♪ ♪ ♪ Darci Strickland> Good evening and welcome to Palmetto Perspectives: Parenting Our Parents.

I'm Darci Strickland in for Thelisha Eaddy.

"Once an adult.

Twice a child."

It's an age old quote that reminds us that at some point in our lives, we will all need some help.

As children, we rely on our parents to help and protect us.

But as our parents get older, it becomes our job to help and protect them.

This change is often challenging and can put a lot of stress on families.

So how do we adjust to this new chapter and when do we start the conversation with our loved ones?

We have invited a very distinguished group to help us navigate these conversations.

Joel Lourie is a familiar name.

He is a former member of the South Carolina House of Representatives and state senator, and he's also the founder of Lourie Life and Health.

Tanya Rodriguez Hodges is the founder and president of Limitless Community Development, a South Carolina based nonprofit.

Dr.

Macie P. Smith is a licensed gerontology social worker with more than 20 years of experience working with aging and vulnerable populations.

And Connie Munn is the director for the South Carolina Department of Aging.

Throughout this show, you will see a graphic with the website and phone number for the Department of Aging.

If you need assistance, you can call 1 (800) 868-9095 or go to getcareSC.com .

Again, thank you so much for joining us.

And we're going to get this conversation started.

Director Munn, we'll start with you because you know firsthand how this can be very difficult conversation to have for families with their loved ones.

When do we know that it's the right time to start having that talk?

Connie Munn> Well, you know, unfortunately, we don't have a notebook that gives us that guideline.

It's so important to really just know where your parents are and that stage of life to know how to start the conversation.

Sometimes it may be earlier on and sometimes, unfortunately, our older adults, you know, our parents don't really want to have that conversation.

So it may take just beginning the conversations and working up to those difficult conversations.

As you said in the introduction, it is extremely hard to have those conversations with our parents.

And many times they are not responsive or they don't want to hear it because they raised you, and they don't want you to have to take care of them.

So you really just have to, to know your parent, understand the situation, understand their circumstances before you start having that conversation with them.

But when you start seeing one, the decline or you see that they may be going down that path to where they might need to be placed in a nursing home, it's so important.

We see so many times that sometimes it's too late.

We've waited to have that conversation, so just being intentional and being there and present and knowing when they're okay with having that conversation.

Darci> Dr.

Smith, you have done this for more than two decades.

You've helped families find the right language to have the conversation.

I would imagine that there's never a time that's too early to start talking about it.

Dr.

Macie Smith> Absolutely.

Now, I think there's a misconception about who's aging Every day, we're all aging.

The decisions you make today will determine how you will be tomorrow.

Will you be independent?

Will you be living on your own?

So the time to start having the conversation is now.

It will shift in terms of if you're planning for yourself.

I have one daughter I have been planning for some time.

She goes with me to these training events because I want her to be prepared and ready.

But when it comes to your parents, because you know they don't want to get old and they don't want to seem like they're old, I think it's best to have smaller, bite sized conversations, not talk about, okay, when you die, where are you going to be buried?

But just start talking about in the event you become ill or injured or have an accident, who do you want to make the decision?

And the family caregiver should have a notebook and start writing the information down.

And then the next time you have a conversation at dinner or at breakfast, then go to the next stage.

So don't have the whole gamut of the conversation all at once.

It's very overwhelming.

Darci> Tanya, I think it's difficult... and you can speak to this personally when it happens quickly.

You know, when there's one moment where our parents are completely independent and living their best lives, and then the next moment you have become their primary caretaker.

>> I think that I was born, though, to be their caregiver.

I grew up in a time where remote controls were nonexistent, and my parents when, as I was growing up in my formidable years, I remember the conversations about sodium and cholesterol.

So we had a plan in place.

I just didn't realize how quickly, you know, "death by a thousand cuts" Dementia, would be.

And from one moment to the next, how quickly we went from a physical appointment with them at the doctor's office to, I cannot believe how quickly this is, this is going.

And it did seem very much like it happened overnight.

Darci> What advice would you have for a family who is dealing with that today?

Tanya> Ask for help.

I think that we are trained, especially ladies, that we are to just absorb and take in as much as we can because we're strong.

If I had just asked for help when help was being offered, I think that I would not have had the mental breakdown and the physical breakdown that I did, once both parents took their better offer and went on to a heavenly place.

Darci> Joel, A lot of times we think that there are so many things we need to handle on our own, and I think people still look at you as a lawmaker, even though you took that hat off a long time ago.

But where does the government step in, in times like this?

Joel Lourie> That's a great, great question.

And just watching the incredible presentation before and big shout out to our friends at ETV for taking this issue on, by the way.

I just think the, the documentary was excellent and looking forward to this, this presentation.

I think the government really, and I'm going to use South Carolina.

You know, my dad served for 28 years.

I served for 18 years.

And he and I were both strong advocates for our aging population.

But I think the government probably is a little too reactive and not proactive.

And I think if you look at perhaps the healthcare infrastructure in South Carolina and Director Munn, you could probably speak to this too.

Everybody could.

In terms of when you look at the demographics of the people that are coming to South Carolina, and we have an office in Myrtle Beach, I bet 19 out of 20 of those people haven't been in Horry County, haven't lived there for more than five years.

It's amazing if you moved away and come back to Myrtle Beach, you wouldn't recognize it.

But we have got to make sure that we have enough health care providers.

You know, very few people coming out of residency want to get into primary care medicine or internal medicine because they have so much debt.

They want to go into a specialty or to become a surgeon of some sort where they can generate a higher income.

And then we don't have enough residency program.

And then you go into the nurses, the, you know, the radiologists, excuse me, the radio, the people that do the, the techs that do the lab work and that kind of stuff.

We're falling way short of that.

So as our population shifts, and if you go back and look at the last 15 years, we've gone from about 22 to about 33 percent of our population 55 and older, where our population has grown significantly.

This tsunami is real.

And I think the government has to be better prepared to make sure, because let's face it, very hard to afford a long term care policy today.

There aren't just Medicaid beds popping up everywhere for people that fall into the to the, you know, into Medicaid and are eligible.

So we've got to be prepared to make sure we have enough, a medical infrastructure that can deal with this aging population.

And I don't, I think we could be a little too reactive.

And there are things we need to be doing now, because the next ten to 20 to 30 years are going to really be potentially catastrophic if we're not prepared.

Darci> And preparation is what you do Director Munn.

I think there are people who may be watching this evening who may not have even heard of the Department of Aging before tonight.

Talk to us about what your agency does and how you all are trying to get in front of the "Silver Tsunami".

Connie Munn> Well, so we basically our mission and our vision is that older adults can remain in their home, healthy, active, living at home with the services they need.

And part of that is making sure that we have those services in place.

But we also know a big issue is the workforce.

And so we do know, we saw it in the video, in the documentary, there's not enough in our nursing homes for home care, which is where, you know, 99 percent of our older adults want to remain at home, but there's not enough services, there's not enough workers to be able to provide those services.

But part of what we do, and I think it's so important because we're talking so much about caregivers, is we were able to go before our legislators.

We showed the impact for our caregivers, knowing that we did not have the resources in the communities.

And so they funded the positions for us.

They funded ten, ten positions.

They're all in our regions.

This was just funded this past year.

And so we're really excited about that because it was, at least the legislators were understanding that impact.

And we know that if you're if you are a caregiver, you're going to be one, one day.

You know, someone, someone is in your church.

We have to take care of our caregivers.

And so having those Dementia care specialists out in the community is key.

Also, like I said, the other services that we have, we have the contract with all of our area agencies on aging.

There are ten of them across the state, and those are the ones who have... They are the boots on the ground, if you will.

They contract with our providers to provide the services.

But we think what's so important is making sure that our older adults know the resources that are available, and so you don't know what you don't know.

And so we have to be able to have that information.

We've updated our website.

We have Get Care SC.

That is a website, a state of the art database that someone can put their... If you're looking to move to South Carolina, you can just type in your zip code and it takes you to all sorts of resources that are available.

It has the bed locator, but also it has that option that because many times people don't want to put something on a website, they want to talk to somebody, we have that option, as well.

If you type that in, Darci> Well, the great thing is that's a wonderful transition into me giving this phone number again.

It's 1 (800)868-9095.

Obviously, there's nobody there to answer the phone right now, but they'll be available first thing tomorrow morning <Right> to have the conversation about what next steps could be in your planning process.

As we learned in our documentary in 2030, there will be more people over the age of 65 than ever before, and statistically this has not happened before.

Is our health care system, Mr.

Lourie, prepared to handle something like this?

Joel Lourie> Yeah, and by the way, I think Director Munn and the Department of Aging do an excellent job and just was always really proud to support them.

I think we've got a lot of work to do.

I mean, I'll look at, for example, the partnership that this past year, it was announced 2 or 3 years ago that Lexington Medical Center did with the University of South Carolina to create more nurse education slots available in a joint venture.

And I think that kind of innovation and creativity is what we need, because I'm, I'm worried about the system and, you know, our, our company, you know, we work with, with seniors and helping them decide what makes sense from a Medicare standpoint.

And we can spend all the time in the world making sure that certain doctors are in the network for the plan they choose.

The challenge is going to be having enough doctors.

The challenge is going to be having enough beds.

And, and I think we're a little bit behind the eight ball, and maybe we need to invest more in innovative partnerships like we saw with Lexington and University of South Carolina, because that's where the need is, you know, not only for the nurses, but the, you know, people that, the lab techs the nursing assistants trying to figure out an innovative, innovative way to recruit more primary care physicians or internists, because let's face it, it's, everybody says it's coming.

It's pretty much here, and all of us are going to be part of it one day, you know?

Darci> And that's a good point.

All of us, if we're lucky, like my granny used to say, will get old.

And so aging doesn't have to be a negative thing.

How do we have the conversation, Dr.

Smith, where we change the narrative and we use the positive language about getting older?

Dr.

Macie> Well, I think a lot of times people who talk about people getting older are actually older themselves.

They don't see it.

And that's okay.

Age is definitely is a number.

You are how you feel.

But as I stated earlier, you're aging every day and so you have to plan for long term care, just like you plan for your children's college funds.

To Joel's point, I don't even know if long term care insurance even exists today.

If it does, it is unaffordable.

But this is the language that people typically don't know.

They think when they turn age 65, they get Medicare.

And Medicare covers the gamut of health care, but it doesn't cover long term services and support.

So non-medical care, someone coming into the home to provide support with A.D.L.s or I.A.D.L.s, it doesn't pay for assisted living.

And so...part of the problem with the narrative of aging is what we see on TV.

Reverse the aging process.

I don't want to reverse the aging process, because that means I'm not living.

Right?

And we have to continue to see different elements of what aging looks like today.

Because I promise you, aging today, someone 80 today does not look like the person 80, 50 years ago.

And so really telling your age, because more so women than men don't tell their real age.

Tell it, because you look good.

When you look good, you feel good, you do good, and you motivate and empower other people.

So I think it really does start with us and sharing our true story and sharing who we truly are.

Because again, what you choose to do today will determine how you will be tomorrow.

I can't say that enough.

Darci> Yeah, I think so many of us imagine that old is five years older than whatever we are, at that point.

You know... (laughing) maybe ten years for some people.

But there is beauty in, in the aging process.

And, and Tanya, there's even beauty in the ability to be able to care for our parents.

Tanya> Absolutely.

Darci> In, in, in that as well.

Tanya> I consider myself fortunate through the good, the bad, the ugly and diaper changes, that it was an honor and a privilege to be there for both my parents and to have that experience of being there when they took their last breath, for me, for my children, and for my beloved husband, who no matter the time or day, would do whatever he needed to do to support you know, his in-laws.

It, this is a full circle moment for me because we have senior resources here.

They helped.

We have aging.

They helped.

Macie was the first person that heard me, saw me, and was able to speak to my panic in what is this, "What is happening?".

Yesterday she knew what a spoon was.

Today she does not know what a spoon is.

And Macie helped me just kind of organize everything.

And then from there it was so much easier.

And every time I called Macie and there were many a time at three in the morning or three in the afternoon to say, I don't think I'm going to make it.

This is harder than I thought, because my mother was 86, my father was in his 90s.

She had words and her words were constant.

They were constant and the same.

It's not about you, it's about her.

It's about them.

And make certain that you're listening to what, whatever that fear is in this moment.

So in the beauty of that is that age old thing of, you are here to take care of your parents no matter how you grew up.

I'm a, I'm an advocate for that because my mom had some issues.

We had some issues growing up and she apologized for those.

But in spite of that, it was my privilege and my honor to take care of them.

Darci> You know, I understand that intimately.

I had the privilege and honor of caring for my mother in her final days.

And Macie was always, always there for us, as well.

So, if God ever put an angel on this earth, Dr.

Macie P. Smith was there.

Tanya> Amen.

Joel> Let's just turn this into a Macie P... (laughing) I can't tell you the number of times I've called Macie for clients of ours, okay, for clients of ours.

Dr.

Macie P. Smith> Yeah.

But, Darci, I want to tell a quick story, a lot of people don't know, so, I lost my father at a very early age.

You know, he was the real Senator Lourie.

He was the real one.

And he died of a very progressive disease called progressive supranuclear palsy, P.S.P.

Think of it as Parkinson's on steroids.

And...he didn't make it to his 71st birthday.

Okay.

And to Tanya's point, we would encourage my mother when she, when she would accept this invitation to go to the beach for a couple of days with friends, and my brother, who lives in Columbia, who's an attorney, and I would take the time, you know, we'd take turns spending the night at dad, with dad while she was out of town.

And finally she just was not comfortable leaving anymore.

But I've seen it on both sides.

I mean, it was a blessing.

I remember my dad calling me one day because he was up all night, he knew I had to go to the State House the next day, and he called and he said, "Son, I'm "you know, I'm very sorry that "I kept you up all night."

because he, he would get up.

It's a very, it's a terrible disease.

And I said, "Dad", to your point, I said, "look, you took care of us when we were babies.

"It's my honor to take care of you.

"But just promise me you'll do the same thing "to my brother tonight when he spends the night."

(laughing) But I've seen it on the other side.

My mother is 85.

She just took off today on a trip to the Dominican Republic <I love it.> for a family wedding.

I called her last Friday.

I call her every morning on my way to work, and I say, "Mom, what are you doing today?"

Honest to God, she says, "Well, I'm not going to go play bridge today "because the carpet cleaner is coming at 11.

"I'm having lunch with Jane at 12.

"Then I'm going to a workout and dinner, "and then we're going to the ballet.

"So I'm not going to play bridge."

That's more than I do in a whole week... So, you know, you see it on both sides to Macie's point, we all age differently.

Tanya> Yeah.

Joel> We really do.

Darci> But we have to start planning today.

Tanya> Yeah.

Darci> For sure.

How do families know that it's no longer safe for mom or dad to stay home alone?

Connie> Well, I think they have to pay attention.

You know, a lot of times it could be just from a personal experience we had, you know, my father in law had Dementia.

And we for, for a couple of years, I kept saying to them, I don't think he's able I don't think he needs to be driving.

But the family did not want to admit it.

But one day he didn't come back home and he was in the car driving.

Well that was the worst four hours of our life.

And so fortunately, he was able to get to a filling station.

And the guy called and and we were able to go get him.

And so I constantly tell people to pay attention to those signs, because when they start forgetting if they're out driving and they forget, many times family members are like, well, we just hate to take that independence from them.

But, but what would happen if they don't ever come back or in a wreck, or they injure somebody else in a car accident?

So just always making sure that you're paying attention to those signs because they will tell you.

Darci> They will tell you, and we probably should stop looking at it as taking something away from them.

Instead, we're giving them the power to live longer.

Yeah, we have a live studio audience, and we've got our first question this evening from Jennifer.

Jennifer> So my question, Dr.

Smith... What would be the best time to talk to a family member, if you live away from other people and the one you care for is in another state, so a long distance caregiver, if you will, and maybe they come in and they see things that the caregiver who's there all the time has not noticed?

So how if you are that long distance caregiver and you're coming into the home with the family that's there all the time, what's a good way to approach that subject?

Dr.

Macie> Yeah, that's an excellent question.

It's important to speak with, before you speak to the senior, because the last thing they want to lose is their mind.

Right.

So you need to come with facts and receipts, talk to those around the person just to ensure that what you're seeing and what you're thinking is actually happening.

And that person that's there all the time, because they're there all the time and they're inundated with care, they may not even notice it.

And so speaking to the neighbors, speaking to other family members that may come over and visit friends and just talk about what they've seen, or what your concerns are and compare notes.

And then from there, I am a proponent of least restrictive environment, so I don't automatically make recommendations to the family and say, assisted living or nursing home because there are so many factors to consider.

I always start with in-home care.

People really underestimate the power and the relevance and importance of in-home care.

They're not just there to provide hands on care.

They're there for companionship.

They're there for transportation measures.

In fact, the caregiver, the paid caregiver that comes in, they can get more out of that person and get them to do more than any family member does, because, again, you're the daughter.

That's your role.

You're not my nurse.

You're not my manager, you're not my boss.

But the caregiver comes in, Ms.

Lucy and just say, "All right, Miss Janie, "you know, you need to get up and do some stuff today."

"Come hang out with me today", because that's their friend.

And so it's important.

Don't go to the senior first with your concerns, because it may be a reasonable explanation as to what they're seeing, but really have the conversation with the family.

And when I say family, that's family by choice, biological, or family by chance.

Those are the family members and the people you've developed a relationship with at work, in the community, at the grocery store, at the pharmacy, you know, they can play a role, as well.

So really talk with those natural supports, first.

Darci> Great question.

How do we prepare our parents financially for in-home care?

Dr.

Macie> Oh, that's a good question.

I might toss that to Joel, to be honest with you, because again, people again, the lack of knowledge thinking Medicare is going to fund it.

So you miss the boat.

And so I think we're having a conversation now that we should have had 50 years ago and had it a part, had it be a part of the natural conversation.

But I do know one thing I do recommend, and I'll toss it to Joel, is life insurance.

So whole life insurance, depending on which one you have, look at a long term care rider to see what that looks like.

I mean, it's never too late to do that.

But again, the cost of care you're going to have to, you know, consider it as a reasonable expense in your planning.

Joel> I'll pick up on where she left.

And she's actually right.

You know, we're in the middle of Medicare and enrollment.

I can't tell you the number of times that people call the office right now wanting to know what type of long term care or home health care benefit they have with Medicare, and they don't have any.

I mean, it doesn't cover custodial type care.

It may cover transitional care if somebody is moving from a skilled nursing facility back into their home after going through some sort of rehabilitation.

And so, Dr.

Smith is 100 percent right.

Now is the time where people need to be looking at either saving money in a separate account to pay for that nurse or home health care worker to come into the home.

There are certain types of insurance plans.

They're called like home health care, short term health care plans that will help pay for some of that too.

Long term care unless you are extremely wealthy, you know, is almost cost prohibitive.

I mean, it is very expensive.

It's a very, it's a tough market to work in.

So making those preparations or as she even mentioned, there are vehicles like life insurance products where you can put a certain, pay an extra amount monthly to put a rider that will pay some benefit for that.

The biggest mistake people make, Darci, is they wait till they're 65 or 70 years old.

And just like life insurance, if you buy a life insurance at 50, it's a heck of a lot cheaper than at 75.

So having those conversations now, working with your agent, talking about things you can do to prepare for that time, because that time will come.

I forgot the quote they used, but I was fascinated by it, where somebody said, remind me who said this.

They said, either you will be a caregiver or you'll be <First Lady Rosalynn Carter>, Rosalynn Carter, right.

May she rest in peace.

You either be a caregiver, you'll be receiving care, you're going to be a caregiver, or you're going to be receiving care.

There are four types of people.

So be prepared.

Darci> Yeah, Tanya, let's talk about this.

We know that our population is aging.

We know we have more of a multi-lingual population, as well.

Can we talk about the difficulties that existed in trying to navigate that with your parents, who spoke very good English, but it was not their native language?

Tanya> Yes.

Mom spoke five different languages.

Spanish was her first, and she went back to just speaking Spanish.

So at that point in time, which was we're talking about seven, eight years ago, there were, no, we couldn't find not one person that could speak both languages.

So there was it was just a nonstarter.

Macie helped me through that process, and we wound up just kind of changing everything.

And then I became this proponent within the nonprofit of showing, well, we need more interpreters, even if it's just to accompany on a doctor's appointment, if it's to accompany to, you know, long term memory care, whatever it is, we need an interpreter.

Leeza's Care Connection, they were welcoming with that idea.

So that's how we managed it.

And then we continue to help our neighbors, if you will, with that lingual, it was like a vast ocean, but we helped them maneuver it because there were there weren't any, there was not anyone.

And I'm not sure that the field has grown too much right now to say that we have a varying number of health home providers that can come in that are bilingual by any stretch of the imagination.

And when you have someone who is declining because Lord knows Dementia is a beast, um, you have to meet them where they are.

You cannot get a, you can't pull language out of them that they're they are no longer able to tap into.

So you have to meet them where they are in order to give them the best care that you possibly can.

Dr.

Macie> Darci, I want to say something about this one here.

So Tanya represents the sandwich generation caregiver.

So that's the caregiver that's caring for their parents, also caring for their family member.

But this one here also cares for her community.

Right.

So she's like a triple decker sandwich.

Tanya> I'll take that.

(laughter) Dr.

Macie> And not really caring for herself.

But that's what makes her very unique because she has lived experience.

And when you have a gap generation caregiver, so that's the caregiver, you know, I tend to relate to in terms of caring for someone who doesn't have enough resources to pay the $35 an hour for an in-home caregiver, but makes too much money to qualify for Medicaid, because in America, you got to go broke to be able to afford long term care.

So what she's done is she has created space.

She has created resources that really connect to a very vulnerable population when it comes to caregiving.

When we talk about Alzheimer's and Dementia, Black people are two times more likely to develop Alzheimer's than their comparable groups, but Hispanics are one and a half times more likely.

And we're not diagnosed early enough, when the medications are most effective.

And so the work that you do, Tanya, in your community has been a game changer and I am sure has saved lives.

And so when you don't have the resources, create the resources.

And I just had to give that plug because that gap generation caregiver, we don't talk about them enough, you know, and they're the ones that don't get the support.

You're a gap generation caregiver and the profile of a caregiver, is everybody in here tonight.

<Yeah.> There's no one particular person that looks a certain way that will become a caregiver.

You can wake up in the morning and become a caregiver.

And the question is, who do I call?

Where do I go?

As I speak across the country, I tell them all to reach out to their Department on Aging.

<Yes.> Dr.

Macie> Whatever name they go by, the Department on Aging is a great way to start.

Darci> One of the things that surprised me the most, and you may remember this conversation that we had towards the end of my mom's life.

I was asking, where do we get this help?

Where do we get this help?

And I'll never forget, you said she's got too much stuff.

<Yeah.> And I'm like, what do you mean?

And, well, she has a home and she has cars and she has a 401K, and I'm like, "That doesn't... "Why does that mean she can't get help?"

Director Munn why does that mean she can't get help?

And when can we change that?

(laughing) Connie> Well, if I had that crystal ball and I could, <Magic wand> make those changes, that magic wand.

Because you're right, that is an issue.

And it's one that we can't change at the Department on Aging.

It's a nationwide problem, but it is difficult.

And I think that's, that's what's so frightening is people get to that point where they feel like they have to lose everything before they can get any type of help.

Dr.

Macie> Yeah.

And I'll say too, to that, I love Sarah Clingman.

She works with me.

I work with her.

A certified elder attorney can help you plan for Medicaid.

Unfortunately, I'm just going to speak the language as the language is given.

Medicaid planning, preserving assets, spending down to be able to qualify for Medicaid.

Medicaid still does a five year look back.

So again, the planning that we talked about earlier, planning now, and I also have to plug the PACE programs, Program of All-inclusive Care for the Elderly.

That program also goes underutilized.

And so a person can have Medicaid, both Medicaid and Medicare.

They can also have Medicare.

And so the PACE programs can help folks also with Medicaid planning.

And we just really have to speak the plain language to the people that in order to be able to afford long term care, you will probably have to qualify for Medicaid.

Joel> Darci, I want to I want to take that conversation on a more macro basis, too, because Dr.

Smith brings up a great point.

Think about all the people that are moving to South Carolina.

We were the number one drop off state for U-Haul rentals.

Okay, people bringing U-hauls from another state and dropping them off here, right, Horry County.

And they're in senior communities popping up everywhere.

But Macie mentioned Medicaid.

Here's the challenge, though, is that some of these people live here and they move here and they will have a lot of assets.

Okay.

Many of them are, you now, were middle class, had solid careers, working wherever they worked.

They don't have a big retirement.

So they potentially could be on Medicaid here.

And it gets back to a point I made earlier.

You can't just snap your fingers and create a bunch of Medicaid beds, right.

You know, probably Medicaid I imagine is probably 90 percent of nursing home beds in the state.

And the cost to the Medicaid, I remember when I served in the Senate, this was really interesting.

The Medicaid director at the time came in and said approximately two thirds of the Medicaid people on Medicaid in this state are children.

And you know what, 70 percent, 75 percent are born into Medicaid today, but they're only about one third of the costs.

One third of the Medicare members are seniors, and they're about two thirds of the cost.

And so to the point, you asked me earlier about the medical infrastructure, and, you know, you were asking Director Munn about Medicaid.

And, you know, there's got to be a day of reckoning where that Medicaid budget is going to continue to have to go up to pay for these services for people that are no longer eligible, no longer can stay in their own home, can't, don't have a long term care policy, qualify for Medicaid due to some sort of spend down process.

But they've got to have a place to go.

Darci> Yeah, we have a very educated panel, but we have a lot of folks in our audience that know a lot about this subject, too.

And so Beth is with the Alzheimer's Association.

Beth, thank you so much for joining us this evening.

Beth> Absolutely.

And I want to thank all of you both, the documentary and this panel has been just, I think, an outstanding crash course for anyone who is new to caregiving or the landscape of aging in South Carolina.

There's so much you don't know until you have to figure it out.

And those who come into caregiving, it's often not a chosen role.

It's something that happens to your family and it's drinking from the fire hydrant.

So thank you for this excellent resource.

I want to take just a second to highlight some of the progress that we've made, because this can feel really heavy.

And I think right now there are some really hopeful things happening.

South Carolina General Assembly has funded those Dementia specialists in place across the state through the Department on Aging.

That is a huge win.

We're so excited about that.

And when it comes to Alzheimer's diagnosis and treatment, we are now living in an era of treatment for Alzheimer's disease that we were not before.

Just in the last few years, there are now FDA approved antibody infusions available to treat Alzheimer's in the earliest stages.

This is to give people more of those good days.

And a lot of people don't know that's available.

That's a huge reason not to wait to have those conversations with a family member, to have those conversations with your doctor and with the health care system the way that it is, we know it takes time to get those appointments, to have those tests run, to get the results.

And if you want to be, have that window of opportunity for these treatments, you got to start right away.

So I encourage anyone who has concerns, go to alz.org.

We've got the ten warning signs.

We've got how they're different from regular aging, and we've got tips for talking to your loved ones, as well as a wealth of education resources for caregivers, including a 24 seven helpline that people can call with any question on any topic, in any language.

So we encourage folks to check that out.

It's (800) 272-3900.

Darci> Thank you so much.

Thank you.

I think the overwhelming theme for all of us today is start today.

<Today.> It doesn't matter how old you are, start today.

As we continue to look forward to the opportunity to age gracefully.

What's the one thing that you tell people?

And I'll start with you, Director Munn I know this is a question for the entire panel.

What's the one thing that you tell people, and they immediately say, "Oh my goodness, "I didn't know that!"?

What is the thing that surprises them the most about your agency, about resources, about caregiving, about insurance?

What's that aha moment when you speak to folks?

Connie> I think the aha moment for folks is that we... We're a small state agency, but we do so much.

And the only reason we can do that is because of the infrastructure that's in place with our area agencies and our service providers.

We're a small staff, but we're mighty.

And I think it's just that, that we reach, whether it's the Long-Term Care Ombudsman Program.

We have a V.A.G.A.L.

program.

We have all the services that we can provide.

And people are amazed at what all we do at the Department on Aging.

Darci> You don't have to do it by yourself, is what it sounds like you're saying.

<Right.

Right.

Yes.> Dr.

Smith.

Dr.

Macie> You know, one thing that I can speak on today is the new Medicare program that is funding some Dementia care support, and that's the Medicare Guide program.

Medicare is now covering approximately, I would say, about 72 hours of respite care.

They're providing a care manager.

They're providing education and training.

And it is all now a Medicare benefit.

And, you know, I tell folks all the time, you know, aging on purpose, you can't help that aging is a requirement.

But getting older is a choice.

Do what you love and love what it is that you do.

And when people say you're not alone, you're not.

But it is our responsibility, and the onus is on us to ensure that people have the resources at their fingertips.

I know the Alzheimer's Association number by heart.

Not a problem at all.

And so when they can get together and have those resources, they're understandable.

And most importantly, they are transactional.

I mean, we know the numbers.

Now it's time to put the names to the numbers and action to that.

And so when we can share that, then it gives family members hope.

I didn't know that.

So Medicare now is covering some form of Dementia care.

And there is treatment now.

But knowing the early signs and we ended up talking about Alzheimer's and Dementia as we're talking about aging, that's because age is the number one risk factor.

But newsflash, it is not a normal part of aging.

Just because you're getting older doesn't mean you're going to get it.

There are more people over the age of 65 who don't have it than who do.

Darci> Wow!

Wow!

Tanya?

Tanya> All of that.

(laughing) But for me, respite...that, that I call it a mini grant, because in my world, that's what it would be.

But respite care, when I tell another person who is taking care of someone and I can see the exhaustion and I can hear the exhaustion.

I say, do you know that there are programs for respite?

And when I was introduced to senior resources and they said, you know, we have this program and there is a wait, but we can do something.

And I finally got someone to come to the house.

I waited at that door like it was Christmas morning with Tylenol PM in one hand, a glass of water in the other, and I was just waiting.

I was waiting for them to come through the door so that I could sleep.

And when I give that, that description to someone, they're like, "Somebody will come to the house?

And I'm like, "Yes, yes, girl.

"So, let me give you all the numbers and all the contacts, "and I'll stay on the phone with you "as we make this call", because I'm telling you, it was one of the things that saved me mentally and physically, to know that someone could come to the house overnight, get paid for it, and just allow me a time to restore.

Darci> This has been so good.

Connie> That's one thing we preach too, you know, to our caregivers is that if you, if you're not taking care of yourself, you cannot take care of your loved ones.

And that is so sad because we see that so many times you don't feel like you can take that break.

But we have to keep educating.

And that's one of, one thing we educate.

Take care of yourself.

Darci> Yeah, because you can't pour from an empty cup.

Connie> No you cannot.

Darci> All right.

We're going to have closing remarks.

We're down to less than four minutes.

Joel> Sure.

Real quick.

On the insurance side, and I appreciate you mentioning Senior Resources.

I see Andrew Boozer here.

They do such a great job.

And we have these types of organizations throughout South Carolina.

And they also...in addition to Meals on Wheels, in that they operate the Lourie Center, which was named for my late father, which is a great facility here in the Midlands.

On the insurance side, here's what I'll tell people right now, because this happens every day in our office.

A spouse will call in and say, "My husband has Dementia, my husband's ill.

"Can I come in and change his Medicare plan?"

A child will come in, a child my age and say, "Hey, I need to look at my mom's Medicare plan."

Legally, you cannot do that without a medical power of attorney.

So if you take anything that I've said tonight, go ahead and get a medical power of attorney with you and your spouse and your parents so that in the event when that day comes where they are not capable of making those decisions, you've got the legal authority to do so, because a compliant agent will not do that without knowing that they're dealing with a medical power of attorney.

Darci> Awesome and 30 seconds, last final thoughts?

Whoever wants to go first.

Tanya> There's a, there's resources.

ask questions and receive the help when you need it.

Dr.

Macie> Yeah.

And I'll say your parent actually doesn't need a parent.

They need a partner, a partner in their care to help both of you age on purpose.

Connie> Just look at as aging with dignity and grace.

Darci> Ladies and gentlemen, thank you so much for joining us this evening.

To our live studio audience, Thank you so much.

And thank you for joining us.

We hope today you walk away with more information, feeling empowered and knowing that you don't have to parent your parent.

You can be your parent's partner.

(silence) Oh look, it looks like we still have a minute left.

Oh wow!

I never that never happens in TV.

We have more time to talk.

That gives us time to give the phone number one more time for the Department of Aging.

That number is one (800) 868-9095.

Again 1-800-868-9095.

And as always you can go to their website, getcareSC.com.

Dr.

Smith your website?

Dr.

Macie Smith> It is DrMacieSmith.com that's M-A-C-I-E.

Darci> And Tanya your website?

Tanya> LimitlessCDC.org Darci> And Joel your website?

Joel> Lourielifeandhealth.com.

Darci> All right, I hope everybody got all those websites.

(laughing) But if nothing else, you can always reach out to the Department of Aging and you will find a friend there who will be able to help you along the way.

So we are wishing you the best of luck as you take this very important information and use it in your life and with your parents.

Have a great evening.

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