Where Will You Call Home? Housing Options for Elders and Their Loved Ones

Join host Jan M Flynn in conversation with Kira Reginato as they explore the issue of where it makes the most sense to live as we or our loved ones age and our needs change. 

As an elder care manager and consultant, Kira has served hundreds of older adults and their families in a variety of settings: hospitals, residential care and skilled nursing facilities, hospices, Alzheimer’s adult day care programs and Meals on Wheels. 

Kira's three decades of expertise, as well as her warm personality and compassion were enjoyed in two weekly radio shows focused on aging: The Elder Care Show and Call Kira About Aging! 

 Kira is the author of the book Tips for Helping Your Aging Parents...Without Losing Your Mind – click the link to purchase a copy.

For more information about Kira, visit her website at www.Callkira.com  and check out her YouTube channel at https://www.youtube.com/channel/UCyO7atbCToRbKmnFI6EZGAg

Interested in finding a care manager for yourself or your family? Visit the national Aging Life Care organization at www.Aginglifecare.org

You can also book a phone or video consultation with Kira to discuss your needs and help connect you to a local care manager by clicking this link: "https://tinyurl.com/2p855cyx"  

(Note: this information is provided as a potential resource but does not indicate an endorsement nor any other business relationship. Crow’s Feet: Life As We Age does not receive any financial consideration for providing this link).

Transcript

Kira Reginato  00:00

I think people think, oh, let's just get a couple of hours of home care. No big deal. It is a full time management job for whomever is managing the comings and goings of people into a home. But they're paying me as an outsider so that relatives don't have to spend their time doing it, because it is a big job.

Voice Over  00:18

This is Crow's Feet. A place where we ponder the question, Are these our golden years? Or does aging just suck? Well, yes, getting older is not for the faint-hearted. But aging also brings wisdom and humor, a finely tuned perspective on life. In our podcast, you'll meet writers and others rethinking our later years, people who inspire us to reimagine our future.

Jan M. Flynn  00:52

(phone ringing) It had been another long day, and my husband and I were relaxing after dinner when the call came.(phone ringing) My mother, who lived in a town four hours north by car, had just had a massive stroke.(phone ringing) Get here as soon as you can, we were told, if you want to say goodbye. 

We made the drive in three hours. Mom was awake and happy to see us. But her speech was slurred, and she couldn't move her limbs. She'd already made her wishes clear while she was still healthy, no heroic measures. So we waited for the end to come, while the business we ran back home, waited for us to return and keep it going. 

Five days later, we were told mom had to leave the hospital because it appeared she had no immediate plans to die. Where was she supposed to go? Not home. She was still immobile and needed total care as she would for the next four years until she passed away peacefully in her nursing home at the age of ninety-six. But we didn't know that then. We didn't know anything then when it came to what mom's options were. Turns out, it doesn't have to be that way. 

I'm Jan M. Flynn, your host for this episode. Rosalyn Carter once said, “There is nothing more important than a good, safe, secure home.” And today we're exploring the topic of elder housing. Where and how we or our loved ones are going to spend our later years. So I'm delighted to have as my guest Kira Reginato, who has three decades of experience as an elder care manager and consultant. She has served hundreds of older adults and their families in all kinds of settings: residential care, adult daycare, skilled nursing facilities, hospitals, hospices and Meals on Wheels. And she's also the author of the book Tips for Helping Your Aging Parents: (Without Losing Your Mind). So, welcome to the show, Kira Reginato.

Kira Reginato  02:53

Thank you so much, Jan, I'm thrilled to be here.

Jan M. Flynn  02:56

I so wish I'd known you or someone like you back when my mother, who lived independently until she was ninety-two suffered a stroke that left her alive but completely dependent for the next four years. I know that a lot of our listeners have been in this situation where they maybe suddenly have to find a better housing situation or a more appropriate housing situation for themselves, or for someone they love. And it can be so bewildering. There's a whole new language, you know, assisted living and independent living and skilled nursing and all that kind of thing. So give us a breakdown of what the options are when we're looking at housing for us or for someone else as our needs change.

Kira Reginato  03:40

I think the majority of people who call an elder care manager such as myself, always say, I wished I had called you a year ago. Our family would have made such different decisions. But you know, we did the best we could at the time with what we thought we knew. And housing has a lot to do with it, because people are faced with a quick discharge from a hospital. And oftentimes, they can't quite come home, or the nursing facility where they've received some rehab says, okay, in two days, you're going home. And the family is like, wait, we don't have the home tricked out for her to come home. Where else can she go? And they're handed a list of twenty-two places and then their head falls off.

Jan M. Flynn  04:26

Totally! Been there. 

Kira Reginato  04:30

I think it's always good to chat with your loved one, whether it's your spouse, or your great aunt or whomever it is to say, you know, how do you envision if something happened where you might like to live? Because that kicks off the conversation about, I never want to go to a place for care. I want to remain in my home. And then the follow-up question is, could you possibly afford that if it were, as in your mom's case, 24/7 care? And just for point of reference, in the Bay Area where I live in California. Currently, homecare through a licensed home care organization is about $1,000 a day. 

Jan M. Flynn  05:07

Wow. $1,000 a day. So we're talking $30,000 A month. 

Kira Reginato  05:13

Exactly. So people will say, honey, I don't want to go to any place, I'd like to, you know, be here if anything happened. And the family goes, oh okay, but they don't really delve into the finances. So unless you are very, very wealthy, 30 grand times 12 times for four years is something most people cannot afford. 

And so with economies of scale, we look to a care community, that's what they call them, that can meet your needs at a much lower cost than $1,000 a day. However, people still will say, you know, I'd really rather kind of eke it out on my own. So let's walk through it. If you want to stay home, great. If you can afford to stay home, great. But there are a few reasons why you might not want to stay home even if you can afford it. And I get asked this a lot of times with children to say, when should I kind of insist mom move. And I would say one of the things is if your loved one is isolated, we have a lot of beautiful little properties out in the outlying areas. But guess what, I can't get services to them. There may be no hospital, there may be no hospice, there may not be any home health aides that are willing to drive there. So isolation is a big reason to consider relocating. Another is if the person is lonely. UCLA just did this study, Jan, on loneliness. And they, you know, surveyed hundreds and hundreds of people and the people reporting the highest degree of loneliness, (laughing) were married.

Jan M. Flynn  06:43

That's not encouraging. (laughing)

Kira Reginato  06:48

So even if you have people around you, you may feel lonely. And we know lonely, and loneliness is a huge factor to having poor memory and poor physical health and death

Jan M. Flynn  07:01

And didn't the Attorney General just last year or the year before decide that there was a loneliness epidemic?

Kira Reginato  07:06

They said it's equivalent, loneliness is equivalent to smoking 15 cigarettes a day. So if you're isolated, if you're lonely, if you're unsafe, especially with memory loss issues, that may mean you're unsafe preparing a meal, that may mean that you leave the home and get confused whether walking or driving about how to get home. And it's not normal aging where you occasionally forget, you have something on the stove, that's ubiquitous. I'm talking about repeatedly, you know, turning on the tap, walking out of the room, flooding your bathroom twice in the year. And then the other is what I mentioned before is they cannot afford enough homecare to come in if it's available. So those are sort of the four factors. 

Jan M. Flynn  07:50

One of the other elements about having home care is that it means a big management job for somebody. My sister has a terrible degenerative neurological disease that has been gradually eliminating all of her ability to move on her own. She would have loved to stay in her house, but her house was full of stairs. Even going to assisted living, she, after a while, she needed 24/7 care. But it was such a huge job for her son, my nephew, to manage the caregivers who came in because sometimes they call in sick. Or you know, my sister decided she didn't like one or trust one. And it was, he was running his own business and also ran essentially a one person care facility for one patient. I don't think people realize what a job that is. 

Kira Reginato  08:42

I think people think, oh, let's just get a couple of hours of home care, no big deal. It is a full time management job for whomever is managing the comings and goings of people into a home. And unfortunately, it also includes if the person is working with an agency. I have had agencies call me:  we're paying them forty bucks an hour, the person is supposed to work a four hour shift. They say I'm sorry, Sarah's car didn't start and we can't find a replacement. 

Jan M. Flynn  09:07

And that's exactly what my nephew was doing. He was working with an agency. The agency was good. They really tried but stuff happens.

Kira Reginato  09:15

It's real life and you have to budget. I have that in my book too. You really need to be realistic about how much time you can devote. And it's a perfect use of a Geriatric Care Manager such as myself, because I come in, I supe. This is if you're hiring, let's say private caregivers. I have a woman, she has five people who help her get twenty-four hour care.

Jan M. Flynn 

Right. 

Kira Reginato

She lives with a relative but the relative is unable to provide hands on help when she's toileting or in her wheelchair getting into bed and standing for long periods to do all the dishes or the housework. So I supervise those five people and I run background checks on them when they start. I interview them. And then I run their payroll so that all the taxes are deducted. And I look at their timesheets and put them into the system. But they're paying me as an outsider so that relatives don't have to spend their time doing it because it is a big job. And also, the nice thing is I'm a buffer, so that if one of the caregivers has a gripe about another caregiver, or even about the client, they can go to me and not have to go directly to the client to try to broker a solution.

Jan M. Flynn  10:29

And I also love that you point out that this woman, who was fortunate enough to afford full time care at home, it's not, it's not like in the movies where there's one wonderful person who lives there, and is just like an angel taking care of them 24/7. No, we're talking five people, because these people also have to have time off and sleep.

Kira Reginato  10:52

To do it right, I think a lot of people will say, well, I just found some wonderful woman, I'm going to hire her. And it's like, well, you do realize that she cannot work twenty-four hours a day forever. Like, you know, if you're just out of the hospital, and the person's going to go the extra mile to stay with you for a full week, great. But every agency is not going to allow that. 

Jan M. Flynn

No, they can't.

Kira Reginato

Private caregivers sometimes will go above and beyond. I've had caregivers say I will stay twenty-four  hours a day straight through. There's other people that have slept on the floor, because they want to be able to really hear the client when they're out of bed until we get them a Wireless Pressure mat, which they didn't know existed. 

At any rate, homecare is a conundrum, it is broken, we have a very much a shortage of homecare employees. And unfortunately, that dovetails into our housing situation. There are many senior housing options, those four factors being isolated, being lonely, being unsafe, or not being able to afford the home care you need are all factors that you want to tuck in your hat to think maybe I need to move, or maybe my mom should move. And the first least restrictive housing is independent living, it's just a basic model. And I think of it like a hotel, you get weekly housekeeping, meals are available downstairs and some offer transportation. So you do your own laundry, you come and go as you want. Meals are provided. So it solves the problem of grocery shopping and cooking and driving. You know, they wash your linens, and they vacuum your apartment and take out your trash. So it's better than living alone. But they don't provide any hands on care.

Jan M. Flynn  12:35

But they may provide social activities, right? 

Kira Reginato  12:39

Most independent living communities that I'm familiar with might have a downstairs room where there's a jigsaw puzzle set out, they may or may not have transportation that will take you to an activity or to, you know, the pharmacy or grocery store. But it's usually not particularly social. It really depends on the independent living community. But you're just paying monthly rent, there's no lease, there's no big commitment, there's no big health form to fill out. They're not reviewing, you know, if you can continue to pay and live there forever. So it's kind of a low threat. And actually, I did a radio show last week, and then a caller or listener called me and said, You know, I'm living in my home, my neighborhood has changed a great deal. The people I used to know as my neighbors have sold, and now they're all rentals, and her relatives whom she enjoyed locally have all died. So she said, I didn't know independent living existed. I thought I had to go into a care setting and I don't need any care. I was so glad to hear that. There's just basically a place where I can get, you know, housekeeping done for me and I can go out and do my own cooking if I want or I can go downstairs for meals.  

Jan M. Flynn  13:53

So independent living is maybe the first step beyond, just say, living in our own house. If we're kind of looking at this as a, you know, a step up, then what would come next?

Kira Reginato  14:03

Independent living can work until you need some help with what we call activities of daily living. Anybody who has had an elderly parent becomes acquainted with that acronym of ADL. And that means assistance with bathing, dressing, getting to the toilet, walking or even feeding yourself. And the reason we have some of those ADLs is really because that's what long term care insurance is looking at before they start paying on a policy. 

So we pay a lot of attention to functioning, functional status. And again, if  you're in an independent living situation and you need a caregiver brought in to help you shower twice a week, you can pay privately to have that person come in and do it and still stay in independent living. It's really a matter of how much care are you needing to bring in? Would it be cheaper to go to an assisted living home where they have staff twenty-four hours a day? Although what I'll say is assisted living, is not medical. It's really to help you bathe and dress, prepare your meals, give you your pills, and that's it. They're not doing anything else medical with you. It's still considered a non medical social model. 

And here's where you will find full activity programs; happy hour, music programs, trips outside of the community, bingo, exercise, etc. And that's for a monthly fee. But what's interesting is that these assisted living homes, that most of our baby boomers are familiar with now are large, what I call big box stores. And most of the care homes are actually like, at least in Sonoma County, 90% of our assisted living homes are six beds or less. 

Jan M. Flynn  15:55

So, is that what we sometimes refer to as board and care?

Kira Reginato  16:00

Yes, and when you and I were little, we'd go to visit our grandma in a ”rest home”. 

Jan M. Flynn

Right

Kira Reginato 

But to tell you the truth, the industry thought, well, nobody wants to go to a rest home, because you know, they're more active than just resting. So they changed it to assisted living. But I think it was really a nomenclature to get people to think it was something different than a sedentary type place. But most six bed board and care homes, which are also assisted living, they're all the same name, because they hold the same license, at least in California, don't have structured activity programs, so it's more boring and more sedentary.

Jan M. Flynn

Yes.

Kira Reginato 

But it provides a heck of a lot of one-on-one guidance to people. So I love small board and care homes, because they know if I don't look quite right, if I'm running a temperature, if I'm constipated, if I might have a urinary tract infection, that staff knows me so well, because I live in one home with five other residents. And the staff sees me over and over and over and over and really gets to know me, when you're in a big box store, you're behind a closed door. And you're sleeping at night and then you're up in the activities in the day, or you're not. And nobody's really getting to know you in the same way in a building with one hundred people.

Jan M. Flynn  17:27

So maybe if you don't show up for meals for a day or two, nobody notices?

Kira Reginato  17:32

I think that would be unusual. If it were a day or two. Maybe they would assume you'd called up or you weren't feeling well. But yeah, you know, if you really were on the floor between lunch and dinner, nobody would know, unless you were scheduled for medications to be delivered or a bath or some sort of outing. Yeah, it's your own apartment, you're behind the closed door. And they might not know. And that leads to more isolation when I have people that move into assisted living, and the adult kids are all wagging their tails about Oh, Mom, they have blackjack and happy hour. Guess what? Mom was never social. And she certainly doesn't necessarily want to associate with those other people, because they're old. 

Jan M. Flynn  18:10I 

Actually, I have another sister and her husband who both have memory issues, and they are in one of those facilities. And it's very nice, it works really well for them. But I can see how, you know, if they weren't to get there, there could be a potential for one of them to not get the kind of attention that they need. Whereas in a smaller facility, you know, it'd be pretty hard to miss if somebody has a UTI, or has a fever or something like that. So there's sort of a range even in there. And it really depends on what is appropriate for the person. 

Kira Reginato  18:44

That’s right. So really, it's the amenities that color assisted living in our State Community Care Licensing has regulations that you have to meet whether you open a home that has six residents, ten residents, or one hundred residents. And some of those board and care homes or larger corporate places offer memory care now, that's the hot trend, right? Some do not meet or don't want to have a memory care unit. But the memory care unit again has to have specific Alzheimer's dementia care regs that they follow to be considered appropriate for having a memory care unit. You can't just call some of your rooms memory care. You have to have a plan of operation that says you've got, you know, secured exits and windows and maybe staffing changes a little bit. And the money now in California for memory care is, I don't know ten to twelve grand a month, where I live. I mean, it's so exorbitant.

Jan M. Flynn  19:43

Figuring out how to afford all this is a whole other topic. But let's move on from, so we've talked about, you know, living at home, independent living, assisted living, what's the next step and what makes that something you might want to go to or need to. 

Kira Reginato  20:01

In the old days, it was called nursing home care.

Jan M. Flynn

Right

Kira Reginato

Then people didn't want to go to a nursing home. So we called it a skilled nursing unit or skilled nursing facility. And then we didn't really like that. So now we call it post acute care.

Jan M. Flynn  20:18

So now it's not even skilled nursing anymore. It's post acute care. And I think this is what becomes bewildering because like I said, It's like learning a new language that keeps changing.

Kira Reginato  20:28

It does. And part of that is because the skilled nursing facilities, nursing homes want to get away from being called and perceived that way, because there's such a negative perception of a nursing home, is it someplace people want to move to forever? I would venture to say not, because it is not homelike in what it does, but it does provide. 

So post acute care, skilled nursing care, or nursing home care, those are all synonyms, provide the most care you can get outside of a hospital. It is the step down from the hospital, it has to have licensed nurses on board 24 hours a day, and it has a medical director, and it can provide all sorts of medical services, you can usually go there for a short stay that's covered by Medicare, or your insurance. And then you move out of there to what we call a lower level of care, you'd move back home, you'd move into an assisted living home. 

That's the idea. Is that you're there for a little bit of time, and then you're moving to a lesser level of care.

Jan M. Flynn  21:36

I have to ask you, does this differ from a rehabilitation facility?  

Kira Reginato  21:41

The same thing, it's a synonym. Going for rehab, is going to a nursing home ,is  going to a skilled nursing facility, is going to post acute synonyms. And that's why working with a Geriatric Care Manager is really helpful because most people say my mom needs care, I guess she needs to go to a nursing home, right? She's falling in her home, so she has to go to a nursing home. That's not necessarily accurate. And I do want to mention that nationwide, we have placement agencies, Jan. And even though that's not a very warm and fuzzy name, there are people locally who go and visit all of the assisted living homes in the area and know about their requirements and their openings. And a family calls the placement agency and explains what their loved one needs, what they can afford. And then that person chooses three of them or so to connect them and visit with them, and helps with the paperwork to admit them. This is not a national firm, you always want to work with a local firm who's actually in touch on a regular basis with these owners. They're in those homes, seeing how clean they are, how they smell, what the food menu is, you don't just want a name of a home, you want to know someone who knows that currently, there are two chihuahuas that the owner brings over every day. And if your dad loves dogs, great! If your dad's afraid of dogs, you don't want to go to a place with two chihuahuas or a smoker or… so they intimately know board and care homes and assisted living and the way they make their money, Jan, is that once a person whom they've helped find this home for moves in, the owner of that home pays them part of the first month's rent. 

Jan M. Flynn  23:34

Oh, I see.    

Kira Reginato

No fee to the family. 

Jan M. Flynn

No fee to the family. Great. And where would one find one of these agencies?  

Kira Reginato  23:40

The Area Agency on Aging is the nationwide hub for senior resources. We call them triple A's. So the Area Agency on Aging in a person's state would be able to direct them probably to a local placement agency. Or you could Google placement agencies. And they don't usually refer to independent living homes because those don't pay them a fee. And they don't usually refer to skilled nursing because they don't pay them a fee. They can help with ideas if they know good ones, but their main bread and butter is finding assisted living homes, whether it's memory care, or just some physical help. A small home, a large home and they will even like, tour the person with them, have lunch with the person who's considering living there, negotiate the paperwork, really hold their hand, check on them afterwards of how living there is going for them. But it's all free to the resident and the family because they get their money from the home.

Jan M. Flynn  24:45

That's great to know about. So the magic words for our listeners is placement agency. (laughter) That's maybe who you want to look for. Yeah, if you're faced with this, is there a way to make this process less you know, less stressful? Is there a way to make this less of a, less of a panic situation?

Kira Reginato  25:03

Knowing your options always lowers your anxiety. Even if you don't pull the trigger on it, you like knowing that you have a plan, and you've had a discussion. So in my book, I mentioned sitting down with your parents and sort of asking what they want, and what they don't want. And also, what are you willing to do? And what do you not want to do? 

Jan M. Flynn  25:28

And we have to ask these questions for ourselves too, as we get…

Kira Reginato  25:32

That's exactly right, Jan. And so if I know that I am willing to go to an assisted living home, that would be important for my daughter to know. So what I think now, at sixty may be different when I'm eighty. But at least she has a general concept. But if I am eighty, I might want to know what the local places cost, I might want to go and visit and get a feel for the actual building and the rooms and layout. And working with a Geriatric Care Manager in advance. And even doing like an hour phone call, can be immensely helpful to families. And I want to give out the national website for people who do what I do so that they can find no matter where you're listening, you can find someone that are in our nation who does what I do, and just book half an hour or an hour with them and your loved one and find out what the local options are

Jan M. Flynn  26:27

Great. What is that website? And we will include it in the show notes as well. 

Kira Reginato  26:31

It’s www.aginglifecare.org.

Jan M. Flynn  26:35

And that's all one word aginglifecare.org?

Kira Reginato  26:38

It is.

Jan M. Flynn

Great. 

Kira Reginato

And then you just click on find an aging life care expert, which is located on the upper right hand side of the screen. And it's a beautiful orange color. And you type in your zip code and upcome the people who are in your vicinity whom you could call. And just as I said, I do zoom calls with people actually all over the nation, you don't have to be local. But if you know that you really want to know what's available in Tallahassee, you're going to look up Tallahassee care managers.

Jan M. Flynn  27:11

 Sure, of course. Right. You're listening to Crow's Feet: Life as We Age. And today, we're talking housing solutions for older adults with elder care manager Kira Reginato. She's also the author of  Tips for Helping Your Aging Parents: (Without Losing Your Mind), which I've read, and it's really helpful. And that's available at her website www.callkira.com. That's callkira, all one word: C-A-L-L-K-I-R-A.com. And we will include that link in the show notes. 

As we were saying, it can be kind of overwhelming to find, let alone choose the right living situation as our needs increase. But it's really terrific to at least know what our options are. So what I wanted to do was sort of pivot to your profession itself. Because I so wish that I had known you when I was going through, you know, what the fallout from my mother's stroke. Or I wish I'd known that a profession like yours even existed. Why don't we know more about a profession like yours? And how do we,well you've told us a little bit about how to access people who do what you do. But can you speak to that a little bit?

Kira Reginato  28:20

A part of it, I think, is that people don't want to deal with aging issues until they’re a crisis. So they're usually not getting any education until they're in a hospital.(chuckling)

Jan M. Flynn

Right.

Kira Reginato

And that hospital wants to cover their butts by giving you a sheet of five hundred things that are nonprofit so they don't get in trouble. So you get a list that is not very well curated, not up to date, and certainly doesn't provide a fee for service people. They only want to put nonprofit, not that there's anything wrong. But something like Catholic Charities or Jewish Children Family Services that people often go into as a main funnel, because they're well known and their nonprofits, is that they don't provide the amount of hand holding and attention that my families need. If you just need a generic question answered, it's fine. But if you need someone to do a zoom call after hours, if you need help on the weekend, if you need someone to show up at the emergency department when you're there with your dad, that is not something those agencies are able to do.

Jan M. Flynn

And you do that in the course of your job.

Kira Reginato

Yeah. Care managers do all of that. Yeah, I was telling somebody the other day, we're kind of like a Rent-A-Daughter. (laughter) You know? Because they want the psychosocial support, and they want to be shorn up because it's hard to go in there and care for Dad day after day. And I've been to dad, I know him, I've done a little assessment, and therefore I can work with that daughter over time to support her and really know what I'm talking about and know what the situation is.

Jan M. Flynn  29:56

It may sound nice to think oh, my daughter will take care of me or My daughter-in-law will, but that changes a relationship so drastically; you know, do you really want your son or daughter helping you to the bathroom? It becomes a very different relationship. And that's another reason I don't think we look at enough for, you know, finding professional care. Yeah. And keeping the family, the family, instead of caregivers who work for free.

Kira Reginato  30:24

Or just changing the role to being a caregiver, what I'll say is, would you like to be returned to your role as the son in the family and not the caregiver? 

Jan M. Flynn  30:47

Absolutely.

Kira Reginato

And they'll say, Yes! I just want to go and sit with dad in the garage, and you know, whatever, or watch Jeopardy with Mom, that's, you know, I miss that. I miss telling her what's wrong with my life and getting some help. (laughter)

Jan M. Flynn

And Mom misses being a mom instead of a patient.

Kira Reginato  30:50

That's exactly right. And I also think it's hard to be told what to do by your kids. So by hiring a professional, we come in with our expertise, and I just say to people, Look, just tell your parents, you're out of your depth. This isn't what you do all day. And you've met someone who's a resource specialist, could they come and meet you? We know what those adult children do not know. And it's money well spent to have someone else deliver that information in a nonthreatening way, I think.

Jan M. Flynn  31:20

In terms of money well spent in your situation, are you paid for by the client or the family? 

Kira Reginato  31:27

Either. But it is all privately paid. Medicare does not currently recognize care management, as a cost savings, or a benefit to make sure the person meets benefit criteria, and then he or she goes away. They are not there to talk with you every day about the latest crisis or your dad's dementia getting worse. No, they are not going to hold your hand over the years as a Geriatric Care Manager will. 

And the other thing I'll say is a lot of people come to us when they have “difficult parents”. People who have long standing personality disorders, who have substance use disorders, even if things have never been diagnosed, those children like they've estranged themselves from Mom or Dad, it's very hard to now they feel beholden to help. But they were such hard parents, that the kids are coming in at a really difficult time to be loving and compassionate. And even though they want to, they really need somebody to help broker that. And that's where a skilled Geriatric Care Manager can be aces.

Jan M. Flynn  32:34

It sounds like it can save a relationship and save your mind. 

Kira Reginato  32:38

Yes, and return that kid if they don't want to have much to do with mom. To know maybe that they're paying for my bill, and I'm doing everything. I just had a client actually, that the ex husband paid me to see her and visit her every single week, to make sure that she was getting everything that she needed. 

Kira Reginato  

And I visited her for eleven years. 

Jan M. Flynn 

Oh my goodness.

Kira Reginato

She just passed away in September of 2023. I visited her every single week, come rain or come shine. She was not a happy person. She was pretty miserable. But I got to report out to him and her family how she was doing and buffer them. And that daughter went on to have a wonderful career, marriage, and three children without having to run interference for mentally ill mom.

Jan M. Flynn

Sounds like you earned every penny of what they paid you. Wow.

Kira Reginato  33:35

You know, it's funny, I miss her. But it was very difficult. People with personality disorders, mental health issues, especially if they're untreated, can be quite the challenge. But that's what we're paid to do. Right? We're not family putting up with nonsense. And I'm also not triggered when the mom says something.

Jan M. Flynn  33:54

Again, what are the magic words? What are we looking for? When we are looking for someone who does what you do? Is it elde rcare manager? Elder care consultant?

Kira Reginato  34:01

The National Association which I belong to has rebranded us to be called aging life care, aging life care experts.

Jan M. Flynn  34:19

Aging life care experts

Kira Reginato

That's what you would search for us now I think most officially.

Jan M. Flynn

So I want to pivot now to you a little bit and find out how you as a person who has more expertise than most of us do when it comes to aging, how you are confronting your own aging. So there's three questions that we like to ask of our guests. And you just give us kind of off the cuff answers. First, if you could, what would you tell your twenty-five year old self?

Kira Reginato  34:44

I think I would tell myself that I need to lighten up. I think I was very hard on myself. But I have so little discipline now, Jan. (laughter) I used to be so disciplined and I have not become more disciplined I have become less disciplined. I was so caught up in doing the right thing and being right and being on time and all that was just like constricting. So I think I would know that just like if you get there twelve ‘o five people will still love you. All okay, it's gonna work out.

Jan M. Flynn  35:22

Okay, and what is it about aging that you are still trying to figure out? 

Kira Reginato  35:27

This is kind of a heavy answer. My daughter is a nurse. And apparently she likes me a lot and wants to last a really, really long time. 

Jan M. Flynn

Awwww

Kira Reginato

Never dying would probably be what she would tell you. And I'm really okay with talking about death and dying. I've been many bedsides and I've looked at my own mortality. And I'm lucky to be hearty and healthy now. But I know I will die. Right? So I think what I'm still trying to figure out is how much medical intervention I'm going to allow as my health changes, and helping my daughter know I may not want as much done as she wants me to have done.

Jan M. Flynn  36:12

Okay, now, last question. What is it about aging that surprises you? 

Kira Reginato  36:17

Well, not as much as I think the average person, because I've studied and worked in aging my entire life, read about it all my life. So I understood body changes were going to come and that I could find love later in life, which I did.

Jan M. Flynn  36:34

Oh, nice. 

Kira Reginato  36:37

Yeah, but I did not know that I was gonna need so many darn pairs of eyeglasses in my house.

Jan M. Flynn  36:44

How many do you have? Let's Fess up.

Kira Reginato  36:46

I think I have seven pairs and yet I can never find them. I've tried to put them on a chain. I've tried to leave them at my desk. I have two or three pairs in every room and I swear I get up and I do not have them accessible and I make myself crazy. Thank you for your time and for crafting such a good show. I hope that it's really helpful to your listeners.

Jan M. Flynn  37:10

I'm sure it will be. Thank you.

Voice Over  37:20

Thanks for joining us on this episode of Crow's Feet: Life as We Age. Don't miss any of our great stories. Subscribe to Crow's Feet wherever you get your podcasts. And be sure to tell your friends and family to give a listen too and leave a rating or review. You can read more Crow's Feet stories online www.medium.com/crows-feet. So until next time, remember to savor every moment. 

As John Glenn said, “there is still no cure for the common birthday”. 

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