What Do I Need to Know to Age in Place?

Episode 001 – What do I need to know to age in place?

Fri, Sep 30, 2022 9:48PM • 23:36

SUMMARY KEYWORDS

people, house, live, stay, safe environment, life, financial, person, chairlift, stages, ramp, caregiver, alternatives, mobility, age, electric wheelchair, activities, home, weatherproof, assisted

SPEAKERS

Joe Soricelli, Glenn Shapiro

Joe Soricelli  00:02

You are listening to Aging Issues Radio and Joe Soricelli. This is the station that will help you age into and through retirement. We bring advice and education on all of the issues that we face as we get older, offering financial and life strategies. Hope you enjoy the subject matter and our down to earth and simple solutions to the problems we all eventually face. While the issues are not unique, the solutions are for you.

Joe Soricelli  00:39

Joe Soricelli coming to you live from 101 Mobility with Glenn Shapiro. This is a follow up to the last recording that we did, which answered the question, should I stay, or should I go? Basically, a housing decision. You see, most people want to stay in their house. But sometimes you can’t. Or sometimes you can adapt the house to let you live in it longer. You see, there’s alternatives. Sometimes the neighborhood it’s because I want to stay in the neighborhood. Sometimes it’s because I don’t want to stay in the house with my spouse. There’s lots of reasons why you want to stay in the house. And then there are reasons why you might want to move because physically you can’t stay in the house. Because you know something? Steps look taller. Right? Entryways are unsafe. The first thing that I always tell people, is it a safe environment? And can we create a safe environment? And then if not, if we can create the safe environment, what do we have to do? And how much do we have to do? What I unfortunately find out that in many cases, it becomes a financial decision. That’s the background that we talk about. That’s why we talk about financial, you know, life stages in the financial implications. Because if you go to a nursing home, could cost you $15,000 A year you go to assisted living, high end assisted, not low end, someplace that you would like to live, it’s $14-$15,000 a month, right? $180,000 a year? How many years can you afford to live there? If you can, it’s hotel style living, maybe it’s the greatest thing in the world, but most people like their homes. Now let’s figure out with Glenn what can you do in a home that lets you continue to live in it?

Glenn Shapiro  02:29

I just want to add that staying at home allows you to keep the same doctors, keep the same resources, keep the same drugstores, keep the family that you know and love the children and the grandchildren. There’s loads of reasons to stay. Of course, there’s a lot of reasons to go to. But our focus is on trying to make staying home a safer, happier, healthier, and even more independent form of living, than you can possibly have by changing venues by moving. So, we love to help people stay in their home and enjoy what they’ve grown comfortable with throughout their life.

Joe Soricelli  03:07

That’s really the case. Because if I like where I live, and I’m functioning, sometimes I just need the assistance. I just need that bit of help. Sometimes it’s a professional, right, and that professional even needs tools or equipment to help care for you. But all of a sudden, I want my life to stay as similar as it’s been for the last 20-30-40 years. I enjoy having my grandchildren over the house. Right? They’re not going to feel the same way if they go into some sort of a facility. It’s just it’s not the same. My grandchild is not going to run and jump on my lap in a nursing home or some other facility. But also, I want to talk about perception. You and I had a conversation about five years ago, and you, maybe six years ago, we were talking about perception. And you brought up a story and you said sometimes nursing homes or facilities, I’ll use it as a generic scenario there’s low-end and high-end, specifically a nursing home, sometimes feels almost like a zoo.

Glenn Shapiro  04:26

Well, there’s good analogies to zoos and bad analogies to zoos. The thing I love to recall is when I was a kid, I used to go to the Bronx Zoo. And I loved seeing the monkeys in particular, but they were in tight cages. And because they were in tight cages, it seemed they were hostile. They were not happy little monkeys. And it turns out somebody over time, realized that putting animals in their natural habitat is a key to making animals succeed in a zoo. They become more docile, more social, they reproduce better in a zoo, when they had their natural habitat. They ate better as well. And they socialize better. And to me, it drove home a very, very important point.

Glenn Shapiro  05:21

If you are free in your natural environment, free to enjoy what you’ve enjoyed naturally, you’re programmed to do that you certainly are going to do better. And that’s what the zookeepers found out now across the nation. Natural habitat produces happier animals. And they live longer, they are healthier. And boy, does the same analogy hold true for people. Give them what they’re grown used to, it makes them happy. And they live longer and more happily.

Joe Soricelli  05:55

That’s the key. There was a, everybody has seen Rocky movies. What is the argument, the glimmer in the eye? That when you’re caged, and you’re not happy, you lose the glimmer in your eye. I want people to keep that glimmer. I have to say, I deal from the financial perspective, as well as the care perspective. First and foremost, safety, right? Safety, making sure it can work. That is simply the first and foremost. If you can’t live in your house for various reasons, because it’s not safe, that’s an important piece. But you know something? There’s an overlay with financials, because not everybody can afford the modifications, not everybody can afford different options that can convert a property or housing situation into a very livable safe environment.

Glenn Shapiro  06:56

No doubt, that’s true. And sometimes insurance will help pay for some of those modifications. But insurance tends to focus on what’s called Activities of Daily Living – ADLs. And the ADLs are very, very restrictive in and of themselves. As long as there is a way to get food, as long as there’s a way to toilet, as long as there’s shelter, as long as there’s a bedroom. It doesn’t really matter to the people who assess ADLs whether you can tuck Johnny in at night in his bedroom, which happens to be on another floor than yours, even though you’ve been doing that all your life. The idea of resuming your normal social, emotional activities, doesn’t enter into the equation when insurance assesses Activities of Daily Living. So I’ve become a little hostile towards Activities of Daily Living, because I don’t think it does enough to help people enjoy their lives. We try to give people much more than that. A real sense of independence, gaining as much mobility, as much independence as they had before their injury or their aging, to try to make them feel as if they are as comfortable as they were before whatever got them into their current state.

Joe Soricelli  08:18

I address it. And 100% is I will say in favor of what you have just discussed making life, keeping life as similar as it was before. But I always tell people, it’s stages. And it’s sometimes you can bridge from one stage to the other with some help. I can’t guarantee that you’re never going to need 24/7, not be able to get out of the bed. But it’s little things. You talked about Activities of Daily Living. I live with them all the time because I deal with Medicare and Medicaid and long-term care, right? So, we’re sitting in lift chairs. One of the first things, one of the activities of daily living is called transference, right? I often sit back and say, “Can you get out of this chair and walk across and get into a bathroom if you need to?” That’s a transferring skill. And then you have toileting skills. You have all these things where you sit. They are the bare bones, the activities of daily living, of quality of life? But you can enhance them. Instead of needing somebody to pull you out of the chair. You can hit a button and be lifted out of the chair.

Glenn Shapiro  09:37

And as long as you mentioned that, it brings to mind that a lot of what we do is not only for the patient, but it’s also for the caregiver. Because that person who’s pulling you out of a chair, should they hurt their back and now you’re both injured, what happens?

Joe Soricelli  09:53

It is statistically shown that caregivers, unfortunately pre-decease or get injured than the person that they are providing care. We have a case in Florida right now that the caregiver unexpectedly, and I’m not gonna say unexpectedly, just the ultimate diagnosis, said he was in pain. But he had a cancer episode that he had to be in pain. And after he was diagnosed, he lived three months. He had been taking care of his wife for the last 10 years. He passed away in March, she passed away this month. Now, family stepped up as best they could. But that caregiver, and I’m really focusing on that, that caregiver probably ignored medical issues that he was feeling in order to continue to care for his wife. It’s not an uncommon story.

Joe Soricelli  11:01

Hey, you know, little things you learn in this business, and we teach, and people teach you. But guess what, if there was a chairlift, it’s like, alright, all you gotta do is just buckle and then hit a button. Right? And it’s not like it’s a prohibitively expensive item. Then again, everything is relative. If you have assets of $100,000, an income of Social Security only and or whatever and have income of 40 or 50. Yes, sometimes things become prohibitively expensive. And that’s when you have to say, I can’t adapt this environment. I have to sell. I have to move to a safer environment. But if you can adapt the environment, you got all these resources. I mean, it’s amazing what’s available. And just in the five years since I’ve been dealing with you, it’s amazing what’s available.

Glenn Shapiro  11:01

Sure.

Glenn Shapiro  13:32

And we often try to find ways to make things affordable. Affordable, whether it’s on a payment plan, whether we sell used but recondition products. We usually can find a way to make something affordable, where it’s needed.

Joe Soricelli  13:50

It’s the affordability is a big piece, because I don’t care what anybody does in life, there’s always a financial decision that’s associated with it.

Glenn Shapiro  14:01

Sure, no doubt about it.

Joe Soricelli  14:03

So while I am an advocate of adapting property, I also sit back and say to people is, if we can buy another two or three years in this house, and it costs you $30,000 to make the renovations that are required. In some cases, it’s just $30,000 that your kids aren’t going to get. And I’m, I’m cold on that side. Because if your kids are planning on figuring out how to spend your money, you got a problem.

Joe Soricelli  14:36

If your kids fully support you staying in the house, and sometimes if you can adapt the house and make it safe, they do. But other times I’m brought in to turn and say you got to move. You got to move. But, it’s everything from a recent situation that Glen and I worked on where we were dismantling a house that a person was living in. But it had everything from ramps to electric wheelchairs, to Hoyer lifts, to a hospital bed, to all of the other smaller ancillary pieces that are needed that I have to say the small stuff. It’s funny, it’s all stuff Medicare pays for it like that. You need a bench, you need a commode they’ll pay for. You need this, they’ll pay for it. A Hoyer lift? Not always sometimes, right? An electric wheelchair. And that’s usually unused. Sometimes you can get Medicare to pay for it. But that’s also where you retain people that understand the business. And don’t always assume you can’t get some help and reimbursement for something.

Glenn Shapiro  15:42

Absolutely.

Joe Soricelli  15:43

I’m not going to tell you you’re gonna get 100% because it’s sort of like, okay, you go where you go, been a long time. So there’s been a Yugo on the road. But, or a Ford Pinto or any of the other things. Let’s take one of the most, the least expensive cars you can think about, it will get you from point A to point B.

Glenn Shapiro  16:00

True.

Joe Soricelli  16:01

And then you have the Escalade, or whatever else that will also get you from point A to point B. Medicare might talk about reimbursing you for that low priced car, assisting you. And if you want to upgrade, you have a basis. Yeah, you have you know, you have a choice, you have 10% 20% 30%, whatever it may be, but the key is making the space livable. Because the goal here is age in place. Not age in a nursing home, not age here.

Glenn Shapiro  16:37

Not age and another place age in your place.

Joe Soricelli  16:40

Age in your place. But, and I always references every client every time we go in, it may be for a period of time. Because there may come a time that we just can’t provide the adequate care for you in this house. Or it may just not be safe. But you can modify a hell of a lot to make it safe. I love the five I’ll be honest, I didn’t realize that the new ones can do five stories. And just for yourself, everybody here usually has a basement, most people’s houses have a basement, first floor, and a second floor. Could be an attic, could be other distances. But the first set of elevators that I was aware of did one floor. If you can do three floors, that means you can come in through the garage and be brought up to the bedroom if necessary.

Glenn Shapiro  17:34

And it’s funny, you said that. I always prefer the garage as the entry point, because it’s weatherproof. So whenever we’re trying to analyze what’s the best solutions for this house, given these people and their capabilities, we always start by saying can the garage be a useful entry point where it’s weatherproof, where you don’t have to worry about rain or snow? Oftentimes, people jump right do I need a ramp in my front of my house. And I’ll say, well, let’s take a quick look at your garage. Let’s take a quick look at other exits. I tend to avoid putting ramps in the front of the house, because it promotes the fact that a disabled person lives here. And that could be for somebody who isn’t the nicest person in the world to say I’ve got an easy prey here, I’ve got a disabled person. So, we try not to put that in front of the house. There are so many alternatives. And there’s so many tricks of the trade that helped us understand this is the best way and we love to help people find the best ways.

Joe Soricelli  18:34

You know what we are really talking about, besides just the best ways, which this all revolves around? Is create a plan. First off, what are the goals? When you do planning, you sit back and say, here’s what I want to accomplish. I want to get from point A to point B. I want to make safer house. I want to do whatever it is. So, let’s create, a plan. Not that it’s the final plan. But let’s create a plan that will allow us to get to the goal. Now, if the goal can’t be accomplished, then you know you have to change the overall plan.

Glenn Shapiro  19:10

Right.

Joe Soricelli  19:10

If the goal can be accomplished and in a way that everybody agrees, and sometimes alternatives, it’s not that you have to go down this street, that street, and this street. Maybe you go down the street, that street, and a different street. But there’s a way of getting to the ultimate goal.

Glenn Shapiro  19:27

Sure.

Joe Soricelli  19:28

And if the ultimate goal is we want to stay in the house, 101 Mobility can help. And pretty much can convert almost anything. For a price we always have to put it that way because it’s not a single, I’ll say not a single contractor or person that’s involved. Because sometimes you have to do major renovations. You know, I had a client that didn’t want to put a ramp in front of their house. And it was cosmetics more than anything else.

Glenn Shapiro  20:00

Right.

Joe Soricelli  20:01

We added four feet of topsoil and a retaining wall. We eliminated the steps in front of the house by just raising the entire front yard. Basically, creating a walkway that was a ramp that, instead of having an aluminum ramp or a wooden ramp or whatever else in the front. And it actually made the house look better. Because it took out that little bottom piece of foundation that everybody, a lot of people have.

Glenn Shapiro  20:27

Yep.

Joe Soricelli  20:28

And we did have to do window wells, and we had to do, other things. But it was a landscaping issue. And it wasn’t cheap, it was $10,000 to do what we had to do with all the stonework, and all the other stuff. But it accomplished the goal in a way that nobody else had thought about. It’s like, why can’t you reuse the front yard, you can.

Glenn Shapiro  20:48

Coming up with different solutions that meet the needs of the people and the situation. It’s problem solving. And you sometimes need professional problem solvers working with you. And we like to think that’s what we are.

Joe Soricelli  21:02

And I’m gonna even focus something that you just said. I’m doing a fiduciary presentation this evening for attorneys, because attorneys are fiduciaries in cases. They try to delegate or share their fiduciary responsibilities with other professionals that should be experts in their field. They should have a thorough knowledge of what the issues are, and

Glenn Shapiro  21:27

bring in a team of experts where necessary.

Joe Soricelli  21:29

And more importantly, as you say, experts, when you start talking about changing a house or doing something of that nature, you don’t talk to your brother in law, unless he’s unless he’s an engineer, architect, whatever else. You don’t talk to the neighbor who said, “Oh, I got a chairlift and it worked out great.” Talk to somebody that can walk you through the stages, first of the planning process. And ultimately, is everybody on the same page with the goal? Right, and then how do you get there? And then Joe Soricelli brings in Glenn to say, okay, let’s see if we can modify this. Oh, looks good. Well, or, which is, I think one of the worst things in the world that you can get different pieces, is when doorways are like 24 inches into bathrooms. And then you look at tiny move and it’s like wait a minute and we got to do with the entire new bath to open the doorway.

Glenn Shapiro  22:25

Yep.

Joe Soricelli  22:26

He’s nodding his head. He’s had this.

Glenn Shapiro  22:28

Oh, many times.

Joe Soricelli  22:30

That’s one of the hardest things is whatever, for whatever reason, back in the 60s, they made 24 inch door entries to bathrooms. They are not safe. They can last for a period of time. But if you’ve ever tried to walk through a door, a 24 inch doorway with somebody, it doesn’t work.

Glenn Shapiro  22:47

Right.

Joe Soricelli  22:47

But again, this is Joe Soricelli coming to you from Aging Issues Radio, the podcast that’s going to hopefully get you through the stages of life and retirement. Glenn, thank you very much.

Glenn Shapiro  22:58

Pleasure. Thank you, Joe.

Joe Soricelli  23:00

We’ll talk, okay.

Joe Soricelli  23:03

You’ve been listening to Aging Issues Radio and Joe Soricelli. This podcast has been for informational and educational purposes only. It is not to be construed as financial or legal advice specific to your circumstances. If you need help with any matter, be sure to consult with an advisor regarding your specific need. Thank you and tune in again.