took was obviously your expertise, your team's expertise, but for this robot to help stimulate

SPEAKER_01 24:15

parts of his body. So it is an adjunct part of the treatment. So we do address all deficits in different ways and different directions, but it's an incredible, incredible part of the treatment and a big aspect of it and an advantage for us. to have EXO available also. Not only for the patient, also the therapist themselves because we have someone that is not able to hold himself up and we have the assistance as well of this robotic system that is gonna bring the patient up and we can work in other several aspects of his treatment while the robot is holding the patient up and assisting to move forward into his mobility and ambulation, et cetera.

SPEAKER_05 25:04

You know, one thing Laura also covered was perhaps a patient can't handle three plus hours of acute rehab elsewhere, that your facility and this program may be a very good alternative, if not maybe a first step for somebody. How long is the typical therapy session?

SPEAKER_01 25:25

So it varies because it depends on the level of severity, the condition, the tolerance of the patient. And it could go usually in 15-minute increments. We can start with 30 minutes if the patient is very, very involved and it doesn't tolerate that long. But what we try to do is we try to accommodate also to the patient's situation. And if it's necessary, we can revisit the patient several times throughout the day. It's a small facility at Briarcliff Manor. And it's a very dedicated team in rehab. So we try to get very involved with patient care and in all sense of it. And if we need to go four times, five times to sort of complete our rehab time and provide everything that the patient needs to move ahead. we do so. So it really ranges. It could be 75 minutes. It could be an hour and a half. It depends on what the patient needs.

SPEAKER_05 26:26

And because you know your patient so well because it's intimate, you get a sense of what their tolerance level is. Exactly.

SPEAKER_01 26:33

I would say that nobody in a rehab facility, long-term rehab facility or short-term rehab facility, knows the patient best than the CNAs that are there all day long taking care of them and rehab because of the amount of time that we spend with them. Absolutely. Any other stories you want to share? Well, we have a whole different gamma of conditions and situations from multiple sclerosis stories helping patients to just get a better transfer when it comes to moving from one surface to another one in cases that they they haven't been able to ambulate or to do a safe transfer at home and they want to go home. And sometimes it's just having a good transfer from a bed to the chair and so on. Correct. What it takes for them to go back home and have someone to provide care from there. So simple things as such, just to increase the performance during the transfer, to really just walk, be able to walk at least... sometimes at least to manage their home you know patients with stroke as well that are not able to bring one side of their body into movement and bring a leg up in order to to walk a few steps and uh the assistance of this system of uh the exo allows them to increase uh the height of their step and the length of the step to make it safer to shift weight and learn how to manage and navigate the walk in the house. So all these things are just wonderful to see. And we see it at different levels with different cases. Every person is different, every case is different. So it also makes it an incredible adventure for us. It's a very exciting experience. experience.

SPEAKER_05 28:34

So if someone's in a hospital and they're facing discharge, they know they need to go get rehab, and they're hearing bad news, like that one example you told us that this person may never walk again, what do you encourage the patient or the advocate to do or to express so possibly your program gets on the radar screen? Actually, Laura, let me ask you that question.

SPEAKER_02 29:01

Well, what I've been currently doing is educating the discharge planners at the hospitals. I do in-services so that they're aware of our technology. But it's really important for families to understand that they have to advocate for themselves. If they have heard of this technology and done their research through this radio show and are interested... They make the final choice. So what happens, they let the discharge planner know their top three choices of places they'd like to be discharged to. Then we receive their documentation. If it's appropriate, we accept the offer. I reach out to families, ask if they'd like to come see the community. And it's a very seamless program. But families have the choice and they have to advocate for themselves. And so that's really exciting.

SPEAKER_05 29:47

Excellent. So we have about five seconds left. How else can they find you?

SPEAKER_02 29:51

We're all over social media, so please look us up on Facebook, Instagram, LinkedIn, and you can find out our videos and other education information.

SPEAKER_05 30:01

Laura, thank you for being here. Sergio Antonio, thank you for being here. And if you missed any part of this broadcast, just log on to our website at eldercareontheair.com. It's an exciting show. You really want to hear about this level of therapy. Be well, be safe, and I'll talk to you all next week.

SPEAKER_04 30:20

Amoruso and Amoruso Empowering you Amoruso

SPEAKER_00 30:26

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 30:46

Amoruso and Amoruso empowering you

SPEAKER_03 30:51

to care for the ones you love