Peace of Mind: Navigating Healthcare As You Age

0:00 Welcome to Something More with Chris Boyd. Chris Boyd is a certified financial planner, practitioner, and senior vice president and financial advisor at Wealth Enhancement Group, one of the nation's largest registered investment advisors. We call it Something More because we'd like to talk not only about those important dollar and cents issues, but also the quality of life issues that make the money matters matter. Here he is, your fulfillment facilitator, your partner in prosperity, advising clients on Cape Cod and across the country. Here's your host, Jay Christopher Boyd. Welcome to another edition of Something More with Chris Boyd. My name is Jeff Perry. I'm a financial advisor working for AMR team and working with Chris Boyd.

0:43 And Chris has the well-deserved week off here. He's on vacation, so I hope he's enjoying himself and hopefully, I'm sure he'll listen to the podcast. He'll be back next week. I'm really happy to have with us for this episode, a very special guest, Jen Mahoney. Jen, welcome to the show. Thank you, Jeff. You're very welcome. You are the director of care management for LiveWell Care Management, and I wanted to have you on to talk about a subject that we often think is going to happen to someone else, and that's care after you retire, typically, as you get older. We always think these things are going to happen to someone else, and we think about them, we reflect on them, but it's something that's really super difficult to talk about and think about and to actually plan for.

1:32 So you're the expert in the field, and thank you for joining us today. If you just start out by introducing yourself and telling us a little bit about yourself and your company, and we'll go from there. Yes, of course, Jeff. Thank you so much for having me today. I'm excited to be here and talk about this topic. A little bit about myself, I'm a master's level social worker. I'm licensed in Massachusetts and New Hampshire and certified in care management as well as hospice and palliative care, so that's what gives me all those fun letters after my name, that when people ask, I just said they could be made up, but they aren't, I assure you. I have been a social worker and in healthcare for almost 20 years now, and most of that time or nearly all of that time has been working with the elderly or senior population, and the bulk of that was about 10 years I worked in hospice.

2:28 So now in this position as the director of care management at LiveWell, I've been in this role for almost three years now, and LiveWell Care Management rebranded on April 1st of this year, 2025. Prior to that, we were AZA Care Management, and AZA Care Management has been in the Boston area for over 30 years. We have a large team of about 10 care managers, including myself, that are all healthcare professionals that have worked in the field for decades. I think I have the least amount of experience on the team, and we get hired privately by clients and families to help them navigate the healthcare system, which can mean a lot of different things, and we can be very flexible in that way.

3:12 And so we were excited to switch over to LiveWell Care Management so that our care management offices throughout the country now, we all have the same name, LiveWell. So we have some offices in Houston, New York, San Francisco, and kind of throughout the country in that way. And that's my role. I kind of oversee all of the operations and everything going on in the office. So you see it all. You see things you expect and things that you don't expect, I'm sure. Exactly. So is there a typical client? Is there a typical scenario where people come to you and say, you know, we need help navigating this.

3:55 I'm a retired lawyer, and before I joined Chris Boyd, I'd done a few things. And as a lawyer, I came across so many clients who I did their estate plan for. And then there was a medical issue. And not everything goes as planned, right? So people who might have had a healthcare proxy in place, maybe that person moved, or they had a power of attorney and that person passed away, or they just never got around to it because there are tough decisions to make. And the number one, you can correct me if I'm wrong, but this is just my narrow perspective. The number one challenge that I saw for people in this sudden healthcare setting, it may not be sudden, actually, if you look objectively, but they believe it's a sudden situation, is they're just not able to, for physical, cognitive, emotional, whatever reasons, they're just not able to navigate and advocate for themselves in that very complex world of healthcare.

4:56 And they get, they're almost solely reliant on a system that is well intended, but far from perfect. Is that a common thing for you? Yes, absolutely. I think when, you know, family members call us, they're always surprised, you know, when they say, oh, well, I always assume that this doctor talked to that doctor and they read all those notes and they did all that. And, you know, I have to explain to them that yes, in a perfect world that does happen and providers would like that, but whether it's a time crunch or different systems, there are tons of reasons why that doesn't happen. And that's why it's so important to have that person advocating for you, whether, you know, you're able to advocate for yourself or you have a family member to go with you, because it's something that we're all going to need at some point, unfortunately.

5:44 And, you know, in terms of a typical client, you know, I would say we probably have categories of typical, you know, we have a number of clients that come to us, you know, it's usually the adult children calling us and they say, oh, well, you know, you were recommended when I met with my, my wealth manager or my attorney. And, you know, mom is at home and she's aging and she has dementia and she's starting to need help, but we don't know how much help we don't know where to turn to. We don't know if she can stay at home safely. She has the funds to stay at home, but we just don't even know where to start and what to do. And, you know, they just need to kind of hand that over for someone to take on so that they can remain involved as a family and the care manager can kind of take on all of the, you know, the caregiver is out sick and someone has to run over and is alone or make sure that the right medications are in the pillbox.

6:44 You know, it's all of those little things that I think people don't realize that the little things can really add up and end up being a lot. So. And this is magnified if the family member is not local as well. I mean, this can be, you know, I've seen cases and maybe this is typical because I've seen so much of it where family members who are not local, meaning they might call mom every day or every, you know, frequently or whatever, but they just, they just aren't there enough or for a long enough period of time or actually physically there to actually see the warning signs. Like a lot of us as we age are pretty good at covering, covering, you know, everything's fine.

7:27 Things are great. Oh yeah. When that may not be the case. So do you find that a lot of your clients or a lot of your children of clients, I don't know how you'd frame that, but our loved ones who don't live in the vicinity of the person needing the extra help? Yeah, I would say that's very common. We have a lot of people that, you know, mom lives on the Cape and the daughter's in California and, you know, for a long time that works fine, you know, via phone calls and checking in, but at some point, you know, you might not realize that, you know, mom doesn't have any groceries in the house or she's not going to her medical appointments or, you know, whatever it might be, or the house is in more of a disarray and you know that something must be going on.

8:09 And so we can kind of become the boots on the ground for that family member and report back to, you know, the family member across the country who presumably is acting as the healthcare proxy and power attorney, and we can help them in that way. We can bring the client to the appointments. We can follow up with reports. We can make sure that, you know, new medications are picked up and, you know, groceries are in the house, just anything from, you know, healthcare related to, you know, any other needs as well. So I would say that's a huge category for us as we see a lot of people that do live in this area and then, you know, their loved ones have moved away over time.

8:50 Or even if they're just out in Western Massachusetts, you know, that's not, that's, you know, a few hours away, that's not, you know, running over to, you know, bring someone milk or something like that. You know, that's still quite a distance. So we get called in for those sorts of situations all the time. So let's talk about that situation. So if you're down here in Florida, like I am, and I had a loved one back in Massachusetts, when do I call you? Like, what's the right time to call you? Should there be, should I be calling you before this is needed? You know, if my loved one hits 90 and everything's fine, should I be checking in and doing some planning? Or are there other signs? You mentioned few, but are there other things that would trigger that?

9:34 What's ideal? So ideal is for people to pre-plan and to get us involved before they need us. And to meet that demand, we do have what we call our peace of mind program. And it's basically before you need the active care management, and you're assigned a care manager, and you pay a small annual fee, and the care manager visits quarterly, and just basically gets to know you. So they'll know, okay, your son is the healthcare proxy, Jeff, he's in Florida, we have his phone number, we'll have a conversation to introduce ourselves. And, you know, just kind of becoming enmeshed in who the person is, how they're doing, so that we're ready to act and already familiar with the person and familiar with the house.

10:18 So we know that, you know, if there's a mobility issue after the hospital, can they return home? Or do we have to bring in, you know, grab bars or whatever other equipment there is? So that's what, that would, I'd say, be our preference, of course. Now, I would say most people, you know, take in the information before they need it. And, you know, don't necessarily act until they do need it. And I think that's because a lot of people who haven't been through this, don't realize how much it can really become, you know, because this is something that, you know, family members do all the time for loved ones. And, you know, but it but it takes a lot. And, you know, especially if you're further away, and you're not able to, you know, run over to the ER, or take mom to the appointment or something like that.

11:02 So we can also, you know, I would say the bulk of our clients, we get involved when there's a new diagnosis, maybe a new hospitalization, there's something going on, you know, that prompts them to say, Okay, I think we need care involved, or we need some guidance, or, you know, it's almost like they know that they the family knows that something is needed, but not even sure what and how much and, and where to go to. But they know that it's related to the health care. And, you know, oftentimes, we get people who want to remain at home. And so that's where we can come into play, because we can help them, you know, locate the right resources and oversee the caregivers in place and everything like that.

11:44 So ideally, ahead of time, but realistically, it's not. Well, the other benefit from my point of view of the early inquiry is that you get the caregiver, your team gets to build a relationship with the loved one. And so when it is time for heavier, heavier involvement and more detailed assistance, it's like almost like a friend or someone you're familiar with, it's the adoption or the willingness for the loved one to receive the help must be tremendously increased by having that relationship prior to someone meeting them in the hospital, for example.

12:24 Yes, absolutely. And that ends up being extremely helpful. The flip side of that, too, is that even when if the families want us to be involved, sometimes the individual themselves are not open to it. And they aren't ready for it. And that's another another element and curveball that gets added to the scenario as well. Yeah, it's almost a for some people. And I want to talk about the people who call on their own. But in the situation that we're scenario we're talking about, for some people, I've seen it become almost adversarial between the person, the social worker or the person trying to provide assistance and the person needing assistance.

13:06 They don't view it as help because they're not ready for it. So anything is anything done before, whether it's financial planning, estate planning, care planning. It's really a gift to do it before for so many reasons. But but there are those people who actually don't have anyone. Right. So they're they're trying to live their whole life alone or they've lost their spouse a number of years ago and they don't have someone that they feel they can count on or the famous famous verbiage is I don't want to be a burden. I'm not going to call my daughter in Georgia because I don't want her to worry. I'm not going to call my son in Kansas. I don't want him to rush out here.

13:47 He's got his own life. So if someone's in that situation, what's your best advice when maybe they should call and say, can you help me? Yeah, I would say those situations, it's definitely very beneficial if they're open to the care management for the reason, like you mentioned, the relationship building and really getting to know that person. So it's not a stranger coming in bedside that you're meeting in the hospital when, you know, you just had a bad fall and you're a little disoriented and and that's when you haven't talked to the family before and everything like that. So it's definitely helpful to to put that in place ahead of time if the person is open to it.

14:29 Most of the time we see that, you know, whether it's the adult children or the client themselves, but there's some resistance to some level there. And we meet that a lot and we deal with that a lot and can deal with that. And one of the ways that we deal with that is actually, you know, I tell family members all the time that sometimes hearing the same thing that your daughter might tell you, hearing it from a professional sounds different to people, you know, because regardless of how old you are, you're still the son or daughter. And to hear it from a professional other times will get the doctor involved because to hear it from a doctor is really helpful as well.

15:10 And so we try to use all those little tools to get the people the care that they need to remain safe and help them understand that we're on their team and that we want them to remain independent but safely independent. And what does that look like and what do they want? So as far as the scope of services that you might provide, if someone is living alone or there's a family member either side now and it's at least an agreement between the family that maybe mom, it's usually mom, maybe mom needs to go to some type of other residential setting. Do you help with that? Because I know there's so, I have friends who work in the industry and, you know, they are very, they're two close friends and they're very, you know, they're friends where they tell me the truth.

15:56 And there's very different types of facilities out there. And there's different types of aggregating sites that you might see on TV that really are just kind of a referral service to a feeder institution. So it's the system, if you will, moving on to that next residential setting isn't as uniform as people might think. And it's not always designed for the best interest of the resident. So is this something that you help like location, quality, cost? Yes. Yep. We help with all of that. You know, when that typically happens, it's usually, you know, after the person's been at home because their first goal was to remain at home.

16:39 And then, you know, someone along the lines decides, okay, we want to, you know, move this person or the person themselves wants to move. And then, you know, from there we can assess their level of care to figure out, okay, do they need independent living? Is it assisted living? Is it memory care? Is it nursing home care? You know, to figure out where we're looking, because then we can kind of break down, okay, what are you looking for? A lot of people like the idea of the large campus, the continuing care retirement community, where you have almost all of those levels of care. And, you know, that's very beneficial because then, you know, you're going off campus if you have to go to the hospital, but then you could be using the nursing home back there.

17:21 And, you know, you're already in the system and familiar with people and, you know, you're going to be on a different wing or in a different building, but it's still the same system. And then there are other people who, you know, have other things that are important to them. You know, sometimes it's strictly based on geography and, you know, you want to make sure that it's fair between the two children so that everyone can get there. And so you're picking a place, you know, off a highway that has a lot of good, you know, levels of care that another one that we deal with a lot is married couples that come to us. And, you know, so married couples can many times be at different levels of care. Maybe one person is independent living and the other person is nearing memory care.

18:05 And so they really need assistance. And so, you know, we're familiar with facilities, you know, most facilities would have, you know, only one level of care per room, but there are facilities that do have, you can have a married couple in the room where one is independent and one is assisted living. And, you know, so you're able to keep the people together that way. Then there's other married couples that, you know, whether it's the disease process or just the personalities where the family says, no, we want to separate them. And, you know, so we're just used to taking whatever the situation is and finding the right fit. And we're very familiar with all of the facilities in the area. Fortunately, there are tons of different facilities in this area, but at the same time for families, unfortunately, there are so many different facilities in the area.

18:52 And how do you know as a one -time consumer? Exactly, exactly. So you don't know, you know, the reputation and what's important to that facility and, you know, the, you know, religious affiliations and all of those things, you know, come up and then we locate the right, the right place for them. We'll set up the tours, we'll bring them on the tours and, you know, really make sure that it's the right fit for them before they move there. And talk about the future of, you know, okay, if you, if you decline, then you can move to the assisted living here. But if you had to go to a nursing home, you'd have to go to another location. So that would be another move. And, you know, kind of weighing all those different options and moves and everything that goes into it.

19:36 So your services don't end with that placement, I would assume. Correct. Yeah. Because one of the problems, I'm glad, I'm glad that you said that, because one of the problems that I see from, well, not so much, not from my own experience, but from my friend's experience, is that someone will move to a, say, an assisted living facility that just has assisted living. And that their level of care is fine for a while. And then it isn't. And the facility, I'm told, isn't always eager to move that person along. Because it means that person's leaving there. Business. Right. And so that level of care isn't always matched up to what they're getting to what they now need.

20:21 Is that true in your experience? I think that facilities definitely try to be very transparent with people. I think there can be resistance on both sides for different reasons. That's fair. Yeah. And, you know, I would say, and that's why, you know, you mentioned, do we remain involved when the person moves? And we do, we certainly prefer to, but it's always up to the family. If they say, okay, we're all set, then, you know, we'll certainly end services. But, you know, we like to be involved because a lot of times families don't realize that, you know, the assisted living or wherever you're moving mom, they can handle a lot. You know, they'll, they're there 24 seven, they'll handle all their needs.

21:04 They'll, you know, their meals, activities, everything like that. But, you know, let's say, you know, mom's in a facility in Newton and all of her family is in Florida and, you know, she's running out of, you know, clothing, she needs summer clothing and, you know, it got lost in the laundry or, you know, more importantly, she's, you know, heading to the ER and, you know, they're, they, they're not able to send someone from the facility because it's just physically impossible, unfortunately. And those are times where having a care manager, you know, that already has a relationship and can, can go into action for the family. You know, it ends up being really beneficial for those sorts of things that you don't really think of and don't come up every day, but it's helpful to kind of have someone in the background for that.

21:50 Yeah, absolutely. I've been pigeonholing you into certain areas, not on purpose, but why don't you share with other, other opportunities or places that your company provides services that we might not be talking about so far? Yeah. So I would say in care management, the bulk, just the fact that we deal with healthcare and oftentimes healthcare becomes more complicated as we age. And so the bulk of our clients end up being, you know, the older adults, but we do also deal with, you know, adults and younger people. So we've had a number of people that have mental health disorders that we're helping them manage their care and they just need a little more guidance and a little more handholding.

22:33 And we're able to help them with that. We've also had a number of couples that are aging come to us and they don't need help yet, but they have a child with autism that's in their twenties or thirties and they have support and they have services and they have a sibling to serve as a healthcare proxy. But mom and dad have essentially been the care manager and have all these binders from decades of, you know, doctors and treatment and follow-up, and they want to be able to hand that off to someone. And so that's where they end up bringing in a care manager to eventually, you know, kind of take over for them and help them in that way. So, you know, it ends up being more of the older adult population, but it's not strictly the, you know, older, anything with healthcare related needs we're able to assist with.

23:21 Now that's, I hadn't contemplated that, but, you know, if you do have a child in your care that needs lifelong care after you're gone, sometimes a professional is the best option. In the beginning, Jen, I talked about advocacy and maybe a hospital setting. How deep does that go? Can someone who is, doesn't have someone to name as their healthcare proxy, which surprisingly, you know, as a former lawyer, I was surprised by the number of people who would say, I have no one. There's no one I want to trust with this. Is that a role that your company takes on? So it can be, we're very careful about that role.

24:05 I would say that we usually will ask the person, you know, okay, well, is there, you know, because oftentimes they think, you know, the person has to be nearby them. And, you know, so we had one that we took on recently that she said she had no one. And it turns out she had a sister in Italy. And yes, that's not ideal, but, you know, if we're aware of the time difference and, you know, all of that, that person can still be the healthcare proxy and we can be the person, the boots on the ground, guiding them and educating and supporting them along the way. So they're more comfortable with the decision-making in terms of, you know, the decisions that they have to make at that time. You know, I would say that it's never a hard no, it would depend on the circumstances.

24:50 You know, we definitely want to give people the resources that they need. And there are also a couple of resources out there for people that either are in need of a power of attorney, via professionals or healthcare proxy. So we can definitely take those individuals and kind of figure out like, you know, under the layers and figure out, okay, who can we have? Would it be us? And, you know, because we always want to make sure it's not a conflict of interest. So it's on the rarer side that we, that we will serve as a healthcare proxy, but it's not an impossible task. Well, I think the best thought about that is there may be someone that you individually think that you don't have someone, but the assistance from a company like yours or a good estate planning attorney or financial advisor is to help walk them through that because there could be someone that you're just not reflecting on or that.

25:43 So that's good advice. We're just about running out of time, Jen. Am I missing anything? Is there a question I should have asked you that you wanted to answer or information that you wanted to depart on our listeners? Well, I will say that our, I don't think I mentioned our territory to start. So our, the territory is very important because that's where we're familiar with the resources in the area. And so right now our team covers from Southern New Hampshire, basically Manchester and South, all of Eastern Massachusetts, East of Worcester and Cape Cod. So we cover a pretty big service area and our care managers live throughout that territory.

26:24 And so we can assign someone based on, you know, geography and what they're looking for and what their needs are and everything. And we do also have a care manager on call 24 seven. So, you know, most of the time you're dealing with that one person, you know, even if it's weekends, care managers usually prefer to get the calls themselves because they're the ones who have the relationship. But let's say a client goes to the hospital in the middle of the night and the ER physician needs to talk to someone, they can call and they can always talk to a care manager that can log into the system and, you know, figure it, figure out whatever it is that they need and guide them through that. Great. Well, it's been very informative half hour. How do people learn more about you if they'd like to check you out?

27:07 Yeah, absolutely. So we do have a website. It's www.livewellcm.com or people can feel free to email me at jennifer.mahoneyatlivewellcm.com. And then, of course, you can always call our office at 617-254-9800. And, you know, I'm happy to talk on the phone with people that, you know, just have questions. There's no obligation to by any means. You know, I'm happy to talk to anyone. Well, that's great. I'll put that information in the show notes. So if you're listening and you missed that, you can look at the description of the show and Jen's contact information will be right there.

27:49 Jen, thanks so much for your time. Thanks for what you do. It's a valuable service and I would encourage people who think they might need it to check you out. Thank you so much, Jeff. I appreciate it. And thank you for listening to another episode of Something More with Chris Boyd. Chris will be back next week. Until then, keep striving for something more. Thank you for listening to Something More with Chris Boyd. Call us for help, whether it's for financial planning or portfolio management, insurance concerns, or those quality of life issues that make the money matters matter. Whatever's on your mind, visit us at somethingmorewithchrisboyd .com or call us toll free at 866 -771-8901.

28:31 Or send us your questions to amr-info at wealthenhancement.com. You're listening to Something More with Chris Boyd Financial Talk Show. Wealth Enhancement Advisory Services and Jay Christopher Boyd provide investment advice on an individual basis to clients only. Proper advice depends on a complete analysis of all facts and circumstances. The information given on this program is general financial comments and cannot be relied upon as pertaining to your specific situation. Wealth Enhancement Group cannot guarantee that using the information from this show will generate profits or ensure freedom from loss. Listeners should consult their own financial advisors or conduct their own due diligence before making any financial decisions.