The Care Compass, April 2, 2026
The Care Compass with Nicole Brandon
Guest, Alexis Cruz on Home Care for Aging Parents from P P Cruz Homecare Services
This detailed interview between Dame Nicole Brandon and Alexis Cruz, founder and owner of PP Cruz care agency, offers an in-depth exploration of caregiving for elderly parents, especially those with complex health conditions such as cancer, Alzheimer's, and dementia. Nicole shares her personal journey caring for her parents, highlighting the challenges she faced navigating healthcare systems and caregiving agencies. Alexis Cruz provides expert perspectives on what families should expect from care agencies, how to select the right caregivers, the distinctions between types of care, and best practices for maintaining quality and safety in home care.
Key Themes and Insights
Personal caregiving journey: Nicole’s experience caring for her parents simultaneously diagnosed with cancer and advanced Alzheimer's underscores the emotional and logistical complexity of eldercare, emphasizing that no caregiver can manage alone without support.
Importance of a relationship-based caregiving approach: Alexis emphasizes that her agency does not simply provide a service but builds relationships, treating clients like family and ensuring personalized, compassionate care.
Matching caregivers to patients: Successful caregiving depends on aligning caregivers' personalities and skills with the unique needs and preferences of each elder, particularly for dementia or Alzheimer’s patients who require patience, kindness, and specialized knowledge.
Owner involvement: A critical differentiator for care agencies is the hands-on involvement of the owner or management, including surprise visits—even in the middle of the night—to ensure caregivers deliver consistent, high-quality care.
Caregiver qualifications and training: Caregivers should have clinical backgrounds (e.g., nursing or certified home health aides) and specialized training for conditions like Alzheimer’s or dementia. Experience matters—ideally 10-15 years with similar patients.
Differences between home care, home health, and hospice:
Home care: Non-medical, focused on daily living assistance such as bathing, meal prep, companionship, and transportation.
Home health: Medical-focused care post-hospitalization or rehab, including physical therapy and clinical support.
Hospice: End-of-life comfort care emphasizing symptom management and emotional/spiritual support, typically when prognosis is six months or less.
Communication and collaboration: Effective care requires ongoing communication between caregivers, families, and medical providers. Caregivers often provide crucial insights into patients’ nonverbal cues and daily needs, which families should heed to improve care routines.
Safety and monitoring: Safety is paramount, especially for fall-risk patients. Agencies must proactively identify, recommend, and supply appropriate safety equipment (e.g., rails, alarms, cameras) to prevent accidents. Caregivers must remain physically close to and attentive to vulnerable elders.
Financial considerations: Funding care can be complex. Long-term insurance often helps cover private caregiving, while Medi-Cal and other public programs may cover some home health or hospice services. Agencies often assist families with insurance coordination and paperwork.
Caregiver responsibilities: Beyond basic tasks, caregivers engage patients in therapeutic activities (exercise, puzzles, memory stimulation) and adapt to behavioral changes such as sundowning in dementia patients.
Family-caregiver dynamics: Families should foster open communication with caregivers, respecting their professional recommendations while also providing input. Caregivers’ observations can reveal needs that families might not notice.
Detailed Analysis
The Emotional and Practical Challenges of Caregiving:
Nicole’s narrative provides a vivid account of the emotional roller coaster when both parents fall ill simultaneously with vastly different but equally demanding conditions. This dual caregiving responsibility introduces a maze of healthcare systems, insurance, medical supplies, and specialists that can overwhelm even the most dedicated family members. The testimony underscores the universal truth that caregiving is not a solo endeavor; support networks and professional help are indispensable.
Agency Philosophy and Owner Engagement:
Alexis’s approach at PP Cruz is rooted in deep personal involvement and accountability. Unlike many agencies that may treat clients as mere cases, Alexis treats them as family members, going beyond contractual obligations. Her practice of surprise nighttime visits—sometimes at 1:00 or 2:00 AM—ensures caregivers are attentive at all hours, particularly critical for clients like Nicole’s mother who may be awake or agitated at night. This level of dedication by the agency owner is a differentiator in quality care.
Matching Caregivers to Patient Needs:
The significance of matching caregiver temperament and skills to patient personality and condition cannot be overstated. For example, Nicole’s father requires a caregiver who is lively and engaging, while her mother needs a calm, patient, and gentle caregiver. This matching process involves trial and error and requires flexibility and responsiveness from the agency. The willingness to change caregivers until the ideal fit is found fosters patient comfort, reduces agitation, and improves overall care outcomes.
Training and Expertise in Specialized Care:
Caregivers with clinical backgrounds or nursing experience bring valuable skills to dementia and Alzheimer’s care. They understand subtle body language and behavioral cues indicating needs or distress, allowing preemptive interventions that reduce risks such as falls, agitation, or aspiration. These caregivers also follow specific routines such as changing patients every 2-3 hours to prevent bedsores, recognizing how critical these details are in maintaining patient health.
Role of Routine and Cognitive Engagement:
Rehabilitation and mental stimulation are shown as integral parts of caregiving. The caregivers at PP Cruz actively engage patients in physical exercises, puzzles, memory recall through photo albums, and reading, which not only help maintain physical function but also improve cognitive state and emotional well-being. This highlights caregiving as a dynamic, active process rather than passive supervision.
Communication and Partnership Between Caregivers and Families:
The dialogue stresses the importance of a bidirectional communication channel. Caregivers observe daily changes and may suggest adjustments or new supplies; families must remain open to these insights. For example, trying new routines or equipment recommended by caregivers can lead to significant improvements. This partnership fosters trust and ensures that care evolves to meet the changing needs of patients.
Navigating Financial and Insurance Systems:
Understanding payment options is a major challenge for families new to caregiving. Alexis explains that while some services like hospice or home health may be covered by insurance or Medi-Cal, private caregiving often requires out-of-pocket payment or long-term insurance coverage. PP Cruz supports families by coordinating billing and providing necessary documentation to facilitate claims, relieving some of the administrative burdens from families.
Safety as a Paramount Concern:
Safety protocols are emphasized, including fall prevention, appropriate use of assistive devices, and environmental modifications such as rails and alarms. Alexis holds caregivers accountable for patient safety and highlights that neglect or inattentiveness can lead to serious consequences like falls or bedsores, increasing patient suffering and caregiver workload.
Integration with Healthcare Providers:
Caregivers coordinate with doctors, therapists, and home health professionals to ensure continuity of care. They assist with transportation, medication reminders, and follow-up on treatment plans. This integration is critical as it helps maintain stability and supports recovery or progression management in chronic conditions.
Flexibility and Adaptability in Care:
Care needs fluctuate over time, and Alexis’s agency adjusts care hours and personnel accordingly. For example, when a patient’s condition improves, hours can be reduced from 24-hour care to 12-hour care, optimizing resource use without compromising safety. This adaptability reflects a responsive, patient-centered care model.
Geographic Reach and Accessibility:
PP Cruz serves clients across Southern California and even beyond, highlighting the potential for high-quality care to be accessible over wide areas. For those outside the region, consultations and advice are offered to help families find or establish comparable care.
Essential Qualities for Caregivers and Agencies
Specialized training:
Experience with dementia, Alzheimer's, wheelchair-bound patients, and other chronic conditions.
Clinical background:
Many caregivers hold nursing credentials or are licensed home health aides with clinical knowledge.
Reliability and responsiveness:
Agencies should be hands-on, conduct random visits, and respond quickly to issues such as caregiver mistakes or emergencies.
Safety vigilance:
Caregivers must maintain close physical proximity to fall-risk patients and use safety equipment proactively.
Emotional intelligence: Ability to recognize nonverbal cues, manage agitation or sundowning symptoms, and adapt routines accordingly.
Collaboration skills:
Engage effectively with families, doctors, therapists, and other care providers.
Personalized matching:
Assign caregivers whose personalities and skills align with the elder’s needs and preferences.
Best Practices in Family-Caregiver Relations
Open communication:
Families should listen to caregivers’ recommendations and consider trying suggested interventions or routines.
Respect and partnership: Caregivers are the eyes and ears on the ground and can provide vital feedback about patient condition and needs.
Consistent caregiving:
Whenever possible, the same caregiver should accompany patients to doctor visits and daily routines to maintain continuity and knowledge of medical advice.
Safety advocacy:
Families and caregivers should jointly monitor safety, ensuring timely acquisition of supplies and equipment.
Emotional support:
Caregivers provide more than physical care—they help maintain patients’ dignity, joy, and mental stimulation.
Key Recommendations for Families Seeking Care
Research carefully:
Avoid agencies that make empty promises or fail to respond quickly. Seek agencies with owner involvement and strong accountability.
Verify caregiver qualifications:
Look for clinical experience and specialized dementia or Alzheimer’s training.
Expect personalized care:
Caregivers should form relationships, understand patient personalities, and adjust routines dynamically.
Demand safety and supervision:
Caregivers must be attentive at all times, physically present to prevent falls, and proactive in requesting safety equipment.
Communicate openly:
Families should collaborate with caregivers, valuing their insights and suggestions.
Prepare financially:
Investigate insurance coverage options, public aid, and payment plans early.
Engage the agency owner:
Agencies where owners are hands-on and conduct surprise visits tend to provide higher quality care.
Consider consultation:
Even if hiring local agencies, consulting experts like Alexis Cruz can provide invaluable advice.
Conclusion
This interview provides a comprehensive, expert view of what quality home care entails for aging parents, especially those with complex medical conditions. The core message is that caregiving is a deeply relational and specialized service requiring clinical knowledge, owner involvement, personalized matching, continuous safety vigilance, and open communication with families.
Nicole’s testimonial illustrates the transformative impact of a dedicated care agency like PP Cruz in enabling families to maintain dignity, health, and joy for their elderly loved ones while preserving their own sanity. Alexis Cruz’s agency exemplifies best practices, demonstrating how professionalism, compassion, and responsiveness can create miracles in eldercare.
Families stepping into this challenging arena are advised to prioritize agency ownership involvement, caregiver qualifications, safety protocols, clear communication, and financial planning, while being open to adapting care routines as patients’ needs evolve.
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The time has come to tell my story and to open my heart. Its been a crazy four years with my parents care. I have learned so much. I have learned about senior living and I have learned about myself. I never knew the true definition of care. I now truly know what the word care means. I could never have imagined deep love. I have loved before. Not like this, love is a deep well that never ends and always there is the light shining through. The smile, the laugh, the touch, the wink, the hand held tightly, fingers wrapped and never letting go. It is the unspoken thanks you-s and the tears behind the fears. It is the angels that surround you and the breath, and the kiss that seem like the first kiss and the last kiss at the very same time. It's appreciating each moment, each second, each day, each sunset, each nightfall, each song, each memory in a brand new way. It is life appreciated and a life of gratitude that we are together. I have stepped outside myself for this journey, I actually stepped away from my life, yet I dove in without question, inside this world I never knew called parents and child love. It has been extraordinary and many of you have been by my side for the ride. Thank you.
So many days and nights I would talk to myself inside my head, questions, no answers, no one to talk to, no where to turn. My Dad's Cancer, my uncle's Parkinson's, my mom's Alzheimer's and her stroke, the uphill battle to keep them together, the journey thru home health and hospice, hospitals and assisted living, caregivers and therapists, doctors and heroes. My friends that sang to my parents, those that came by to say hello, those that sat in the hospital next to me, and said close your eyes, rest, I've got this and knew when I was ready to fall. Each mountain; insurance, Medicare, long term health, feeding tubes, oxygen, wheelchairs and walkers, medical supplies, transportation and days to just cherish another milestone - birthday, anniversary, and new year.
Lately I have been compelled to share. I'm heading back on the radio. To create a podcast for other me-s. Other children my age whose parents are aging and need help. I wish someone, anyone would have given me some direction or help. I have been my own compass and guide. If I can help even one person not have the tears I shed, or the sleepless nights, and the fears I endured, then I have gifted my journey and shared that little light. I now want to share what I've learned and open doors and ease hearts in anyway that I can. It's an extraordinary journey. This thing called Life.
My new Podcast "The Caring Compass" The Aging Parent's Survival Guide, will launch next week. If you would like to be a sponsor, or a guest please reach out to me directly. If you are on this journey and you have a question, feel free to reach out. Anything that I can share or anyway that I can help, I have reached the top of the mountain and I can say, this is how you climb.
For those looking for miracles, my mom is back with my Dad. Yes, I moved her in on Wednesday. She fought her way back to him. (For those that remember; two years ago she spent months in the hospital - unable to move, walk, or to talk) she was in limbo and we would talk to her and whisper in her ear trusting she was inside. Her love for my dad brought her home. This week, the miracle, Now she has returned. She’s walking, and talking, laughing, and hugging, and she can tell you she loves you. That’s the power my parents have together. When she came through the door, she kept saying; Oh God! Thank You! Thank You! Thank You! Oh God! Thank You! There wasn't a dry eye in the house, the entire facility was crying happy tears. It is a path, it is a journey, it is one step and then the next. Hold my hand and I will walk with you. Steady and together we will stand. See the light, it's there, ….just one step forward. Yes! …. and together we will walk towards love.
*****
"It is with pride and pleasure that I submit this letter of endorsement for Nicole Brandon. For more than two years I have witnessed her demonstration of caring, dedication, commitment and advocacy for her parents' geriatric increasing needs and care, as well as for their peers, at two seperate assisted-living communities.
Nicole would be an asset to any entity fortunate to gain her employ."
Rochelle S. Stephens, Reitired Executive Director of Public Houstin Authority.
*****
"I have had the opportunity to witness Nicole in her role as a caregiver to her parents over the past two years, and her commitment to their well-being has been nothing short of extraordinary. She has made significant personal sacrifices, including putting her professional speaking and travel on hold, in order to be fully present for their care. These sacrifices have come at great personal, financial, emotional, and physical cost.
Despite the strain, Nicole continues to show up for her parents with unwavering dedication. She routinely cancels appointments, business opportunities, and social engagements at a moment’s notice to drive the seven hours from Prescott, Arizona—where she lives part-time—to Newport Beach to attend medical appointments, coordinate insurance matters, hire and supervise caregivers, manage household and medical bills, and advance funds when payments were delayed or interrupted. She has also spent countless hours advocating for her parents on the phone with doctors, providers, and insurance companies.
As a caregiver myself, I recognize the level of responsibility and emotional endurance this requires. Nicole has gone far beyond what is expected to ensure her parents receive the highest possible standard of care. Her devotion, integrity, and selflessness are unmistakable, and I am proud to offer my full support and testimony on her behalf."
Claudia Hartman
*****
"To Whom It I am in awe of Nicole’s ability to care so deeply for her parents, she literally changed her mother’s prognosis. When I initially observed her mother, she had no sitting balance and was dependent on her aide for all self-care. Through Nicole’s guidance the treatment team continued to pursue goals that seemed unreachable. As a result, her mother is fully ambulatory and able to assist in all self-care and feeding herself. I have never seen so much progress as an OT for over forty years!
Nicole is simply amazing at encouraging her mother’s treatment team in all aspects and her mother’s progress is the result."
Kim Binder, Occupational Therapist
*****
"I am writing to recommend Nicole Brandon to host a radio show in senior care, or in any space in the senior community.
Nicole is a great example of someone who is compassionate, caring, and dedicated.
You will find Nicole to be someone who not only is dedicated to any role she is given, but she displays professionalism, passion, and true selflessness.
We had the opportunity to work together when I held a Walk to End Alzheimer's event last October. Nicole was eager to help and so kind throughout the process. As our Keynote Speaker Nicole made an impact with those attending by her heartfelt personal connection to Alzheimer's. Her profound commitment to her parent’s care was inspirational to others especially to those who are facing similar challenges, life changes, and triumphs.
I am honored to know Nicole and all that she brings to our community in so many ways. This is evident in public speaking, supporting others, or just being a great example of being a kind individual."
Malena Peraza, Community Engagement Coordinator
*****
"I am writing to offer my recommendation for Nicole. As her father’s physical therapist, I have had the opportunity to work closely with her and to witness firsthand the dedication and advocacy she brings to every aspect of his care.
Nicole is proactive and persistent in coordinating her father’s medical needs. She advocates on his behalf. She is determined when navigating through insurance issues. Which, anyone who has dealt with insurance companies knows how necessary that trait is to get anything done. Her determination and follow-through have made a meaningful difference in his access to services and overall quality of care.
Beyond medical coordination, Nicole ensures that her father’s daily needs are consistently met. She oversees his caregiving support, maintains his schedule, and remains closely involved in his social and emotional well-being. Her approach is thoughtful, organized, and compassionate, reflecting a holistic understanding of what quality elder care truly entails."
Maria Valencia PT, DPT, Clinic Director
*****
"I've had the pleasure of knowing Nicole Brandon for over a decade. Year after year, I have watched her walk through the clinic doors, expertly navigating the complexities of caring for her aging parents. Her level of patience and empathy is truly admirable. In a world that often moves too fast for our seniors, Nicole is the person who slows down.
In our clinic, Nicole is more than just a daughter. She is her parents' fiercest advocate who ensures her parents are never overlooked or unheard. Whether she is meticulously managing their medications or providing a gentle word of comfort, she does it all with grace.
Nicole is the embodiment of what it means to honor our elders. Her reliability is the bedrock of her family's well-being. Nicole is a beautiful exan1ple of selfless care. I am honored to recommend her for this recognition and her dedication deserves to be celebrated. Thank you for your consideration. Please do not hesitate to contact me."
Gregg Feinerman, M.D. F.A.C.S.
*****
"On Behalf of Coastal Heights Senior Living Community, I would like to express my sincere gratitude and appreciation for the exceptional care, compassion, and dedication that Nicole Brandon consistently shows towards her aging mother and father within our community.
It is evident that in every interaction that she surrounds them with genuine care, and unwavering support, and deep love. As an adult daughter, the responsibility of caring for an agin parent can carry significant emotional and personal weight. It is a role that often requires strength, patience, and selflessness, and she embodies these qualities with grace.
While this journey can be challenging, having the support of a compassionate community and devoting varegivers helps ease that burden. Her partnership withour team allows her mother to feel safe, valued, and truly at home, while also offering the peace of mind that comes from knowing she is surrounded by people who care deeply about her well-being.
We are honored to be part of this journey with Nicole and are grateful for the trust she places in our community. Her devotion does not go unnoticed, and it is a privilege to witness the love and advocacy you provide each and every day."
Catherine Ratelle, Executive Director, Coastal Heights Senior Living
*****
[00:00] Speaker 1: Oh yeah. You are the care compass pointing hearts back home. Turning quiet, lonely rooms into places they belong. To the elderly, the wise, you give your steady light. Careful care, caring compassion in the soft hours of the night. Ah, ooh.
[00:39] Speaker 2: Hi, it's Dame Nicole Brandon and welcome back to Care Compass. For those of you that have been following this show, um, four years ago, I came across a time in my life where both my parents, uh, took ill at the very same time, my dad with, um, cancer, and my mom was diagnosed with advanced stages of Alzheimer's on the very same week. And it has been a rocky roller coaster ride all the way through the past few years, and it has been a maze of healthcare and insurance and medical supplies and on and on and, and, and doctors and medicine and vitamin and dieticians. And for those of you out there whose parents are at that stage of their life where they are aging and you are becoming the caretakers, and this is a whole new world for you, and you are now taking care of your parents, the people that took care of you. You are now the responsible party for making sure they are safe, they are healthy, they are well, um, and that they are leading their very best lives.
[01:46] Speaker 2: And what I learned most in this journey is that you can't do it alone, that nobody, there is no superhero child that can, on their own, navigate, um, the aging parent. And I am very blessed because I have had tremendous help (laughs) over the past few years with my parents. And without these people, I'm sure that my parents would not be here and I would not be here. I would be in a little rubber room right now (laughs) and probably not even know my name. So, um, today we're bringing on a, a very special guest, and I know I had so many questions. What is, you know, home health? What is hospice? And, and, you know, what are the responsibilities and how are people trained and how do you even find somebody? And so today we are talking with Alexis Cruz, and Alexis is w- the creator, the owner, the, the f- the lighthouse for PP Cruz. And I can tell you, I went through nine agencies before I found her, and I can tell you everything that was wrong with those nine agencies.
[03:02] Speaker 2: (laughs) And I can spend the rest of my life and the next 100 million years telling you everything that is right with PP Cruz and Alexis and her team. And so she's generously offered to join me today to be able to give information to you, to help you be able to navigate finding a caregiver, how care works, what to look for, what are the best practices, and how you keep your own sanity in the process, (laughs) which is so important at this time. So Alexis, thank you so much for being with us today, and, and thank you so much for, um, swaddling me and taking care of me all of these years, because I could not be breathing right now. I could not be doing what I'm doing right now. I couldn't be helping other people if you didn't help me. So I, like, owe you the world of gratitude.
[03:58] Speaker 1: Welcome, Ms. Nicole. Um, I'm so very, very happy, and I remember I cried when I found out that I'm the one who's going to take care of your mom when you called me, because I've been looking for her for so many months when, you know, something happened to her, and I keep on seeing your dad walking along because they're one of my favorite patients in Atria at the time. So I was really, really happy, you know, when Atria called me that they're going to be, um, they're going to introduce me to you, because I've been looking for her for so long.
[04:32] Speaker 2: Oh, thank you. You know, for those of you that are listening, Atria is the assisted living community in which my parents chose to live at. And, um, I went through agency, after agency, after agency, after agency, and it was heartbreaking that these are agencies and people that tell you that they're gonna care for your parents and then they're not. They're just not. They're not getting healthier or better or stronger or... And then Atria itself said, "Let me recommend this agency to you, PP Cruz." And not only did they recommend you, but they said that you create miracles, and you've told me about that.
[05:15] Speaker 1: (laughs)
[05:15] Speaker 2: People that were in hospice and got back up. And so what is... First of all, thank you for being you. Thank you. And for your team. And so what does that look like, one care agency to another care agency? For somebody that is, is me who, whose parents are aging and parents need help, w- what's the first step?
[05:41] Speaker 1: It's a baby step, of course, but, you know, you need to look for an agency that is not just looking for, um, someone to take care of them, because for me, me and my team, we're not just looking for a job. We're looking for something that we can build a rela- relationship with that's different. And if you can see, you know, even late at night, and I remember before when Mr. Norman, um-... uh, something happened to him, even if it's in the middle of the night, I'm the one who went there to, to check on him. Because for me, I don't treat my clients just a client. I treat them like family. So, of course, um, not all my clients, their families are nearby. That's why I make sure if the family is too far, I'm the one who's, you know, going... I'm the one... I- I- I'm being the one who's going to be their representative, if needed. And what I do is, like I do surprise visits just to make sure that my caregivers are really taking care of my p- patients.
[06:49] Speaker 1: Of course, if it's going to be my parents, I want them to be very, um... That, that, the, the care will be different, the routine will be different. That's why sometimes if you visit, sometimes I'm there, sometimes I'm not-
[07:05] Speaker 2: Right.
[07:05] Speaker 1: ... even if it's too late-
[07:07] Speaker 2: And-
[07:07] Speaker 1: ... because for me, they're really special to me.
[07:12] Speaker 2: Thank you. I- I- I mean, you've gone above and beyond.
[07:14] Speaker 1: (laughs)
[07:14] Speaker 2: You'll come, you'll bring, you know, flowers or, or gifts or, you know, candy to, to my dad or, I mean, you have remembered special occasions or things that, that are meaningful for them. And I know that you've tried to find caregivers that match them, which isn't-
[07:33] Speaker 1: Yes.
[07:33] Speaker 2: It's not just the caregiver. Like my dad needs someone that tells jokes and sings to him-
[07:38] Speaker 1: Yes.
[07:38] Speaker 2: ... someone that's very active.
[07:39] Speaker 1: They need to match. That's true.
[07:40] Speaker 2: And, and my mom needs someone very patient and very kind and non-threatening and, and someone that makes her feel safe. And so, what does that look like when you're matching a, a caregiver to, you know, to a patient or to someone's parents? Like, you know, I call you and w- what do-
[08:01] Speaker 1: So just like what I've said, I do surprise visits, because of course, I cannot control what the care- caregiver can give or what the caregiver can think. So, just to make sure that they're going to match, I'm doing surprise visits. Because sometimes the caregiver, if they know that somebody's coming, of course they're going to be very hands-on, they're going to be like, full attention. But if they know that nobody's coming, at least you know you can catch them off-handed, so, I mean red-handed. I mean, you know, that's why sometimes like around, um, 1:00 to a- two o'clock, I still visit. Even, especially in Atria, just to make sure that my pa- my, my patients are well-covered. Because what if, especially your parents, most of your parents are 24 hours. I know they need full attention, especially your mom.
[08:59] Speaker 1: There are some cases that your mom is, um, w- wide awake at night, and I've been suggesting to put a camera, because of course if your mom has a camera, the caregiver will be wide awake. But I know you're not open to that and like with your dad. So, what I do sometimes, I do surprise visits like around 3:00 or 2:00 AM because I want to make sure that your mom is being changed. We need to change her at least two to three times a night. I don't want to have a bed sore. So, that's what I do just to make sure that they're matched, you know, or, um, before the shift ends, I just wanted to check, you know, if, um, how are they taking care of my patients, especially your mom. I can easily read her when she, when... She's very sweet, but you can see it in her face, you know, when she doesn't like someone. She will smile at that person, but you know, Sandalyn, she will roll her eyes. So I, I, I've known her. She's my miracle baby.
[10:01] Speaker 2: Mm-hmm.
[10:02] Speaker 1: So that's why I'm so, uh, hands-on with her. She is, she is, she's my special one. So yeah, that's what I do. I make sure that, um, even if it's too late, even if I'm very, very tired, if I feel that I need to check on someone, especially if the caregiver is new on her team, I'll make sure I need to visit it. I'm going to see, you know, even if it's too late or early in the morning. That's what I do.
[10:28] Speaker 2: That's wonderful. And what are the responsibilities? So if somebody's looking to get care, what, how, how would care help?
[10:36] Speaker 1: Uh, so at least we can give, um, um... Of course if the patient has a family, they can relax. If they know that somebody is taking care of their parents, um, with good routines, of course, you're not going to worry. You're going to be carefree. So that's a difference. That's a, the- that's the big difference.
[11:02] Speaker 2: And they bathe them, they take them to doctors, they make foods-
[11:06] Speaker 1: Yes.
[11:06] Speaker 2: ... they clean. What are, what are some of the things people would be looking for a care service for?
[11:12] Speaker 1: Uh, aside from basic housekeeping, um, yeah, driving to the doctor's, please, um, especially with your mom's care team, most of my care team with her are clinicals, so they can easily talk to the doctors and then, um, know the routine that we need to do with your mom and your dad. So aside from-
[11:35] Speaker 2: What does that mean? What does that mean, clinical? Sorry for interrupting you.
[11:39] Speaker 1: Yeah. So for clinical, some of my caregivers are not just, uh, a regular caregiver. I make sure that they have a good background when it comes, when it comes to clinicals, like some of them are real nurses. So I make sure that, you know, some of them are from, uh, a nursing school, but of course they're also licensed as home care aid. But I want to make sure they have a good background or they have been a caregiver for too long. They really, um, are well-trained for, especially for dementia patients, Alzheimer's patients, very special.We want to make sure that they've, uh, they've taken care of a patient like that for like 10 to 15 years, just to make sure. Or they are well-trained from onboarding care because it's different. It's not just for companion. Especially with your mom, we need to make a routine, especially when that time she was on G-tube and now at least she was eating on her own. So it's a big, there's a big impact. There's a big difference.
[12:42] Speaker 2: Absolutely. And so when somebody gets trained for Alzheimer's or for dementia, what does that look like? They know their patterns, they know their rages. How do they help them? How do they keep them safe?
[12:56] Speaker 1: The, uh... Because if a caregiver is well, uh, trained with that or, um, they know when, uh, with an Alzheimer's or dementia patients, they know when they move their eyes, when they m- their body movements, you can easily see if they're not happy, if they're agitated, or if they need more attention. Especially with your mom, you know, when, when she's, um, agitated, you can see if she wants to go to the bathroom because with her, she can't express herself. There are times she, she can say, she can express herself but most of the time, she can't. So when she's like folding her, um, folding her, uh, um, blanket, you know that she's, she wants some-something. Either she's hungry or she wants to use the bathroom. That's why I want to make sure that your mom's care team are, um, matched to her. But it took me a while to, yeah, before we, we matched her caregivers. And I'm so happy you're open to like changing the caregivers until we find the perfect match for her.
[14:00] Speaker 2: Yeah.
[14:01] Speaker 1: And of course, we want to make sure that before we add a new person, that person needs some training, some shadowings, just to make sure, you know, the routine will still be the same.
[14:14] Speaker 2: And that's great. And then how do, when people are looking for a care agency, um, what should they be looking for and what are telltale signs not to hire an agency? What are things they should avoid? What are the pitfalls of hiring a care agency?
[14:31] Speaker 1: Um, of course, everybody will, will give you promises that they're, um, they're going to give full attention. Um, of course, they want to, they can ask around or aside from that is, I know it's really hard to ask around. Or just, um, you just, you just need to make sure that the owner itself is very hands-on. You know, they're fast to response, they're fast to, you know, and they take responsibility when, when something came up because not everybody's perfect. Sometimes, you know, a caregiver can, um, can make a mistake and we need to take responsibility out of it. So we're, we need to act fast. If something happens, you need to change the caregiver within an hour maximum. So that's why sometimes if something happens, I remember and your dad is very special, I remember I, me, myself, I went, I went to take the whole shift because I can't just, uh, change the caregiver. So d- you need to, you need to, to make sure that the agency is always on top in the admins.
[15:53] Speaker 2: That's great advice. And what's the difference between home care and hospice? 'Cause I know that's a big question for a lot of people that are listening right now. A- and, and what is the difference and when do you choose one over the other?
[16:10] Speaker 1: For hospice, hospice, um, uh, focus on comfort if it's in the end of life. Like if the doctor sees that will, the patient will only live for only six months, so of course, they need, um, full attention with spri- that's why most of the time the agency sends spiritual counselor and we only focus for comfort. When it comes to home care, home care provides only care, just like us, a home h- home care agency. So home care agency sends caregivers. So that's the difference bet- between hospice and home care. Or you meant, uh, home health?
[16:54] Speaker 2: Both.
[16:55] Speaker 1: Oh, home, ho-
[16:56] Speaker 2: You know, yes. Uh-
[16:57] Speaker 1: Yeah. So home health focuses, uh, when the patient is still, we need to stabilize the, the patient because, um, hospice is onl- just for the end of life. And for home health, we can still make the patient like, the patient can still see her primary or his primary doctors. Home, ho- home health, um, follows the patient at home after the hospitalization or after, uh, getting out of the rehab. That's why we need to send physical therapist for them to bounce back and be stable again. Unlike for hospice, we only focus on comfort care.
[17:39] Speaker 2: Okay. And does the care agency or the caregivers work with the home health agencies? Do they work with the doctors? How do they interact? Or are they totally separate entities? Or do they help schedule appointments?
[17:54] Speaker 1: Yeah, so caregivers, we do like with your mom especially, um, if n- um, most of the time, if we can see that we need to call the co- the, the doctor's office, yes, we do. We coordinate with her doctor's appointment. I know because we're non-medical, so we also check on her, um, medication management. But it's also, it's mostly the home health and hospice who, who does the medication management. We just remind the patient to take it.So that's what the caregivers do. We, we help the patient, um, coordinate with the doctor's office. And if we need to drive the patient, going to the doctor's office, we also assist the, the, the patient. Especially if the family member can't, uh, come with the patient, if needed. So we support them, we support the family.
[18:46] Speaker 2: That's great. I know that, um, it's been important to me, you know, and you've worked very hard with me on this, that-
[18:53] Speaker 1: Especially, you're always too far. Yeah.
[18:55] Speaker 2: ... that there is, um, a consistency in the doctor visit, the, the, the same caregiver that takes my parents to a particular doctor be the same caregiver that goes back the next time and the next time. Because then they're able to track it, they're able to follow the patterns, they're able to listen-
[19:14] Speaker 1: Mm-hmm.
[19:14] Speaker 2: ... and know what the doctor is recommending, and then they could say the progress or any changes-
[19:19] Speaker 1: Mm-hmm.
[19:20] Speaker 2: ... since that last appointment. And so, I think that that's been really vital, you know-
[19:25] Speaker 1: Yes.
[19:25] Speaker 2: ... for me and in their care, the fact that somebody is actually following and knows the difference and knows the protocol. Or like you're saying, that my mom sometimes communicates by folding the blanket or by smiling-
[19:37] Speaker 1: Mm-hmm.
[19:37] Speaker 2: ... or, you know, w- with non-verbal communication. And I think having a caregiver that is not just a babysitter and not just somebody that's coming to sit and make sure they don't fall or they're, you know, being fed or that they're bathed and groomed and whatever that is. Um, but literally, the fact that somebody knows the signs and knows their needs and knows their personalities and knows their ebbs and their flows. Or even, I, I know from my mom, she has sundowners.
[20:07] Speaker 2: So she gets agitated at a certain time of the day-
[20:10] Speaker 1: Oh.
[20:10] Speaker 2: ... and to expect that, or for the caregivers to say, "She already walked today and now she's tired, so we're gonna put her in a wheelchair because we don't wanna..." You know, somebody that, that can make those decisions that I would make myself for my parents. So that if I were with them right now, then I might, "So she looks a little tired right now-"
[20:30] Speaker 1: Mm-hmm.
[20:30] Speaker 2: "... I'm not gonna have her walk again." Or that she's agitated and, you know, maybe we wanna put on this movie or a particular kind of movie. Or like you said, she doesn't like the news and, and the news bothers her, violence bothers her, and she shouldn't be watching movies, you know, that have guns and whatever those things are. And, and so for a caregiver to actually jump in, if you're listening to this, there are things that you can, um, not only request and not only talk about, but that the caregiver should be giving you impact. It was important for a caregiver to say, "Your mom doesn't like violent movies.
[21:02] Speaker 2: Your- She gets upset." Or, "She doesn't like when the news is on," or, "At this time of day, she gets agitated," or, "I think she's too tired to be walking, you know, this many times a day." I, I think that caregivers, you know, especially the ones on your team, are very vocal and they actually-
[21:20] Speaker 1: They're always on top.
[21:21] Speaker 2: ... help navigate her care. They don't just care for her, they actually help make choices on things that are better, better practices, better ways of doing it, um, safety. You know, from... Safety from getting up, from walking, from safety equipment, from walkers and wheelchairs and bed frames and, and mattress pads. And so, um, actually being able to do that. And then also, I know that all of you, um, receive feedback so effortlessly when I share information a- and say that there's something I need, you really listen to my needs and you never shut me out.
[22:01] Speaker 2: And, um, and especially when I get scared-
[22:04] Speaker 1: (laughs)
[22:04] Speaker 2: ... you've given me the space to be scared quite often, right?
[22:08] Speaker 1: Yes. And we, we do understand that, of course. You really love her. So, you just need to be an observer when you're going to take care of a pr- patient, a special patient. You need to see the difference, if she's very unhappy, if she needs something. So, that's how it is.
[22:30] Speaker 2: And then one of the care agencies that I had hired prior to you, and, and we had talked about this sort of laughingly, but, um, my dad is a fall risk. If you're listening to me right now, and your parents may have the fall risk, as most aging people are. They where... They have the little necklaces that you push the button if you fall, and they have bars and all the safety everything. But, um, my dad fell and broke his neck, right? My dad is a huge, huge fall risk. And we had a caregiver that had been hired prior to you, and she would walk ahead of him. She's a fast walker, and she'd walk ahead of him. And she was halfway down the hall and he was behind in his walker.
[23:07] Speaker 2: And I thought, "How safe is that?" (laughs) Because-
[23:13] Speaker 1: That's true.
[23:13] Speaker 2: ... the whole point of having a caregiver is that they are next to him, behind him, hanging onto him to make sure he gets off sidewalks, to make sure he gets up out of bed or out of a chair safely, sits in a dining chair safely. The whole point of having someone there is to make sure that he is safe and that he doesn't fall. And to have someone-
[23:33] Speaker 1: And he falls so fast. (laughs)
[23:34] Speaker 2: Yeah, he does. And to have someone halfway down the hall-
[23:37] Speaker 1: Yes, that's true.
[23:39] Speaker 2: ... and not ahead of him, you know, doesn't make sense. Or when they sit to eat and for someone to leave, you know-
[23:47] Speaker 1: Mm-hmm.
[23:47] Speaker 2: ... if they're there by themselves or if, you know, they have food safety issues like my mom does with swallowing. And if somebody's not sitting there making sure that she has just small amounts so she doesn't aspirate. And so, what is the best way? Because I don't know I was always perfect at the way I've done it. Um, I, I... If we're somebody that's listening and they're hiring a care agency and they have a caregiver and, um, it's scary. You know, so they don't know what the caregiver can do or can't do when they come in and the place is dusty or their, you know, the, the laundry is not done or the place, whatever. They see that their hair is not brushed or their face isn't... How does-Somebody first say, "These are the things you need..." 'cause you don't even know what you need until the caregiver's there taking care of your parent. And then, what is the right way to ask without making people wrong?
[24:47] Speaker 2: And what is the best practice for us to be able to listen to a caregiver if the caregiver knows better than we do on how to take care of someone? What's the best way for the child of the parent to listen to the caregiver and to take notes or to buy something that's necessary if the caregiver thinks it's necessary? What is th- that best exchange going both directions?
[25:14] Speaker 1: Um, just, uh, just like with you, Ms. Nicole, if my caregiver asks something or needs something, um, you listen to us. You can always try. I know there are some- sometimes the- there are some cases that we ask even if it's not, because we need to try. But we can never know if she really needs it if we're not going to give it a try. And, uh, just like us, um, there are some suggestions also from you. That's why I always tell my caregivers, "If Nicole wants this one, if she, she suggests for us to do this one, we need to do it." Because with- just like your- with your mom, you, you, you send us the books. Not all caregivers are aware that the patient needs it, but because we tried it, then now it's on her routine and it really helps her a lot. So both ways, it needs a good communication. And, you know, there's nothing to lose if we're going to try it.
[26:18] Speaker 1: So for the families out there, if a caregiver suggests something, then we can give it a try because sometimes I know families are just going to block it off that, "Oh, my parents doesn't need this one." And it's the caregiver who's always by the patient's side. So that's why sometimes the, the caregiver knows what's really... what's, what's the best, uh, things for... what's the best routine for the patient because they can see the progress. They can observe the patient, you know? So there's no- I don't think there's nothing wrong if we're going to do good communication about it.
[26:58] Speaker 2: That's a great answer 'cause I know it's been a journey, you know, and...
[27:02] Speaker 1: Yeah.
[27:02] Speaker 2: And, and, and it's-
[27:02] Speaker 1: I think it's three years now. Yeah. Three years, it takes.
[27:05] Speaker 2: And... Oh my gosh. You know, and it-
[27:07] Speaker 1: Yeah. From your mom that she- she's totally like... We can't even talk to her that time, I remember. Now, she's walking. She's trying to run, (laughs) to, to, to run. If my caregiver is just not looking at her for only one minute, that's when my caregiver's m- make... is making sure that somebody is there if they needed to use the restroom.
[27:33] Speaker 2: Right. So-
[27:34] Speaker 1: Because for me, one minute is very important.
[27:37] Speaker 2: It is. You know? And, and that's when-
[27:40] Speaker 1: Yeah.
[27:40] Speaker 2: When we started with my mom, she was basically in a coma. She couldn't talk, she couldn't-
[27:44] Speaker 1: Yes.
[27:44] Speaker 2: ... move her hand, she couldn't move her feet. There was no, um... you know, there was no recognition. We took her-
[27:51] Speaker 1: Yeah.
[27:51] Speaker 2: ... from rehab to the hospital. We put her in hospice. We took her out of hospice. We put her on home health. And she was in and out of the hospital, you know, constantly.
[28:01] Speaker 1: Yeah.
[28:01] Speaker 2: And she couldn't swallow and she aspirated, and, um, we fought. You know, we fought to have the catheter removed. We fought to have the Foley removed. We fought to teach her-
[28:11] Speaker 1: Yeah.
[28:11] Speaker 2: ... to walk. We taught to teach her to talk. We taught to teach her to write-
[28:15] Speaker 1: Yeah.
[28:15] Speaker 2: ... and-
[28:15] Speaker 1: Even to write. Now, she's writing right now.
[28:17] Speaker 2: Even to write, yes. And she-
[28:19] Speaker 1: Yeah.
[28:19] Speaker 2: You know. So it's amazing. But the caregivers would do the daily exercises. That was-
[28:25] Speaker 1: Mm-hmm.
[28:25] Speaker 2: That was another thing, because the physical therapist would come once a week and do the exercises, and then she wouldn't progress, or my dad wouldn't progress in physical therapy and balance. But when the caregivers watch the physical therapists and then every day, they take your parents through those exercises, through the paces, if they do the puzzles, if they do the crosswords with them, if they-
[28:48] Speaker 1: Yes.
[28:48] Speaker 2: ... read to them, if they're asking them about the past, if they're showing pictures and reminding them, "Who is this and who is that? When was that time?"
[28:56] Speaker 1: Yeah.
[28:56] Speaker 2: "And what was that trip?" And, and evoking those memories. And so how important is all of that as a caregiver's duty for someone that's hiring a caregiver in caring for your parents?
[29:11] Speaker 1: Uh, your suggestion before that we followed, it help us a lot, because for 12-hour shift, each shift for 24-hour care, you know, aside from giving the, the patient a, a nice routine and a nice care, you, you can see that the time flies so fast. And our progress from bedbound to like... that time I remember my caregivers can even remove her bare hands with your mom 'cause we need to put the oximeter on her to make sure her, her oxygen is really stable from now that she's just trying to run away from my caregiver.
[29:52] Speaker 1: She's even-
[29:53] Speaker 2: (laughs)
[29:53] Speaker 1: Yeah. I remember one time the dietician is there, it's only like a few minutes and suddenly she... you know, she stands up already on her phone. It's only a matter of minutes. So, it's really important to have a routine because it can help them progress. And before, she can't even remember anything, but now she knows who she is and she even remembers her, her husband and her family. So it's really important to have a routine. And her memory is... I know it's not totally that it brought her back, but it helps a lot. You can see it with her. Now she's happy when... you know, even her hair.I remember one time, her- her eyebrows is not even and she knows it.
[30:44] Speaker 1: When she saw her face in the mirror- (laughs)
[30:46] Speaker 2: Oh, wow. (laughs)
[30:46] Speaker 1: ... she's trying to count her- her eyebrows. So yeah, she was trying to count it. That's why we s- we started laughing. That's- that's a really big impact. That's why I'm so happy now with my new patients. I always make her as my example. I always tell them that she's my miracle baby and, um, if I'm going to have an incoming patient just like her, we're going to add that routine to the new patient, because it really helps us a lot. Even the albums, the family pictures, it helps her a lot and she knows it. Sometimes she remembers it, sometimes she's- she not- she's not. But most of the time, she remembers. So e- e- now I'm surprised one time when I visited her, especially on her birthday, she knows how to read now.
[31:33] Speaker 2: Yeah.
[31:33] Speaker 1: Unlike before, she can't read.
[31:36] Speaker 2: But that's the caregivers reading with her-
[31:39] Speaker 1: Yes.
[31:39] Speaker 2: ... really working with her every day. I mean, even with the little weights, the one-pound, the two-pound weights-
[31:44] Speaker 1: Yes.
[31:44] Speaker 2: ... and she'll hand them to you and the- and the counting. And sometimes the caregiver will send me a message and they'll say, "Miss Nicole, you know, she doesn't wanna exercise today." But then later on, they'll try again-
[31:57] Speaker 1: Yeah.
[31:57] Speaker 2: ... or they'll do something or they'd do- play a game and inspiring and all of a sudden, they exercise. And so they don't just say, "Oh, she doesn't wanna exercise," and they don't exercise that day. The caregivers really ensure that she's getting that care, that she's getting that motion, that she's getting that stability, that she's getting that strength, that every day-
[32:17] Speaker 1: Yes.
[32:17] Speaker 2: ... she's growing, she's progressing in some way and being communicated to.
[32:22] Speaker 1: Yes, it helps them a lot.
[32:23] Speaker 2: And what's the diff- what's the difference between daycare and night care for people that are hiring an agency?
[32:31] Speaker 1: Um, with the daycare, of course, that's the number one important for, um, the daily routine because it has a routine. It's a morning, but it depends upon the patient because there are some patients that are more awake, wide awake in the morning. So for the night- nighttime, for- for me, it's almost the same because well, just like with your mom, sometimes she's more wide awake at night and, uh, and sometimes, she's more wide awake in the morning. So I know other- with other patients, there's a big difference. But with her, we're trying to adapt with her- with her daily routine. So the caregivers for the morning and the night shift, both should be wide awake. I know they can take naps, but they need to make sure that, you know, when she moves. That's why some of my caregivers sleeps beside her or sometimes they're- they're holding hands with her or when they- when they wait- when they can feel that the bed is moving, they're- they're wide awake, or sometimes even me.
[33:37] Speaker 1: You know, I- I do surprise calls with them. I just want to make sure that they're going to answer me. But I always, um, I always think that both night and day are just the same because if we're going to think with other routines or other patients for them, they think that nighttime care is the patient is just sleeping. But not all patients are asleep at night, so I- I- I just make sure that it's just the same when it comes to the level of care. Because, like, in the middle of the night when your mom is agitated or she's wide awake, my caregivers are reading books for her. I know you usually do it in the morning. But if she's agitated at night, yeah, that's what they do.
[34:23] Speaker 1: And I always tell them, if she's agitated at night, try to bring her to the bathroom, maybe she just wants to use the restroom or try to feed her, maybe she's hungry or try to read books for her, try to give her the puzzles or try to give her the albums, because sometimes she's more awake- wide awake at night more than in the morning, especially if she's not too... Sometimes she sleeps during the day when she's so tired. So for me, it's we- I- I- I take it, like, just the same, same routines.
[34:58] Speaker 2: Mm-hmm. And I know your team has been very instrumental as far as, like, sending me list of medical supplies. These are the things that we need this week. And, you know, saying, "This doesn't work. This walker doesn't work for this reason," or this is, you know, the wheelchair, you need a pad or you need a bag for this. And i- is that part- is that standard for a care agency to do that or is that something special for your agency or something that somebody that's listening to the show that- that's getting care for their parents, do they say, "Make a list of their needs every week," or, "If they run out of diapers or bed pads or, you know, can you let me know when something has to be ordered or d- is that my responsibility because they're my parents and I need to do this," or wh- what is the communication thread?
[35:47] Speaker 1: For me, with my caregivers, I n- I- I always make sure that they're always on top when it comes to the supplies. I- I- I'm telling them, for example, with the diapers, if there's al- already, like, one or two packs left, you need to call the family member, because sometimes family members are always busy. That's why the- there's an agency to- to offl- to offload your- your problems. And if you're going to add that supply problems with the family members, it's like you didn't hire an agency. And so if you can observe, we're trying our best to- to always be on top when it comes to the supplies. It's not just helping us because it's really hard, for example, we run out of supplies. It's always- it's al- it's going to be also our- our problem because what if we need, um...... uh, gloves and diapers and the family member cannot run to the shop just to-- or to the grocery store to buy some supplies.
[36:48] Speaker 1: So the-- it's going to be the patient and the caregiver who's going to be in big problem about it. That's why I always tell them, if the gloves is running like only three boxes or two boxes, call the family member. Even for wipes and also for diapers. All the supplies, I always tell my caregivers to be always on top. Or sometimes if there's really an emergency, you know, if the family member cannot Sometimes, you know, even if you order the supplies, sometimes they, they ignore. So sometimes we're trying to borrow from a different patient from next door and then we're just going to, to bring it back or return it when we receive the supplies. Or sometimes me, I deliver it myself because I don't want the patient to suffer (laughs) . We- we're, we're trying to prevent the bed sores when it comes to the diapers, if it's going to run out of the supplies.
[37:48] Speaker 1: Because for example-
[37:49] Speaker 2: I know that's why-
[37:50] Speaker 1: Yeah. It's really important.
[37:51] Speaker 2: Yeah.
[37:51] Speaker 1: Because if the patient have bedsores, it's going to be more, um, complicated when it comes to maintain. You know? It's- it's they're making their life, um, hard. Unlike if the patient doesn't have sores, of course they don't, they don't need to turn the patient every two hours. So it's going to be more work for us if we're running out of supplies and something happen to the patient. And that's why I always tell them, always make sure that my patients are, you know, not going to have a fall. Because if something happens to the patient, either we're going to lose our job or we're going to lose the patient or if the patient is going to be bed-bound, you know, it's- it's going to be more hard for them because it's going to be o- I mean, it's going to add more work for them. You need to turn the patient every two hours, you're going to change the patient in bed. They're going to shower the patient, but it's more work.
[38:49] Speaker 1: Unlike if the patient is walking just like your mom right now, she's walking now. So there's a big difference. It's- it's less work for them. And of course now they can joke around, they can play with her. There's a big difference. It's- it's like they're- they won't feel that they're working for her. They will feel that they're just being a companion. So there's a big difference.
[39:16] Speaker 2: That's really lovely. And I know safety wise, you need ... Your agency has called me to say, "We need a half rail, we need a full rail, we need a baby monitor, we need-"
[39:26] Speaker 1: (laughs) .
[39:26] Speaker 2: ... "an alarm when they get up." I mean, so safety-
[39:30] Speaker 1: Even a camera. (laughs)
[39:32] Speaker 2: So talk about safety, you know, as far as, is that my responsibility, the child's responsibility? Is it the caregiver's responsibility? Who is the one that, that says, "Okay, they, they're not safe right now, they need this X, Y and Z to be able to stay safe"?
[39:56] Speaker 1: It's the care ... It's the agency's responsibility. That's why I always tell my caregivers we need to make sure that our patients are well covered, our patients are safe. Because like what I've said a while ago, it's more work for us if there's going to have a fall. It's- it's going to be more complicated. Of course if the patient can still walk, they can still go out, they can still go to the mall and there's always like a happening, you know. They can watch the movies. Just like with your parents now, they're watching downstairs unlike before they're just inside the room. So it's going to f- the caregiver will feel that it's less load for them. That's why I always tell them, "Always be on top of my patient's care." Because it's, I'm not going to suffer from it. It's not me who's working for them, it's them. I always tell them or for example, I give them a warning and they don't listen, I always tell them, "What if it's your parents?
[40:56] Speaker 1: Are you going to be happy if you're going to give that level of care?" Of course not. So I always tell them to make sure to treat our patients like their own family.
[41:08] Speaker 2: And you do, and thank you so much for that.
[41:11] Speaker 1: (laughs) .
[41:11] Speaker 2: And then financially, let's talk about the big chunk. So does insurance cover caregivers or does extended care or is that something that people set aside or do different family members contribute to the care? Is there, um, a matrix or when people call you, do you help them get financing? Can ... It, I mean, it's a lot for someone that doesn't know. So, eh, eh, I've gone through this (laughs) . Know I've gone through it, I know and on the other end but for the people that are listening to us today or that are just stepping in this world or have had, like I did, all these care services that didn't work and th- they're looking for the right one, um, or they're just saying, "Oh gosh, I need more help and I'm gonna need to hire a care agency soon," whether that's temporary or full-time or 24 hours, um, what does that look like for someone and where do they begin?
[42:08] Speaker 1: Uh, just like with, uh, there are some cases that the f- family truly doesn't have, um, um, financial capacity to hire a private caregiver. So if it's totally zeros, medical can cover, but it's going to be, uh, you need to apply for it. So either hospice or home health can help them when it comes to IHSS. Yeah, so they can get, um, in-home support. But with families that have long-term insurance, then it's re- it's better. So if a family that if they can feel in the future they needed it, I think long-term insurance really helps a lot.... because I have a lot of patients that's under long-term insurance. And me as an agency, I know we don't bill it, but we do help the family when they need it, what really, what they need so they can claim the, the pay. Because just like with your parents, they have long-term insurance.
[43:09] Speaker 1: So what they do-
[43:10] Speaker 2: Right.
[43:10] Speaker 1: ... what we do, we coordinate with them, you know. We coordinate. We, we, if they needed us to send the full statement, then we're going to send it. If they ask for a copy of our certificates or insurances or license, we're giving it so that it will, you know, they can claim smoothly. We always help the family.
[43:34] Speaker 2: That's terrific. And are there ... is there, um, places that you can go to, I don't even know how to say it, where you can make payments? Like let's say somebody needed, you know, care for a short time, for rehab or something like that. Do ... are there payment plans?
[43:54] Speaker 1: For rehab?
[43:54] Speaker 2: Are there payment plans?
[43:54] Speaker 1: For, for rehabs, insurance cover, insurances covers it. Like with, uh, for example, the patient came out from the hospital and they-
[44:03] Speaker 2: Mm-hmm.
[44:03] Speaker 1: ... needed to go to a skilled nursing facility and rehab, yeah, insurance covers it.
[44:08] Speaker 2: Okay.
[44:08] Speaker 1: Except for the private caregivers. Yeah, it's going to be out of the pocket or it's going to be paid with long-term insurance.
[44:17] Speaker 2: And then how does it work when, um, when a, a caregiver drives someone to the doctor's? Do you pay for the gas? Do you bill for the gas or do people pay for the gas or parking and things like that? Because I know that's a big deal to have a caregiver take your parents to the doctor and sometimes there are hospitals and sometimes you have to pay at the hospital for the parking. And then going there, it could be a long ride going and do you have handicap stickers and, and what does that look like?
[44:50] Speaker 1: So it depends. If the patient is in assisted living, then we're requesting for the family to, to request for transportation from the assisted living to make it more or less, um, liability from us. Or if needed, if we need to drive for the patient, then we're billing them for the mileage. But sometimes we don't. There, it depends upon the case. But most of, of the time, we don't bill the family, especially if the patient is already 24-hour in our care, we don't bill the family. Except when it comes to parking, yes. We bill the parking tickets. But when it comes to mileage, sometimes we do, sometimes we don't. Especially if it's not too far, then we're not going to bill it. It's already covered. It's like a help with the family, especially, um, if the patient will be long, will be, um... is going to be long term with us so we don't bill it.
[45:49] Speaker 2: And do you do couples? Like can you see two people at once? Do you have a caregiver... is that like a different rate when you do that? Where somebody is bringing you into their home and they have two parents in their home, but they just need some extra care or the wife doesn't cook anymore or the (laughs) -
[46:06] Speaker 1: (laughs) .
[46:06] Speaker 2: ... she doesn't clean very well anymore.
[46:08] Speaker 1: (laughs) .
[46:09] Speaker 2: Is ... what does that look like?
[46:10] Speaker 1: Actually, I have some cases that I have, I have a patient right now in Irvine, other couples. So I know the care for us is just for the husband. But of course, um, we both love them so we, we always add the care for the wife. Especially for meal preparation, if the wi- wife needs something, we're also adding it but we're not billing for both. But there are some cases that, you know, the patient really, both of them really needs close monitoring or both... you need to be hands-on with them because especially if the wife is not stable and then the husband is not stable already, then we need to have separate caregivers. We don't suggest, um, one caregiver and then we're just going to bill for both. It's going to be a big risk and it's going to be... or as if, you know, if something happens to the patient, sometimes it gives them a big risk. It's not going to heal anymore, especially if they're like 70 up. If they fall then break their bones, sometimes it heals, sometimes it doesn't.
[47:26] Speaker 1: So it's a big risk. So I'm always telling the family, I can do one caregiver for both patients, but we're still going to suggest two caregivers and, uh, you know, we're going to observe. And then if we can cover only one caregiver for both, then I'm going to tell the family. Then we're just going to bill or extra for, for the other one. I have a patient before that she's on a 24-hour care and I observed that the patient only needs 12 hour, uh, 12 hours only. And I told the family member, for now, uh, we can cut the hours to 12 hours, and if I can feel that the patient needs 24 hour, then we can bring it back to 24 hours.
[48:10] Speaker 2: Mm-hmm. That's wonderful. That's really special that you can do that and sort of navigate-
[48:15] Speaker 1: Yes. Yes.
[48:16] Speaker 2: ... that time. I- it's terrific. And you know, and before we get to the top of the hour, how do people find you? I mean, if they... your agency is so far superior and I hope if you are in a different state listening to this that you find an agency just like PP Cruise, that you're listening to the things that Alexis is sharing with you. As far as it, what I really heard, and correct me if I'm wrong, but I heard one of the most important things is that the owner of the agency is involved.
[48:48] Speaker 2: That-
[48:49] Speaker 1: Yes.
[48:49] Speaker 2: ... you are taking responsibility for those clients, for those patients. That you stop by periodically and do checks.Random checks, even if it's 1:00 or 2:00 in the morning or in the middle of the night, to make sure that everybody is handled correctly, to make sure that people are clean, to make sure that, um, you know, that they are being treated well, and that they look healthy and strong, and that the caregivers are on top of everything, that the people that you hire are licensed, that they're bonded, that they've been trained, and especially trained in specialties, is if somebody has Alzheimer's or dementia or whatever that might be, Parkinson's, or if they're wheelchair-bound, or if they're in hospice, that the people that you are hiring are trained specifically for that care you are giving them, correct?
[49:37] Speaker 2: That, that, that was something that you were sharing, and that you also have people that are RNs, who are nursing students that are capable-
[49:46] Speaker 1: Yes.
[49:46] Speaker 2: ... of doing that as well, that, um, making sure that supplies are there, that people don't run out of supplies, and making sure that everything, that their needs are being met in advance of them needing their needs, and the caregiver suggesting ways to, uh, keep them safe and make them healthy, and, and things that, that might make the journey better, as well a- as listening to the children, that, um, Medi-Cal, which I did not know can pay for it, that insurance, if people don't have money, they can get this care through their insurance or through Medi-Cal or through long-term insurance, and, and that you'll assist in the billing and in the process of that. And, um, for you, how do people, where do, how do people find you and your agency? Which I would highly recommend to anyone who is watching or listening to this podcast.
[50:43] Speaker 1: (laughs)
[50:43] Speaker 2: Go to PEPCRUZ because I can tell you, I am a different person because of you. I can breathe, I can smile, I can laugh, and both my parents have flourished, have flourished under your care, and you have cape- ... You've kept them safe and happy, and, um, your caregivers have just done remarkable work every second of every day, you know, day and night. Um, they have been so diligent, and so I am grateful beyond words, more words than I could ever put into a show or a lifetime. Um, but please tell people how they could find you and your agency.
[51:23] Speaker 1: Um, me, so I think, um, they're going to post my number, right?
[51:29] Speaker 2: We will.
[51:30] Speaker 1: Yeah.
[51:30] Speaker 2: Yes, we will post everything.
[51:31] Speaker 1: Yeah.
[51:31] Speaker 2: Yes.
[51:31] Speaker 1: So they can contact us. Um, so we cover also, um, L- Los Angeles, and we cover Orange County up to the valley, and also up to San Diego. We cover that. And if needed, if it's, even if it's too far, I can still send a caregiver, um, even for San Francisco, yes. So if it's-
[51:56] Speaker 2: Except for-
[51:56] Speaker 1: E- except for, may- maybe sometime, I'm still thinking, if I can cover out of state, then we're going to happy to cover it if there's going to be a client, so-
[52:06] Speaker 2: You know, I would, if you are out of state and you're looking for someone, you know, to come in full-time, or caregivers or a team to come in, I would recommend that you reach out to Alexis, and even reach out to Alexis just maybe even hire her for a consultation before you hire a care agency-
[52:23] Speaker 1: Care giver, yeah.
[52:23] Speaker 2: ... if you are in a different state, because she cares. This show is about The Care Compass, and Alexis truly cares, and, um, and she's diligent with me, and really has opened my eyes to so many things that I, I never knew and I never saw, and you don't know. If, if this is not your business, if care is not, you know, caring for an aging parent is not your livelihood and your full-time business, it's crazy, because there's so much you don't know, and every day there's a new challenge. Every day, there's something you didn't know. Oh, they can get bedsores. Oh, their feet, oh, their toenails need to be clipped. Oh, this is what's going on. Oh, they need dental care and whatever, and they, th- there's this, they need a different kind of hygiene. Oh, they broke their neck and they can't h- be in the dentist chair. They can't lean back to get their hair washed, so you need a special basin to wash their hair because they have a fracture. I mean, there's so much to the care.
[53:31] Speaker 2: There's just so much to it. And so even if you just wanted a consultation, and so I know we are wrapping up the show, but I just wanted to say, um, thank you, Alexis-
[53:44] Speaker 1: Welcome, you're welcome.
[53:44] Speaker 2: ... from the bottom of my heart. And if you have questions out there, reach out to me. I'm happy to connect you with Alexis. We will definitely post for her, and anything that you are interested in the future, any questions on care, send them to me. We will bring you the experts. We have, we know all the experts now across-
[54:04] Speaker 1: (laughs)
[54:04] Speaker 2: ... the nation and internationally in the aging parents survival guide and the compass, and we will find the specialist for you, and, um, just, I just wanted to say, thank you, Alexis, for being with us today, and thank you for-
[54:21] Speaker 1: Thank you for choosing us, Miss Nicole. I know I started-
[54:23] Speaker 2: You know, you're-
[54:23] Speaker 1: ... with your mom. Now we both have them, and I'm really, really happy.
[54:29] Speaker 2: And please thank your team for me as well, and, uh-
[54:32] Speaker 1: Yes.
[54:32] Speaker 2: ... to all of you out there, we will see you on the next show. I am wishing health to your parents, healing to your hearts, love, family, and, uh, stay strong. You're, you're doing a great job out there. I know you are because you're listening to this show, so you care enough to get the right information to be able to help them, and that alone says something magical, so blessings, right? And, uh-
[54:59] Speaker 1: Thank you, Miss Nicole.
[55:00] Speaker 2: And your story begins today. (laughs)
[55:04] Speaker 1: (laughs)
[55:04] Speaker 2: Thank you. We will see you all on the next episode-
[55:08] Speaker 1: Thank you.
[55:08] Speaker 2: ... of Care Compass. Thank you.
[55:10] Speaker 1: Thank you. You are the care compass pointing hearts back home. Turning quiet lonely rooms into places they belong. To the elderly, the wise, you give your steady light. Careful care, caring compassion till the dark turns into light.
