The Medicare Program Giving Dementia Caregivers Relief at Home | The Care Table Ep. 38

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Greetings, listeners, and welcome to the Caretable Podcast, dedicated to educating and supporting family caregivers of aging loved ones.
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I'm your host, Amy Huddleston.
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Through insightful interviews from both industry experts and family caregivers, we aim to provide valuable perspectives and resources.
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Let's see who we're learning from today.
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Welcome to today's episode of the Care Table.
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I'm Amy, your host.
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And before we get started, I want to remind you please leave a review, tap the bell on YouTube to subscribe, leave, you know, leave some comments, let us know if there are any topics you want to hear about that we haven't covered yet.
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We really appreciate the support.
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I am looking forward to this conversation because I heard about this product from someone that I used to work with at the Home Instead franchise.
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And I became curious saying, what exactly is this?
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And thankfully I got to connect with our guest.
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Nancy Gillette is the chief growth officer at PocketRN.
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So thanks for being here today, Nancy.
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Thanks for having me, Amy.
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I'm so excited to be here.
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Great.
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Can't wait for you to share about what exactly this is.
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So let's start with that of just what exactly is, in simple terms, what Pocket RN is.
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Pocket RN is a virtual nursing company that was founded out of the biodesign program at Stanford University with the goal of closing the gap between home and healthcare.
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That's a simple answer.
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Okay, so you know, we don't, I didn't have this on my list of questions, but what do you consider to be the gap between what you just said?
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There's the gap of home and the gap of healthcare.
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What do you how would you define that?
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So I define that, and we as a company define that as the millions of little moments that happen at home in between appointments and visits.
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You know, so much of healthcare happens when you're not expecting it.
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And it's never when, you know, it's never what you're thinking.
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And you learn by being in and out of the emergency room.
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You learn from being in and out of urgent care, realizing, oh, you know, maybe I should have limited the salt on a congestive heart failure patient, right?
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Oh, I knew the weight went up and down, but I didn't know what to do in the moment.
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And before I knew it, mom was in a full-scale exacerbation.
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And, you know, a lot of times what we hear from our patients and families constantly is I left a message from my physician five days ago, and I'm still waiting for someone to call me back because we have a really big crisis happening in the United States today, right?
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One of the little metrics, we didn't talk about this in advance, but I always like to share this with people that 55% of nurses in the United States are over 50.
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Our nursing school enrollment is at its lowest level of all time, not because people don't want to be nurses, but we don't have enough educators to put people through programs.
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11,000 plus people a day are turning 65 in the United States.
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And so we have a crisis on our hands.
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The same holds true for physicians.
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Physicians are retiring, we don't have enough going through the funnel.
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So we have a rapidly aging patient population, a very rapidly dwindling pool of clinicians who can support, and everyone has a backlog, right?
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So you people are not getting to those voicemails.
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They're not getting in to see their primary care physician as quickly as possible.
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And so so much of what healthcare is today and where we see it moving in the next 20 years is in the home, in those millions of little moments in between visits and appointments.
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I'm just thankful that there's finally discussion about that because it's where people want to remain anyway.
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So you know, most people say, I just want to stay at home.
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I know there's a lot of caregivers that are trying to do that.
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They're trying to say, what can I do to keep my aging person at home?
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So, what makes your approach different with Pocket RN that's different from this traditional uh, you know, system that we have now?
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Yeah.
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So, first of all, uh with Pocket RN and our team, we have a support team that's available 24-7.
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So you can always speak to an actual human uh 24-7.
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And a lot of times families are calling in and saying, something's going on with mom and dad.
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Can I schedule an appointment with my nurse for tomorrow?
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You know, being a virtual company, we have nurses all across all 50 states.
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So it's a lot easier to get time with us.
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Um, and and really what I think is one of the most exciting things about our model, you know, coming from the provider space, I've worked in the space for almost 30 years, really helping discharge patients home, helping them navigate home health services, home care services, all the things.
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And, you know, really one of the things I realized when I worked in pediatric home health was that when I had a nurse that was working with a pediatric child, that nurse's relationship with the family was not transferable.
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They became part of the extended family, right?
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And so having that continuity of care, when you have a nurse who's very empathetic, but very clinically savvy, who can help you navigate, that trusted relationship is not transferable.
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And so I learned early on is that if if my nurse left and went to work for another agency, the families went with that nurse, right?
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And so something that I think that we really leaned on in in the telehealth telemedicine space was that there was no continuity of care in a virtual platform.
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You got whoever was in the queue.
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A lot of times they were new grads, they didn't really have lots of lifetime, you know, real-world experience.
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And even if you hung up and called right back, which has happened to me, you can't speak to the same clinician because it's not designed that way.
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And so we said, well, what if we could create a nurse for life model so that once we matched a nurse with a family, they would have that same experience that my pediatric children had with the same nurse who was in there on an ongoing cadence, someone that gets to know you, someone that knows your family, someone that becomes a trusted coach, advisor, support system for you that you'll actually listen to, that you, you know, feel like actually cares about you.
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Um, and so that was really the model of care that we went out to design.
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And what we have seen is phenomenal outcomes.
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I mean, it's just unbelievable.
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We are we have a net promoter score at around 91.
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So families love us.
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They say, you know, I listened to my nurse, the suggestions that they made were unbelievable.
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Um, you know, I'm so happy that I have this resource.
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And and really, people, it's really moving the needle.
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Like our families will call us before they'll go to urgent care in the middle of the night, which is unbelievable.
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Because you can reach someone.
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You're saying so any time of day, you can reach a nurse.
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So there's so much I want to unpack by what you just said.
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So let me let me let me just go back and say it's not a nurse always, it's a support person.
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But that support person can help you schedule an appointment with it.
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I always say we're not an emergency on-call service.
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Like if you have a 911 emergency, you need that.
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But you do have access to our team, someone that can schedule an appointment with you with a nurse, someone that can escalate if we need to, you know, but you're talking to a US-based human.
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And when you feel so isolated at home, especially like you're saying, if it's three o'clock in the morning, and let's say your person is wandering and you can't get them to come back inside, or you know, things are just getting escalated and you do feel so alone.
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And to be able to say, I I've got someone that I know, whether it's a nurse or not, that I know is gonna pick up the phone is right there alone, is is worth gold because it just lets them know you are not alone.
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So you said your nurse for life.
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What exactly does that mean for a client?
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Yes.
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So that means that as long as you're proactively scheduling your ongoing touch points, you're gonna meet with that same nurse throughout your entire healthcare journey.
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And I know we're gonna talk a lot about the guide model of care, which is the guiding and improved dementia experience model.
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But in the guide model, it's a seven-year demonstration project.
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So once you're enrolled in the program under Medicare and you're with your Pocket RN nurse, you'll have your ongoing touch points with your nurse that knows you.
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So you don't have to tell your story over and over again.
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I mean, now there could be a time where if someone was on vacation, there'd be another nurse filling in, but it's not like you're gonna talk to a different random person every single time you have a visit.
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And what's interesting is that a lot of times our nurses are actually noticing changes in condition before even the families do, because we get so used to seeing these patients in families that we're like, oh, something's not right today.
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They can sense it already.
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So before we go into that CMS guide discussion, what do you feel is you know I'm I guess I'm more just gonna ask, like, what's the mission and or the purpose or vision of Pocket RN?
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Yes.
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So our mission is to really give everyone the chance to care and be cared for in their home.
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And we do that by enabling our nurses to care through coaching, enabling our caregivers, the family caregivers, to confidently support each other, and enabling patients to access care when and how they want in the privacy of their own.
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And I will say something I want to mention, uh, because I think it's really important, is that we have a partnership with a company called Nivon.
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And Nivon originally was a paid agency caregiver training platform to help agencies, home care agencies meet state competencies.
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But when we saw the guide model, we thought, you know, there's a really interesting uh idea here where if we could create more family-facing content for training, right?
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Because family, like I said, family caregivers learn by going to the emergency room and realizing what they shouldn't have done.
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That's how we learn.
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We learn by making mistakes that are expensive.
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They cause hospitalizations, inpatient stays.
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And we we really worked with the CEO and founder, James at Nivon, and said, listen, we have this idea.
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We'd love to create more family caregiver content, training that is specifically for someone that's unpaid and untrained who's dealing with their loved one.
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Could we create content?
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And we did.
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So when a family member has an exacerbation in the middle of the night and they're overwhelmed and they can't reach any of their other providers, they can take one of our trainings that we've created in the middle of the night as a reminder of what to do and what not to do in those situations.
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Um, it's amazing.
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Like families can access this content anytime, wherever they are, on their phone, on their laptop.
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And it's been wildly successful.
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We then also worked with Nivon and we created a chat bot so that you could ask a clinical question to the chat bot via AI, and it would only search our clinically vetted content and not the greater Google.
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So, as you know, Amy, from being a provider yourself, when families Google things, we call it Dr.
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Google these days, right?
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But when families Google things, they have 25 other things wrong with them that they didn't start when they were looking.
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It's because Google is telling you all the possible things that could be going wrong.
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We're giving you the clinically vetted answer that is related to your mom and dad's dementia.
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So, in and let's specify that because I don't think we clarified.
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This program is specifically right now supporting families that are caring for somebody with some type of dementia.
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Yes, the guiding and improved dementia experience model is specific to dementia.
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We work in other verticals.
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We do uh some care transition programs with some health systems.
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We've done in the past RPM and CCM projects with FQHCs and other stakeholders across the country.
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But right now, the primary focus has been this new innovation out of the centers for Medicare and Medicaid that supports families and individuals living with dementia.
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Do you think that's because that is the largest part of the population that's, I don't want to say draining the resources of Medicare, but am I am I close when I'm estimating that that's probably why that's the route that you went first?
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Is let's go for that population?
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Yeah.
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I mean, this innovation when the RFA came out and we we looked at it.
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I mean, we as a leadership team, we all looked at each other and said, this looks a whole lot like the model of care that we just built, right?
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Really being able to support individuals in their home, supporting the unpaid, untrained family caregiver, having access to the same clinician that understands you, that builds trust with you, that helps you navigate, know what resources are out there.
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And then, of course, naturally coming from the home care and home health space.
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So many of my friends run agencies or work for agencies or own agencies.
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You know, the ninth care delivery domain in the guide model is respite care.
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So uh that a family member can utilize.
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It's almost almost 76 hours.
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There's a dollar amount that's attached, but they can use about 76 hours a year in respite care.
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So if you're a family member and you're at your wit's end and you're overwhelmed and you're stressed out and you don't know about home care because you've never used it before and you don't know anyone that's used it, you know, this gives you an access to try these services out paid for by Medicare.
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And most of the time, families are like, this made my life so much better.
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I really want I really want to have this help.
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You know, but people are reluctant to write the check and they're also afraid to invite strangers into their home.
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So when it's a fully funded benefit under Medicare, you're more likely to say yes.
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And so that's been very, very successful for families in this program.
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So let's go back to talking about to clarify what exactly is the CMS guide program?
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Just explain, like in layman's terms, what exactly, first of all, when we say CMS, we're referencing Medicare.
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Um, but when you say CMS Guide program, what exactly is that?
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So it's the Centers for Medicare and Medicaids Innovation Center Guiding and Improved Dementia Experience.
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It is a no-cost comprehensive program for families and patients living with dementia, and all dementias qualify.
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In order to be eligible for the program, a patient has to have traditional Medicare A and B and a dementia diagnosis.
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And that's really it.
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Now, there are a few exclusions.
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You cannot be on a Medicare Advantage plan.
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You have to be on traditional red, white, and blue Medicare.
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Uh, you cannot live in a memory care community.
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You cannot be on hospice.
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Um, you cannot be enrolled in a PACE program.
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Um, and right now, uh with Pocket RN, at least, you cannot live in a senior living community.
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Medicare changed some of the requirements in terms of assisted livings and the contracting needs, uh, which is just super operationally not feasible to do.
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Um, so that's an exclusion.
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But ultimately, if you have dementia and Medicare A and B of any kind, we can get you into this program.
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And once you're in, unless you hit an exclusion criteria, you stay in the program.
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And it's uh a seven-year demonstration with us.
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So um so it's going to so so once you're in, you will have these services and you'll have this respite every year.
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It resets on July 1.
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So it's use it or lose it.
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Um, and a lot of families are using it because they're like, this is amazing.
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Even if they already pay for services, they're like, I can get a little more, like about two weeks of extra care.
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Yes, free.
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Like this is amazing.
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Uh, and they love it.
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And so it's definitely been taking some of that stress off of family caregivers.
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Um, and it's not just the respite.
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I mean, there are monthly touch points with our nurses.
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Um, you know, we have a social services team that's helping with community resources.
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We help families navigate.
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You know, do you need an elder law attorney?
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Do you have your advanced directives done?
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Have you thought about those?
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Most of the time the answer is no.
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We haven't even thought about those.
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Um, you know, do you want to live the rest of your days in your private home?
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Do you want to go to senior living?
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Do you need a resource for that?
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Like we do, you know, do you need meals on wheels?
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Do you need, you know, food services?
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And so we have a lot of partners that we have clinically vetted.
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I mean, music therapy, for example.
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Uh, so we have a partnership with an organization that does music therapy.
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So it's really like the nurse is spending a lot of time understanding what motivates this individual with dementia, understanding who they were prior to their memory loss, what do they love.
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If it was music, then we have a resource for the family.
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We work with memory lane games.
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They have over 3,000 games for people with dementia.
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And uh they're doing cool stuff with Mayo, uh, with Mayo in the accelerator program.
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There's been a bunch of white papers written about how amazing they are.
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So we really do try to work with the best in class, other providers, as we're helping families with the navigation services.
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And they love it.
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We do a med reconciliation.
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So we're looking to make sure that you don't have three different kinds of blood pressure meds that one provider ordered and the other one didn't know.
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Uh, and then now you're taking three different at the same time, and then we wonder why you're off and dizzy and not feeling great, right?
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So the nurses are definitely trying to support not only the clinical care, but also all of the emotional resources that are needed.
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And the one thing I always like to mention is that we're not trying to replace in-person clinicians.
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Like we love our in-person clinicians, we love our home visiting docs, we love the home health agencies.
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They can all still be in there doing the things that we're doing.
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We're doing a lot of the emotional support for the family caregiver.
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Um, because really, if you don't support the family caregiver, the family caregiver is the one that freaks out at nine o'clock at night when they come home from work and puts mom and dad in the car and goes to the emergency room.
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Right.
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If you really think about it, right?
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Well, so more often if it's if it's the spouse, they they are not taking care of their own health because they're so exhausted and overwhelmed.
00:18:04.240 --> 00:18:26.400
And what what I hear that I love is I'm I'm thinking from the perspective of the nurse, you're you're giving them also the gift of time, which they don't typically have when you're providing care and you're let's say you're in the ER or you're in even in the doctor's office, you don't get that amount of time to sit down and say, Let's talk about music therapy or let's talk about your advanced directives.
00:18:26.480 --> 00:18:34.880
I mean, all of those things are desperately needed, but that now there's a program that's letting people spend that time.
00:18:35.519 --> 00:18:52.319
So when I I was thinking about um when you said you can have other agencies also still helping, I know that though with Medicare, for instance, like you can't have hospice care and home health at the same time because you can't double dip into Medicare.
00:18:52.720 --> 00:19:02.160
Is there any issue with, let's say, a home health agency is still coming into the home to do, you know, speech therapy or physical therapy with one of your patients?
00:19:02.400 --> 00:19:06.079
If this is a Medicare program, how is that still allowed?
00:19:06.480 --> 00:19:08.559
Because it's not a double dipping of services.
00:19:08.720 --> 00:19:16.880
When you really think about it, the speech therapist or the physical therapist, right, is in there doing a home exercise program, making sure that you're not getting muscle atrophy.
00:19:16.960 --> 00:19:19.359
They're really doing physical work with the patient.
00:19:19.599 --> 00:19:25.279
Occupational therapy is making sure that you're not, you know, that you know how to use your oxygen when you're showering.
00:19:25.440 --> 00:19:26.480
We're not doing any of that.
00:19:26.640 --> 00:19:28.079
Those are very different services.
00:19:28.240 --> 00:19:30.400
We are really supporting that family caregiver.
00:19:30.559 --> 00:19:38.160
We are making sure that they understand their resources, that they know how to de-escalate, they know the signs and symptoms of things to look out for, right?
00:19:38.240 --> 00:19:42.400
We're helping that family caregiver with the respite to give them a break.
00:19:42.559 --> 00:19:45.519
Um, you know, and it's a different, totally different geocode.
00:19:45.599 --> 00:19:51.680
There's only about 320 of us in the entire United States that can bill the guide code.
00:19:51.920 --> 00:19:59.039
So home health doesn't even have the option to bill it unless they're a guide-approved provider, which is very unusual that they would.
00:19:59.119 --> 00:20:00.799
There's a few, but mostly not.
00:20:01.039 --> 00:20:04.640
Um, and we are one of the very few national providers for this program.
00:20:04.799 --> 00:20:06.240
So we are in all 50 states.
00:20:06.480 --> 00:20:08.319
That, I mean, I'm just in awe of this.
00:20:08.400 --> 00:20:19.839
And I I I'm I'm so excited that we're doing this conversation because people need to hear about this and feel like, you know, the one thing that you hear a lot is people say, I just went into the doctor.
00:20:20.079 --> 00:20:23.599
I got this diagnosis of my husband who has dementia.
00:20:23.839 --> 00:20:28.720
My doctor suggested a medication or two and said, good luck.
00:20:28.960 --> 00:20:30.960
And I felt so alone.
00:20:31.119 --> 00:20:33.119
I felt like nobody could help me.
00:20:33.359 --> 00:20:42.559
And, you know, financially, you might not be able to hire a home care agency or you may not have the energy to even, you know, start consider it or have, you know, start that conversation.
00:20:42.880 --> 00:20:50.480
So when you say this program exists, for how do people find out, hey, can I use your services?
00:20:50.640 --> 00:20:52.160
Where do they go to do that?
00:20:52.400 --> 00:20:53.599
There's lots of places.
00:20:53.759 --> 00:21:03.519
So, so this conversation and a podcast, we've had a bunch of people who have seen or heard a podcast that I've done and called in and said my mom has dementia.
00:21:03.680 --> 00:21:07.680
Um, many people who know me know my daughter's on a national softball circuit.
00:21:07.759 --> 00:21:13.440
I have met so many families who are dealing with dementia, just even at tournaments.
00:21:13.599 --> 00:21:14.400
Like it's everywhere.
00:21:14.559 --> 00:21:17.839
Everyone knows someone who knows someone who has dementia.
00:21:18.000 --> 00:21:19.759
Um, so people find us that way.
00:21:19.920 --> 00:21:26.559
We work with over 3,000 home care companies that are under contract with us to provide the respite all across the United States.
00:21:26.799 --> 00:21:31.440
Many of their existing clients that they're servicing today are eligible for this program.
00:21:31.599 --> 00:21:34.480
Those people's family and friends are eligible for this program.
00:21:34.559 --> 00:21:35.599
So they call in.
00:21:35.759 --> 00:21:40.880
Um, sometimes people go to our website, sometimes they, you know, heard me speak on stage.
00:21:41.039 --> 00:21:49.440
Like sometimes they're coming right out of the hospital, they're newly diagnosed, uh, and their doctor says, I'm not in this program, but it's a free program, you should try it out, and they come to us.
00:21:49.599 --> 00:21:53.279
Um, sometimes it's the Department of Aging, sometimes it's leading age.
00:21:53.359 --> 00:21:55.599
Like referrals are coming from everywhere.
00:21:55.759 --> 00:22:01.039
And I think that one of the, you know, people always ask me, Well, do you think there's any risk that the Program's going to go away.
00:22:01.119 --> 00:22:10.400
And what I say to people is this is one diagnosis, this is one issue that doesn't matter what side of the aisle you're on.
00:22:10.640 --> 00:22:12.559
If you are, it doesn't matter.
00:22:12.720 --> 00:22:21.920
Like you are when you're dealing with dementia and someone you love has it, you want solutions, you want resources.
00:22:22.079 --> 00:22:26.960
And so this is one of the few things I think that everyone can agree on.
00:22:27.599 --> 00:22:29.359
We have to do something differently.
00:22:29.519 --> 00:22:30.720
People want to be in home.
00:22:30.799 --> 00:22:33.279
It's the least expensive place to be cared for.
00:22:33.519 --> 00:22:33.920
Correct.
00:22:34.160 --> 00:22:47.839
Spending the time to answer your questions so you don't drive to the emergency room and get your question answered after a$10,000 or$15,000 visit that we could have done for you in 15 minutes at home.
00:22:52.720 --> 00:22:54.480
I mean, it's all of those things.
00:22:54.640 --> 00:22:57.519
So is the website just pocketrn.com?
00:22:57.839 --> 00:22:58.240
It is.
00:22:58.400 --> 00:22:58.720
Yes.
00:22:59.039 --> 00:22:59.359
Okay.
00:22:59.519 --> 00:23:07.920
And then you're so you're saying you can just go to the website, you can fill out something or just say, this is how I want to find out if I'm eligible.
00:23:08.240 --> 00:23:09.200
Yeah, you, yes.
00:23:09.279 --> 00:23:13.119
And also there's some improvements to the website coming, but there's a phone number you can call.
00:23:13.200 --> 00:23:16.000
You can email us at guide at pocketrn.com.
00:23:16.160 --> 00:23:18.240
Uh when you call in, you'll get to support.
00:23:18.319 --> 00:23:19.680
They can send you over to intake.
00:23:19.759 --> 00:23:21.039
You can talk to the intake people.
00:23:21.200 --> 00:23:24.160
If you happen to know one of our home care partners, you can call them.
00:23:24.319 --> 00:23:28.720
Um sometimes discharge planners fax referrals right over our fax numbers right on the website.
00:23:28.799 --> 00:23:30.000
So you can fax a referral.
00:23:30.079 --> 00:23:33.039
Like we'll there's so many ways that people can get in touch.
00:23:33.119 --> 00:23:34.319
Sometimes people call me directly.
00:23:34.400 --> 00:23:37.279
They know me and they're like, hey, Nancy, my father-in-law is really bad.
00:23:37.359 --> 00:23:38.160
Can you help me out?
00:23:38.319 --> 00:23:40.880
Uh and so of course I put them in touch with the right people.
00:23:41.039 --> 00:23:49.440
So it's it's very similar to the way referrals come in for home health, I think, which is, you know, a big part of my background was building Medicare certified home health care agencies.
00:23:49.519 --> 00:23:52.640
Uh, and so a lot of these referrals come in very similar ways.
00:23:53.039 --> 00:23:57.119
Well, I will we'll put the website for sure and the phone number in the in the podcast show notes.
00:23:57.279 --> 00:23:57.519
Thank you.
00:23:58.079 --> 00:24:07.440
When families are just preparing to say, I'm gonna reach out, see if I'm eligible, what can they expect in those first conversations with your intake team?
00:24:07.759 --> 00:24:08.000
Yeah.
00:24:08.079 --> 00:24:13.359
So basically the most important thing is we need to have the Medicare ID number, your date of birth, and your name.
00:24:13.519 --> 00:24:19.119
Uh, and then of course the zip code that the patient lives in, because that's how we determine the respite.
00:24:19.440 --> 00:24:25.119
So uh based on where you live, you we have to have a contracted respite provider in your zip code.
00:24:25.359 --> 00:24:27.119
And that's really the most important things.
00:24:27.279 --> 00:24:31.119
And then we know very quickly uh whether you have Medicare or not.
00:24:31.279 --> 00:24:39.200
Um, and then what happens is then we schedule a welcome call where we go over all the things on the program, answer all your questions, and then we schedule your visit with your nurse.
00:24:39.279 --> 00:24:49.440
And when you're the family caregiver, this is very important because there is something that the family caregiver has to do at least annually, but we prefer it to be monthly where they have the visit with their nurse.
00:24:49.599 --> 00:24:56.400
They have to complete the Zaret and the promise, which helps us understand how overwhelmed the family caregiver is, right?
00:24:56.480 --> 00:25:05.680
These are standardized tests from Medicare that the primary family caregiver has to complete on an annual basis, and we send that information off to Medicare.
00:25:05.759 --> 00:25:09.200
And that's how they determine whether you'll be respite eligible or not.
00:25:09.359 --> 00:25:13.839
Um, you have to have a family caregiver and then you have to complete those two tests every year.
00:25:14.079 --> 00:25:15.200
Would you say Xerit?
00:25:15.279 --> 00:25:15.920
I've never heard of that.
00:25:16.640 --> 00:25:20.880
Yeah, Zarit burden score and the promise.
00:25:21.039 --> 00:25:26.079
And so they're really, we're really trying to understand how overwhelmed family caregivers are.
00:25:26.400 --> 00:25:38.960
I mean, they I I like that you're saying you try to do this monthly, not annually with your So the Zerit is annually, but we have monthly touch points with the families, with our nurse and the patients.
00:25:39.440 --> 00:25:43.200
I mean, I would imagine they're very willing to tell you how they're feeling.
00:25:43.519 --> 00:25:44.480
Of course they are.
00:25:44.640 --> 00:25:49.680
And you know, people like I I've been on this little soapbox personally for a really long time.
00:25:49.839 --> 00:25:54.880
Uh, and when I met Pocket Aren, I was so excited because I was like, I think we can actually change healthcare for the better.
00:25:55.039 --> 00:25:59.599
Like I just learned all of the pitfalls that my families were dealing with.
00:25:59.759 --> 00:26:08.559
Um, and you know, and just just having that availability, having a proactive approach to healthcare has been my soapbox for a long time.
00:26:08.720 --> 00:26:12.960
And, you know, we don't do things proactively in the United States typically.
00:26:13.119 --> 00:26:15.119
We wait till you fall and break your hip.
00:26:15.359 --> 00:26:18.880
We don't order physical therapy when you fell and didn't break your hip, right?
00:26:18.960 --> 00:26:21.359
Like we used to ask surgeons that all the time.
00:26:21.440 --> 00:26:25.440
I'm like, why don't we order physical therapy if someone fell but they didn't break their hip?
00:26:25.599 --> 00:26:26.640
Well, great question.
00:26:27.119 --> 00:26:29.759
You get paid when you break the hip if you're a surgeon.
00:26:29.920 --> 00:26:32.480
You don't get paid to do physical therapy always, right?
00:26:32.559 --> 00:26:36.319
And I'm not saying people have bad intentions, it's just the way the system was designed.
00:26:36.480 --> 00:26:36.720
Right.
00:26:36.960 --> 00:26:50.480
And so with this guide model, we do have the opportunity to have these ongoing, proactive, more longitudinal care where we're constantly like checking in, noticing changes in condition.
00:26:50.559 --> 00:26:57.440
We're not waiting for the emergency that starts the cycle, if that makes sense.
00:26:57.759 --> 00:27:01.680
Well, you're you're taking advantage of today's technology, first of all.
00:27:01.920 --> 00:27:06.960
You are letting people stay in their home and supporting them 24 hours a day.
00:27:07.119 --> 00:27:07.359
Right?
00:27:07.440 --> 00:27:10.640
That their alone is enormous.
00:27:10.880 --> 00:27:14.000
That any caregiver knows you are not alone.
00:27:14.160 --> 00:27:24.960
You have somebody that you can speak to at any time that's going to listen to you and at least direct you to some resources, whether it's the online training you offer or let's schedule a time, you know, at 9 a.m.
00:27:25.200 --> 00:27:26.400
to speak with your nurse.
00:27:26.640 --> 00:27:31.359
At least you know I have support and I don't feel alone.
00:27:31.599 --> 00:27:50.160
I mean, that just I I I would love to know with your surveys that you're doing, you know, I don't know how long the program has been in existence, but what have you seen as far as when you've started and where you are today with just patient and caregiver satisfaction?
00:27:50.400 --> 00:27:51.519
Oh, it's 91%.
00:27:51.839 --> 00:27:52.960
It's through the moon.
00:27:53.119 --> 00:28:00.480
I mean, I've never if you're at if you were at a 50% net promoter score in healthcare, and that's good.
00:28:00.640 --> 00:28:08.720
We're at across, and I have to say, across all of our patients, not just our guide patients, but across all of our patients and our whole company, we're at 91%.
00:28:09.519 --> 00:28:10.880
That's just insane.
00:28:11.200 --> 00:28:11.920
It's insane.
00:28:12.079 --> 00:28:15.440
Families are like, I don't know how I survived without you.
00:28:15.599 --> 00:28:21.440
I mean, it's really like if you the name Pocket RN really came to be our CEO is a family caregiver.
00:28:21.599 --> 00:28:23.599
She lives out of state from her mom.
00:28:23.759 --> 00:28:26.319
Her mom lives much closer to me in New England.
00:28:26.400 --> 00:28:30.160
Um, you know, and it was like always relying on the nurses in your ecosystem.
00:28:30.319 --> 00:28:32.400
One of my best friends in the planet is a nurse.
00:28:32.480 --> 00:28:38.160
I'm telling you, if I have like a rash or I don't know, sniffle, I'm calling her freaking out constantly.
00:28:38.400 --> 00:28:40.960
And really, it's that nurse that's in your pocket.
00:28:41.119 --> 00:28:45.920
You start to realize if you do have a friend that's a nurse, you call them all the time, right?
00:28:46.079 --> 00:28:48.079
They become the trusted person for you.
00:28:48.319 --> 00:28:55.039
We wanted to demo to, you know, make that access, democratize that access to a nurse in your pocket.
00:28:55.200 --> 00:29:04.079
We think everyone should have a nurse that's a trusted clinical support for you who can coach and teach and educate you so that you don't end up in the hospital.
00:29:04.559 --> 00:29:13.759
What is a story that you could share with us, obviously without sharing names of just, you know, just a recent example of someone that's been using pocket RN?
00:29:14.480 --> 00:29:15.519
Here's a good one.
00:29:15.759 --> 00:29:32.640
So we had a a patient in their 90s, and the daughter was very concerned because their loved one was losing weight very quickly, they weren't participating in activities, felt very tired.
00:29:33.359 --> 00:29:44.400
And our nurses realized that this individual had Ozempic ordered for them and had been taking Ozempic.
00:29:44.880 --> 00:29:49.359
So the daughter was about to roll this person into hospice for failure to thrive.
00:29:49.519 --> 00:29:51.279
And we're like, wait a minute.
00:29:51.519 --> 00:29:55.920
So then our nurse called the physician and said, I don't think this is a good idea.
00:29:56.160 --> 00:30:00.640
For whatever reason, what if you're even if you're trying to manage A1C, right?
00:30:00.720 --> 00:30:04.480
Like whatever it is that you you ordered it, it's not working for this individual.
00:30:04.640 --> 00:30:06.480
We got it discontinued.
00:30:06.799 --> 00:30:15.039
Within a couple weeks, this individual was back participating in activities, gaining weight, super happy, would have been on hospice.
00:30:15.119 --> 00:30:18.480
It could have been a whole very bad situation, but it wasn't.
00:30:18.640 --> 00:30:23.759
And that's just one example of the things that when you have the time to pay attention, you can find.
00:30:24.559 --> 00:30:29.359
And because they can reach you at any time versus you were in the doctor, you have to wait.
00:30:29.440 --> 00:30:32.720
If you call to go back to the doctor, it often will take you.
00:30:33.359 --> 00:30:33.759
Yeah.
00:30:33.920 --> 00:30:34.960
Or or longer.
00:30:35.119 --> 00:30:39.200
I mean, you can't even, I think today, yeah, it's hard to even get in within a week.
00:30:39.359 --> 00:30:45.119
So I can understand just the the the benefits of this are just endless.
00:30:45.359 --> 00:31:03.759
Um, when you said you're you can qualify, you you know, you have to get share your zip code, you have to be on Medicare A and B, but you mentioned sharing the zip code is where you're looking at whether there are respite home care agencies that can are in the area that are participating that can provide that respite care.
00:31:04.480 --> 00:31:12.079
Can you still use Pocket RN if Pocket RN does not have a relationship yet with a respite provider?
00:31:12.480 --> 00:31:18.480
So we're supposed to make sure when we accept a referral that we have a provider that can provide the respite, if in fact.
00:31:18.720 --> 00:31:18.880
Okay.
00:31:19.359 --> 00:31:26.799
But I will say that I'm we're very fortunate that we do have a hundred percent of the zip codes in the United States covered under zip code coverage right now.
00:31:27.039 --> 00:31:27.920
Well, that's amazing.
00:31:28.079 --> 00:31:29.920
Okay, so that shouldn't be a limitation.
00:31:30.640 --> 00:31:31.279
Yeah.
00:31:31.759 --> 00:31:33.119
How are you doing that?
00:31:33.359 --> 00:31:36.000
30 years of and lots of friends, I guess.
00:31:36.319 --> 00:31:38.240
I mean, that's really phenomenal.
00:31:38.480 --> 00:31:41.279
So let's let's explain a little bit more about that respite.
00:31:41.519 --> 00:31:43.920
So not everybody always understands what that is.
00:31:44.079 --> 00:31:49.440
So let's say you right now I'm getting the support of my nurse, my nurse for life.
00:31:49.680 --> 00:31:52.640
I can call 24-7 and speak to somebody.
00:31:52.799 --> 00:32:04.400
I can use your online training, and then you you're when you have that primary caregiver, they are often sometimes at their breaking point, sometimes completely exhausted.
00:32:04.559 --> 00:32:14.480
And you'll hear the term respite used, where sometimes, for instance, like a facility will say, we'll offer you a five-day respite stay, or you know, a hospice unit does that.
00:32:14.640 --> 00:32:19.279
But when you say in the home that respite is available, what do you mean by that?
00:32:19.680 --> 00:32:24.559
So, what that means is uh we work with home care agencies across the country.
00:32:24.799 --> 00:32:28.960
And the respite, like I said, it's approximately 76 hours a year.
00:32:29.200 --> 00:32:33.279
Um, you have to schedule it in four-hour blocks or four-hour increments.
00:32:33.359 --> 00:32:40.240
But you could, for example, we have families that will say, okay, I want to have an eight-hour Friday once a month.
00:32:40.400 --> 00:32:48.640
Um, I've had, we had a family member say, I haven't had lunch with my sisters in three years because I can't leave my loved one alone.
00:32:48.960 --> 00:32:51.519
And so they can leave for the day.
00:32:51.680 --> 00:32:58.880
Uh, we'll have a caregiver from the agency, the home care agency that's contracted with Puck at RN, go out to the home and do the eight-hour shift.
00:32:59.039 --> 00:33:05.680
And they're gonna, you know, make sure that individual is eating and make sure that they're, you know, safe at home and not wandering out of the house.
00:33:05.839 --> 00:33:09.680
And that family caregiver can go do whatever they want for that eight hours.
00:33:09.839 --> 00:33:13.119
And so, like I said, some people are going to have lunch with their family and friends.
00:33:13.200 --> 00:33:18.160
We have some of our female caregivers who've said, we want to, I want to go to the hair, get my hair done.
00:33:18.319 --> 00:33:19.839
I haven't had my hair done in a long time.
00:33:19.920 --> 00:33:22.079
Like, I want to go get a facial, a massage.
00:33:22.160 --> 00:33:23.519
Maybe I'm so stressed out.
00:33:23.759 --> 00:33:32.079
You know, we've had some, some of our male caregivers say, I want to go fishing, or, you know, I'm gonna go do X, Y, anything you want to do, like you can go do it.
00:33:32.319 --> 00:33:36.880
So, you know, our family caregivers are unbelievable and they do so much work.
00:33:37.039 --> 00:33:44.240
And sometimes it's just really important that they have some self-help time so that they can regroup.
00:33:44.400 --> 00:33:56.160
You know, there's a crazy statistic that I saw the other day, and it was like 63% of family caregivers die before the person they're taking care of because they're so overwhelmed and stressed.
00:33:56.240 --> 00:33:56.960
And I believe it.
00:33:57.119 --> 00:34:00.319
I believe I saw it all the time in my home care agency.
00:34:00.480 --> 00:34:14.800
It it is absolutely a true statement because they don't go to the doctor, they don't get the sleep that they need, they aren't probably taking their medications properly because all they're doing is focusing on caring for their person.
00:34:15.199 --> 00:34:17.360
It is a hundred percent true statement.
00:34:17.599 --> 00:34:27.840
And when you say they need, they need that oxygen, they just need to get out and be themselves and and just that I'm fine.
00:34:28.079 --> 00:34:36.000
I'm just thrilled that Medicare is understanding that this is part of healthcare that you have to take care of the caregiver.
00:34:36.320 --> 00:34:36.639
Yes.
00:34:36.800 --> 00:34:38.239
You want to keep these people at home.
00:34:38.400 --> 00:34:48.719
And and like you're saying, it does, it's it's less expensive keeping them at home than moving into facilities or being in the hospital, you know, once or once a month or once every few months.
00:34:48.960 --> 00:34:58.320
So it's it's just I think you've just completely opened the door for the data that Medicare needs to see that says, this is going to work.
00:34:58.480 --> 00:35:16.639
It is working, clearly, if you have an you're just like when you were saying that net promoter score, I'm thinking, you know, when when I have friends that ask me, I'm looking for a facility for my mom, and I just kind of take a deep breath and say, you know, you're gonna start searching, let's say you look on Medicare.gov and it's not good.
00:35:16.800 --> 00:35:19.679
I mean, the star ratings that you're gonna see are not good.
00:35:20.000 --> 00:35:23.280
And if you see a decent one, it's pretty rare.
00:35:23.360 --> 00:35:27.519
So when I hear to get in, the good ones always have a waiting list.
00:35:27.840 --> 00:35:28.239
Always.
00:35:28.400 --> 00:35:34.400
But it's because I hate saying this, but there's not as many good ones.
00:35:34.559 --> 00:35:42.800
So if you have a product that has a 91 net promoter score of their patients, I'm I mean, that's five star.
00:35:42.880 --> 00:35:48.239
You've got a five-star government-funded program, which is like, I'm sorry, what?
00:35:48.559 --> 00:35:49.679
This is a game changer.
00:35:49.760 --> 00:35:51.280
This is what healthcare needs to be.
00:35:51.440 --> 00:36:02.639
Like, this is this is 30 years of learning as a provider, you know, witnessing the gaps in care, understanding the challenges that families were facing, really innovating a category.
00:36:02.719 --> 00:36:06.000
Like PocketRN has been innovating a new category of care.
00:36:06.159 --> 00:36:08.960
No one ever says we're gonna doctor you back to health.
00:36:09.199 --> 00:36:11.519
It's we're gonna nurse you back to health, right?
00:36:11.760 --> 00:36:15.599
And nurses have largely been sort of beaten up at work.
00:36:15.760 --> 00:36:19.679
They haven't been listened to, they haven't been valued, they haven't been heard.
00:36:19.840 --> 00:36:25.840
I mean, there's been so many strikes with nurses that are just like, you can't make these ratios worse.
00:36:26.480 --> 00:36:26.639
Great.
00:36:26.880 --> 00:36:27.760
You need more support.
00:36:27.920 --> 00:36:28.880
You need to listen to me.
00:36:29.039 --> 00:36:30.880
I should have a voice at the table.
00:36:31.039 --> 00:36:40.880
Uh, and and we very much believe that nurses need to be valued, respected, heard, understood, and they really are the people that nurse you back to life, to health.
00:36:41.039 --> 00:36:42.960
It's not, we don't doctor you back to health.
00:36:43.119 --> 00:36:47.440
Our doctors are important, but our nurses are really the ones that do so much of the work.
00:36:47.599 --> 00:36:52.079
And so this model of care is really putting that front and center.
00:36:52.239 --> 00:36:57.199
And so far, the families have very much responded to the positivity of this model of care.
00:36:57.360 --> 00:36:59.039
They love their nurses.
00:36:59.199 --> 00:37:00.960
Uh, nurses love this work.
00:37:01.199 --> 00:37:04.000
It I hear every day, it's so rewarding.
00:37:04.239 --> 00:37:07.920
We have never spent a dime recruiting nurses ever.
00:37:08.719 --> 00:37:09.360
What?
00:37:09.840 --> 00:37:11.440
No, we don't.
00:37:11.519 --> 00:37:17.280
So we don't have to because when nurses come to work here, they tell other nurses how amazing it is, and then they tell their friends.
00:37:17.360 --> 00:37:20.320
And it's just like the word of mouth with patience, right?
00:37:20.400 --> 00:37:24.960
They, these adult children are telling all of the kids at the book club, yeah, guess what?
00:37:25.039 --> 00:37:28.320
I mean, I'm on the softball field and everyone's like, oh my God, I gotta sign up my dad.
00:37:28.400 --> 00:37:29.920
I and my father-in-law needs this.
00:37:30.079 --> 00:37:36.239
I mean, care family caregivers also, by the way, let's just acknowledge the fact that they come in all shapes and sizes and all ages.
00:37:36.480 --> 00:37:38.880
I've been a family caregiver since I was really in high school.
00:37:38.960 --> 00:37:41.760
My grandmother had Alzheimer's and dementia when I was really young.
00:37:41.920 --> 00:37:47.920
And, you know, but a lot of family caregivers that are young also have not been through these experiences before.
00:37:48.079 --> 00:37:58.880
So giving them the tools and resources, you know, they don't have the life experience to have learned all of the mistakes that I learned when I was, you know, 14 as a family caregiver to my grandmother.
00:37:59.039 --> 00:38:07.280
Um, I would have much rather to have someone give me some online training to understand what I was dealing with, not to kind of learn as I go.
00:38:07.440 --> 00:38:10.480
Uh, you know, back then, of course, I'm so old we didn't have the internet back then.
00:38:10.559 --> 00:38:11.840
So, like, you know what I mean?
00:38:11.920 --> 00:38:13.519
Like, there wasn't a whole lot of research.
00:38:13.679 --> 00:38:25.039
And now we're just able to feed this information uh, you know, to family caregivers that are of all ages and shapes and sizes so that they're equipped for the job that they did not sign up for.
00:38:25.840 --> 00:38:37.920
We at my home care agency used to have nurses that had retired and they came to apply to be caregivers with us because they said, I want more one-on-one time with these people.
00:38:38.159 --> 00:38:39.679
I'm not gonna do the nursing anymore.
00:38:39.760 --> 00:38:44.559
I'm gonna become a non-medical caregiver, but I want that one-on-one interaction.
00:38:44.719 --> 00:38:58.239
And that's what you're also giving them as an employer, is they're getting that time with these patients and they really can help them and not and not in just the medication or, you know, the therapy or whatever.
00:38:58.400 --> 00:39:04.239
It's it's everything that you're talking about that you're helping them thrive at home.
00:39:04.719 --> 00:39:24.960
And do you have any statistics about, you know, when you first started the program and uh, you know, keeping track of maybe hospitalizations of your patients, what have you seen happen as far as when you first started to now on, I would imagine you're seeing fewer people going to the hospital.
00:39:25.360 --> 00:39:25.679
Yes.
00:39:25.760 --> 00:39:32.719
So across all of our patient populations, we know that our minimum baseline of reduction in unnecessary inpatient stays is 30%.
00:39:33.440 --> 00:39:33.519
Okay.
00:39:33.760 --> 00:39:36.400
And in some cases, it's significantly higher than that.
00:39:36.559 --> 00:39:40.239
It just really depends upon the the patient population and the location.
00:39:40.320 --> 00:39:45.360
But 30% with all of the patients that we have across all of our verticals is insane.
00:39:45.679 --> 00:39:46.400
It's insane.
00:39:46.480 --> 00:39:51.760
And I'm sure Medicare is just like they're skipping around the room because you can't do that.
00:39:51.920 --> 00:39:54.320
You you I mean, have they ever done that?
00:39:54.480 --> 00:39:54.719
No.
00:39:54.880 --> 00:39:56.079
No, this is unreal.
00:39:56.480 --> 00:40:14.159
It's really like, you know, Medicare, what I'm so excited about is really the future of healthcare because I think what for you know, just from being in the space for so long, you know, Medicare is really realizing the things that most of us that have been doing this as providers for so long know that home is the safest place to be, right?
00:40:14.320 --> 00:40:22.480
You don't get community of infections when you're at home, uh where your neighbor has, you know, MRSA and all of a sudden you have it now because you're right next to them.
00:40:22.639 --> 00:40:24.320
So you're safer at home.
00:40:24.559 --> 00:40:28.239
People want to be home, home is less expensive, right?
00:40:28.400 --> 00:40:31.119
Being proactive is better than being reactive.
00:40:31.280 --> 00:40:36.079
And I think that Medicare is really focusing on the future and sustainability of the program.
00:40:36.400 --> 00:40:50.559
And, you know, there's been, yeah, like what I say to home care providers is this is so massive because you, in general, as a home care operator provider, have never been in the conversation that home care is healthcare.
00:40:50.800 --> 00:41:03.760
I have been in so many rooms, uh, you know, focusing on reducing and avoiding hospitalizations that had nursing homes and rehab facilities and acute rehabs and home health and hospice and all these different people.
00:41:03.840 --> 00:41:07.840
And you know who was never in the room, who was never sitting at the table ever?
00:41:08.079 --> 00:41:09.039
Was home care.
00:41:09.599 --> 00:41:11.679
I'm like, you never had a place at the table.
00:41:11.840 --> 00:41:15.199
People didn't even acknowledge you as being part of healthcare.
00:41:15.360 --> 00:41:20.159
And now this program not only brings you into healthcare, but it gives you a front row seat.
00:41:20.320 --> 00:41:29.920
And Medicare is now starting to talk about home care being a covered benefit in the long run because they're already seeing the amazing effects of this program.
00:41:30.159 --> 00:41:34.480
So, I mean, that it's so much bigger than just the one guide program.
00:41:34.559 --> 00:41:36.880
It's so much bigger than just the respite.
00:41:37.039 --> 00:41:45.760
It is the the whole entire model of care that Pocket RN was founded on that before guide even was a thing, we were already doing this.
00:41:45.840 --> 00:41:46.719
We had already built it.
00:41:46.800 --> 00:41:49.119
So we were just so excited to have a payer source.
00:41:49.280 --> 00:41:53.840
And I do see in the future, I'm hoping that it'll expand into some advantage plans.
00:41:54.079 --> 00:42:00.239
Um, I think there's lots of opportunity uh to focus on other disease processes down the road.
00:42:00.400 --> 00:42:05.119
You know, uh it's just the beginning of what I think is the future of healthcare.
00:42:05.440 --> 00:42:12.719
I mean, you just said so many things there that first of all, my heart is beyond happy that home care finally has a seat at the table.
00:42:13.039 --> 00:42:17.679
I opened my franchise in late 2004.
00:42:18.239 --> 00:42:24.079
And I will never forget when I started to go market to facilities or the hospitals.
00:42:24.400 --> 00:42:28.639
I I couldn't believe that people would say to me, No one's gonna pay for this.
00:42:28.800 --> 00:42:29.039
Right.
00:42:29.199 --> 00:42:30.239
There, what's the benefit?
00:42:30.400 --> 00:42:34.400
There's no use, you know, what why would anyone want to use this service?
00:42:34.639 --> 00:42:39.119
And I saw time and time again that home care changes lives.
00:42:39.440 --> 00:42:39.760
It does.
00:42:40.079 --> 00:42:43.280
People think of it as, oh, it's just a companion coming over.
00:42:43.440 --> 00:42:46.079
And it is so much more than that.
00:42:46.239 --> 00:42:51.199
It is, you know, it gives you a purpose to get up, it gives you a purpose to get ready for the day.
00:42:51.440 --> 00:42:54.800
You have somebody to interact with that you're gonna have a conversation with.
00:42:54.960 --> 00:42:58.480
You might, you know, get outside for the first time that week.
00:42:58.719 --> 00:43:03.199
You might go and, you know, go out to lunch, which you haven't done in quite some time.
00:43:03.440 --> 00:43:07.199
But I saw it time and time again change lives.
00:43:07.360 --> 00:43:13.599
And I am it's been a very long time coming, but I'm fine, it's better late than never.
00:43:13.760 --> 00:43:22.079
But but they we deserve a seat at the table because it these caregivers are angels for what they do.
00:43:22.559 --> 00:43:26.480
And they come in there and they're not there to just so I made a meal and I left.
00:43:26.639 --> 00:43:32.960
I mean, they are there because they want to create a relationship with this person, not even just with the the patient, but the caregiver.
00:43:33.280 --> 00:43:33.360
Yeah.
00:43:33.679 --> 00:43:34.880
Just say, I've got you.
00:43:35.039 --> 00:43:36.000
Like you go out, right?
00:43:36.159 --> 00:43:40.480
Like you go out to lunch with your sisters, you go, you're I'm I've got you, everything's gonna be fine.
00:43:40.639 --> 00:43:41.840
I know what I'm doing.
00:43:42.000 --> 00:43:43.920
And I'm just I'm thrilled to hear it.
00:43:44.000 --> 00:43:59.840
I'm also happy to hear that you you hope this will eventually expand into other, you know, modalities, whether it's, you know, I don't know, that you know, what like diabetes or whatever it might be that people are having a hard time managing, but this is a great first place to start.
00:44:00.079 --> 00:44:00.960
With dementia.
00:44:01.280 --> 00:44:05.119
There's just so many people with dementia, and there's that we know there's no cure, right?
00:44:05.199 --> 00:44:07.280
I mean, there's a lot of things you can do for diabetes.
00:44:07.360 --> 00:44:09.760
You might not, you know, if you have type one, obviously it's not going to go away.
00:44:09.840 --> 00:44:15.360
But you know, the there's a lot of people that with diet and exercise and changes with type two, they start to do better.
00:44:15.440 --> 00:44:17.920
And, you know, but we don't have that for dementia, right?
00:44:18.000 --> 00:44:19.360
We don't have that for Alzheimer's.
00:44:19.519 --> 00:44:23.440
We no, we it and some people are just in so denial, so much denial about it.
00:44:23.519 --> 00:44:25.760
Uh, and and it it doesn't go away, right?
00:44:25.840 --> 00:44:32.960
So this is something that is a longer-term, progressively worsening disease that we have no solutions for.
00:44:33.199 --> 00:44:35.440
And this program is just such a game changer.
00:44:35.599 --> 00:44:45.920
We had we had a family uh who actually got to go to their son's wedding because they could use the respite money to have a caregiver and said, I wouldn't go, I wouldn't have been able to go because I can't leave.
00:44:46.079 --> 00:44:53.440
Um, and you know, so we hear stories like that time and time again, every single day, about how this program gave them so much hope.
00:44:53.599 --> 00:45:02.639
We had a family come to our conference and that mom and dad had been married almost 65 years and uh she got really bad dementia.
00:45:02.719 --> 00:45:16.719
And he said that some days that uh you your nurse, my nurse was the only person that I got to talk to who wasn't yelling at me all day, and someone who was able to, you know, just hear me when I just needed to talk to someone.
00:45:16.960 --> 00:45:18.800
And literally, we were all in tears.
00:45:18.880 --> 00:45:20.480
Like we were crying, yeah.
00:45:20.800 --> 00:45:29.679
You know, just like seeing the real world impact that it has, I think that people don't realize how isolating being a family caregiver is.
00:45:29.920 --> 00:45:42.719
And most of us try to hide the fact that we're family caregivers because, you know, we have jobs and we're working and we're trying to do a lot of things, and the person you're caring for doesn't want their business all over, you know, the whole whatever, right?
00:45:42.880 --> 00:45:47.360
And so there's so many people suffering in silence, I think, that are family caregivers.
00:45:47.760 --> 00:45:55.440
And being able to access our team from the privacy of your own home in a trusted way does give you that relief.
00:45:55.679 --> 00:46:06.639
This just, like I say, there's just so many benefits to this program, and many of them aren't even seen to the outside world, but we see it, and it's just it's a great reason to get up out of bed every day.
00:46:06.960 --> 00:46:07.679
Oh my gosh.
00:46:07.840 --> 00:46:16.880
I mean, the the other benefit you had mentioned that I think is a hundred percent true is we saw so many times over the years people were so hesitant to try home care.
00:46:17.280 --> 00:46:21.519
You know, obviously there is a cost associated with it, it is typically private pay.
00:46:21.679 --> 00:46:23.599
You're gonna have a stranger come into your house.
00:46:23.760 --> 00:46:28.480
There's all these barriers that make it very hard for someone to say, yes, I want to do this.
00:46:29.119 --> 00:46:34.639
But this is amazing because you don't have to worry about the cost.
00:46:35.119 --> 00:46:38.960
The agency's already been vetted because this is an agency through Pocket RN.
00:46:39.199 --> 00:46:41.039
We're taking care of this for you.
00:46:41.280 --> 00:46:45.840
You just need to say the word and we will we'll schedule it and it and we'll make it happen.
00:46:46.079 --> 00:46:47.760
So, do you schedule it?
00:46:47.840 --> 00:46:51.360
Does actually Pocket RN reach out to the home care agency or they just work together?
00:46:51.679 --> 00:46:51.920
Yeah.
00:46:52.000 --> 00:46:57.920
So when so when we get the referral and we check, then we send it out to our home care partners and we ask if they want the referral.
00:46:58.079 --> 00:47:06.639
Um, we still have to go through, you know, getting the comprehensive assessment done and getting everything sent, and Medicare has to then send us yes, they're approved for respite or no, they're not.
00:47:06.800 --> 00:47:07.519
Most of the time they are.
00:47:07.679 --> 00:47:10.960
Moderate to severe complexity dementia where the family caregiver qualifies.
00:47:11.039 --> 00:47:16.079
If you're low complexity, every now and again someone's low complexity and they don't qualify, but we'll know.
00:47:16.239 --> 00:47:18.559
And then the family works with the home care agency.
00:47:18.639 --> 00:47:26.159
They still have to sign some of the agreements with the home care agency because, you know, there are rules in place on how home care agencies have to operate.
00:47:26.320 --> 00:47:33.519
Um, and then they work with the home care agency to decide how and when they want to schedule it and what what the good timelines are and how it all works.
00:47:33.599 --> 00:47:36.079
And so, and then the thing is it's use it or lose it.
00:47:36.159 --> 00:47:45.039
So you have to use your hours before June 30th, and then on July 1, you'll get another 76 hours the following year.
00:47:45.280 --> 00:47:48.400
And so they're all using their 76 hours.
00:47:48.719 --> 00:47:52.800
We're seeing 95% of the families using the respite with Pocket RN.
00:47:52.960 --> 00:48:00.719
And the other cool thing that you mentioned is that Medicare does a background check on the agency owner and they look for any, you know, anything that's out of compliance.
00:48:00.880 --> 00:48:05.039
So you can't just hang up a sign and say you're Nancy's home care and I'm gonna provide respite care.
00:48:05.199 --> 00:48:06.639
You have to be a legitimate agency.
00:48:06.800 --> 00:48:08.800
You can't be on an OIG watch list.
00:48:08.960 --> 00:48:13.920
You know, you have to be in good standing, and Medicare has to approve you in order to work with us.
00:48:14.079 --> 00:48:20.480
And they have to basically tell the home care agency or tell us this home care agency is now approved to provide respite on your behalf.
00:48:20.639 --> 00:48:22.239
So there's a whole process.
00:48:22.480 --> 00:48:31.199
So they're definitely making sure that, you know, there's there's there's good quality providers that are doing the right things coming into your home.
00:48:31.599 --> 00:48:34.480
Again, you're taking another barrier away for these families.
00:48:34.639 --> 00:48:41.760
So it's just, it's, it's this, it's a team of people that are supporting the caregiver and the patient in the home where they want to be.
00:48:41.920 --> 00:48:54.000
I'm blown away by this, and I really hope that it continues to expand into other modalities and that this is the future of home care because it's the way to go.
00:48:54.159 --> 00:48:55.679
I mean, I'm I'm a big fan.
00:48:55.760 --> 00:48:58.639
I I've known it for a long time, and I know you are too.
00:48:58.880 --> 00:49:02.000
So hopefully we can see that happen sooner than later.
00:49:02.239 --> 00:49:05.519
Is there anything else that we missed about the program?
00:49:05.760 --> 00:49:13.119
Um, you know, obviously I'll put in the show notes the website, the phone number, anything else you'd want to share with listeners to understand about Pocket RN?
00:49:13.599 --> 00:49:20.559
No, I just think, you know, they always say it takes a village to take care of children, and I think it takes a village to take care of seniors too.
00:49:20.719 --> 00:49:24.880
You know, I think that we all need to break our silos and collaborate more.
00:49:25.039 --> 00:49:33.760
There's plenty of room for all of us to do the things that we specialize in to really be able to support individuals in their, you know, quest to live their days at home where they want to be.
00:49:33.840 --> 00:49:47.920
And I just think changing that mindset is really what is the primary goal, at least uh for me personally, to see that, you know, you can still be a home health agency and taking care of someone, and I can be a virtual overlay.
00:49:48.159 --> 00:49:57.760
Having a virtual clinical overlay to an amazing in-person caregiver to support not only the caregiver, but the family caregiver and the patient together is a game changer, right?
00:49:57.840 --> 00:49:59.039
It's the secret sauce.
00:49:59.199 --> 00:50:01.119
Having, you know, it's just the secret sauce.
00:50:01.360 --> 00:50:07.760
So uh that, you know, I just hope that if you know someone that has dementia and you're not sure, reach out.
00:50:08.000 --> 00:50:12.639
If for any reason you don't qualify for the program, we work with the Alzheimer's Association.
00:50:12.800 --> 00:50:16.480
We work with lots of organizations that have programs.
00:50:16.639 --> 00:50:18.320
We work with Hilarity for Charity, right?
00:50:18.400 --> 00:50:22.079
Like we work with a lot of places that we can resource you to.
00:50:22.400 --> 00:50:26.239
Um, and there's so many programs out there that people don't even know about.
00:50:26.400 --> 00:50:30.320
So it's it's never not a good connection to make.
00:50:30.559 --> 00:50:31.280
That's so great.
00:50:31.440 --> 00:50:34.159
I'm working on an episode, hopefully, with Hilarity for Charity.
00:50:34.239 --> 00:50:37.679
So I'm glad that you mentioned it because I want to talk about what they offer as well.
00:50:37.920 --> 00:50:43.280
But this just I'm I'm so happy to learn about this.
00:50:43.360 --> 00:50:45.519
And I can't wait to help spread the word.
00:50:45.679 --> 00:50:50.400
And I hope you get some phone calls from this because it is a gift for families.
00:50:50.480 --> 00:50:54.480
And I have to give kudos to Medicare for saying yes to it.
00:50:54.639 --> 00:51:00.000
Please keep saying yes to it because it's it's the future and it's what people want and what they need.
00:51:00.239 --> 00:51:02.960
So you're um keep doing the great work, Nancy.
00:51:03.039 --> 00:51:03.519
This is awesome.
00:51:03.840 --> 00:51:04.559
Thank you so much.
00:51:04.880 --> 00:51:05.599
Thank you so much.
00:51:05.760 --> 00:51:11.920
I feel so blessed to get to be on this today with you and to share the message and just to help these families.
00:51:12.079 --> 00:51:17.360
I've hit the wall at 90 miles an hour, I feel like, as a family caregiver, and you don't know what to do.
00:51:17.440 --> 00:51:19.599
And so it's just nice to have this program.
00:51:20.159 --> 00:51:21.039
More than nice.
00:51:21.119 --> 00:51:21.519
So thanks.
00:51:21.679 --> 00:51:24.400
Keep up the great work and thank you so much for your time today.
00:51:24.719 --> 00:51:25.519
Thank you so much.
00:51:25.679 --> 00:51:26.719
It was great to see you.
00:51:26.880 --> 00:51:28.719
Have a nice wonderful day.
00:51:29.039 --> 00:51:29.599
You too.
00:51:29.840 --> 00:51:30.480
Okay, bye.
00:51:30.800 --> 00:51:33.360
That's a wrap for today's episode of the Care Table.
00:51:33.440 --> 00:51:35.039
Thank you so much for joining me.
00:51:35.280 --> 00:51:44.719
If you found this information helpful, would you like, subscribe, write a review, or share this episode with someone that you feel could benefit from hearing this information?
00:51:44.960 --> 00:51:46.480
I'd sure appreciate it.
00:51:46.800 --> 00:51:58.960
If you learned of anything during this podcast as far as books, resources, or products that you might think are helpful, be sure to check out the podcast show notes for links to access that information.
00:51:59.360 --> 00:52:04.239
A friendly reminder that this is not medical or legal advice, this is just information.
00:52:04.639 --> 00:52:08.159
Consult a professional for your own personal situation.
00:52:08.639 --> 00:52:16.239
I ask that God would bless you with the wisdom, the courage, and the strength that you need as you're navigating this caretaking journey.
00:52:16.400 --> 00:52:18.960
And I want to remind you you are not alone.
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I appreciate you joining us today.
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And until next time, stay strong, and I hope to see you at the care table.